BY THE TIME he graduated from medical school in 1980, Brian Changlai had already served as an officer in the Taiwanese Air Force, learned to speak four languages, and had earned a Ph.D. in chemical engineering from Clarkson.
By the time she graduated from medical school in 1976, Mary Daye had helped to spearhead the woman's movement at newly coed Clarkson, and had become just the second woman to graduate from Clarkson's mechanical engineering program.
These go-getters married two years after they met at a party Mary threw for a Clarkson roommate, and they are still working unimaginable hours at a time when their contemporaries have begun to retire.
"We work 24/7," says Changlai. "I care about taking good care of my patients, and Mary does too."
He is a cardiologist; she is an internal medicine specialist. Both practice in the Syracuse, New York, area. On a recent weekend, he was preparing for the next week's caseload while she was making rounds. Their weekdays are more of the same - she sees an active caseload at her practice and serves as medical director for a nursing home; Changlai has an active caseload and teaches part time at Upstate Medical University. He's been teaching there for the past 25 years.
The two work so many hours that they only rarely have dinner together. Recently, they planned a dinner with their son, Brian, a doctor at Upstate Medical University. The dinner was cancelled. "We couldn't find a time when we were all free," Changlai says.
The advent of computers and other advanced technology hasn't helped with their workloads, and in some cases has made it worse. On a typical weeknight, for example, Changlai types patient data into his laptop to keep his electronic records up to date. It is part of an evening's toil that keeps him up until midnight. "It's the right thing to do," he says. "If you have a heart attack, you can die in 10 minutes if you're not treated. So I put everything into the computer - if I need it, I can get it faster."
Daye and Changlai entered medicine at a time of accelerating change. During their working lives, major strides have been made against infectious diseases, heart disease and cancers. These days, for instance, doctors are unlikely to encounter a number of once-common conditions. "I've never seen a case of rheumatic fever or tetanus," says Daye. "And I've never seen a new case of polio."
Even routine procedures have been transformed. "When I started practicing, we did stress tests on a treadmill," says Daye. "Now, the treadmill is accompanied by an echocardiogram, or a nuclear scan of the heart. These tests are more sophisticated, and they catch more heart disease in women."
So, in many respects, health care is on a roll. "The devices get better and do more functions," says Changlai. "We have drugs to lower cholesterol and blood pressure. When you do those things, people live longer."
Yet, as one problem is resolved, another appears. No sooner was smallpox vanquished as a global health threat than AIDS appeared. In the U.S., Americans are less likely to smoke nowadays, but they eat more and get less exercise - a shift that has unleashed an epidemic of Type II diabetes.
Even so, some of the biggest health threats, among them heart disease, obesity and Type II diabetes, can be treated in part by the oldest form of medicine around - a healthy lifestyle. "I'm very high tech," says Changlai. "But I always remind my patients of the simple principles. I tell them you are what you eat, what you smoke, and what you drink. I tell them walking is the best exercise. It costs nothing. They don't need to spend thousands of dollars on a treadmill. I tell them sleep is the best medicine, and that it has no side effects."
At Clarkson, Daye was one of nine women in her graduating class, only the fourth since Clarkson had gone coed. Outside of the classroom, she joined the National Organization for Women, which was moving rapidly to improve the status and treatment of women. When she learned Potsdam was without a day care center, she formed a committee that created one.
Meanwhile, Changlai immersed himself in the culture and language of his new country. English is now just one of four languages he speaks, including Taiwanese, Mandarin Chinese and Spanish. He hung out at a Market Street bar, watched movies at the Roxy, and played in a summer softball league. He was also part of a bridge team - along with fellow students from Taiwan - that won the University bridge championship.
He learned the trials of upstate New York winters, and lived through the 1969 blizzard, which drifted snow up to the second story of International House. He came to love hockey, which wasn't played in Taiwan. Typically, he arrived at the rink hours before Clarkson games in order to get a good spot in sections where students stood to watch - and then studied until game time. "I never missed a home game," he recalled. His loyalty to the University remains intact. He is making a $100,000 gift to Clarkson for scholarships in his name and the names of his wife and son. "I am trying to give back what I got from Clarkson," says Changlai, who attended the University on a full scholarship.
The couple's pathway to medicine was roundabout. Daye earned her bachelor's degree in mechanical engineering in 1971, and then headed for medical school at SUNY Syracuse College of Medicine (now Upstate Medical University). After graduating from Clarkson, Changlai worked as an engineer while his wife attended medical school. Then he applied to medical school.
But Changlai faced an immediate problem: As a foreigner, American medical schools weren't likely to take him. So, at his wife's suggestion, Changlai decided he would first attend a foreign university, and then try to transfer to a U.S. school. Though he knew no Spanish, he headed for medical school in Mexico and threw himself into learning the language as well as medicine. Ultimately, he did well enough that after two years, he was able to transfer to Cornell's medical school to complete his degree.
Their decision to switch from engineering to medicine entailed radical changes. Engineers spend their lives wrestling with problems that could take months or years to resolve. Doctors stuff themselves with information so they can quickly treat a large and varied caseload. Engineers engage in deferred gratification; doctors often see the results of their labor quickly. "They come in with a heart attack. We treat them and they recover," says Changlai. "You see the end result much faster in medicine than in engineering. That's what I enjoy." Engineering did, however, help him understand the technical side of cardiology. "An echocardiogram bounces a sound wave off the heart," he says. "It's essentially engineering equipment."
Both Changlai and Daye surmise that had they stayed in engineering, they might be done with their careers by now. But doctors can work as long as they are willing and able. "My classmates in engineering are all pretty much retired," says Changlai. "I could go on another five or 10 years, or even longer."
The couple stay on the job out of commitment for their patients, and because after all these years, they still like being doctors. "It was fun when I started, and it still is," says Daye. "Some doctors are unhappy, but I'm not one of them. I have a stable group of patients. I figure they may be my patients for the rest of their lives."
"If you want to be a good doctor, you take care of your patients," says Changlai. "And that's what we do. I had one patient who was 80 years old. It took me a while to talk her into open heart bypass surgery. She said she was too old. I told her, ‘No, you're not.'"
That was 17 years ago. "It's all been bonus years since, and she's enjoyed every day of them. Recently, she said, ‘Keep me going until I'm 100. I've still got three more weddings to go to!'"
Changlai adds, "That's what cardiology can do for human life."