And what it means for his family of patients.
On May 22, 2006,
Mike Foster was sitting on the padded exam table in his doctor’s office, undergoing his annual physical. It was a familiar place. For 14 years, he’d been coming to see the same doctor in the same Somerville office a few blocks from the same two-family home that had been in Foster’s family for four generations. And it was a comfortable place. Despite having to wear a hospital johnny that stretched to cover his 6-foot-7 frame, Foster felt at ease, because of the doctor sitting across from him. Roy Berkowitz-Shelton, a soft-spoken, bald, middle-aged family physician a foot shorter than Foster, always managed to convey competence and caring at the same time.
Foster, who managed truck sales for a local Chevy dealership, looked younger than his 52 years, with his full head of light-brown hair just beginning to admit some gray. But his body, which had served him well during his days playing basketball for Somerville High School, was definitely showing its miles. Bad knees, bone spurs in his heels, a blood clot in his leg, and a back so bad it required triple fusion spinal surgery. Throughout it all, Dr. Berkowitz-Shelton had been his source of stability, coordinating care with other specialists.
There was something else that made his doctor special. During visits, he always reserved ample time to talk about Foster’s personal life, about his children, his marriage, his work, his level of happiness. They found that despite their different backgrounds, they had a lot in common: Both were 52-year-old, hard-working men devoted to their wives of 25 years and their college-age kids.
"He was a friend, a confidant," Foster says. "I felt I could talk to him about anything."
But as this exam was winding down, it was the doctor who chose to do the confiding. Peering over the glasses resting on the tip of his nose, he told Foster there was going to be a major change in the practice in about a month. A letter would soon be going out to all his patients, but he wanted to give Foster advance notice.
From the seriousness in his doctor’s voice, Foster sensed he was about to tell him he was moving to California or retiring early or leaving medicine. He had built up so much trust in the guy that he dreaded the prospect of losing him.
"I’m going to be transitioning to live my life as a woman," the doctor said.
Foster was floored. He stared at Berkowitz-Shelton, and for the first time noticed that he was not just cleanshaven but now appeared to be devoid of facial hair. This was no joke. Foster struggled to come up with an appropriate response. But his first thought was how some of the tougher townies he grew up with in Somerville might have responded had they been sitting on the exam table, wearing the johnny. Would they have just punched him in the nose? Foster put that thought aside and said, "That’s interesting. How are your peers taking the news?"
Berkowitz-Shelton replied that they were generally very supportive.
"So, do you think this is going to affect your practice?"
Berkowitz-Shelton said he hoped it wouldn’t, but he knew he was going to lose some patients.
Foster regained his footing and cracked, "Well, you’re in the Bermuda Triangle here in Davis Square between Brookline, Cambridge, and Somerville. Your business may actually go up!"
Berkowitz-Shelton chuckled. "I hope so."
Foster wished his doctor well and reminded him he would be back in a month for a follow-up.
But his mind was racing as he left the office. During his lifetime, he had seen a Davis Square once dominated by Italian and Irish families like his become transformed into one of the most diverse swaths of pavement in Greater Boston. No spot in the square captured this cross section as effortlessly as the pale-green waiting room in Berkowitz-Shelton’s Davis Square Family Practice. Conservative and liberal, rosary-bead-clutching and atheist, rich and poor, infant and octogenarian, black and white, gay and straight, townie and foreigner, veal-loving and vegan – they were all here. The other physician in the office would often marvel at the single day when she had seen patients from every inhabited continent on the globe.
Foster was a traditional guy, but he had come to view the changes around him with a sort of amused acceptance – and a sense of distance, as though he were watching it all unfold on film. But this change he’d just been asked to accept was hitting much closer to home. My trusted doctor is a transsexual? To him, even the term was off-putting, conjuring HBO shows airing at 2 in the morning and tabloid headlines screaming about a convicted murderer trying to get the state to pay for sex-change surgery. That stuff had nothing to do with him. So he’d never had to think seriously about this issue of people who felt they were born in the wrong bodies. . . .
Christine Daniels is a veteran sportswriter who has worked at the Los Angeles Times for 23 years -- as Mike Penner -- before announcing in The Times on April 26, 2007 
