For Dr. Nashaat Rizk, who was born in Port Said, Egypt, the journey towards becoming an Anesthesiologist specializing in pain medicine has been filled with many surprises. Rizk had always wanted to become a doctor, but the journey truly began during high school, when his grandfather, his hero, was diagnosed with renal failure. Shortly after, Rizk suffered a spinal injury that kept him off his feet for three months. In 1970s Egypt, there were no MRIs, CAT scans, or pain medicine, only X-rays, physical therapy and lots of suffering. “It was a difficult time,” recalls Rizk. He had always assumed that when people went to the doctor, they got better. But when he encountered his grandfathers’ and his own ordeal, he realized the amount of anguish the disease process can cause, not just physical, but even more so, spiritual and psychological. Rizk saw first hand the importance of a physician’s knowledge, as well as the relationship between the doctor and patient. These events solidified in him his desire to become a doctor.
After graduating from medical school in the 1980s, Dr. Rizk joined the army, where he received “the calling” from Anesthesiology. “I actually did not choose anesthesiology, anesthesiology chose me,” he explains. Anesthesiology chose Dr. Rizk at a Cairo military orthopedic and burn hospital and clinic, where he served as a resident for a year and a half. He was interested in surgery but was assigned to anesthesiology and mainly performed regional anesthesia, which was very costly and time consuming in Egypt at the time. After the army, he applied for different residency programs and was accepted at Cairo’s Heart Institute. The Institute specialized in training cardio anesthesiologists, but the curriculum required residents to spend a year learning general anesthesia at another teaching hospital. It was then that Dr. Rizk realized he was more interested in general anesthesia (especially in OB/GYN and orthopedic surgery), which was just in its infancy in Egypt.
Dr. Rizk decided to come to the US in 1990. Most of his family had already immigrated here or to Canada one by one over the years. With his many family members going back and forth between Cairo and North America and having learned English since kindergarten, he didn’t find the transition tremendously difficult. However, despite these advantages, he sometimes struggled with cultural, social, and spiritual differences. “There are lots of things that are not easy,” says Rizk. “Even the way we were tested in medical school is different than the way people are tested over here. So to prove to them that I’m a good doctor, I have to play by their rules.” He also missed the jokes, movies, and familiar sights and sounds from home. “When you are a foreigner or starting in your life somewhere else, the expectations that you are faced with become difficult and frustrating. You don’t know where to go to get a good laugh.” He also did not know what to expect when encountering everyday problems. The first time he got a parking ticket, he worried that he would be taken to prison. The first time he borrowed money, he could not sleep for two days.
He lived in New Jersey for three years, working various odd jobs and studying for the American medical boards. After passing his boards, Dr. Rizk applied for US anesthesiology residencies, which at the time were very competitive. He was accepted at the University of South Alabama. During his four years there, he was asked to help teach one of the junior residents. Many noted his calm demeanor and how good of an instructor he was. “I found a niche in teaching, which I never thought I had,” says Rizk.
Dr. Doris Cope, formerly the Professor and Vice Chairman for Pain Medicine in our department, was Dr. Rizk’s attending in Alabama and knew how dedicated he was to his patients. She invited him to check out the University of Pittsburgh pain medicine program, which was just starting to become recognized. Dr. Rizk decided to accept a fellowship with Dr. Cope to better understand pain. He soon fell in love with pain medicine and was asked to stay, and in 1999 began his tenure here. It was clear that Rizk had a strong talent for teaching and was well liked by the residents and medical students. He received two awards for excellence in clinical teaching from the department in 2002 and 2004.
Dr. Rizk was giving a cadaver course on sympathetic blocks at the 2009 ASA meeting, where he met the head of the pain program of the Cancer Institute of Egypt. They got to know each other, and Dr. Rizk was invited to visit the institute and lecture, treat patients, and illustrate injections for the residents and attendings. He agreed, and planned a trip for December, which would not only turn out to be a tremendous opportunity to teach and demonstrate the latest anesthesiology standards of care used at UPMC, but also would be the first time he would return to Egypt in nearly 20 years.
The Cancer Institute of Egypt not only treats cancer patients, but also has a pain program for anyone needing pain treatment. During his visit, Dr. Rizk gave a lecture and saw eight patients with different diagnoses selected for him. About 15 residents and 20 attending physicians observed his methods of examination, diagnosis, and treatment and watched him administer various injections.
Dr. Rizk also taught less expensive implantation methods than what is available to the Egyptian doctors. While medical standards of care in Egypt have greatly improved over the last twenty five years, limited access to and affordability of state of the art equipment prevent those standards from reaching the level they are in the US. For instance, Dr. Rizk explains, “They don’t have implantation devices like we have here like drug delivery systems or spinal cord stimulators. Most of the time they do neurolytic blocks, but very rarely do they utilize certain ones.”
Dr. Rizk was not seen as an Egyptian returning to his home country, but as a physician from the University of Pittsburgh, there to extend our knowledge to the physicians there to better take care of their people. “I say ‘their people’ because I am an American, but I think as physicians, we do not have the boundaries of countries – we see people as people everywhere.” The Cancer Institute was very happy with Dr. Rizk’s instructorship and he hopes to go back again next year.
“It has been quite a journey started by dedicated and loving parents and completed by my wife Linda and my great daughters as well as the support of my friends and colleagues. I am very happy with the knowledge I have gained,” says Rizk. “I am very happy that I am worthy of serving people. I consider this as a favor that god has bestowed on me – to be able to help others. I just wish I do the best that I can and be worthy of this favor I got.”