Meet The Doctor

Dr. Frederick Schaerf

Dr. Frederick Schaerf, director of Neuropsychiatric Associates of Southwest Florida in Fort Myers, became interested in geriatric psychiatry while studying neuropsychiatry at Johns Hopkins. He found that some diseases with striking links between brain changes and behavioral disorders-for instance, Alzheimer's and Parkinson's-were associated with aging, and began to wonder whether such disorders could be slowed or even cured. Today, in addition to treating geriatric and other psychiatric patients, he does clinical research trials; among his current studies, five are Alzheimer's-related, including one to identify and halt mild cognitive impairment, often a precursor to the disease.

Depression is another common threat to the elderly, Schaerf says. It's as much of a biological disease as Alzheimer's or Parkinson's, but typically responds to the right treatment. Many geriatric patients, he says, are ashamed or embarrassed to admit that they are depressed, and their denial contributes to the high rate of suicide among the old. "Especially men," Schaerf says. "They won't tell their physicians, and their symptoms aren't picked up, so they blindside everyone." He cautions that behavior often considered part of the aging process-loss of appetite, insomnia, excessive worrying-can instead be a sign of depression. "We want people to realize it's not normal to have problems with memory, concentration, weight," Schaerf says. "If you think you have a problem, get screened."-Tracy Jones

Dr. Dulce Dudley

A founding doctor of the Anchor Health Center, Dr. Dulce Dudley has practiced pediatrics in Naples for 16 years, long enough for some of her first patients to be bringing their children to her. She jokes that she's most likely to be remembered as "that woman who makes the monkey sound." That primal noise burst out one day when she was trying to attract a squirmy four-year-old's attention. It worked, and she's used the technique ever since.

It's not her only trick-"I'll get on the floor with a child if I have to"-but it's a sign of her determination to do whatever it takes to give her patients the best care.

Dudley first knew she wanted to be a pediatrician when she was four. "My mother took me to doctors to talk me out of it when I was 12, because she said I wouldn't have a life," she says. "But I could never do anything else."

Today she sees children surviving diseases once considered terminal, like leukemia, and living with diseases like cystic fibrosis well into adulthood. She says she feels privileged to be part of her charges' lives, remembering one small child whose drawing of parents, pets and home also included a crayoned Dr. Dudley. "He just assumed I was part of his family," she says.-T.J.

Dr. H. Scott Harris

Dr. H. Scott Harris has some perspective on the changing world of medicine. His father, Howard, was a Fort Myers internist, and four of Howard's seven children became physicians. Harris is a gastroenterologist with Associates in Digestive Health in Cape Coral, and his three brothers are local dermatologists.

In his father's day, Harris says, the doctor was the ultimate authority figure. But today Harris and his brothers meet with patients who have diagnosed themselves-sometimes correctly-by typing symptoms into Internet search engines. And Harris applauds the evolution of more assertive and better-informed patients, especially in his specialty, which treats disorders that people are traditionally reluctant to discuss-for example, colon polyps, irritable bowel syndrome, Crohn's disease. When people learn more about these conditions, their fears become manageable, Harris says, adding that Katie Couric's campaign for colon cancer screening has motivated many people to have tests.

For most people, he says, living with chronic symptoms "is a foreign idea." His patients are now finding empathetic ears by turning to online or in-person support groups. Fortunately, he says, the next few years will see drugs that go beyond symptom management and treat disorders before they begin. Another Harris generation may see even more changes; the oldest of his three teenage girls wants to be a pediatrician.-t.j.

Dr. Ziad Deeb

In his small office in the Cleveland Clinic Florida Naples, neuroradiologist Dr. Ziad Deeb sees patients from all over the country. They don't come in person, however, but arrive through e-mail, as CT and MRI scans of the head, neck, spine and brain.

The scans come from physicians who want to make sure that their patients' complaints aren't related to tumors, bleeding or other neurological conditions. As he clicks and zooms on the image of a spine on his oversized screen, trying to determine whether a bump on a vertebra is a natural aberration or something serious, Deeb marvels that he sees something new with every patient. "The human being isn't produced on an assembly line," he says.

Born and trained in Lebanon, Deeb began practicing in the United States in the late 1970s, and moved to Naples a few years ago. As a subspecialty of radiology, neuroradiology was a relatively small field before recent advances in functional brain imaging. Now researchers can even see parts of the brain light up as a subject learns a task or remembers information. The technology, Deeb says, "has taken us beyond anatomy and into mapping what each part of the brain does." He sees a future where such diseases as ALS (Lou Gehrig's disease) and Parkinson's can be located and prevented. "The more we know, the better we can find a treatment," he says.-T.J.

Dr. catherine Kowal

As a rheumatologist, Dr. Catherine Kowal specializes in arthritis and diseases affecting bones, joints, muscles and ligaments. Since moving to Naples with her husband 11 years ago, Kowal has seen many changes in her specialty.

"I have noticed more and more arthritis and autoimmune diseases," she says. "Whether it has to do with the environment or all the antibiotics we take as children, we are doing something to damage our immune systems."

Other changes have been positive, including a new emphasis on healthier living. "Today it is easier to get people to lose weight than 10 or 11 years ago," she says. But the most important changes are drugs. "New medicines-Enbrel, Remicade and Humira-have been the greatest advances and a big help," she says. "These medicines are genetically engineered to slow progress [of diseases] and reduce disability."

When she's not in the office or making hospital rounds, Kowal enjoys snow skiing, cooking and music. She and her husband, Dr. Ray Montecalvo (a radiologist with Naples Radiology Group), have two daughters, Gabrielle, 13, and Christina, 11. "My goal for retirement is to be a ski instructor, along with practicing volunteer medicine in free clinics," Kowal says. "Of course, that won't be for quite some time."-Katie S. Betz