Thomas Fekete

Dr. Thomas Fekete has had an illustrious career spanning nearly 40 years at Temple University, where he served for 11 years as Section Chief of Infectious Diseases, as Chair of the Department of Medicine, and as the Thomas M. Durant Professor of Medicine. Dr. Fekete has also earned many accolades for his academic work, including the Lindback Award for Distinguished Teaching.

Dr. Fekete has a long history with the College, having joined the Fellowship in 1998 and served on numerous College committees. He also chaired our Board of Trustees from 2019 to 2022. We recently honored his commitment to the organization with a portrait unveiling during College Night, in which he traveled from the West Coast to participate.

This Pride Month, we are thrilled to share highlights from a wide-ranging conversation with Dr. Fekete, in which he discussed his strong connection to the College, his work, medical education, and how it has evolved regarding LGBTQ+ topics. 

Hello Dr. Fekete. We are excited to have you back in Philadelphia for College Night and your portrait unveiling. You retired in the last few years, so can you tell us how you are currently spending your time?

I love it. Everyone warns you about how bored you’re going to be or how you’re going to be without [a] mission, and that’s completely not true. You finally have time to organize your thoughts, to be with yourself, to do new things, and that is refreshing. Being able to [be] outside more, to read more, being able to engage more with people at all hours of the day, it’s been revelatory. I have to say, it’s been fantastic.  

What first interested you in becoming a Fellow of The College of Physicians of Philadelphia?

I wasn’t aware of the College as anything more than the combination of the Mütter Museum and back in those days the library, the regional library, and I have to say when I came to use the library on occasion, it was amazing. People were all scrambling around the second floor and running off to get books for you, and you sat on those easy chairs surrounded by card catalogues. It was very romantic. The building was buzzing with people all the time because the combination of the Museum and people using the library was very exciting. But by that point it was starting to taper off as more and more medical schools got bigger and bigger libraries, and the energy levels dropped from the 80s to the 90s. 

What was your focus as an educator?

I came to Temple in ’84, at the end of my training. I was a medicine resident and then I did a fellowship in infectious diseases, and my first job and last job were at Temple. I worked there for close to 40 years. When I arrived, I was an Infection Doctor, so my work was a mixture of internal medicine and infectious diseases, and I had an interest in antibiotic resistance and some various states of infection. It was also the very first years of the HIV/AIDS crisis, so that was beginning to be an issue in our hospital and our clinic. I especially liked working with residents and medical students, and we had a small, but active fellowship in ID [infectious disease], which I also loved. To me, all of it, across the spectrum of experience and age, and opportunity, I really enjoyed the interactions. There were different levels and layers. Each one had its own reward, and I really liked that. 

What was life outside of Temple?

When I first came to Temple, we had a “Humanities Club” that I was invited to join. We would read books, poetry, and even have authors come to the medical school campus and talk about their work. In terms of engaging with learners, this was absolutely useful. You find a common ground to use for comparisons, metaphors, and analogies that are helpful to teach, but also, if you had an experience with a TV show, a book, or something you thought was meaningful, often you would be able to convey that to people that may have already experience that and then you have another channel of communication. I would give people books; I was especially interested in a long time with Darwin. Voyage of the Beagle is an amazing story, also an incredible book for a lot of reasons. (I gave many copies of that away.) So, I did try to engage people in areas that were not directly in medicine, but in some way had a connection in my mind. Fiction, non-fiction, science, humanities, are all very useful and I think people want to know what you think of these things even if they also want to make up their own mind. That tension is very productive in the education sphere.  

How has educating health professionals about LGBTQ+ topics evolved throughout your time in medicine? What do you still believe needs to change?

The question about teaching LGBTQ+ is apposite. I entered medical school in 1974 just after the Vietnam war and during a time of campus protests. The faculty were older and of course had more old-fashioned ideas. There was only a glancing teaching on the topic, and it might be generously called polite or condescending. Students were uncomfortable... expressing interest in a sexual variation.

However, in the adjacent so-called real world there was a growing sense of liberation and pride in the gay movement. Clinics serving sexual minorities were savvy and respectful for the most part to serve public health. If they offended or frightened patients, the overall health of the community would be compromised. So, I would say it was an uneasy standoff between the more Victorian attitude of the professoriate and the pragmatic approach of clinicians. There was no job protection for sexual minorities and no relief from discrimination, which definitely occurred.

Over the next 10 years there was a slow acceptance of LGBTQ+ individuals. But with the emergence of HIV first reported in 1984, there was an urgent need to provide care to a needy community. It was not perfect, but I think education managed to catch up even if it was not comfortable within the curriculum. I would say students and residents did much of the education to one another and even to faculty.

At present, the time available for any specific topic is small. So, the didactic education process is still wanting, and our formal exams tend to shy away from controversy. But getting information is now in the hands of learners. This can be a mix of accurate and completely bonkers information. The education around sexual health matters is somewhat Balkanized and possibly inconsistent. I think it needs attention and some degree of standardization. I am not intimately familiar with the process at Temple, but students appear to be curious and knowledgeable. There are still some who are highly judgmental but represents a persistent but small group. Where we go next is a good question. 

What do you see in store for the future of medical education?

I have thought about that for 40 plus years, and I’m still thinking about it. I think that medical education, like all education, tends to be a mix of what you want it to be and what people tell you it has to be. And there’s been a needle shift towards what it has to be that’s been slightly engaged through standardized examinations and accreditations, which has its good sides, but it also tends to be reductive, and everything is now funneled into the easiest to measure, most consistent, but not necessarily interesting educational paths. And I’m so desirous to expand that and create layers that aren’t easy to test, and therefore have been ignored, and to give people a sense of a richness of medicine. Including medical history, which is completely abandoned. It is not helpful for taking a test, and so it is not being taught. But also, things that are medicine-adjacent that are useful in communicating with people, but again very difficult to test for. So, I’d like to see medicine step down a bit from its focus on testing, documenting what’s documentable, and embrace the larger sphere in which medicine lives. Not just the tiniest area where we can all agree, there’s a factual answer. 

And what is the aversion to that?

People are so afraid of not doing well on these standardized tests that they don’t want to be taught things that aren’t testable. This is not a bad thing; people are very understandably concerned. It’s also true for doctors who are recertifying in their specialty area, they must learn the bevy of facts that can be tested. Everything else is shunted off to the side. Even the test writers will acknowledge this is an imperfect instrument. But, because it’s there and because we can all look at it, it has taken on, in my opinion, a disproportionate component of the air in the room. We’ve kind of created a monster in our best desire to be consistent and useful and so on, and we no longer control it. It’s a combination of that and this internal, consistent self-doubt that makes you have to prove yourself in some objective way repeatedly. No matter how senior you are, you’re still riven with imposter syndrome and self-doubt, and so the only way to abandon that is to really dig into the areas we can all agree are objectively quantifiable. Which does not include everything in there.  

Can you tell us about the creative process that brought your portrait to life? I've had the pleasure of sitting for an artist before and learned a few things about presence, vision, and communion with the person painting. In a lot of ways, I imagine that those things are crucial to being a good doctor.

I was connected to the artist by my good friend and colleague, Dr. Bennett Lorber, and his portrait by the same artist is here in the building. I met the artist on one or two occasions, so I knew a little bit about his work. He asked me to come out to Swarthmore and have lunch with him, and that was our sitting session. I loved meeting him; he was a very interesting person to talk with. I respected his perspective. I thought he was very knowledgeable in many areas outside the art world. So, I went to his studio, and he took... over 100 photographs with his digital camera in different poses in my regular clothes. He chose to paint me in that studio, in that shirt, in that moment, which was a surprise! I thought he’d use that as a jumping off point, and when I saw the almost finished version, I was quite struck by how he took that moment and enhanced it! He really made something out of it that was more than a series of what I think were blank expressions on a digital camera. He created something I thought was really interesting under those constraints. Not allowing himself to put a beautiful background or to enhance the quality of my stare. He was taking a series of images and combining them with a mood that he was perceiving through our lunch and through our conversation and really capture something that I think is lovely. 

What is your favorite part of the College?

I have an affinity with the Historical Medical Library because I’m a book guy. Books are done, and I mean that in that in the nicest, kindest way. Books have become digitized and digital in so many respects, but I love the physicality of books. Older books, where people took great paintings, sometimes even hand drawing in colors to reproduce what they couldn’t capture in the print medium, which wasn’t color friendly. And then people making prints of medicinal plants, they really wanted to have them be almost photorealistic in an era before photography. I find that very engaging. I think that’s something which to me captures a moment in time as well as an image. So, I love that we have this breadth of information.  

What roles do you hope to see the College fill in the community in the coming years?

Compared to my first visits here, where it was the Museum and a bunch of doctors, I think there’s been a better dialogue between the community at large and the College, including a lot of lectures, musical programs, art programs that are useful for everybody, not just the Fellows. But, clearly, the Fellows need to be the backbone because it’s engagement of the Fellows that creates energy, which then allows us to bring the public in and to appreciate what we can do. Dr. Baldeck, for example, is a great photographer. Her books are fantastic, and they capture images that she found in the collection here at the College. That’s a great way to segue from the Fellowship to the contents of our collection to a public-facing object that people can admire even outside the building. The Quay Brothers’ movie, which was made here a few years back, is another kind of way to engage the public with the contents of this building. And that’s the tension, the building is beautiful, the contents are amazing, but they don’t speak for themselves entirely. They need to be mediated through the display and through the presentation and through the experiential aspect of what people get, whether it’s wandering through the museum by themselves or docent-led tours or buying souvenirs they can take home and study in further depth or having events here. All of which are part of [a] two-way dialogue between our community, not just Philadelphia, but the region and world, and the Fellows who are the preservers of the College legacy.  

What do you wish more people knew about the College?

The College is not just the Mütter. I think people sometimes have the mistaken impression that the College exists to house the Mütter, which is really a very small fraction of the floorplan of this building. The people are what make the place. I think that’s such a reductive and simplistic thing to say, but I firmly believe that our staff is amazing. They animate the whole experience of being here, they create opportunities for people to have all kinds of interpersonal engagements that happen in our space facilitated by our collections and based on the individual people and what they bring. So, the Fellows bring their own energy here, which then becomes part of the communal experience, which is then conveyed back to the public. That, to me, is the real College. There’s a whole ineluctable, real component that I think weaves in and out of this space going back to the 19th century, back to the 18th century, to the present and the future. It’s part of a continuum that I think people can experience if you’re open to it.