Efficiency Expert

Michael Apstein is both a lover of wine and a healer of those who love wine too much

Under the watchful gaze of a nude holding a dove, Michael Apstein waxes eloquent on the white wines of France. The nude--a statue actually--stands in an opulent room at the Boston Center for Adult Education, where Apstein, a wine expert who freelances for the Boston Globe and the Florida-based Wine News, teaches a class so popular that it has been featured in Bon Appetit magazine. Apstein's students--mostly hotel and restaurant employees and young professionals--sit at cafeteria tables that are draped in gracious white linens. Samples circulate, and by evening's end everyone, the instructor included, exudes a rosy glow.

A compact Motorola pager hangs conspicuously from the wine critic's belt, but it is not there to alert him to emergencies in the Bordeaux region. Rather, the pager is a symbol of Apstein's other life: as a gastroenterologist at Beth Israel Deaconess Medical Center, in Boston, where he specializes in diseases of the digestive tract, including the liver. The irony is not lost on Apstein. "It's my moral dilemma," he says.

It's a time-management quandary, as well. "The difficulty that I face is that I do four things," explains Apstein, 52. "First, I'm a father to two girls, 10 and 6. Second, I'm seeing patients. Third, I'm writing about wine. And, fourth, I do medical-legal consulting as an expert witness." To accomplish all those things while remaining, in the vintner's parlance, crisp and effervescent, Apstein has developed a strategy that simultaneously embraces and eschews technology, relies on the spoken rather than the written word, and--whenever possible--enables him to pursue activities that fulfill more than one goal.

Following Apstein around on a typical day is a lesson in balance. One of those people whose creativity awakes with the birds, Apstein usually sits down at his PC at 6:30 a.m. and works on his wine columns. This is one of the few times each day he's at a keyboard, since he finds other devices more useful. In fact, Apstein purposefully resists learning the nuances of his computer; he doesn't even recall the brand. "All I know is that it has Intel inside and it's gray," he says.

During the half-hour drive from his home in suburban Newton to the hospital, Apstein either dictates notes for his columns into an Olympus microcassette recorder or uses his car phone to call patients. Arriving at the office just before 8 a.m., the physician sets forth on his rounds and then meets with patients. Today he examines a woman with hepatitis C who has just undergone a liver transplant. He turns his full attention to her, not pausing to take notes during their conversation. Later, in his office, he dictates observations discreetly into the omnipresent tape recorder. The next patient requires an endoscopic procedure, and Apstein performs it on the spot, something he prefers to do whenever possible rather than wasting both parties' time juggling schedules.

After dictating some more notes and using his office phone to make a dental appointment for his daughter, Apstein walks the short distance to a neighboring hospital, Brigham & Women's. A few minutes later he is standing in a conference room, delivering a lunchtime lecture on gallstones to nearly a dozen doctors. Midway through the meeting, his pager chirps. The call is from a medical-journal editor asking him for an ETA for a research abstract on ulcer patients. At 1:30 p.m. he walks to yet a third institution--Children's Hospital--to join a gastroenterology conference. After a quick stop in his office, Apstein is off to pick up his daughter for her dental appointment. Then it's back home to finish the medical-journal abstract before dinner with the whole family. With that meal, he drinks wine.

What follows is Apstein's recipe for turning taxing days into vintage years.

Be easy to reach--but not too easy. Fearful of succumbing to message clutter, Apstein rigorously limits both the number of communications tools he carries and the way he uses them. He likes his pager because it allows him to screen messages. But he refuses to own a cell phone because "I'd always feel an obligation to answer it," he says. "It would drive me crazy." He checks his E-mail no more than twice a day and won't even leave the E-mail screen up on his computer for fear of getting suckered in.

Talk the talk. Apstein loves his hand-held Olympus tape recorder. "I always carry the dictaphone with me," he says, using a purposefully quaint appellation. "It's easy. I just punch a button and start speaking." That's an accurate description of how Apstein captures his thoughts at a wine convention or a tasting, but when he's recording a patient's diagnosis, the process is far more meticulous. He'll record for a few seconds, then pause. Record. Pause. Every statement must be precise and its significance noted. Adjectives and other embellishing details must be avoided so that when he listens to the tape later, he won't mistake a casual observation for a fact.

Apstein also generally tapes the first drafts of both wine-and medical-journal articles, "because I speak faster than I type," he says. "I can make little parenthetical comments while I'm talking, about finding a citation or adding a brief point." He knows that if he composed on a computer, he could fill in the references as he created them, using computerized medical databases or information gleaned from winery Web sites. But he finds that those kinds of searches derail his train of thought. "References are the tedious part," he says.

Pack all your interests in a small bag. Nowhere do Apstein's Hippocratic and epicurean pursuits merge so completely as when he travels. And travel he does--usually at least once a month, whether he goes to Philadelphia to testify as an expert witness at a malpractice trial or to Washington, D.C., to sip Chablis at an oyster tasting with such luminaries as U.S. Supreme Court Justice Antonin Scalia. ("What I like about oysters," Scalia told Apstein on that occasion, "is that I don't have to explain my opinions.") But whatever the primary reason for his trip, Apstein makes sure to slip in some work on his other interests while he's away. A recent medical conference in Europe is a good example. "I had liver meetings in western Germany, but it was only an hour's drive to Alsace, so I had every dinner in France," he said. "Rather than eat German sausage and potato salad, I chose the hour's drive."

Apstein's multitasking even extends to vacations. Every July the family rents a house in France. Apstein takes the kids on vineyard tours and lets them play while he talks to the wine makers. "I'm not a big believer in the concept of quality time," Apstein says. "I think kids still like quantity time better."

Treat teaching as learning. Although teaching consumes a great deal of Apstein's time and energy, he believes that giving unto others is the most effective way to enhance his own mastery of a subject. Through his affiliation with Harvard Medical School, Apstein teaches gastroenterology to several medical fellows and uses his preparations for those lessons--and the lessons themselves--to deepen his own expertise. The same applies to his other passion: one reason Apstein teaches wine appreciation is that it keeps him immersed in the vintner's world, and that, in turn, makes him smarter when it comes time to write his columns.

"The obvious result of repetition is that facts sink in over time," he says. "That way, when you see slight variations in things, you gain a more comprehensive understanding of what you're dealing with."

Mike Hofman is a staff writer at Inc.