The circumstances of our childhood often become the certainties of our adulthood.
Having childhood asthma put Dr. Clayton Eiswirth in frequent contact with pulmonologists. One in particular, Dr. Bernard Brach, stood out for his bedside manner. At St. Martin’s High School, young Eiswirth was even able to do a short internship program in Dr. Brach’s office. Flash forward 15 years and Dr. Eiswirth’s own office, as the newest member of East Jefferson Pulmonary Medicine, is actually Dr. Brach’s old office.
“I remember Dr. Brach demonstrating physical exam findings that I still use in my own practice today,” Dr. Eiswirth says. There is a sniff test he learned as a high schooler that employs only the diaphragm and can help isolate the causes behind shortness of breath.
Along the way, Dr. Eiswirth also was inspired by the enthusiasm of Dr. Chad Miller at Tulane Medical School and, of course, by his own father, Dr. Clem Eiswirth, Jr., a still-active New Orleans cardiologist who must be very pleased but also a little shocked that his son landed in a medical career.
“I saw the amount he worked when I was a kid, and I used to tell him I’d never be a physician,” Dr. Eiswirth says. But studying engineering, he knew it was not his passion. “The more I thought about it, the more I migrated to medicine.”
Now he knows he’s in the right place and says, even if he won the lottery, he would continue to work in medicine. “I would take a lot more vacations,” he says. “I might move towards a teaching setting to pay back those who trained me. But I would definitely be in medicine. That wouldn’t change.”
In fact, as he becomes more established in the New Orleans area, he hopes to bring in medical students and resident to rotate through his clinic. “We see some amazing cases here,” Dr. Eiswirth says. “It would be a good opportunity to expand their education.”
Dr. Eiswirth has high praise for the team of eight pulmonologists at East Jefferson and loves that he, Dr. Kenneth Smith and Dr. Thomas Nuttli are located adjacent to the ICU so they can address emergent issues for their patients and new patients coming through the ER.
The biggest difference Dr. Eiswirth sees that East Jefferson has to offer involves collaboration. “We work very closely with the thoracic surgeons for procedures so we can ensure people get rapid and efficient care,” he says. He also has access to a host of other doctors who can help his patients with ancillary issues. “I have pretty much everybody’s number on a cell phone at this point,” he adds. “That level of coordination and care is a huge benefit to physicians but also to the patients.”
Why pulmonology: “Some of the work we do in ICU with the sickest patients is what drew me to critical care,” Dr. Eiswirth says. “Then there are rare lung diseases that are a difficult diagnostic conundrum where, once you piece everything together, you make a big difference in someone’s life.”
Dr. Eiswirth says even treating some of the more common respiratory conditions — such as pulmonary hypertension, pulmonary fibrosis, asthma and COPD — makes a critical difference in someone’s ability to function.
New technology on the horizon: “Navigational bronchoscopy,” Dr. Eiswirth says. “It combines electromagnetic exploration with real-time 3D CT images to allow biopsy and treatment of masses in distant regions of the lungs.”
It’s a patient, not a disease: “You have to factor in a patient’s needs and goals of care,” Dr. Eiswirth says. “Cookie cutter medicine doesn’t work well in pulmonary medicine. With a lung nodule, there may be four different appropriate actions, but you need to focus on a patient’s goals so you can provide the best care for them.”
Biggest challenges, biggest triumphs: “When you work with critically ill patients in the ICU, you have a lot of people that don’t do well,” Dr. Eiswirth says. “You have to take the successes where they come. But to have someone come in incredibly sick, septic … difficult to oxygenate … and then they pull through and you see them walk out of the hospital … those are the huge victories that keep you going. It’s little victories — and every once in a while the huge victories — that make all the difference.”
Medical School: Tulane University
Residency: Barnes Jewish Hospital, St. Louis, Internal Medicine
Fellowship: University of Texas Southwestern, Dallas, Pulmonary/Critical Care
East Jefferson Pulmonary Medicine
4200 Houma Blvd., Metairie