One is a specialist in internal medicine and gastroenterology. The other is an internist by training who spent much of his career in emergency medicine. Both traded jobs at top hospitals in Boston for rural life on an Island off the coast of Cape Cod. They met many years later, at a walk-in clinic started in the 1980s by Dr. Michael Jacobs. They share a love of medicine and a commitment to practicing family medicine, much as country doctors did years ago, though now they give out their cell phone numbers instead of the number to a home telephone. Both are published authors and both love the theatre — Dr. Gerry Yukevich a bit more, though he did persuade Dr. Jacobs to make his first appearance on stage in a Vineyard Playhouse production of To Kill a Mockingbird. But they have their differences too. Dr. Jacobs loves sailboats and his motorcycle, while Dr. Yukevich speaks six languages, and in middle age began to teach himself the viola. Together, they run one of the busiest and most successful medical practices on the Vineyard.
Interviews by Julia Rappaport
Dr. Michael Jacobs:
I was a philosophy major in college and graduated with a degree in philosophy. And I was sailing across the Atlantic and the boat was sinking, literally, from under me. I had this sudden inspiration that I had better get out of philosophy.
I’ve always thought that medicine was my calling, and it is just a decision I’ve made that I’ve never regretted. It’s a great profession.
I came here in 1976. My attraction was to the sea, to the fact that there was a real sailing community here and that it was a community that was very much in need of an internist.
There were four or five doctors: Dr. Hoxsie, Dr. Mills, Dr. Rappaport, Dr. Nevin and Dr. Frisch. And the population was gradually increasing and they welcomed me, really with open arms. I actually teamed up with Russ Hoxsie and he and I became the first doctors to move into the new hospital, which was just opening in the summer of 1976. We practiced together for at least a decade and we worked as one had to, cooperatively, with all the other physicians on the Island.
Russ Hoxsie was getting ready to retire in the mid-80s, as I recall, and I felt there was a real need for an urgent care center where people could avoid going to the emergency room and could go to a place where they could be seen pretty quickly if they had an urgent problem, not a major medical emergency, but more of an urgent problem. That’s what we call a walk-in clinic or walk-in center.
I moved with Kate Hough, who is a wonderful nurse practitioner. She managed to endure working with me for 25 years and we had a very successful practice together. Every morning we ran a walk-in clinic and we would see five, ten patients at most. They would see us because their doctors were not available, or were off the Island, or were fully booked and they didn’t have health insurance to go to the emergency room. And that worked. It was a great service to the Island.
Dr. Yukevich came to work for me initially in the nineties. He mostly filled in for me because I had to take off some personal time, so we really didn’t work together. He then went to the emergency room and then I asked him to come back and join us again a few years ago. The practice was getting very, very big and busy and I wanted to develop a small group practice with [nurse practitioner] Carol Forgione.
We cover for each other, we consult with each other. It’s really one big practice with three separate, distinct practitioners — different styles, different personalities — and yet, we’re able to share the patients. It works out very well.
Gerry definitely has a flair for the theatrical, so he will often attract the theatrical, literary, creative, excessively verbal people who have often come from larger cities and are here for the summer. Often, they don’t speak English, they speak one of the five languages he speaks. And my job is to knock on his door and tell him, Gerry, there are ten people out in the waiting room for walk-ins and you’re chatting in French about the price of Brie cheese in Paris. I say, Don’t do that! And he’ll laugh and then he’ll correct his behavior, for a little bit, then go right back to it.
The most important thing that people need to appreciate about medicine and physicians is, most of the time — most of the time — the medicine and the medical issues are not terribly complicated. What is more of a challenge, and what gives more enjoyment in the encounter with a patient, is the personal relationship that you develop. I always used to tell the residents, it’s the people, not the diseases, that are the most important thing when you’re seeing the patient. I think Gerry knows how to develop excellent rapport. I don’t think. He has excellent rapport with the patients. He’s sincere. He’s very, very interested in them personally. He’s warm. He does give them his cell phone, which I rarely do, and he makes house calls, which I used to do. And his patients really, really appreciate his warmth and his interest and his outgoing personality. And I’d like to think that I’m, of course a little different, but am much the same way.
It feels very easy and natural to work with him. I think that might say it best of all. It is easy. It is natural.
Internal medicine and family practice is just generally becoming less popular nationwide. I don’t know if we’re a dying breed. We’re a breed with fewer people participating and fewer people entering. So in that respect, it’s a dying breed. But, I think it will survive. I think practicing family medicine, internal medicine, almost any kind of medicine in a small community — and there are thousands and thousands of them — you sense immediately it’s a real privilege to take care of the people in that community.
I’m 68. I enjoy medicine. I want to continue to practice it in a way that is rewarding. I will be active, if I can get someone else to takeover the day-to-day operations of the practice, which is terribly draining, I would look forward to continuing to practice, so I’m not sure. I feel like I’m at a crossroads at my age and I have to figure that out. I enjoy teaching courses on marine medicine. I enjoy writing and I want to continue to practice and explore these other things. Right now I’m starting a program with MVTV television called To Your Health where I will interview physicians and other health providers . . . to help promote health and educate the public on the prevention of illness and diseases.
I probably would invite him on, as long as he doesn’t steal the show from me.
We’d been married for a couple of years and Martha, at the age of 47, had this wonderful baby. We were sort of living in two houses: one in the South End, which was the house my wife had bought a long time before, and one in Roslindale. So we said, where are we going to raise her? I was working in emergency medicine and Martha had been a teacher for 12 years in Roxbury and was doing interior decorating at the time.
We came down here for that Bloomsday performance [at the Katharine Cornell Theatre]. I was looking around the neighborhood. It just seemed absolutely ideal and I thought, boy, wouldn’t it be nice to be able to afford a house in a neighborhood like this? We took an extra day to look at real estate. We rented a Mustang convertible and just drove all over the Island.
We bought the house in June. I think it was ’94. I commuted for the first three years, then it got to be a little bit wear and tear.
So I went over to Charlie Kinney and Charlie asked me if I wanted to work in the emergency room. They were looking for a director and he wondered if I wanted to be the director. I didn’t want to do that, so Charlie said, ‘Go over and see Michael Jacobs.’
My dad was a general practitioner who made house calls in Ohio, so I grew up with this idea of a family doctor as being a part of our lives. It somehow seemed that Michael’s practice reminded me a lot of my father’s practice.
And somehow we immediately bonded. And, you know, we used to do things. Like one day he said, ‘Let’s wear tuxedos tomorrow.’ So we both wore tuxedos to the practice. It was a different style of practicing medicine, which I thought was kind of fun. At that time, I was looking after patients at the hospital as well. Eventually I said I can’t do both. So then I only worked at the hospital.
I had always planned to leave emergency medicine when I turned 60 and that was two years ago.
Finally I just weaned away from the emergency room and worked only with him.
It was clear within a day of working together that the chemistry was correct. In fact, the people that I’ve met in medicine, I have very few people that I’ve felt that simpatico with. It’s in the affectionate teasing, in the comments about his outlandish ties or, you know, his passion for motorcycles. I think motorcycles are extremely dangerous and I remember one time he took time off to go to some kind of advanced motorcycle piloting class. How many doctors would do that? He was the oldest one by about a decade in this course.
When somebody is suffering, it registers very deeply with Michael. And I remember when I first started practicing with him, he would talk about people on the Island with a great deal of vision and compassion and wisdom about what they’d been through. And he made house calls. He went to different people’s houses.
Michael has Monday, Tuesday, Wednesday. I have Wednesday, Thursday, Friday. Each of us has special days where we see appointments and days when we see only walk-ins and days when we see a little bit of both. So Michael and I are together two days a week and we confer, we cover each other. If he’s going away, he’ll tell me about patients that I should be mindful of and likewise and occasionally we’ll have dinner together.
I would say we’re pretty much cut from the same cloth when it comes to understanding people. He has areas — gastroenterology and various other regions — that are much more sophisticated than me. So I’ll confer with him on things like that.
I think he has a wonderful sense of caution with patients, of making sure that the consequences of what you do are carefully considered, and that has been a mentoring factor for me. I’ve very much appreciated his support. He has always trusted my judgment, as far as I know, or expressed trust in my judgment. And sometimes you make judgment calls with a patient. In an emergency room, you see a lot of different sets of data before you allow a patient to leave. In an outpatient setting, that’s not true. In an emergency room, you can lock them in and say, ‘You stay here for tonight.’ But when a patient walks out of your office, you don’t have the institutional blessing.
Sometimes you need an extra [opinion]. You can do without it, but if it’s there? If Michael’s in the next room, I’ll say, you know, I’m a little bit stumped on this one. Or, I’m gonna play this card, what do you think? And usually, it’s a concurrence. I don’t remember either one of us saying, you’re out of your mind! What are you thinking of?
I think Michael has found a way to provide a service for people and I commend him for maintaining this practice. You know, it’s the same practice that Russ Hoxsie originally had and it’s kind of a wonderful thing to be involved in, a practice that’s been rooted through the years.
You almost can’t get through medical school without having a degree of clinical depression because of the nature of what goes on in what you’re witnessing. You learn about death and you learn about the fragility of life. So there’s a certain numbness that happens in the medical profession, I think, through the years, Michael has always bucked that tide. He’s always up for the crest of the wave and he’s always up for the next horizon and, you know, his nose is to where adventure is. And his patients know that. I know that. The people that work with him know that and it’s just an inspiration to have somebody like that. And sometimes we’ll throw up our hands and say, you know, it’s too bad what’s happening to so-and-so because of their illness.
But I think we both have a glorious vision of life that is powerful and rewarding and I don’t see that in many doctors. And you certainly don’t have to coax it out of him, he’s a believer.
This guy is, you know, he’s alive. He’s wonderfully alive. It’s a real treat.