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From foot doctor to science teacher

Through different careers, podiatrist's dream was to help people

By Peggy Peck
MedPage Today Managing Editor

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John Karaffa is shown in 1977 when he was a member of the Ohio College of Podiatric Medicine.

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ROCKY RIVER, Ohio (MedPage Today) -- As a child, John Karaffa had a single driving ambition that became the central theme of his life -- he wanted to help people.

Now at 57, after a radical midlife career change, he thinks he has found the ideal way to do just that -- teaching science to seventh and eighth graders.

But Karaffa is not your everyday science teacher. He is a doctor of podiatric medicine and a former assistant dean at the Ohio College of Podiatric Medicine in Cleveland.

Podiatric medicine wasn't Karaffa's first career choice. When he was a teenager he thought he could help people by becoming a priest. So he attended a high school that accepted boys who were interested in the priesthood. The school was "a great experience," but it also convinced Karaffa that he wasn't meant to be a priest.

He went to Case Western Reserve University, still seeking a career that would allow him to realize his altruistic ambitions. At Case he majored in biology and education, but he also worked full time at MetroHealth Center as a respiratory therapist, which was his introduction into the world of hands-on caring.

"At that time, which was in the late 1960s, all the training for respiratory therapists was done in-house at hospitals," he said. He found the long hours spent at the large public hospital rewarding and he began to consider a career in medicine.

"But I just didn't have the grades to get into medical school," he said, so after graduating in 1970, he took a job teaching science in the Cleveland public schools."

That year was a very busy one for Karaffa, including college graduation, a new career as a science teacher and marriage. His wife Mary Ann had just completed training as a nurse and the newlyweds settled into life in Cleveland's western suburbs.

Introduction to a career

Not long after he started teaching his wife introduced him to a podiatric surgeon. That was his introduction to the field. As he investigated the discipline, Karaffa decided that a career as a podiatrist would fulfill his dreams about a career in a helping profession.

Podiatric medicine is the discipline devoted to diseases of the foot and, in most states, the ankle. Like traditional medical schools, podiatric medical colleges are four-year postgraduate institutions. Podiatrists are trained to perform any medical or surgical procedure related to the foot or ankle. "So in our scope of practice is limited, similar to the way it is with dentists," Karaffa said.

He was accepted at the Ohio College of Podiatric Medicine, "and I pretty much stayed there for the next 14 years," he said. At the college he was able to care for patients in the school's walk-in clinic at the same time that he was "able to continue as an educator because I realized that I did love teaching."

He liked it so much that he also took a part-time faculty position at the local community college where he taught anatomy and physiology.

As his professional career gathered steam, Karaffa was a faced with a medical emergency in his own family. His brother, who was diagnosed with diabetes at age 10, had developed a number of complications including kidney failure. Testing revealed that Karaffa would be the best match to donate a kidney to his brother.

"I never hesitated because I knew it was absolutely the right thing to do," he said. "My brother was the most courageous individual I knew and I learned a lot from him," The transplant was successful, but his brother eventually died of other complications of diabetes.

Karaffa's willingness and degree of comfort were so great, that University Hospitals of Cleveland tapped him as an outreach person to potential kidney donors who were hesitating about the decision to donate.

"I just did that for a brief period," said Karaffa but he still works with donors and families when the opportunity arises.

Time for a change

Not long after the transplant surgery, Karaffa was again confronted by restlessness and the desire for change so he left the world of academia and "against everyone's advice, I opened a solo practice," he said.

He opened a small "house call" practice in Euclid, Ohio, in 1989. "That means that most of my practice was done in the patient's home or by visiting patients at nursing homes and hospitals," he said. "I really did enjoy taking care of people in their homes because you are essentially doing a number of minor procedures that bring great comfort to people."

Many of those calls involved treated patients who had diabetic foot problems. Diabetes, he noted, often takes its toll on the patient's feet where sores can fester for weeks and months as poor circulation slows the healing process. Good foot care, he said, can prevent amputation, which is a common complication of diabetes.

His favorite part of the practice was "the time that I could sit down and visit with people, really get to know them. We would chat about their families, I would tell them about my family. I was a really wonderful experience," he said.

But by the late 1990s, the business of medicine -- dealing with Medicare and other insurers -- began to wear him down. "Our two children were grown, and I began to wonder if it was time for change."

Back to the beginning

As he considered his options, he recalled his first career -- as a science teacher fresh out of college.

He saw his last patient in August 1998, the day before he started teaching school.

He teaches at St. Christopher Elementary School and says that at last, he has finally realized his ambition: to help others.

He routinely tells his students about his previous careers and he said, "They just shrug. It is pretty hard to get a reaction out of kids this age. 'You are a doctor? Okay. Big deal.'"

But while his students may at times be blasť, Karaffa is not. "Teaching science to seventh and eighth graders, helping them to find a little order in their lives; to help them make sense of the world -- I just can't believe that I'm getting paid to have this much fun."

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