Profiles in Character: Joseph Kramer, Physician to New York’s Poor

“All these children and not a single doctor’s shingle” Dr. Joseph Kramer said to his wife, Joan, as they drove through New York’s Lower East Side one day.  He was troubled and growing dissatisfied by what he was doing with his professional life. 

Coming out of medical school in 1963, his goal had been clear.  “I wanted to be a good doctor, and I wanted to enjoy life.  Like everyone else, I wanted a red Porsche, a getaway in the Bahamas, and the most beautiful nurses in North America.”  So he joined a pediatric practice in Bergen County, New Jersey.  Yet after several years he was discontent. His practice helped his patients but was less than satisfying to him.   “I don’t know if I can take this anymore,” he told his wife.  “It wasn’t that exciting; nobody was that sick. . . . I felt like an expensive babysitter,” he recalled years later.  The Lower East Side beckoned.

“So go,” his wife Joan told him one day.  His first stop was Williamsburg, in Brooklyn, where he was born and then on to Manhattan’s Avenue D, colloquially referred to at the time as “D, for death.”  His patients were poor, mostly black and Hispanic.  He moved into an office in an abandoned building taken over by the city, where patients had to bring buckets to catch rainwater and wear coats when the boiler broke in winter.  Joseph Kramer traded money for meaning.

His practice began in 1969 and would continue for 27 years.  From an office without patients at first, he would soon see 40 a day.  While a pediatrician, their needs demanded he transform himself into a general practitioner and sometimes into a neighborhood activist.

One of his first patients was a child with a club foot whose mother didn’t realize it could be fixed.  He treated children with TB, wounds they got from playing with drug needles in the park and herpes of the brain.  He treated prostitutes, bookies, priests and Puerto Rican abuelas.  His income was meager because some of his patients could not pay.  Sometimes he paid for their medicines.  “I had to face the fact that I was gonna be a nickel-and-dime guy the rest of my life,” he said. 

He learned Spanish.  He corralled med students to go door-to-door administering vaccinations.  He couldn’t entice other doctors to join a practice with him, but he built relationships with specialists who would treat his patients, often for little money or none at all.   Despite the neighborhood he worked in, he was never beaten or robbed.  He would often leave clean needles out when he left for the day knowing that was safer than addicts sharing their own.

As profiled in a 1983 article in the New Yorker by Bernard Lefkowitz, “[H]e badgered kids who wanted to drop out of school and found jobs for out-of-work ex-cons.  He called the city when rats chewed up a kid’s schoolbooks . . . and exploded when a twenty-year-old woman with three kids told him that she was pregnant again because she’d forgotten to take her birth-control pills.”

He was a good listener when patients needed a friendly ear, realizing that building trust and caring were essential complements to medical knowledge in a neighborhood where that kind of support could sometimes be as scarce as a livable income.  “Kramer has devoted his life responding to the human needs of the people in his neighborhood,” said Dr. David Rogers, at the time president of the Robert Woods Johnson Foundation. “That was what medicine once was supposed to be about, but a lot of doctors have forgotten it.”

As time wore on, changes in the medical profession wore him down.  “Every patient who came in the door generated four pieces of paper,” he remarked.  Unable to pay for an office manager, it all fell to him.  He had to argue with insurance companies and Medicaid. “Patient Encounter Forms” he once said in frustration, “I’m going to send them back to the president of the insurance company with a note: ‘I don’t encounter patients, I treat them.’”  “Those morons tried to tie me up with their red tape,” he said.  “They buried me with their forms.”

He closed his practice in 1996 when he was 71.  “I feel very guilty about leaving,” he said, hoping he’d had a positive impact.  He need not have wondered.  When Lower East Side old-timers gathered at East River Park every August for a reunion, he was swarmed with attention.  “He couldn’t even get off the ramp to get into the park,” Tamara Smith, whom he had treated as a young girl, said. “He was every child in the hood’s doctor.”

Joseph Kramer passed away on August 30, 2021 at age 96.  Born into a family where his parents owned a bake shop, he left a legacy of healing and hope, a tribute to the American Dream - and his own.

Photo Credit: Courtesy of the New York Times

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