We Need a New Generation of Lyme Doctors: James Bruzzese, MD, is Leading the Way

Bay Area Lyme Spotlights Series

“Some institutions are evolving in research and education, but it’s not translating to clinical practice.”

– James Bruzzese, MD

When James Bruzzese, MD, talks about Lyme disease, he doesn’t speak in abstractions. He speaks as a brother who watched his sister lose her ability to walk; a son who watched his father leave his job to become a full-time caregiver; and as a medical student who sat in lecture halls knowing that what was being taught about Lyme and tick-borne disease was grossly incomplete.

Now, as a young physician preparing to open a practice dedicated to treating Lyme and tick-borne disease patients in New York, James represents something the Lyme community urgently needs: a new generation of doctors who understand that Lyme is real, that patients deserve better, and that the status quo must be challenged.

“It Was Traumatic. We Thought We Might Lose Her.”

James is the oldest of four siblings. His sister Julia, whose story touched people around the world after receiving a blessing from Pope Francis, became gravely ill after what should have been an easily recognized sign: a bull’s-eye rash. But no one recognized it. Her pediatrician dismissed early symptoms as growing pains. Fatigue was brushed off. Concerns were minimized. Over time, her health deteriorated. By the time the family realized something was terribly wrong, Julia was losing her ability to walk. “We were scared that we were going to lose her,” he recalls.

The family’s world became a round of hospital rooms, specialist visits, insurance battles, and overwhelming uncertainty. James watched his father leave his job to care for Julia full-time. The family faced devastating financial strain. For a time, they suffered in silence. For the Bruzzese family, Julia’s illness, deterioration, and then finally her Lyme diagnosis were, in James’s words, “A mountain of terrible news, controversy, neglect, uncertainty, thrown at you all at once.”

Julia ultimately became paralyzed from the waist down, and if you are unfamiliar with her story, you can see it here in The Quiet Epidemic, a 2022 documentary film funded in part by Bay Area Lyme Foundation. Although Julia remains in a wheelchair today, her story is also one of extraordinary resilience. Through years of treatment, endurance, and sheer force of will, she regained strength, clarity, and hope. And in a testament to her strength, Julia recently achieved something remarkable: she took the MCATs, applied to medical school, and has been accepted. “She went from nearly dying in a hospital bed to being accepted into medical school. That speaks volumes about what a warrior she is,” James says, clearly proud of his sister’s remarkable achievements.

Feeling Helpless Changed Everything

James had already been accepted into an accelerated medical program straight out of high school, the highly selective Sophie Davis/CUNY School of Medicine, before Julia became critically ill. Yet, like many 18-year-olds, he still carried doubts about whether medicine was truly his calling. But Julia’s illness erased all uncertainty. “Watching her suffer, watching my family suffer, and being completely helpless, I never wanted to feel that again.”

James describes his family as “fixers.” His father could repair anything with his hands. But Lyme was something no one in the family could fix. That helplessness became fuel and a drive to affect change in any way that they could.

“I was angry. I still am. And that anger drove me to learn everything I could so I could never be helpless again in helping someone I love, or a patient.”

– James Bruzzese, MD

Rather than give in to despair, James used his anger about Julia’s situation to spur himself along the path of his medical training. “I was angry. I still am. And that anger drove me to learn everything I could so I could never be helpless again in helping someone I love, or a patient,” he explains. The family faced many hardships as they pulled together to support Julia and each other as they navigated the financial, emotional, medical, and daily stress of their situation.

Medical Schools Still Not Teaching about Lyme

Despite his personal experience, James found that Lyme disease was barely acknowledged in his medical training. He shakes his head in disbelief at the memory: “We got one lecture on Lyme disease. One.” That lecture grouped Lyme with other vector-borne illnesses like malaria, and he recalls that the lecturer opened with a warning: if you see symptoms that look like Lyme, a swollen knee joint, for example, the medical students in the lecture hall were instructed to “think of something else first.”

“We got one lecture on Lyme disease. One.”

– James Bruzzese, MD

James challenged the logic of this during the lecture, asking about unreliable testing, early seronegativity, and the contradictions in clinical reasoning. The lecturer’s response revealed the troubling state of Lyme training for physicians: confusion, contradiction, and institutional rigidity were being passed down as education.

James continued to press for answers in the lecture, and begrudgingly, the doctor giving the talk conceded that if there was a suspicion of Lyme, the patient should be treated prophylactically with antibiotics. James notes the contradiction, wryly recalling “We started with ‘don’t think Lyme,’ and ended with ‘maybe you should treat anyway.’ That’s what we’re teaching future doctors.”

Later, during his residency training, James advocated for patients he believed had tick-borne illnesses. He backed up his recommendations with medical literature, attaching citations directly to his clinical notes. But it didn’t matter. “Even when my reasoning was supported by research, decisions were made based on optics and liability, not patient care.” James explains that the reason for this was the fear of insurance consequences, legal risk, and professional backlash, which often overrode clinical judgment.

Citing one instance where he was sure that the patient had Lyme, his attending physician, although agreeing with James’s diagnosis, insisted on getting a second opinion from an infectious disease (ID) doctor.

“Even when my reasoning was supported by research, decisions were made based on optics and liability, not patient care.”

– James Bruzzese, MD

The ID physician subsequently overrode James and the attending physician on the diagnosis, and the attending physician had to go along with the opinion, as doing otherwise could have ended in a malpractice lawsuit. “This is defensive medicine, and patients pay the price,” James notes.

The Shift Is Coming—But Not Fast Enough

However, James does see progress. Major institutions like Columbia and Mount Sinai have begun hosting Lyme conferences and adjusting curricula. And his own brother, also training to become a doctor, has helped push for curriculum changes at NYU and Stony Brook. But progress is inconsistent and rarely reaches bedside care. He notes that “Some institutions are evolving in research and education, but it’s not translating to clinical practice.”

“If doctors could treat Lyme patients without being punished by insurance companies, we’d be in a completely different world.”

– James Bruzzese, MD

But in James’s view, one of the biggest barriers remains insurance. “If doctors could treat Lyme patients without being punished by insurance companies, we’d be in a completely different world.”

Building a Practice for Lyme Patients

Now, James is preparing to take a bold step: opening a new medical practice in New York dedicated to treating Lyme and tick-borne disease patients. He plans to incorporate not only medical treatment but also pain management, which is a deeply personal priority after watching his sister suffer from how Lyme impacted her body. “We must focus on treating the disease, which is essential, but quality of life matters too.” James is already recruiting nurse practitioners he can train, building a model of care that expands access rather than bottlenecks it.

His long-term vision is to scale the impact. Train other healthcare providers and build something sustainable. “I want to help everybody I possibly can.” And this drive is especially important right now as so many trailblazing Lyme doctors have recently died or are retiring from practice.

A Call to the Next Generation

James is deeply aware that many pioneering Lyme physicians are nearing retirement. The need for new Lyme and tick-borne disease clinicians is urgent. And his message for medical students, residents, and young clinicians who are watching this space from the sidelines is: “We need soldiers. We need people willing to step into this gap.”

“We need soldiers. We need people willing to step into this gap.”

– James Bruzzese, MD

He describes Lyme medicine not only as meaningful, but intellectually compelling due to its multi-system nature. He notes, “You have to understand the entire body. You’ll learn more medicine treating Lyme than in almost any other field.” But more than just the clinical expertise aspects, James speaks to the human side of the work. “You will meet patients who have been dismissed for years, who arrive in tears, who have lost everything. And when you help them, even a little, it’s one of the most meaningful things you can experience as a physician.”

Why Bay Area Lyme Foundation’s work matters

Bruzzese expresses his appreciation for the organizations working to advance science, education, and awareness in this field, particularly Bay Area Lyme Foundation. “Bay Area Lyme Foundation does critical work for patients and for the future of care. The research, the education, the advocacy, it all matters.” He describes Bay Area Lyme Foundation as “lifesaving for the Lyme community,” emphasizing that the work being done today, funding innovative research for better diagnostics and therapeutics, will directly shape the quality of care that future physicians are able to deliver.

“Bay Area Lyme Foundation does critical work for patients and for the future of care. The research, the education, the advocacy, it all matters.”

– James Bruzzese, MD

There are no quick fixes for a disease as complex as Lyme. Progress depends on sustained investment in research science, which is precisely Bay Area Lyme’s mission, the better education of clinicians in medical schools, and the cultivation of thoughtful, well-informed doctors willing to engage deeply with the realities patients face.

Young physicians like James Bruzzese, who are willing to challenge the status quo, are part of that future. And Bay Area Lyme Foundation is committed to funding the science that will help make it possible for them to raise their voices on behalf of Lyme patients.