61-year-old graduates medical school
■ Clarence Nicodemus, DO, PhD, is ready to take his interest in spine research to the next level.
Michigan State University College of Osteopathic Medicine just graduated the oldest medical student in its history: Clarence Nicodemus, DO, PhD, 61.
Like many MSUCOM graduates, Dr. Nicodemus, known as Nic to his colleagues and friends, is starting an osteopathic general internship this month. Next year, he will do a residency in neuromusculoskeletal medicine, the manual manipulation of the body.
His age put him in the category of nontraditional medical student, but Dr. Nicodemus is a nontraditionalist in other ways as well.
Retirement is not on his agenda. He started medical school at 57, an age when most people are either content in a well-established career or simply doing time until they can quit working.
"My definition of retirement is doing what you want to do, and this is what I want to do," Dr. Nicodemus said.
He's aiming for a clinical practice doing nonsurgical treatment of back pain, combined with research and teaching.
"That's the payback I want to give to my profession," Dr. Nicodemus said. "I'm really grateful for having been given this opportunity. In return I want to step up to the plate and immediately do research on ways treatments in the area of osteopathic manipulation work."
This passion grew out of his former career as a biomechanical engineer. As director of spine research at the University of Texas Medical Branch at Galveston, he spent seven years working alongside orthopedic surgeons, exploring how the spine functions and developing instruments to repair spine damage. Then he became interested in finding nonsurgical ways to treat back pain.
"As an engineer, there was not much I could do," he said, "and the surgeons weren't interested in that [nonsurgical treatments]. They were interested in what surgery does."
So he decided he'd get his own medical degree.
He was presenting research results at an American Back Society conference when he struck up a conversation with the society's president, who was also a former associate dean at MSUCOM. Dr. Nicodemus shared that he was interested in osteopathic manipulation and experienced in biomechanics and research. He also had trained as a massage therapist to learn about manual manipulation.
Encouraged by his MSUCOM contact, he applied to the university and was accepted.
He also applied to roughly 40 other medical schools and was rejected by each one.
Kathie Schafer, director of admissions at MSUCOM, said the school would have seriously considered Dr. Nicodemus, even if he hadn't been referred by a former MSUCOM administrator.
"Nic has some very special qualifications," Schafer said. "He had done spine mechanics research for years. "
Once accepted to MSUCOM, Dr. Nicodemus had to decide whether to leave his six-figure job and four adult children living in Houston and Las Vegas, uproot his wife and move to a different part of the county.
Wilma Wagner, his wife of 16 years, said leaving children and grandchildren was hard, but worth it.
"It's been an exciting thing to watch him unfold," she said. "He's like a kid with a new knapsack going to school. The energy he's put into this is phenomenal."
In Michigan she has joined several university and community groups, while Dr. Nicodemus is consumed with his medical training. She also has completed 250 hours of field work as part of applying to become a Unity minister.
"We've just accepted that [having a social life] is not part of who we are right now. It's up to me to create my own environment. It's easier on him if he knows I'm taking care of myself."
They also made major changes in their financial status. They paid for his first two years of tuition and took out loans for the last two years.
"When you've been making a good living, and all of a sudden you're not making that living and are paying out, that part is scary," she said.
Another risk is the possibility of Dr. Nicodemus becoming ill and not being able to complete his training or replenish their savings through medical practice.
Dr. Nicodemus is aware of the sacrifices his wife has made. "I was very fortunate that my wife saw it as an adventure," he said. "I would have never been able to do this otherwise "
Once in school, Dr. Nicodemus found being a medical student in his late 50s brought its own difficulties.
"The first semester was a challenge," Dr. Nicodemus said. "There are a lot of fundamental medical school subjects, anatomy, biochemistry and genetics, that draw heavily on the presumption that you've just come out of school. My biochemistry was done 35 years earlier."
He found that he had to read material three times to retain it, and with the massive amount of information to learn, he had to focus on only the most important to keep pace.
Not the professor
Another challenge of sorts was making sure that fellow students, professors, patients and attending physicians understood who he was, or more important, who he was not.
"The initial reaction is always one of curiosity and surprise when they find out that the gray-headed, bearded guy sitting in the front row is actually a student and not a professor sitting in," he said.
He took particular care in clinical settings. "If I were to be with an attending physician who is younger and who is really ego-invested and we go into see patients, I make it clear to him or her and to who I'm with as to what my status is, so there's no confusion at the beginning."
Classmate Ben Schnurr, DO, said Dr. Nicodemus' age was not an issue with his fellow students.
"He was a father figure to those who wanted him to be and a peer to others," Dr. Schnurr said. "He met you where you were at. He's a very warm person, willing to give of himself and make the extra effort to help out other people."
While other students told horror stories of running into tyrannical physicians, Dr. Nicodemus didn't experience that. He guessed that might have been because of his age and the effort he made to make clear he was a student and was there to learn. "You'd hear, 'Doctor So-and-so is a curmudgeon. He'll give a real tongue-lashing at surgery.' But I found there was always a great deal of respect for where I was coming from," he said. "My experience was a wonderful one."
Mark Gugel, DO, associate professor in osteopathic manipulative medicine at MSUCOM, was one of the younger attending physicians Dr. Nicodemus trained under. He was impressed by Dr. Nicodemus' enthusiasm for manipulative medicine, an enthusiasm patients responded to.
"Nic is confident and has a great rapport with patients," Dr. Gugel said. "He's very good at putting people at ease."