With Ut Doctoring And Swimming Borders
Doctoring— and Swimming—With utBordersGOING THE DISTANCE WITH CHARLES VAN DER HORSTBY DAVID MCGLYNNhances are, if Masters swimmers whoare also high-profileprofessionals in theirfields have scrapes with the law,they keep it to themselves.But Charles van der Horst isproud to say he’s been arrested.The professor of medicine andinfectious diseases at the University of North Carolina at Chapel Hill, and an internationallyrecognized AIDS researcher, wasarrested in May of 2013 at theNorth Carolina State Capitolwhile protesting the legislature’sdecision not to expand Medicaid as part of the AffordableCare Act. “I didn’t show up tothe protest hoping to get arrested,” van der Horst says. “But Iknew it was a possibility. I feltstrongly about the issue, so I didwhat I felt was right.”That statement might beread as a metaphor for van derC18/// u s m s . o r gHorst’s long and impressivemedical career.The son of a World War IIprisoner of war and a Holocaust survivor, he’s never beenone to shy away from a fight.In 1981, as he neared the endof his residency in internalmedicine, he knew he wantedto continue his training to become a specialist. He was mostdrawn to cancer research andinfectious diseases, but chosethe latter believing the specialtywould spare him the pain ofseeing so many patients die.That same summer, the Centersfor Disease Control releasedits first report of a new diseaseaffecting patients and compromising their immune systems.AIDS had arrived.“When the American medical community was first grappling with the disease, infectedpatients had very few options,”van der Horst says. “Few doctors or nurses wanted to carefor them, and many of thelargest social service and charity organizations refused to getinvolved. AIDS patients facedtremendous discrimination.”AIDS FocusedRather than run away, vander Horst chose to tackle thedisease head-on. He receivedgrants from the National Institutes of Health to study thesafety and effectiveness of AIDStreatments, and he helped establish numerous AIDS clinicsaround North Carolina. However, watching patients die—thevery thing he’d hoped to avoidby choosing infectious diseasesover oncology—became an alltoo regular occurrence. “Foryears I went to funeral afterfuneral, and gave eulogy aftereulogy,” van der Horst says.
Kevin Jellah (left), a community health worker with LastMile Health—an NGO that aims to deliver healthcare toremote villages in Africa—in Whybo village, KonoboDistrict, Grand Gedeh County, Liberia, meets withCharles van der Horst in April 2015.Andy SechlerLast Mile Health community health leader, Aaron Garleh (right), meets with Charles van der Horst in Flah Town, Konobo District, Grand GedehCounty, Liberia, in April 2015Andy Sechlernovember-december 2015///19
By 2000, the AIDS landscape had changed dramatically. The discriminations werelargely gone, pediatric HIVhad been virtually eliminated,and fewer people were dying of the disease. Thanks inpart to van der Horst’s work,North Carolina had a clinicwithin 60 miles of every HIVpositive patient in the state.That year, van der Horst attended a global AIDS conference in Durban, South Africa,that would change his life.Despite nearly 20 years ofadvancements in treatment andprevention in America, HIVand AIDS were still ragingat epidemic levels in Africa.“We traveled from Durban toMalawi, where I saw a womandying of fungal meningitis,”van der Horst says. “It’s arelatively easy condition totreat, if you have the rightmedications. Her dying seemedso unnecessary. I found myselfthinking that I needed to dosomething to help.”Upon his return to theUnited States, van der Horstdecided to switch his focusto Africa. He turned over hisgrants (his most stable sourcesof funding and income) to hisjunior colleagues and begantraveling to Malawi and SouthAfrica, often transportingmedications in his luggage.Africa FocusedBut it wasn’t an easy or safecareer or life transition. Johannesburg was plagued with suchCharles van der Horst pauses in front of a United Nations helicopter before taking off from Zwedru Airportin Grand Gedeh County, Liberia, in April 2015.Andy SechlerCharles van der Horstenjoys an outdoor workoutin Salt Lake City inSeptember 2015.Will Reeves20/// u s m s . o r gintense poverty and high crimerates that he was advised notto wait at red lights in isolatedareas at night. When he set outfor his predawn swim workouts with a local Masters team,he had to double-check that hisgas tank was full and his cellphone was fully charged.“It was a crazy existence,but I loved the people and thework,” van der Horst says. InMalawi in 2001, an estimated440,000 women were livingwith HIV. He and his teamestablished a program thatsought to reduce the transmission of the virus from pregnantand nursing mothers to theirbabies. Over the next 13 years,the results were dramatic.When the program started, asmany as 50 percent of babiesborn to HIV-positive motherswere infected with the disease;now it’s down to 4 percent inmany places. Thousands havebeen saved, and the work ofvan der Horst’s team in part ledthe World Health Organizationto revise its guidelines regarding the prevention of motherto-child transmission of HIV.ACA FocusedMore than a decade ofworking in Africa and more
than 30 years of caring forthe poor and the marginalized were what drew van derHorst to the North CarolinaCapitol building that day inMay of 2013. Van der Horsthad been a supporter of theAffordable Care Act from thebeginning; he’d written newspaper editorials and had rallied with patients and otherphysicians in front of theUNC hospitals.“I pride myself on beinga good physician,” he says.“I’m proud of my ability tomake difficult diagnoses andtreat difficult conditions. It’simmensely frustrating whenyou can identify the problem,and its solution, but you can’tget your patients the medicines they need because theylack health insurance. It’s theworst feeling in the world toknow how to save a life butto be unable to do so.”The Affordable Care Act’spassage in 2010 promisedto alleviate many of thoseproblems. As van der Horsthimself wrote in the NewEngland Journal of Medicine,he believed, along with manyother physicians, nurses, andother health professionals, theACA “meant the dawn of anew era in U.S. healthcare.”Yet three years after the billhad passed and a year afterthe Supreme Court upheld it,the North Carolina legislaturepassed a bill blocking theexpansion of Medicaid. “Several studies have shown thathundreds of people per yearCharlie van der Horst and teammatesenjoy a swim in East Hampton. Left toright: Spencer Schneider, Charlie van derHorst, John Stedila, Marcie Honerkamp,Amanda Foscolo, and Jim Czarnecki.Eric Pettigrewin North Carolina will diesimply for want of health insurance,” van der Horst says.“Many of them mothers andchildren. Just as a good physician can’t ignore his knowledge of internal medicine inorder to focus exclusivelyon lungs or livers, I believeconcern for patients must alsoencompass the effects of public policies.”On May 6, 2013, vander Horst had just returnedfrom California, where he’dtaken part in a 199-mile relayrace through the Santa CruzMountains to benefit organdonation. He’d taken a redeye flight home and had nothad a decent stretch of sleepin more than 48 hours. Hearrived at the Capitol wearing a white doctor’s coat andgathered with colleagues,friends, and local religiousleaders. The group sang traditional protest songs beneaththe Capitol rotunda and soonthe police ordered the crowdto disperse. Van der Horstand several others were toldthat if they didn’t leave, theywould be arrested. Theystood their ground, singingand chanting until they wereled away in handcuffs.In addition to beingcharged with creating a disturbance and refusing to disperse, van der Horst was citedfor “singing.” He was bookedinto the Wake County Detention Center and released onbond. A judge would eventually find him not guilty on oneof the counts and the prosecutor dropped the other two.Van der Horst acknowledges that many people, includingplenty of healthcare professionals, don’t share his politicalviews, especially regarding theAffordable Care Act. Nevertheless, it’s hard not to admire hiswillingness to go the distance—be it to another country or tojail—for the causes he’s mostpassionate about.Swimming FocusedThe one thing that has remained constant throughoutvan der Horst’s globetrottingcareer is his love of swimming. He was captain of themen’s team at Duke Universityin the 1970s and has beencompeting in USMS eventssince 1983. His travels haveallowed him to swim withteams in Malawi and SouthAfrica, as well as at JamesJoyce’s famous Forty FootBeach in Dublin and in theAGE DEFYING SWIM PRODUCTSskincareexercise the body, protect the facewww.sbrsportsinc.comfree samples: www.sbrsportsinc.com/samplesnovember-december 2015///21
tempestuous North Atlanticoff the southern coast of Ireland. (He’s also been knownto do calisthenics in the airplane aisles during his longflights between the UnitedStates and Africa.)Wherever he goes, vander Horst finds teams at local colleges and schools; ifno team exists, he makes hisown, rounding up medicalstudents and volunteers andreceiving workouts via emailfrom his friend and fellowphysician Jon Klein, a worldrecord-holding Mastersswimmer. “When I startedswimming again after medicalschool and residency, I hada hard time pushing myselfunless I swam with a team,”van der Horst says. “Thething I love about MastersSwimming is that it’s truly abroad tent. You have peoplefrom all walks of life, fromex-collegiate swimmers andtriathletes to cancer survivorsand the disabled. And thejoy of Masters is not just thecompetition, or the fitness,or the camaraderie. It’s all ofthose things, all at once.”At 63, van der Horst continues to challenge himself in thewater and beyond. He competes regularly, and in the pastseveral years he’s become a serious runner. In 2012, he wasranked first in the country forhis age group in the aquathlon(either run/swim/run or swim/run). That same year, he alsofinished in the top 15 in threeevents at the USMS Spring National Championship.Future FocusedThese days, van der Horstfinds himself, once again, affected by the healthcare problems confronting the globalcommunity. After 34 years ofcombatting AIDS, he continues work on global health. InJune 2015, he retired from theUniversity of North Carolina,and, again, turned over hisgrant funding to colleagues. InApril, he was in Liberia working on community health andnow is helping UNICEF develop a new program to prevent HIV among adolescentsin Brazil, South Africa, andThailand. “Too many teenagers are becoming infectedwith HIV for want of simpleprevention programs,” hesays. “Diseases, like terrorists,do not respect internationalborders. We need to addressthem at their source. I havethe skills to help, so in a way,I feel I’m obligated.”When asked about theswimming accomplishmentshe feels proudest of, van derHorst at first demurs. “Mybiggest pride is not my athletics,” he says. “Swimminghas a Zen quality for me. Ithelps me cope with bad jujuand stress, and it feeds mycompetitive spirit by tryingto keep up with the youngerdudes and dudettes. But I’mreally most proud of havinghad a role in training the nextgeneration of infectious disease doctors, the smart andenergetic men and womenwho will continue to tacklethe world’s health problems.”When pressed a bit harder,he finally cracks, a little.“Well,” he says, “there wasthe 1650 at the 2012 [Spring]Nationals. It was in Greensboro, N.C., about an hourfrom Chapel Hill. I had togive a lecture that morningand I was running late. Imade it just in time, changedinto my suit, and got up onthe blocks without warmingup. I just had to go for it. Ifinished in fifth place, mybest of the meet, though thatmight also be due to the factthat there aren’t that manyswimmers in their 60s whowant to race the mile.”He pauses and adds, “Ifyou’re willing to take on thetasks that no one else wantsto do, and just jump into it,you can surprise yourself.” Inswimming, and in life. S800-279-0111www.coloradotime.comColorado Time Systems is proud to partner with American SwimmingCoaches Association, Mexican Swimming Federation, CollegeSwimming Coaches Association of America, Brazilian SwimmingFederation, USA Diving, U.S. Synchronized Swimming, USA WaterPolo and U.S. Masters Swimming.22/// u s m s . o r g15% OFFDiscount on Coloradotime.comUsing the code USMS 1415
May 06, 2013 · Colorado Time Systems is proud to partner with American Swimming Coaches Association, Mexican Swimming Federation, College Swimming Coaches Association of America, Brazilian Swimming Federation, USA Diving, U.S. Synchronized Swimming, USA Water Polo and U.S. Masters Swimming. Discount on Coloradotime.com Using the code
Competitive Swimming Organizational Structure - National United States Aquatic Sports USA Swimming Local Swimming Committee (LSC) Member Clubs and Leagues US Diving US Synchronized Swimming US Masters Swimming US Water Polo. USA Swimming Philosophy Vision Statement To inspire and enable our members to achieve excellence in the sport of swimming .
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