By Emily Leclerc | Waisman Science Writer
David Wargowski, MD, had not given a thought to becoming a doctor. He was taking a variety of genetics courses in college and while the subject fascinated him, becoming a doctor never appeared on his radar. “Then I was sitting around with my friends and one looked at me and said, ‘You should be a doctor.’ It had never occurred to me. I don’t have medicine in my family,” he said. “I’d like to say I thought it would be a wonderful way to serve people, but at that point in my life I just thought it would be kind of cool.”
Without that friend’s casual comment, the Waisman Center would not have had this stellar clinical geneticist in its clinics for the last 34 years. Wargowski, after three decades of providing exceptional patient care to thousands of patients in the Medical Genetics Clinics at Waisman, is retiring at the end of June. As he closes the door to his office at Waisman, his influence and impact will not only be remembered but cherished. He has changed the lives of many by not only being an excellent physician, educator, and mentor, but also an extraordinary human being.
It was while Wargowski attended medical school at UW-Madison in the early 80s, that he first heard of the Waisman Center. During his fourth year of medical school, he decided to take an elective in genetics at Waisman. “The Waisman Center was where the amazing medical geneticists, Dr. Rich Pauli and Dr. Renata Laxova, were providing care and teaching, and where much of the research into their patients’ conditions was happening.” Wargowski says.
He then left Madison to go through residency in Virginia. Throughout his residency, Wargowski worked to find a way to do both community pediatrics and genetics. He felt drawn to both and didn’t decide until his third year of residency to focus on genetics, which offered outreach experiences that would allow him to work a bit in both worlds. After residency, he took a prestigious fellowship in Vancouver. Then at the end of that, Wargowski had to figure out where he wanted to go.
He knew that he and his family wanted to come back to Wisconsin, and there happened to be an opening in the genetics clinics at Waisman at the time. It appeared a perfect fit for Wargowski in that he could continue to focus his practice in genetics, he could work with a broad population of patients, and he could be involved in outreach efforts to help those get care who might not otherwise.
“I applied and went up against some stellar applicants. I am humbled to have been picked. But I got the position right where I wanted and have never really wanted to leave,” he says. “It has been an ideal job for me all along.”
Over his many years as a clinical geneticist, Wargowski maintained his love for the field of genetics even as it changed drastically from year to year. Genetics in the 90s when Wargowski started at Waisman is very different from genetics today. But the continual change and discovery is part of what keeps the field new and engaging. That and Wargowski is a big fan of puzzles. The intellectual pursuit of solving a puzzle as well as the ability find answers for his patients is particularly rewarding to him.
“I see somebody almost every week with a problem I have never seen before or a gene variant I have never seen before. We are trying to get patients and parents an answer as to why they have these problems and what we can do about it,” Wargowski says. “When we find something, that is an amazing thing.”
But with that comes one of the hardest parts of Wargowski’s job. Often he encounters patients with gene variants and resultant issues that have only been documented a few times. That means that the literature often lacks answers for Wargowski, the patient, and their family. “It makes it hard for us to get a good sense of what the problems are going to look like let alone an idea of what to do about them. Then it’s really challenging to find a way to help. It can be disappointing but that’s the nature of being on the cutting edge,” Wargowski says.
His love of genetics is a major reason he has stayed with the field for so long. But it isn’t the biggest reason. The ability to work with patients, hear their stories, and be a part of their journey is the main motivator behind his dedication to the field.
“Humans come in all different forms, shapes, and abilities and a lot of that is based in our genetic makeup,” Wargowski says. “It is very rewarding to be able to help people that have these genetic variations and are experiencing medical conditions as a result. Figuring out how to help them live better lives has really been my motivation for my practice all along.”
It is not only his patients though, that Wargowski had a profound impact on during his time at the Waisman Center. His colleagues can’t help but sing his praises and continuously comment on what an excellent person and physician he is.
“David shaped my life more than almost anyone else in my whole life,” says Greg Rice, MD, getting a little choked up as he talks. Rice is currently a clinical geneticist with the Gunderson Health System but trained at the Waisman Center under Wargowski and then worked with him for 18 years in the Waisman genetics clinics before moving to Gunderson. “I am deeply thankful for him and for the honor and privilege of getting to know him as a colleague, as a friend, and as a mentor.”
Rice says even to this day that in various situations he thinks what would Dr. Wargowski do. “A lot of times when I am facing a problem, I think oh, how would Dave approach this? I actually do that almost weekly. I also often find myself adopting his demeanor and his attitudes. At least I try to!” Rice says.
Wargowski’s mentorship and friendship shaped the physician that Rice is today. From the way Wargowski approached patients in a calm soothing way to his utmost respect for everybody regardless of who they are to his sound and grounded clinical judgement. “He treated everybody with dignity, kindness, and gentleness. You can’t ask for more than that from not just a boss but from a person and a colleague,” Rice says.
Tina Iyama-Kurtycz, MD, a now retired developmental pediatrician, also worked closely alongside Wargowski for many years. They would often consult on each other’s patients as it was common for genetic conditions and developmental disorders to have overlap. They had weekly developmental and genetics rounds at the hospital together where they would teach pediatric residents as well.
“Being able to work with him was a joy. Just an absolute joy. He was infallibly kind and even-tempered. He is just a calm person which was really good for me because I had to work at it!” Iyama-Kurtycz says.
She also deeply admired Wargowski’s ability to easily bring in perspectives on patients from across Waisman’s different clinics. The Waisman Center’s clinical approach is founded in interdisciplinary teamwork where experts across disciplines come together to provide the best well-rounded care possible. Wargowski embodied that in not only the way he worked with patients but in his deep respect for all those he worked with.
“In medicine, there is often a hierarchy. The Waisman Center has always strived for interdisciplinary care and that means equality. Everybody has something important to contribute to every patient,” Iyama-Kurtycz says. “Wargowski equally valued the input from occupational therapists, physical therapists, speech therapists, psychologists, social workers, genetic counselors, and more. It was obvious that he knew and respected that everyone had something to contribute.”
Casey Reiser, MS, CGC, the former director of the Genetic Counseling Training Program and retired genetic counselor, echoes the praises given by Rice and Iyama-Kurtycz. Wargowski was always a kind and easy-going colleague and she has nothing but respect for him. “As a physician working with a genetic counselor, he trusted our capabilities and allowed us to do what we were trained to do. That was amazing. I loved working with him clinically and in training settings as well,” Reiser says.
Alongside of his clinical responsibilities, Wargowski also took on teaching roles as well. He would teach courses in the Genetic Counseling Training Program and he would often work with students in the clinic. Reiser says that he was brilliant at working with clinical students and knew how to help them grow and excel. Throughout the courses he taught, Reiser was always impressed by his ability to bring his lectures to his students in a way that they would understand and relate to.
“He was a wonderful instructor. He clearly knew what he was talking about and was always very personable. He always welcomed questions too,” Reiser says. “I always looked forward to having him come to class to give a presentation.”
Wargowski has been an important presence in the Waisman clinics for many years. And while he will be sorely missed, his influence will help guide many clinicians to come. His retirement is bittersweet for him as well, but he is also excited about turning his attention to hobbies that have fell by the wayside over the years.
He and his wife have a cycling tour planned in Europe for later this year as they are both big cyclers. He wants to read all of the books and articles he has been setting aside for years now. Spend some time in parks and get to listen to some live music. Maybe also finish a few of the jigsaw puzzles he hasn’t had time for. Most importantly though, Wargowski can’t wait to spend more quality time with his family. He also plans to continue to help people in different ways.
“I have got some volunteer stuff lined up that I think will not only keep me feeling like I’m making a contribution but also keep me in touch with diverse populations that keep me mindful,” Wargowski says. “I think you have to have contact with people in different situations in order to be empathetic.”
As Wargowski closes this chapter and prepares for the next one, he looks back with great fondness for the Waisman Center, the people here, and the career he has led.
“I always wanted to help people and knowing that I have been able to, is very humbling and rewarding,” Wargowski says. “You always hope that you can have an impact on someone’s life and I am deeply thankful for the ability to have done so.”
Photo at top by Bob Gordon/Department of Pediatrics
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