Alumni Profile: Dennis Maki Deeply Connected to Infectious Diseases
Dennis Maki, MD, the University of Wisconsin School of Medicine and Public Health (SMPH) infectious disease researcher, physician and professor who just won the Wisconsin Medical Alumni Association's top award, has a very personal and emotional connection to a deadly infectious disease.
Maki's aunts died in their mother's arms of diphtheria at ages 3 and 4, years before the disease was virtually wiped out by an effective vaccine.
His face is pained as he recounts his family history.
"My mother, who was 8 or 9 when two of her three sisters were stricken with diphtheria, told me how they cried and begged for water. But they couldn't drink. They choked to death," recounts Maki. "I choke up every time I talk about it."
His mother and her youngest sister never became ill. No one knows why.
The native of Edgar, Wisconsin, grew up wanting to understand his family's grief-filled past. The tragedy helped form his passion for identifying pathogens, finding effective treatments to fight infectious diseases and caring compassionately for people who suffer from diseases of all kinds.
Forty years later, Maki, the Ovid O. Meyer Professor of Medicine and Public Health, has studied, diagnosed and treated everything from AIDS to the pathogen of the moment, H1N1, or swine flu. His wealth of knowledge has made him a highly sought-after consultant for the Centers for Disease Control and Prevention (CDC), National Institutes of Health, Food and Drug Administration and Department of Health and Human Services.
"Whether it's a meeting in the Midwest, a hospital on the Arabian Peninsula or a conference in Europe, all you need to generate extraordinary interest is to mention that Dr. Maki will be a speaker," notes colleague Nizar Jarjour, MD, School of Medicine and Public Health professor of medicine and head of the allergy, pulmonary and critical care division at UW Hospital and Clinics.
But Maki's strong preference has always been to shun the limelight and stick to his work.
In 1969, after graduating from UW medical school and completing an internship at Harvard University Medical School, Maki began studying infectious diseases during a stint as an Epidemic Intelligence Service officer at the CDC. He then returned to Harvard to complete his residency and an infectious disease fellowship before being recruited to Wisconsin in 1974.
Maki brings much more than simply a disease focus to patient care, says Jeffrey Grossman, MD, senior associate dean for clinical affairs at the UW School of Medicine and Public Health.
"When you make rounds with Dennis, you're apt to hear not just facts about the disease but a plethora of other things of cultural, societal, political, philosophical and historical value," Grossman marvels. "And everything he says, every story he tells, comes to bear on the patient's care."
Grossman and Maki first met during a rotation in the intensive care unit at the old Wisconsin General Hospital. At the time, there were no critical care training programs at any hospital in the country. But it was clear to Maki that intensive care medicine was going to become a discipline of its own.
"To be a good critical care doctor, you have to be an excellent, excellent internist and know medicine and pathophysiology in great depth," Maki says. "I thought it would be a good blend with infectious disease medicine."
The decision to combine specialties was clearly the right one-Maki is gratified almost every day.
"We've just come off an exhilarating week in the TLC (Trauma and Life Support Center)!" he exclaimed recently. "We saved five patients, even though I was worried that none of them would make it. That's really satisfying."
Taking the term "24/7" to a new level, Maki gives patients with even run-of-the-mill problems his cell phone number. He says not one patient has abused the unconditional access.
"The buck stops with me," says Maki, who juggles patient care, teaching and research with the agility of an Olympic gymnast.
Even though Jarjour and Maki have been colleagues for almost 20 years, Jarjour is still fascinated by Maki's clinical acumen and his consistent drive to excellence.
"Whether it's three in the morning or two in the afternoon, Dennis has the same level of intensity, curiosity and involvement in patient care," says Jarjour.
The very same qualities that make Maki a top-flight clinician also make him a sensitive colleague who keeps his co-workers' needs in mind at all times.
"Dennis has offered to cover for me in the TLC on Christmas morning so that I could stay home with my then young children while they opened presents," Jarjour says.
Maki opens presents every day — they are the gifts of learning something. He spends hours online or in the library keeping up with the latest information in his field. And he states that he invariably learns from residents and medical students who are curious, smart and bold enough to challenge him. And there's no question that he loves to be challenged.
Maki recalls a favorite story from 27 years ago, when he was teaching medical students how to do gram stains to look for secondary bacterial pneumonia for patients on ventilators. A 50-year-old man who was terribly ill had very low oxygen levels. It appeared to be a powerful pneumonia.
"After I had concluded that it was an overwhelming viral pneumonia and we needed to add high-dose steroids, a very good medical student pointed out objects on the gram stain that he couldn't identify," says Maki.
When Maki double-checked the gram stain, he discovered budding yeasts. The patient had overwhelming pulmonary blastomycosis, the first case seen at University Hospital. Maki and his teams devised a very aggressive treatment plan based on the new information. A month later, the patient walked out of the hospital. Maki still takes care of him today.
The doctor leans forward in his chair when asked if he's all right with being wrong.
"I very much want my assumptions challenged," he says. "Nothing gives me more fulfillment than a very smart medical student or resident saying, 'Are you sure that's what is going on with the patient?' It's especially satisfying if they show me where I'm wrong and we can do better."
While his colleagues praise Maki's breadth of knowledge, resilience despite a demanding and diverse schedule and his care for both patients and co-workers, Maki says he most values the ability to foresee and extrapolate problems and complications. It's something he calls "anticipatory medicine." He laughs when he's likened to a canary in a coal mine.
"It's not enough to ask patients about their symptoms and problems. You have to ask yourself what those symptoms could turn into," Maki notes.
Over his 40-year career, Maki has seen infectious diseases evolve along with an increasingly mobile society. Most of the infectious diseases he now encounters on a daily basis didn't exist when he began in the late 1960s.
"It amazes me to think that I have been successfully treating an AIDS patient since 1980," he says. "At the time, we never dreamed that people could live with AIDS for decades."
Maki's satisfaction is evident in his smile as he announces the AIDS patient is now more than 70 years old and has outlived many of his friends.
Maki's research for decades has revolved around preventing catheter-related bloodstream infections and other hospital-acquired infections. His newest project is the development of a disinfecting "bomb" to clean all surfaces in a hospital room in eight minutes or less with a non-toxic aerosolized disinfectant. He is planning to study it as a novel approach to containing the inexorable spread of Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA) in hospitals.
Despite a dizzying work life, family is the center of Maki's world. Sharing time with family members is not so much one of those challenges that he craves, but a labor of love. Maki says he has been fortunate to fall in love several times with one woman, his wife Gail. Their love has changed and reblossomed several times during the many stages of their 46-year marriage, he says.
"We're as close today as we were when we got married in our early 20," says Maki.
The pictures of his grandchildren and children that cover virtually every square inch of his office door give fair warning that this is the space of a proud grandpa.
Maki says the blessing of six grandchildren has brought him and and his wife even closer together.
One daughter and two of her children live with the Makis during their son-in-law's third deployment to Iraq. Some parents dread when their kids suddenly boomerang back home, but not Dennis Maki.
"It's great having my daughter and grandchildren around," he says. "The bond with the grandchildren has become even stronger because of the experience."
At the other extreme are another child and two grandchildren who live in Australia.
"While we see them only a couple of times a year, we're constantly keeping in touch on the Internet," says Maki.
With Maki's rich professional and personal history and the impact he's had on detecting, controlling and treating infectious diseases, one wonders how he'd like to be regarded when future generations learn and read about him in history books.
His humble answer: "All I want on my tombstone is: 'He was a good and caring doctor.'"
Date Published: 09/28/2009