Physician Spouses Maximize Their Space

Everyone needs space, particularly in relationships, where it’s just as important to grow as an individual as it is to evolve as a couple. But when Mark Epstein, MD, FACS, and Elyse Rafal, MD, FAAD, talk about space, they’re not just talking about the space couples need. They’re also referring to the physical space in the medical practice they share.

“The only issue was, and still is, space,” Rafal explains. “You know, like everyone else, we could always use more space because we’ve grown over the years. And that’s always the issue — that we can use more space. But, we make it work. We definitely make it work.”

Epstein is a plastic surgeon, Rafal a dermatologist. Shortly after Epstein opened a private practice, Rafal opted to join him. Separately, yet together, they have become a very successful team.

His story

When Epstein was a child he nearly died from acute appendicitis. The surgeon, he recalls, was a physically huge and imposing man, yet extremely gentle. He saved Epstein’s life, and the event made a lasting impression.

“It was 48 years ago and I remember it like it was yesterday,” Epstein says. “I was fascinated with the idea that you could cut someone open to make them better, and I never lost that fascination. That’s what got me immediately interested in medicine, and specifically in surgery, as a career.”

He thought that career would be as a heart surgeon, but in college he became interested in photography, and discovered that he possessed an aesthetic sense. In medical school he was exposed to plastic surgery — not just aesthetic surgery, but reconstructive surgery. Fine detail microsurgery. He had found his calling.

“In aesthetic surgery, it’s a marriage of art and medicine,” Epstein explains. “You have to understand anatomy and physiology; blood flow is critical to everything we do. But also understand aesthetics and put the two together, and develop a plan to make someone feel better about themself.”

That means taking the time to understand the patient as a person.

“You have to understand your patients and what’s going on inside them, at least to some extent, and be able to sort of become in tune with your patient to understand what their desires are,” Epstein says. “Because if their desires are not in parallel with what you can deliver as a surgical result, you’re not going to have a happy patient. And the goal overall is to have a happy patient.”

Epstein is more than simply in touch with his patients; he’s in touch with his craft. As an innovator, Epstein invented the Epstein Breast Retractors, which are used during breast augmentation surgery to facilitate surgery in an atraumatic fashion. He calls himself an engineer at heart.

“When I was a plastic surgery first-year resident, I designed my first surgical instrument and I’ve designed quite a few since then,” he explains. “And I design surgical instruments for a few companies as well, which has, at least in my practice, helped me considerably in performing surgeries with easier and shorter recoveries.”

Her story

Rafal says that as far back as she can recall she has always enjoyed working with and helping people. In junior high and high school she worked in hospitals as a candy striper. She also spent time working in an emergency room, and a phobia clinic. But once she began doing research in dermatology, she knew she’d found her niche.

“I loved the research — all clinical research with patients that was related to psoriasis, which I continue to do today,” Rafal says. “There aren’t too many clinical researchers in dermatology, so we all know one another, and we know that we do serious research.”

Serious research, indeed. Rafal has conducted research on more than 100 grant-funded projects since 1989, and has served as a consultant for numerous laboratories, and cosmetic and pharmaceutical companies. She says it’s extremely satisfying to see a newly developed product come to fruition, and more importantly, be a benefit to patients.

“It’s exciting when a product works for the patient, or is even an alternative for a patient who has difficulty finding the appropriate medication that works for them,” Rafal says. “You know, especially in dermatology it’s important that you have choices. People wear their skin, so to speak, so it’s important for them to have choices because what works for one person doesn’t necessarily work for another.”

A successful blend

Rafal shares her husband’s approach to spending time with patients. Education, she points out, is extremely important in their respective and related fields.

“This is not a 10-minute visit,” she explains. “I’m not putting down primary care physicians, but you have to feel comfortable in spending time with your patients; getting to know them, and understanding where they’re coming from.”

Echoes Epstein, “The way I practice medicine now, I spend a lot of time with my patients. By the time we get to the OR I know quite a bit about them personally as well. And it provides a much more satisfying and enjoyable experience for both me and the patient.”

Both doctors understand the importance of spending time as parents, though Epstein admits that his wife better handles the children and their academic pursuits. Both of their children play viola and participate in their school orchestra. Their son also attends Julliard Music School for lessons in music composition, while their daughter enjoys dancing.

“I’m very involved with their schools,” Rafal says. “I learned that from my mom, who is a teacher. I’m on the PTA at both schools, and I make sure I attend every single major activity. That’s important to me. Obviously, that takes up a lot of my time, but I enjoy it — making sure our children are healthy scholastically, emotionally and socially.”