HILFIKER, David 1945-

PERSONAL: Surname is pronounced "hil-fick-er"; born February 12, 1945, in Buffalo, NY; son of Warren T. (a clergyman) and Carol (Koepf) Hilfiker; married Marja Kaikkonen (a teacher), June 21, 1969; children: Laurel, Karen, Kai. Education: Yale College (now University), B.A., 1967; University of Minnesota—Twin Cities, M.D., 1974. Politics: "Independent/Socialist." Religion: Ecumenical Christian. Hobbies and other interests: "Individual spiritual journey as it relates to health, politics, and community"; running; cross-country skiing.

ADDRESSES: Home—1538 Monroe St. N.W. #2, Washington, DC 20010-3148. Offıce—Joseph's House, 1750 Columbia Rd. N.W., Washington, DC 20009. Agent—c/o Author Mail, Seven Stories Press, 140 Watts St., New York, NY 10013. E-mail—hilfiker@pol.net.

CAREER: Physician, medical director, and author. Cook County Community Clinic, Grand Marais, MN, family practitioner, 1975-82; on sabbatical in Finland, 1982-83; Community of Hope Health Services, Washington, DC, physician to the indigent, 1983-92; cofounder of Christ House (a medical recovery shelter for the homeless), 1985; founder, financial director, and past medical director of Joseph's House (a community for homeless men with AIDS), 1990—; on sabbatical, 1993-94.

AWARDS, HONORS: First place award in trade category, American Medical Writers Association, 1986; Christopher Award, 1994, for Not All of Us Are Saints: A Doctor's Journey with the Poor; Virtual Mentor Award, American Medical Association.

WRITINGS:

Healing the Wounds: A Physician Looks at His Work, Pantheon (New York, NY), 1985; with a new introduction, Creighton University Press (Omaha, NE), 1998.

Not All of Us Are Saints: A Doctor's Journey with thePoor, Hill & Wang (New York, NY), 1994.

Urban Injustice: How Ghettos Happen, foreword by Marian Wright Edelman, Seven Stories Press (New York, NY), 2002.

Also contributor to New England Journal of Medicine, Journal of the American Medical Association, and Other Side.

SIDELIGHTS: David Hilfiker began practicing medicine in a rural clinic in northern Minnesota after graduating from medical school in 1974 and completing his internship in 1975. Admittedly at odds with the demands for increased productivity in his work as well as the "unrealistic expectations" of his patients, wrote John G. Deaton in the New York Times Book Review, Hilfiker withdrew from his profession after seven years and went on retreat. He resumed doctoring one year later in Washington, DC, administering health care to the indigent at a local clinic, at a recovery shelter for homeless men and women, and later, for homeless men with AIDS.

Healing the Wounds: A Physician Looks at His Work is an autobiographical account of Hilfiker's early experiences in medicine, which he wrote during a one-year sabbatical. Reviewing the book, Deaton observed that Hilfiker "is brutally honest" in revealing his personal anguish, conflicts, and mistakes. We "witness the pain that accompanies the discovery" of errors, continued Deaton, as well as the anguish of a failed attempt to save a life, or of telling a patient that he or she has cancer. In these instances "the book explores the stress and frustrations . . . of a sensitive physician," determined the reviewer, but Healing the Wounds is also "a medical odyssey from idealism to disenchantment and back."

Expressing a similar opinion in the Washington Post, Jonathan Yardley remarked that it is Hilfiker's purpose "to describe 'the conflicting pressures [doctors] face, which often seem to defy solution.'" From the standpoint of the lay person, assessed Yardley, "what is most useful about Healing the Wounds is its depiction, from the inside, of the stresses that make doctors behave the way they too often do." As Hilfiker points out, noted Yardley, physicians resort to "elaborate defense mechanisms in order to cope" with their patients' "utterly unrealistic" expectations of them as "ultimate healers, technological wizards, total authorities." The reviewer noted that Hilfiker has "by his own confession . . . fallen into some of the very traps he deplores," which range from clinical detachment and callousness to condescension. Nonetheless, Yardley added, "he has earned our esteem" for both his convictions and this "thoughtful" book. Deaton also judged Healing the Wounds "triumphant," while a critique in Newsweek deemed it an "exceptionally interesting memoir . . . extraordinary."

Hilfiker once again uses his own life experiences as the basis for his Not All of Us Are Saints: A Doctor's Journey with the Poor. In this book, Hilfiker examines "poverty medicine," the treatment of individuals too poor and too broken to afford traditional health care in the United States. Hilfiker, who has worked to provide health care to poor communities in Washington, DC, presents readers with a glimpse into a world which is, as Philip Berryman mentioned in the Christian Century, "closer to health care in Third World countries than to the kind of medicine most of his readers encounter at their HMOs." Berryman continued, "Ordinary medical problems like high blood pressure or substance abuse become more complicated among poor people, who may not be able to afford medicine, pursue follow-up care, or escape the effects of chaotic neighborhoods and homes." Hilfiker willingly and ably demonstrates the hardships faced by doctors practicing poverty medicine. He relates the physical, mental, and emotional struggles he faces in his personal and professional life. Lancet's Reed Tuckson noted, "In Not All of Us Are Saints, David Hilfiker raises uncomfortable, provocative, maddeningly frustrating, and important questions for human beings in general and physicians in particular."

Hilfiker's next book, Urban Injustice: How Ghettos Happen, attempts to explain the many reasons why people continue to live in poverty, outlines reasons why current programs to help the poor do not necessarily work, and offers suggestions for remedying the poverty problem in the United States. He explains that there are certain forces and policies that make it impossible for people living in poor communities to escape. "For Hilfiker," wrote John A. Coleman in America, "the essential causes of American poverty are primarily structural: the paucity of jobs on which one can support a family; inadequate access to health care and child care; meager educational resources in inner cities; the workings of the criminal justice system; and, for African Americans, a painful history of slavery, segregation, and discrimination." After years of working in poor communities, Hilfiker discusses the problems afflicting these communities. Rather than just pontificating about the many injustices, however, Hilfiker offers suggestions and solutions to end poverty and give the poor a second chance. Coleman praised, "Hilfiker culls the best of studies on urban poverty and carefully weighs data," all while writing "in a lively prose, juxtaposing personal experience with social science studies of poverty." Janice Dunham wrote in Library Journal, "The last chapter suggests very practical public policies and budgets that could win a real war on poverty." A Publishers Weekly contributor concluded, "This accessible, clearly written book . . . may inspire ordinary people to work toward full desegregation of our society."

Hilfiker once told CA: "My motivation has been to find in my work and in my writings the source of our fullest life."

BIOGRAPHICAL AND CRITICAL SOURCES:

PERIODICALS

America, December 9, 2002, John A. Coleman, "Look and See!," review of Urban Injustice: How Ghettos Happen, p. 20.

Christian Century, February 15, 1995, Phillip Berryman, review of Not All of Us Are Saints: A Doctor's Journey with the Poor, p. 182.

Hastings Center Report, July, 1996, review of Not All of Us Are Saints, p. 39.

Lancet, April 1, 1995, Reed V. Tuckson, review of NotAll of Us Are Saints, p. 845.

Library Journal, October 1, 2002, Janice Dunham, review of Urban Injustice, p. 118.

Los Angeles Times Book Review, May 19, 1996, review of Not All of Us Are Saints, p. 11.

National Catholic Reporter, February 6, 2004, Denny Kinderman, "Poverty As We Know It: Lutheran Pastor's Journey, Study of Ghettos Uncover Innercity Life," review of Urban Injustice, p. 12A.

Newsweek, December 30, 1985.

New York Times Book Review, November 3, 1985, John G. Deaton, Healing the Wounds: A Physician Looks at His Work.

Other Side, March-April, 2003, Kevin Thrun, review of Urban Injustice, p. 41.

Publishers Weekly, September 2, 2002, review of Urban Injustice, pp. 72-74.

Readings, March, 1995, review of Not All of Us AreSaints, p. 20.

SciTech Book News, December, 1998, review of Healing the Wounds, p. 56.

Second Opinion, Arthur W. Frank, review of Not All ofUs Are Saints, p. 53.

Washington Post, September 18, 1985, Jonathan Yardley, review of Healing the Wounds.*