Forty Two years as a Physician-1979-2021

A Physician-for Forty Two Years

1979-2021

I. Part 1: Pre-medical School. Medical School; Residency OB/Gyn (at the University of Utah); Subspecialty Training (Fellowship )-Reproductive Endocrinology and Infertility (at Duke University) and Medical/ Academic Practice (at the University of Florida). 1972-1988; 2016-17.

Part II. Verkauf-Bernhisel Practice and  The Reproductive Medicine Group in Tampa Bay Florida. 1988-2020

Part I. What led  up to my decision to become a doctor?

I guess it started with my love of books and information, following my  parents' example of their  love of books (and borrowing my dad's reading glasses). I also was taught the medical vernacular as a child. I never knew the word Belly Button or even Navel until grade school. It was the Umbilicus. When my fellow first graders were reading about Dick and Jane, I had memorized the word/malady from my neurologist dad, amyotrophic lateral sclerosis- ALS-Lou Gehrig's disease. I also read all the books about Lou Gehrig's baseball career.   

HG Bernhisel, M.D.

My Dad, Harris Glenn  Bernhisel, did his under-graduate work and medical school at the Univeristy of Utah. His internship was in Albany N.Y. and residency in neurology at the University of Minnesota. He later did a second residency in radiology, which is what he practiced into his seventies, mainly in Utah.

                                                                                         

My mother, Bethine Sax Bernhisel, met my father at the University of Utah, while she was in nursing school. She later received her Bachelors Degree in nursing at the University of Minnesota (where I was born).  

This is Dr. John Milton Bernhisel-my great-great grandfather. He completed his medical school at the U of Pennsylvania. He was trained in "blood letting" (the practice at the time-and which reportedly had contributed earlier, to President George Washington's death), but there is no indication that Dr. JMB actually used this "therapy". He joined the Church of Jesus Christ of Latter day Saints, and moved to Nauvoo Illinois (then the geographical center of the Church) and lived with Jospeh Smith and Emma Smith (and delivered at least one of her children). He essentially served as a mediator/negotiator for the Church and for Joseph Smith in dealing with state and local governments. He was mentioned as a great help and hero to a group of African Americans who came to Nauvoo and were in dire need of his medical care and compassion.  Joseph mildly rebuked him one time for standing up each time  that Joseph entered the room in which John Milton was in. JMB stated: "I will always stand when the prophet of the Lord enters." JMB migrated to what is now Utah and was selected/elected as the Congressman in Washington D.C. , representing the Deseret Territory-eventually the state of Utah. He did serve in the U.S. congress for 5 terms and did know, met  and communicated with Abraham Lincoln. President Lincoln, in a letter written during the Civil war, described JMB as being loyal to the country and trustworthy and projected that he and the people of Utah would stand with the Union. JMB's  son, my great grandfather- JM Bernhisel II and my grandfather, Harris Faye Bernhisel, were famers in Lewiston, Cache Valley, Utah. So,  we seem to have been Docs & Farmers in the "Bernie" family. 

In addition to my father and mother being in  medicine, my Dad's older brother Ted Bernhisel (internal medicine), two of Ted's children-my cousins Kurt Bernhisel (Emergency Department director at the U of Utah) and Jan Bernhisel Broadbent (pediatric allergist ) are physicians as well as a number of children and grandchildren. My sister Gretchen Bernhisel Wilcox and cousin Liz Wilson Roach are RNs.

This is Dr Edward Hashimoto, who interestingly, was my professor of Anatomy (former surgeon) in 1975-1976 as he was for my parents in the early-mid 1940s. My parents  related one day to me  that after the attack on Pearl Harbor by the Japanese, while they were awaiting for him to enter the classroom, the room was abuzz with speculation because of Dr. Hashimoto's Japanese ancestry. He did enter the room and exclaimed to all-"hey don't look at me that way--I'm IRISH." I remember a very important lesson (non-anatomical) he taught me and all my medical school classmates. He stated that one time while operating on a patient, nothing was going right and there was bleeding all over the place. He said, "I could have panicked and I did somewhat,  but I packed the abdomen with lap pads (large laparotomy/surgery pads) to stop the bleeding,  backed up a little--leaned my back against  the wall, and then weakly asked 'does anyone know what the heck to do?'. Not hearing an answer (from the assisting doctor, the nurses or scrub techs), I proceeded to take one lap pad out at a time, stopping the bleeding in each area as I progressed and finished the surgery." This was an important lesson for me as I faced desperate situations both in and out of medicine in which I remembered his advice to take a breath, pack up the area, stop the bleeding, analyze, think it through and proceed onward and upward.

I started medical school at the University of Utah in the fall of 1975. Previously, I had worked for my Dad as an X-ray assistant since high school and later a technician while in pre-med and in medical school. I also worked as an Emergency Room tech at LDS hospital during my last two years of undergraduate school. I graduated with a Bachelor of Science degree in biology in 1975. 
While in medical school, Julee and I had two children. Heidi (Rex) in 1976 during the spring of my first year in medical school,  and Preston in the fall of my third year in 1978. We lived in my Grandmother Sax's home in the basement area in Bountiful, Utah. My inclination in my clinical years of medical school, was to go into surgery. However, I really enjoyed the atmosphere of Obstetrics and Gynecology as I did my clinical rotation during my third year in medical school.  I did research with the Chairman of Ob/GYN, Dr. James Scott,  for my senior medical school honors program. Testing mice, to which I had removed their thyroid glands and to which I gave them immunological  injections. My research was presented and published in the Society of Gynecological Investigation. 

This is Heidi with me in the lab that I was working in- at the U of U hospital research lab with my mice as a 4th year medical student. 

Julee, my wife, and I got our graduate degrees on the same day in 1975. Julee received her Masters degree in teaching children with learning disabilities and I got my M. D. . I did graduate with honors (Alpha Omega Alpha), which I did not expect. An interesting side note- on the day that we got our graduate degrees, I saw an old high school football coach of mine who was now teaching at the U of Utah, and who was with a bunch of students. I had played in a high school football game as a junior in which as I tackled an opposing running back, and dislocated my middle finger so that at the finger's first knuckle joint, it was pointing sideways/perpendicular to my other fingers. Somewhat freaked out, I headed to the sidelines where this coach pulled out and up on that injured finger, putting it back in a normal position, taping it to my ring and index finger and then put me right back into the game. As I walked with my medical diploma, I thought-"I could have potentially lost any chance at performing surgery, if the finger did not heal up properly" (which it fortunately did). I debated on going up to him to let him know this, but I ended up just waving at him and smiling. 

My first year of residency in Ob/Gyn at the U of Utah. I am 4th from the left/first row, next to Dr Scott, the head of the Department

Medical Helicopter flying into the  University of Utah  Hospital

Residency-University of Utah 1979-1983
Internships and residency programs are generally decided upon in the third year of Medical School. Julee and I visited programs at the Universities of Iowa, Michigan and Minnesota. All of them had an interest in me and it finally came down to a decision between the U of Utah and Iowa. We decided to stay at Utah and buy a home in Bountiful (10 minutes from my parents home). 

We were pretty poor during my medical school years and in those days (really always), residents were  not payed very well. I did "moonlight" in emergency departments in Preston Idaho and St George Utah in my second to fourth years of residency. I recall while covering the Preston emergency room, that an Idaho cowboy-rancher came in  all banged up with bruises and lacerations. He was somewhat groggy,  and had what appeared to be a broken arm. A large truck had run into him and his cattle has he was hearding them down a local canyon on his horse. I worked with the ED nurse to clean him up, suture his lacerations, put a cast on his arm and watched him as he became more alert as we finished. At that point, I noticed that my nurse looked exhausted and like she was going to faint. I had her lay down on a gurney to rest. It was then that she told me that the beat up cowboy--was her husband.

On some Emergency Department weeks, I would work Thursdays on call in Ob/Gyn, getting little sleep if any at night in the hospital. Then, after my work was finished at the hospital,  I went to one of the EDs Friday evening to cover it for emergency admissions.  Typically I would not get a lot of sleep on the Friday and Saturday nights in the hospital, and then I would come home on Sunday night and go back to my residency duties on Monday morning. 

The helicopter pictured above the building ( the University of Utah Hospital/Medical School) was also a common way of transportation for us as we  were sent to help pick up sick patients, usually pregnant, from different sites in Utah, Wyoming and Idaho (or other places). We would watch over the patients as we rode in  the helicopter, flying back  to the U of U hospital. I never had to deliver a baby in flight, but I had a nurse who often got severely nauseated during the flight in the helicopter, so that I had to have her lay down while I gave her a shot of an anti-nausea medication.

Lyndi Bernhisel, born at LDS hospital (part of our residency training facilities ) coming home.

The day after call in the hospital at the U of Utah

We had two children born (Brooke and Lyndi) during my residency to make our family a total of four kids as I finished my four years of residency in Ob/Gyn.

Brooke was born my third year and Lyndi (pictured above, outside LDS hospital) was born during my fourth (Chief Resident) year.   LDS hospital was the second hospital that we worked in and where I spent half of my first year of residency in.

The second picture is the day after being on call at the University and delivering babies all night long. 

The last picture is the group of residents and facultyGroup picture in 1983, my fourth year/Chief Resident (Richard Worley front, second from left; James Scott-Chairman of OB/GYN, front-third from right; Neil Kochenhower-(Fetal Maternal Medicine)-front far right. I am in the second row-second from left. 

Durham N.C., Duke fellowship in Reproductive Endocrinology and Infertility

1983-1985 

Sarah P Duke Garden 

83, after finishing my residency in Ob/Gyn, the Bernhisel clan took a long trip. We moved ourselves with the help of my two brothers Paul and Todd, cross country to Durham N.C. .    

I was accepted as a fellow at Duke University in reproductive endocrinology and infertility, in the fall of 1982,  my chief residency year.  Dr Charles B. Hammond, a Reproductive Endocrinology and Infertility (REI) physician and the Chairman of Duke Ob/Gyn dept.,  had given a talk at the U of U Ob/Gyn winter conference in Park City Utah, earlier in the year, which I attended. I loved the talk and had a good feeling about going to Duke.

This picture above  is of our family (four children at that time) at Sarah P. Duke Gardens, which I could see from my back office window (the Ob/Gyn offices were in a former nurse's boarding home building). Duke Gardens was a favorite of ours as we did not have to pay to visit it- as we were literally as poor as "church mice" and occasionally splurged on a burger or some ice cream. Because of our financial difficulties, Julee opened up our rental home to child care and I moonlighted by covering for an obstetrical/gynecology group occasionally, during weekends in Rockingham North Carolina.

Duke University Chapel Drive

My Division of REI leader at Duke University - Dr Arthur "Cap" Haney 

Department of Ob/Gyn Chairman at Duke University Dr Charles B. Hammond (also an REI physician)

Duke University

8 cell, day three-human embryo 

The REI director was AF "Cap" Haney (first picture). Our chairman was  Charles B Hammond (an N.C. native-second picture). In Vitro Fertilization-IVF (referring to fertilization occurring outside of the body) was in its early days. An IVF- 8 cell embryo, noted above, was referred to then as a "Test Tube Baby" and was still fairly new in the U.S. . The first IVF success was in England. Louise Brown was born in 1978, my third year in medical school. Drs. Robert Edward (PhD embryologist-who I met in my first year at Duke) and Patrick Steptoe (Gynecologist) had worked many years before this successful try. The first IVF success in the U.S. was in 1981, under the direction of Drs. Howard and Georgiana Jones (formerly of John Hopkins, and mentors there to my RMG partner- Barry S Verkauf, M.D. ) at Norfolk Virginia in 1981. I participated in one of the first IVF attempts at the U of Utah in 1983, just before coming to Duke, which had started their IVF program a few years before.

I was fortunate to be at Duke University as a fellow (a title indicating I was still in training- in our subspecialty, but at Duke we were also designated as Assistant Professors, i.e. faculty when in our second year of fellowship)  and was  invited to write Chapters in OB/Gyn standard text books, primarily regarding Androgen Excess. Androgens are hormones secreted by both males and females, such as testosterone, but in significantly higher levels in males. Some females did secrete these hormones in higher than normal levels, which often caused "hirsutism"-excess hair growth in the facial, chest abdomen etc. and which often also caused women to not ovulate and therefore having irregular menstrual cycles as found in the clinical problem of Poly Cystic Ovarian Syndrome. Later at the U of Florida and in private practice in Tampa, Florida, I did write subsequent chapters and articles for books and scientific journals. 

A requirement of the fellowship and for the subspecialty board certification in Reproductive Endocrinology and Infertility, was to publish in a peer reviewed journal, a scientific article from a research  investigation and to defend it in the oral (face to face) portion of the board examination. I used ovarian estrogen and progesterone producing cells from female pig ovaries (N.C is famous for its pork BBQ) and from human ovarian fluid (who were undergoing IVF) in this research to see if they were modulated by male type hormones (androgens).  This is the title of that research.

Estrogen and Progesterone Production by Granulosa Cell Monolayers Derived from In Vitro Fertilization Procedures: Lack of Evidence for Modulation by Androgen. Bernhisel MA, Holman JF, Haney AF, Schomberg DW. Journal of Clinical Endocrinology and Metabolism, June 1987. 

One of our rotating  responsibilities as a Duke REI fellow was to cover as faculty, the labor and delivery room and all admissions or emergencies at the obstetrical or gynecology areas of the hospital during the weekend. One night I was covering with a chief resident ( in his 4th and last year in Ob/Gyn residency and who supervised younger residents), who was a friend and a member of my church. We had a woman who was delivering a fetus (baby) who earlier, had died in her uterus. At the time that we saw her, she was bleeding very heavily. We tried a number of the usual methods to try to stop the uterine bleeding (pads and balloon catheters in the uterus etc.) and  nothing was working. I was preparing to order several units of blood, essentially to save her life as she was  minimally responsive, and getting worse.  Her husband  let us know that they had recently adopted the practice/faith, which had decreed to its members not to receive donated  blood. He was obviously torn between the possibility of losing his wife and violating the precepts of his new faith. I called a senior faculty person and after describing the situation, he said, "you may just have to let her pass away." Her parents, who were called and were not of her daughter's faith, insisted on a blood transfusion. It obviously put the husband in a difficult position as it did to all of us. The patient did survive and the husband was happy that he had a wife who survived. This topic of whether to transfuse or not, became the subject of Grand Rounds and many discussions at Duke and other hospitals. 

Gainesville, Florida. 1985-1988

We had originally intended to return to Utah, after my Duke fellowship and likely to work at the U of Utah or LDS hospital. However,  the offer I got from the U of Utah was a little delayed and we fell in love with the South and the passion and spirit of the University of Florida "GATORS". I was initially hired at the University of Florida to start the IVF program there and work with Frank Riggle, M.D. who headed the Reproductive Infertility Division. I was able fairly quickly, to get the IVF program up and going there and soon after arriving, we had the first GIFT procedure (Gamete-[sperm and egg] Intra-Fallopian tube, Transfer), consisting of putting the retrieved eggs and sperm in an infertile women's fallopian tube via a laparoscopic procedure, which had resulted in a pregnancy. This was the first GIFT pregnancy in Florida. I also had time for research and I worked closely with the residents, teaching them to do  vaginal hysterectomies (frequently done in Utah, but hardly done at the U of F). This in turn lead me to laparoscopic assisted vaginal hysterectomies and finally total laparoscopic hysterectomies-one of the first in Florida to perform these.  I loved to use the laparoscope to do minimally invasive surgery as opposed to opening the abdomen.

This is a dinner at our Gainesville home in 1985, with a young man from China who was working on ovarian preservation. Jack, our first embryologist is seated next to him and Jack's wife Kathy 

When I would give lectures to residents and  faculty as well as  for teaching patient groups, explaining In Vitro Fertilization, specifically regarding the use of frozen embryos (which is currently what we use now  for about 90% of our embryo transfers), I would use these fun cartoons.

The picture here finds the husband drinking a glass of water by the sink with ice just taken from the freezer. The wife says in the caption, "By the way,  I changed things around, the ice cubes are on the first shelf now and the frozen embryos are on the second."(The husband realizing his mistake is now gulping!).

"Things are getting way too complicated Bernie (which just happens to be my nickname).. "-- I think you can read the rest.

A couple coming out of the Frozen Embryo Clinic... Maybe this will be the theme for the movie-FROZEN III!

Steve Spurrier with QB Danny Wuerffel

As at Duke University, I was asked to cover the obstetrical services for complicated deliveries and Caesarian Sections("C Sections"), post operative cases and admissions from the emergency department with the residents. As a resident, I had a lot of exposure to surgery, particularly in doing vaginal hysterectomies and laparoscopic surgical procedures, which was enhanced in my Duke Fellowship.  Teaching the residents and medical students, both in lectures and with them assisting me in surgery and practical patient care, was and still is, a very enjoyable endeavor for me.  With in a few months after starting at the University of Florida in Gainesville, the division director, Dr. Frank Rigall, moved to Orlando and I was appointed to be the Director of the Division of Reproductive Endocrinology and Infertility.  I did have wonderful PhDs, lab people and nurses to work with.  However, I was then the only medical doctor in the division, so as delightful as it was, it was also very exhausting.  Soon after, our department chairman, Dr. Eduard Friedrich got terribly sick and passed away.  This put a serious dent in my ability to recruit other physicians who, like me, were sub-specialized in reproductive endocrinology and infertility (REI).   Finally, in my third year at UF, there was a new chairman appointed, Dr. Byron Masterson,  from Louisville, who I really liked.  However, by the time he came aboard, I had determined that I would explore going into private practice. If Dr. Masterson had arrived earlier, I likely would have stayed longer at UF. He had known in Louisville, an REI-fellow, Stan Williams and recommended that he join us. Dr  R. StanWilliams replaced me as division director and eventually became the chairman of the UF OB/Gyn Department. 

We did (and still do) love Gainesville. We were (and still are) true Gators-as well as being Dukies and Utes. We loved our co-workers, friends and fellow church members there.  Gainesville is where we had our last child born-Jenny Leigh Bernhisel (kiddo #5) in 1987. In fact, as  Julee was laboring, her doctor, my fellow faculty member, turned to me and asked if I would like to deliver our last baby. I was happy to do so (and fortunately, so was Julee). Julee told me later that  it was her best delivery.  With all the great things at the U of Florida, a  physician-Dr. Barry Verkauf came up to Gainesville, from Tampa and talked to me about teaming up with him and his staff.   

                

The Bernhisel kids in 1987. Lyndi, Jenny Leigh-being held by Heidi, Brooke and Preston.

Part Two 1988 Tampa

In 1988 Dr. Marc Bernhisel, then the Division Director of Reproductive Endocrinology at the University of Florida, joined Dr Barry S. Verkauf in Tampa Bay Florida. Pictured above is Marc and Julee Bernhisel with Arline and Barry Verkauf, and below, Marc and Barry at our nurse, Cindy Phillips' home for the office summer party in Brandon Florida.

Sherry Smith at the Swann office.

                                            Cindy Phillips (posing for a picture with Dr. Verkauf's mother-Mrs.Rose Verkauf)

Swann Office nurses Jill Sheppard and Joyce Prather

Arline, working the accounting books for the office in the late 80's

                                                             

"one more thing that I would like you to do Sherry...."

The Bernhisel crew watching the Gasparilla parade with Pirate crew member Barry Verkauf ("ahoy-aarrr") stopping for a visit.

Lynn Smalley and Marilyn Horner in Dr Bernhisel's Swann office room

 Office Summer Party at the Bernhisel home

Kevin (our Swann office dictation transcriber) with Marie Tarter to his right

Christmas Office party at the Verkauf's Home

Sherry Smith and Marie Tarter

While Dr. B is out of the office--fun time for the staff (Marie, Judy, Jill, Joyce, Cindy and Sherry)

Lori and Jennifer

Sherry and Cindy

Another part of medicine that I came involved with was "Outdoor" or "Wilderness medicine". I loved to ski (including back-country skiing), hike, backpack, mountain climb and scuba dive.  I was often designated the "doc" of the group when we climbed. I was involved with the care and rescue of fellow-climbers on Mt. Rainier and Denali. 

 Mt Rainier (I'm in the back with the hat on) 2002 treating a 

climber with altitude sickness 

Denali (Mt McKinley)-Rescue of a fellow climber who passed out in front of me from 

what turned out to be a heart-valve aneurism in 2007

In 1994 Drs. Bernhisel and Verkauf teamed with Dr. Samuel Tarantino to  perform In Vitro Fertilization (IVF) at University Community Hospital (now Advent Hospital).  IVF in Tampa was formerly done at Humana Women's Hospital before it became St Joseph Women's Hospital and was disallowed there afterwards.  In 2000 Drs. Verkauf, Bernhisel and Tarantino combined to form the Reproductive Endocrinology & Infertility group, later named The Reproductive Medicine Group-'RMG'

Drs. Tim Yeko and Sandy Goodman soon joined the group in 2000 and RMG was formed

The RMG physicians felt that an independent IVF center with our own surgery center and office building would best suit our needs

Marie Tarter and Drs. Goodman, Bernhisel, Yeko, Verkauf and Tarantino at the ground breaking.

The RMG Fletcher Office was completed in 2004

New Orleans in 2006 for American Soc. of Reproductive Medicine, the year after Hurricane Katrina hit New Orleans.  Drs Bernhisel, Verkauf and Goodman with spouses Julee Bernhisel, Arline Verkauf and Carmen Tarantino. 

Dr. B and Julee at a RMG Christmas Party

Susan Guy-COO, running the work at RMG

Hwan Rho-Head of the ART lab

Renee'

Sue and Jim Rutherford

Diane, Stephanie and Sharon at the North Tampa office

Haley, Hwan and Laura

Linda and Hwan

Christine

Business office staff: Kerri, Lisa, Merci, Heather, Mia and Kendra

Kelly and Zaan Gast 

Ambulatory Surgery Crew: Nancy, Maria, Bell, Andrea and Crystal (front). Kelly, Debbie and Nukul (back)

Debbie, Crystal and Sheryl

Debbie was posing as a patient undergoing surgery by me, assisted by Crystal (photo below) for pictures.

ASC pictures, with an IVF "Bernhisel" Transfer catheter

Dr B and Debbie

Angela and Andrea 

Ricky and Debbie in the ASC

Lynn at the helm in the ART office

Cindy, Shanna , Kathlene, Lynn and Renee'

Dr Betsy McCormick, who had finished her Reproductive Endocrinology 

and infertility fellowship at Ohio State University,  joined us at RMG in 2011.

OR crew at St Joseph's hospital

RMG lab technicians 

The lab crew for all 4 offices

Lucy and Judy

RMG Sonographers

Renellda and Amy 

Kim and Danielle 

Sonographers Amy, Danielle, Kim and Dani

Brandon Office

Cori, Kristin, Amy and Kathy from the Brandon office.

Brandon Office: Cori, Chrissy, Natalie and Amy

Amy and Sue and Dr B at the Christmas Party at the Bernhisel's

Dr. Bernhisel and his wife Julee were asked by his Church in 2012 (The Church of Jesus Christ of Latter day Saints) to be the Mission President and Companion in North Carolina Raleigh Mission (the eastern half of N.C.) for three years. We would be leaving our home, my medical practice and our dear friends and co-workers.

So we had many "Good Byes" with everyone 

NORTH TAMPA CREW 

Sarah and Crystal (behind)

Sue and Jim Rutherford 

"RMG" banner that I put on top of the Grand Teton (13,775 feet) in June 2011 

Upon our return to Florida from our mission, we visited our friends at RMG and then headed out to Utah to help out a friend who was the  Chairman of the OB/GYN department at the University of Utah and who was an REI doctor. The REI division head, was my U of U mentor from my OB/GYN residency days-Dr "Bud" Keye, who had been brought in to help as well, after they moved back to Park City, Utah from Michigan.

Christine, Kelly, Merci and Cindy with Sherry next to Julee 

Julee and I visiting Lynn and Renee at RMG in 2015

My  University of Utah office crew (Farmington-office). 2017

While at the U of U, I did get to have several of my former missionaries come

and "shadow" me. All three, Israel Cerda; Derrick Graham, and Michael Duplisea- are now in medical school

Now back at RMG  as of March 2018, with my wonderful old partners: Drs Tim Yeko, Sandy Goodman, Sam Tarantino, Betsy McCormick and myself. 

Ambulatory Surgery (ASC) crew

A valued benefit of working along with great partners and an unsurpassed staff, was a culture of caring and putting the patient's welfare and expectations, foremost in our efforts.  A great joy came to us from individuals and families that were in some way,  aided by our work. In many ways, the babies and happy parents- hallmarked  that joy of our practice. 

So, an often asked question, "Would you do all this again-if you could?" ABSOLUTELY!  A medical career, starting in reality as the ambition of a young kid, followed by a long and sometimes painful journey through college, medical school, residency, sub-specialty fellowship and through academic and private practice, has in the long perspective, been a blessing to me and my dear family.