Meet Dr. Ricardo Morgenstern

A NEW PRESIDENT WITH A BREADTH OF LIFE EXPERIENCE

By Karen L. Chandler

As its new president, Dr. Ricardo Morgenstern, MD, FRCPE, FACG, FCPP, brings to the Philadelphia County Medical Society a rich tapestry of life experiences interwoven with an understanding of other cultures and an appreciation of the history of medicine.

Currently serving as the Clinical Associate Professor of Medicine, Division of Gastroenterology and Hepatology, at the Perelman School of Medicine at the University of Pennsylvania, and at the Corporal Michael J. Crescenz VA Medical Center, he was board-certified in gastroenterology in 1984. Morgenstern is a native of Bolivia.

When Morgenstern was born in 1952 in Oruro, Bolivia, he began his life in an important South American city at that time, well-known for its tin mines, a product crucial during World War II.

“Bolivia was the largest producer of tin in the world. It is the largest producer of many things, and it is the poorest country in South America,” Morgenstern said.

The son of a holocaust survivor, Morgenstern tells of his father’s arrest by the Gestapo from his upholstery shop when he lived in Warsaw, his imprisonment in a forced labor camp, and his eventual escape.

Morgenstern’s father was hidden away behind a false wall from 1942 to 1944 until he moved his family to Bolivia, one of the few countries in the world willing to accept Jews desperately trying to escape Europe. In Bolivia, Morgenstern’s father married his mother, a native of Uruguay. A move with his mother to Uruguay by age five meant that Morgenstern entered a school system with a focus on careers. “I liked medicine and philosophy, but I wanted something productive; both are useful; philosophy is supra-useful, as it serves as a base for every advancement in life but is not productive” he said. “In Uruguay the system was of six years of high school and the last two years you selected what you’re going to do. I was very interested in medicine and science.” After completing high school and a year of volunteerism in Israel, Morgenstern returned to Bolivia and started medical school at the University of San Simon in Cochabamba. He describes a cruel dictatorship in power at that time with a multitude of arrests that frequently reduced school availability to only one semester a year due to government closures.

“The medical school was good, and you had opportunities. There are very good physicians all over the world from Bolivia,” Morgenstern said.

The differences between the U.S. and European and Latin American school systems are striking to Morgenstern who notes that in the other countries students finish high school and head into medicine, as opposed to American students who enter other fields of study prior to medical school.

He said, “When you finish high school you go directly to medicine. You don’t have to spend the most productive four years of your life doing something you aren’t going to practice. If you want to study medicine here, you have to go into biology or engineering. It may be useful, maybe not.”

In an interesting twist of history, just as Morgenstern’s father found a safe haven as a Jew in Bolivia, many Japanese people also fled to Bolivia during the second World War and grew a sizeable Japanese population in South America. A collaboration between the Japanese and Bolivians was born with the creation of three hospitals known as the Bolivian-Japanese Gastroenterology Institute.

As a young resident, Morgenstern found the new hospitals to offer the cutting edge of endoscopy and his GI specialty with a field of expertise in advanced endoscopy was decided.

His residency complete, Morgenstern began to work, and he put plans in place to move to the United States, but an unexpected invitation created a life-altering opportunity.

“I was invited to Scotland to do training in Edinburgh. At that time, I didn’t know much about Edinburgh because in those days we didn’t have the internet, we had the Encyclopedia Britannica.”

Morgenstern headed in 1987 to begin a Fellowship at the Western General Hospital and the Royal Infirmary, University of Edinburgh, and Institution he describes as a cathedral of medicine.

Founded in 1729, the famous university was also the training ground for many of the founders of American medicine, a fact that made an impression on Morgenstern as a young physician but was made even more inspiring as he met, among many physicians, Professor Ian Bouchier, the Chairman of the Department of Medicine, President of the World Organization of Gastroenterology, Professor Niall DC Finlayson, Professors Anne Ferguson, Kelvin Palmer, Martin Eastwood, Peter C. Hayes, and others.

“When I stayed late at night in the Royal Infirmary at the top floor where the Medicine Department was, there was this room from the beginning of the Royal Infirmary history. You could see the great Physicians’ portraits, William Cullen, Alexander Monro and others. I thought, wow, this is amazing, the fathers of modern medicine teaching were here.” Morgenstern said.

The historic path Morgenstern followed becomes more apparent with the connections he described between Benjamin Franklin and England and Scotland, with the famous American eventually suggesting that many of the first American physicians of that time be trained in those countries, like Benjamin Rush, the first President of PCMS.

“Then they came here and founded the Pennsylvania Hospital, and the College of Physicians. His influence had a big part in that,” Morgenstern said, “and he had a bright view of the future.”

On his return to Bolivia, Dr. Morgenstern re-joined the University Hospital, and grew a busy private practice treating patients from all over the country, work that continued until his move to the U.S.

Other focuses in Bolivia were Morgenstern’s position as a senior advisor at the American Embassy in Cochabamba, advisor to other embassies, and a physician to many Religious Missions from the U.S. and Canada. He was President of the GI Society of Bolivia, a member of the Board of Internal Medicine Society, the Secretary-General of the InterAmerican Society of Endoscopy, and international coordinator of the Latin American Training Center from the World Gastroenterology Organization in La Paz since 2004 to the present, having trained 3450 and 750 endoscopy assistants from all Latin America.

He served as Chairman of Cochabamba Health Service by appointment of the City Mayor but corruption made any move to change impossible and Morgenstern eventually resigned, but he also served as Dean of Universidad Privada Abierta Latinoamericana for a year in Cochabamba before moving to the U.S.

The political situation in Bolivia became dire with a change in government. Morgenstern said, “The situation became worse and worse. The future for younger generations looked very bad.”

To ensure a safe future for his children, Morgenstern moved with his family to the U.S. in 2004 with the help and advice of Dr. Barbara and Leonard Frank. He began work at Drexel when his children were ages twelve, nine, and two, a position he retained until two years ago when an end to GI services at Drexel caused Morgenstern to transition to the University of Pennsylvania.

Morgenstern notes the difference in health care between his earlier experiences in Bolivia and his work in the U.S.

“Things here are different, because although the quality and technology is higher in the United States, the relationship between doctors and their patients in Bolivia is much closer. You have more time to be with your patients. It is very important to get the connection with the patients and you need to spend time. Maybe here it was the same in the past, but now with the number of patients we have, you don’t have the time to spend with your patients,” he said. “There, the doctor is part of the family.”

His work in mostly GI, endoscopy, and specialized procedures at the CMJC VA Medical Center brings a similar fulfillment to Morgenstern as he sees veterans suffering and feels rewarded by doing what he can to relieve some of their distress.

Today Morgenstern resides in Wynnewood, which he says provided an excellent education system for his children and created a nice neighborhood environment with good neighbors. His son is now an engineer in California, his middle daughter is in her fourth year at Drexel University Medical College with an interest in reconstructive surgery, and his youngest daughter attends the Drexel University business school.

Although in earlier life Morgenstern enjoyed tennis, soccer, music, and reading histories and biographies, with Jewish history around the world as a favorite topic, he admits that these days he has little time for hobbies.

Looking ahead to his role as the new PCMS president, Morgenstern anticipates continuing the good work of past presidents, including the CME program, courses in specialties, public awareness of health screenings, and interactions with medical students.

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He hopes to find more offerings for area physicians to encourage an increase in PCMS memberships and looks forward to collaborations with the Philadelphia College of Physicians.

Both the cost of malpractice and the growing number of mass shootings are also key issues for Morgenstern.

Recent shootings cause him to question what in society is causing the rise in violence.

“The gun violence is the symptom, not the only problem. It’s a symptom of disease in our society,” Morgenstern said. “I think that part of our society is very violent. Could it be because of extreme violence in the games, movies, and media? With this constant virtual violence, kids are being desensitized and eventually, they can’t tell what’s good from bad in the real life if they don’t have good family guidance. It’s a crucial age when you are more prone to receive information. I think not only gun control, but they should bring control into games, movies, and media.”

He said, “When we were kids, we used to play cowboys with a water pistol and never thought to shoot people.”

Dr. Joyann Kroser invited Morgenstern to join the PCMS during her tenure as president from 2005-2006, and he willingly joined and became a member of the society’s international graduates committee.

Morgenstern’s broad educational and international experiences have led to his interest in Project ECHO (Extension for Community Healthcare), developed by Sanjeev Arora, M.D., at the University of New Mexico Health Sciences Center. ECHO is a collaborative model of medical education and care management helping clinicians provide expert care to patients wherever they live through video conferencing technology to train, advise, and support primary care physicians. The project also strives to increase access to specialty treatment in rural and underserved regions.

Through PCMS, Morgenstern hopes to have members, with students’ participation, willing to give one or two hours every so often to talk to physicians both in Pennsylvania and around the world.

Morgenstern’s wide range of experiences from living internationally and observing firsthand when countries are run by political interests makes listening to all political views vital to him. He believes strongly that the PCMS not be used for politics and that members should hear all sides and seek solutions in the middle.

Morgenstern also expresses some apprehension about the welfare of his fellow physicians and hopes to find ways through the PCMS to help.

“What concerns me, is to try to be more protective of our colleagues. Increased burnout in general. It is very concerning to me that I hear from physician friends about overwork even in out-of-office hours. I think we have to improve and look for solutions. There should be a way to get more physicians, so we can give less work and more efficient work and have more physicians in general,” he said. “We have to find out what are the needs of the physicians that we can solve to give them a better life.” •

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