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Am Fam Physician. 1999;59(7):1719

Dr. Jay Siwek, AFP's editor, and his wife, Linda, posing in front of the Emperor's palace in the Forbidden City, Beijing, during a recent tour with the National Symphony Orchestra.

Being a family physician means caring for families—all kinds of families—even if it means packing up and following them halfway around the world. For the past 10 years, AFP's editor, Jay Siwek, M.D., has served as a tour physician for the Washington, D.C., National Symphony Orchestra (NSO)—an opportunity that arose through his connection with a physician acquaintance of Mstislav Rostropovich, then music director of the orchestra. Jay and his wife, Linda, pictured above, recently returned from a tour to China and Japan with the NSO, his fourth international tour with the orchestra.

The three-week, January–February '99 tour took the group to Beijing, Shanghai, Hong Kong, Tokyo and six additional cities in Japan. Earlier international tours took Jay and the orchestra to Europe, Japan and Taiwan. While touring, Jay stays very close to the group, traveling with them on the plane, on the train and on the bus. Remaining this close, Jay says, truly gives him a chance to practice a biopsychosocial model of family medicine. In addition to the “office” hours that he has every day in the hotel, he's on standby at concert halls during every performance and at intermission, and he's on call the rest of the time, giving medical advice and providing treatment whenever necessary.

Like most families—who tend to share communicable diseases—the NSO family shared a virus during this year's tour, with fully one third of the 105-member group falling prey to the Sydney flu. Although Jay was traveling with two suitcases of medical supplies that he prepared before leaving the country, he had to make an emergency stop in Hong Kong for some amantadine when the flu epidemic hit. Luckily, many orchestra members responded well to the treatment, some with an almost miraculous recovery.

In addition to providing care for the NSO family, Jay was responsible for 45 other relatives and companions traveling with the group. Jay cared for patients ranging in age from three months to 87 years, treating complaints ranging from a sudden attack of nausea in an orchestra member boarding an airplane to congestive heart failure in an elderly woman and a urinary tract obstruction in an elderly man, which required a stop at a local medical facility for insertion of a catheter.

Although Jay says that the medical offices he visited did not differ drastically from practices in Western countries, he commented on the juxtaposition of modern high-tech culture and ancient practices in China, with a curious blend of Chinese customs and Western influence. There's one sight that he won't forget: one morning, he woke to see dozens of citizens practicing tai chi in the chilly streets of early dawn, with oriental music pouring from loudspeakers. But what made this scene so memorable? Abruptly, and inexplicably, the music changed to the original 1960s version of “Love Potion No. 9.” It was “‘inscrutable,’ as Confucius would say,” quoted Jay.

When the traveling family returns to their homeland, Jay stays in touch with them throughout the year, attending concerts and social gatherings, even their weddings. To Jay, they're like a family—and, like a good family physician, Jay is there when they need him.

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Copyright © 1999 by the American Academy of Family Physicians.

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