Solving medical mysteries turns into alum's specialty

From the jungles of northeastern Guatemala to the hospitals of Phoenix, Dr. Steven Oscherwitz has seen many strange ailments.

Which, for him, is the point.

As a specialist in infectious diseases, tropical medicine and epidemiology, Dr. Oscherwitz, who graduated from UT Southwestern Medical School in 1986, tries to get to the bottom of the medical mysteries other doctors can't diagnose. He is one of only 429 individuals worldwide to hold the Certificate of Knowledge in Clinical Tropical Medicine and Travelers' Health issued by the American Society for Tropical Medicine and Hygiene.

"When I was little, I was sick a lot, and I thought of faraway places I wanted to visit. ... I also did a lot of puzzles," he said. "To me, this is just sort of an extension of what I like."

Dr. Oscherwitz got his first hands-on experience with tropical medicine in 1992 as chief resident of internal medicine at the UT Health Science Center at San Antonio. An archaeology expedition from a nearby college was looking for a doctor to travel with them to the Peten jungle of Guatemala - a remote and dangerous area with one road, one river and numerous drug runners. Dr. Oscherwitz volunteered to go.

"One guy lost a leg to a snake," he recalled. "The head of the expedition got malaria, so I had to give him medicine."

Not long afterward, Dr. Oscherwitz had the opportunity to travel with a U.S. government parasitology delegation to a central area of China and help eradicate parasites. "At that time, they were still using human waste to fertilize the crops," he said.

Primarily, though, Dr. Oscherwitz sees patients in the United States through his private practice in Phoenix. Most are critically ill or unstable hospitalized patients.

"Phoenix is really a hub of international stuff," he said. "[It] has an international airport, and a few times a year, people will come off those planes hemorrhaging."

Many of the cases Dr. Oscherwitz sees involve diseases like meningitis, tuberculosis or a fungal illness often referred to as "Valley Fever." He's even treated a contestant on a reality TV show who ingested eggs with chicken embryo, pig parts and ground-up toads on the show and became critically ill.

Some cases even have an element of humor to them. Dr. Oscherwitz recalls one man he saw in his office who had a fungal infection on his lip. The patient had spent thousands of dollars on medical treatments and creams to find a cure, but the infection persisted.

After questioning the man at length, Dr. Oscherwitz learned he was a retired candy salesman who ate 100 chewy candy bears every day and had a habit of putting a yellow one between his gum and lip every night as he went to sleep. As Dr. Oscherwitz examined the lip infection, he found the patch actually had the shape of a little bear.

Mystery solved.

He admonished the patient to stop his nighttime habit in the hopes of clearing up the infection. And sure enough, "in a week, it was gone," Dr. Oscherwitz said.

One of his patients, a man who had survived a rare sleeping sickness, was invited to appear on a recent BBC feature called "Natures Vampires," which aired on the Animal Planet cable channel. Dr. Oscherwitz was included in the program as a commentator.

Additionally, his expertise has led to his being part of a local team trying to prepare the Phoenix area for the possibility of bioterrorism. As chief of epidemiology and infection control at Banner Desert Medical Center, he concentrates on disease pattern recognition - the possibility of many cases of the same strange disease at a single hospital in a short period of time, indicating bioterrorism.

Despite treating so many sick people, Dr. Oscherwitz said he been able to remain healthy, with only a few exceptions. "I've never caught anything, except viruses," he said, "probably from patients coughing in my face."