Say the word “Chicago,” and Pizza, hot dogs, the Chicago Cubs, architecture, Michigan Avenue, theater, and political machines come to mind. Defining Chicago is no simple matter. It is a large and diverse city of 227.1 square miles composed of 77 distinctive neighborhoods with 29 miles of lakefront as well as the Chicago River snaking its way through downtown and some north and south side neighborhoods.
Chicago: One of the world’s leading medical centers
Chicago is one of the leading medical centers in the nation. The Rehabilitation Institute of Chicago has been voted number one for eight years in a row by US News & World Report for rehabilitation services. Other well-known hospitals grace the downtown and surrounding perimeter such as Northwestern Hospital, Rush-Presbyterian-St. Luke’s Hospital, the University of Illinois Medical Center, Cook County Hospital, and the V.A. West Side Hospital.
Population statistics for the year 2000 show 2,896,016 people living in Chicago. The fastest growing ethnic group in the city is the Hispanic population.
In recent years, it is not the Loop or North Michigan Avenue that show signs of Chicago’s vitality and improvement. It is the neighborhoods. One such neighborhood is Lake View. Just north of Lincoln Park, Lake View is a fast-paced neighborhood that is alive with young professionals and benefits from the influx of families. This neighborhood has come full circle from a family oriented community to one that few people wanted to live in, and now one of the most sought-after Chicago neighborhoods. This neighborhood is also home to the city’s largest gay population. To its residents, Lake View is an exciting place to call home.
The medical expertise of Lake View’s physicians draws patients from surrounding communities. These physicians target the needs of a growing Hispanic population, the elderly, HIV patients, and high school students with a myriad of problems.
When settlers first arrived on the east side of Lake View in the 1830s, Clark Street was an Indian path and scattered bands of Indian tribes camped long the north branch of the Chicago River. The Lake View community supposedly received its name from the “Hotel Lake View” built on the Lake Michigan shore in 1853. After a cholera epidemic hit Chicago, residents fled to this area, seeking relief in what was then the countryside. People liked the lake view and many stayed to purchase nearby homesteads. In 1887, the town of Lake View was incorporated into the city. A large shopping area at Clark Street and Diversey Parkway developed to serve the growing population.
Lake View’s principle building boom occurred between 1885 and 1914 when brick and wood two and three-flats were constructed. At that time, Lake View had large populations of German and Swedish immigrants. Over time, immigrants from other nations— Hungarians, Poles, Slovaks, and Italians—moved in along the community’s western and southern edges.
Today the community borders Lake Michigan, Diversey Parkway to the south, Irving Park Road and Ravenswood Avenue to the north, with a section running from Irving Park to Montrose Avenue and from Clark Street to Ravenswood. The north section of Lake View is known as Wrigleyville, an area named after its famous historic resident Wrigley Field, home to the Chicago Cubs. And, at the northern edge of Wrigleyville is Graceland Cemetery, a resting place for many Chicago legends and leaders.
Lake View still has a wonderfully diverse population. According to the 2000 U.S. Census, 94,967 people live in Lake View with its mixed population of 79.5 percent white, 4.4 percent black, 8.7 percent Hispanic of any race, and 5.4 percent Asian.
In the last 20 years, Lake View has become an entertainment mecca with theaters and ethnic restaurants to please everyone. Home seekers can choose from the rehabbed apartment buildings, many new condominiums, and new apartment construction with higher rents. Some buildings date back to the 1800s with new construction homes fetching nearly one million dollars. Many rental buildings have been converted to condos, some of these from former factories and stores.
While parking in Lake View can be a challenge for residents, Lake View’s convenience to the hub of the city is perfect for those who don’t want to own a car. Lake View is 15 minutes from central downtown (the Loop) with two train lines (Els) and buses making public transportation a cinch. The nearby public and private schools, abundant neighborhood stores, and the low crime rate make it an ideal neighborhood for families. Numerous social service agencies are located in Lake View intent on keeping families together or preventing abuse and neglect.
Lake View is home to Advocate Illinois Masonic Medical Center, a large community, academic, teaching hospital that is affiliated with the University of Illinois-Chicago. It is the primary focal point for physicians practicing in Lake View and the surrounding neighborhoods. St. Joseph Hospital is also here in Lake View.
Helping families and the elderly
Body and Mind Medical Center is an internal medicine practice that draws patients not only from Lake View, where it is located, but also from surrounding north side communities. Sole practitioner Dominic Gaziano MD, in practice for just over three years, provides health care to many Hispanic patients. He speaks “medical Spanish” and can do a patient’s history and physical in Spanish. He is learning more Spanish with the help of new computer software. To facilitate appointments, he has hired secretaries who speak Spanish.
More than 40 percent of Gaziano’s patients are 50 years and older. Many of his geriatric patients have chronic illnesses such as diabetes, high blood pressure, asthma, strokes, and seizures. “I like working with Hispanic family groups,” he says. “As a physician, you hear many interesting stories, but you need lots of patience. You need to slow down and take your time with them. It may take a third or fourth visit to really get a patient to open up and talk to you. I believe I’m practicing where the need is.”
Gaziano is a member of Advocate’s program to help find doctors for Hispanic people. He also practices at Strong Spirit, a wellness center inside the hospital. At this alternative medicine center, the best medical knowledge of the east and west are combined. A strong advocate of fitness, stress management, and preventative medicine, Gaziano has been selected as one of only four physician members to serve on Mayor Richard Daley’s 35- member Fitness Council. Besides speaking at the mayor’s Sportsfest in December and at numerous fitness expos, he speaks about fitness, stress management, and preventative medicine with his elderly patients and residents.
Working with the HIV population in Chicago
Although it caters to the Lake View neighborhood, Northstar Healthcare is known nationwide for its outstanding care in treating HIV/AIDS patients. Located only a few blocks from the Advocate Illinois Masonic Hospital, this independent clinic with four physicians, two psychologists, and a nutritionist focuses on the HIV infection and its related problems.
Before the clinic’s inception in 1991, Daniel S. Berger, MD had an office in the Andersonville neighborhood. There he encountered HIV/AIDS patients discouraged with the treatment they were receiving. “Many physicians were telling their patients they could do nothing to help them,” says Berger. “I was aware of research developing in the field and wanted to become a part of this research and see if I could change a prognosis of a short life expectancy. In the past, most people were dying; now most people are living.”
When individuals with HIV/AIDS come to the clinic, besides seeing a physician, they have medical care from a research nurse and a nutritionist. The nutritionist sets up a program for each of the patients to help them eat better. Even though his patients are coming to the clinic for the treatment of their HIV infections, Berger notes that many patients suffer from other medical conditions such as diabetes, coronary problems, or arthritis. All medical conditions are treated here. Berger believes in treating patients holistically—not just for the virus itself. His goal is to enable them to continue with a good healthy life.
Berger’s clinic is in an ideal location since the neighborhood has a large gay community. According to 2000 census figures, the Lake View community has 27.5 percent of the total number of households in Illinois headed by same sex partners. However, his patients not only come from Chicago but also from all over the United States. Northstar Healthcare is one of the largest private research facilities in the Chicago area and has participated in the development of most drugs that have come to market. “Our patients have the ability to get access to this medication way before it’s on pharmaceutical shelves,” Berger says.
Currently, Northstar is one of the main sites for study of a new drug, TMC114, that was developed in Belgium, but has never been studied in the United States. In Berger’s opinion, this new drug “may be a blockbuster drug in terms of its ability to suppress HIV.”
Besides being on staff at Advocate Illinois Masonic Hospital, Berger is a clinical professor of medicine at the University of Illinois-Chicago and gives lectures at the Chicago Medical School. When medical students come to the clinic and spend a one-on-one day seeing patients with him, they are exposed to a wide range of internal medicine problems and get a unique perspective on patients who are HIV positive.
“It is extremely rewarding to practice in Chicago, and our patients are very grateful for what we are doing for them,” Berger says. For physicians interested in the field of HIV medicine, Berger recommends getting an infectious disease fellowship because it’s not that easy to get into this field of medicine today. Although the physicians at the clinic are internists and family practitioners, they entered the field before the medications became so sophisticated and drug interactions so complex
and have kept pace with the growing body of knowledge in the course of their practices.
Caring for teens in Chicago
Elizabeth Feldman, MD is board certified in family medicine and adolescent medicine. She did her residency at Cook County Hospital in Chicago because she wanted an urban family practice. After her residency, she joined a small managed care practice at Ravenswood Hospital. Four years later, she became a full-time faculty member in the family practice residency program based at the hospital. When Ravenswood Hospital was purchased by Advocate Health Care—and later closed—she continued her position at Advocate Illinois Masonic Hospital. Feldman now teaches at the hospital in the family practice residency program.
That is only half of Feldman’s job. She is also the medical director to two school-based health centers located at Chicago high schools—Amundsen and Lake View high schools. The budget for these two centers doesn’t come from the hospital, but it supports the centers and sponsors them. Feldman is employed by Advocate Health Care, with a budget stemming from state grants, private philanthropic grants, and the Ravenswood Health Care Foundation (money that was left over when the two hospitals merged).
Nurse practitioners and clinical psychologists staff the school-based centers, along with another physician. Feldman also brings residents on site to see and work with patients. Students who drop out of school or graduate from high school can come for up to three months for their medical care.
The health centers offer comprehensive full-service primary care for acute illnesses ranging from earaches to sports injuries. Physicals are also conducted. Pregnancy prevention is stressed, and pregnant girls are given prenatal care. Feldman’s colleague delivers the babies. However, the number one services month after month are mental health care for anxiety, depression, stress, family problems, and relationship problems.
“Both schools are socially-economically disadvantaged,” says Feldman. “Ninety percent of the teenagers are eligible for free or reduced lunch. Many culture issues also exist since many of the children were born in other countries.”
Feldman’s philosophy is to try to practice prevention above all else. Parents must sign one permission slip for their children to be seen for the four years. Every time a student is seen, a full social history is conducted to determine risky behaviors and risky environments. Students are asked if they are victims of any kind of abuse ranging from alcohol, drugs, or sexual improprieties. During the conversation, the staff tries to find out the students’ goals and dreams for the future.
Amundsen has ESL programs for a large Bosnian population. The school also has many students from eastern Europe and the Middle East, as well as a Hispanic population with origins from Mexico to South America. Lake View High School has a higher number of Hispanic teenagers, 15 percent African Americans, and a diverse mix of eastern Europeans from Poland, Romania, Bulgaria, and Russia. When communicating is difficult due to a language barrier, Feldman and the staff use AT&T
language interpreters who can help them with any language.
“When you stop and think about what underprivileged, urban, and ethnically diverse teenagers face, it’s not surprising some come from serious family trauma, others are raising themselves, or their parent is in jail,” Feldman says. “In this complex world, they are exposed to gangs and violence on the streets.”
There are 21 residents in Feldman’s program. Her first-year residents come to the clinic to see patients with her for two half-days per week. Her second-year residents, during their subspecialty pediatric rotation, also spend two half-days per week with her. Third-year residents spend one entire month at one of the two clinics and have the option of coming into the Advocate Family Practice Center just north of the Lake View neighborhood and seeing their own patients.
“My goal is to allow these residents to, once in practice, provide comprehensive care to teenagers and help launch them into adulthood,” she says. “What I love about the school health centers is the opportunity to be providing good care directly to the teenagers and be able to bring residents into this setting and allow them to see a way of providing care that they wouldn’t see in our family practice office. I watch them develop their expertise.”
Besides educating residents and administrating the two health centers, Feldman sees her own patients at the Advocate Family Practice Center. Economically diverse patients range from immigrants to university professors.
These Lake View neighborhood doctors may have diverse practices, but their goal is the same. They want to provide medical care that helps their patients overcome the challenges they face each day.
Vicki Gerson is an award-winning freelance writer based in Chicago. She writes for the Chicago–Tribune as well as national and international consumer, trade, and custom publications.