Candy Tedeschi became a nurse practitioner when the job was new

Candy Tedeschi wanted to be a nurse for as long as she can remember.

A faded family photo shows 4-year-old Candy smiling and wearing the blue cape of a nurse.

“I liked taking care of people,” said Tedeschi, 80, who lives in Glen Cove. “I always got [toy] nurse kits. I always had a doll I was nursing. It was just something that was ingrained in me. That’s what I wanted to do.”

Tedeschi became one of Long Island’s first nurse practitioners, specializing in women’s health and difficult gynecological issues over a 50-year career.

She also made her mark as one of the foremost experts on diethylstilbestrol, known as DES, a drug used for decades to prevent miscarriages. That use was halted in 1971 after it was determined the daughters of pregnant women who took the drug have a higher risk of developing some cancers.

She spread her vast knowledge through training and lectures around the country. But her focus always remained on the care of her patients.

“I didn’t feel women were getting as much health care as they needed in those early days,” Tedeschi said. “They weren’t getting personalized care, and every woman deserves that.”

Her retirement in July was greeted with praise but also tears from her patients and colleagues.

“This place looked like a florist shop,” her husband, Tony Tedeschi, a travel and business writer, said laughing, while standing in the couple’s living room.

Cheryl Roth is a longtime patient who also served with Tedeschi on the board of DES Action USA, an organization for people who were exposed to DES.

“It’s a big loss for us and a big loss for the DES community, but I’m happy for her because she has worked so hard,” said Roth, who lives part of the year in Locust Valley.

Roth noted that many young women, including her own daughter, were referred to Tedeschi because of her warm manner as well as her experience.

“Going to the gynecologist at any age is not the most comfortable thing,” Roth said. “Candy made it easy.”

A DREAM ON HOLD

Candice Tedeschi is quick to tell a reporter she never uses her surname. “Everyone knows me as Candy,” she said.

She lived in Illinois until seventh grade, then moved to Southern California. After graduation from high school, she returned to Illinois for nursing school, until her plans were derailed by a chance encounter.

“I went to an ice cream social and met this guy,” she joked, pointing to Tony, who was an Air Force lieutenant at the time.

“We met and we fell in love,” Candy Tedeschi said. “He was being transferred to New Mexico. So we got married and moved to New Mexico.”

She quit nursing school and put that dream on hold. She and Tony married in 1964 and in the following years their two daughters, Lisa and Annie, were born.

“The nearest nursing school in New Mexico was 100 miles away, so it wasn’t something I could do,” she recalled. But she was determined to return to school one day.

In 1968, her husband was honorably discharged from the Air Force and they moved to Queens and then later years to Long Island. Tedeschi decided once Tony was settled in a new job, she would return to nursing school.

Tony recalled coming home one day and finding his wife in tears, talking about how much she wanted to continue her nursing studies.

Now her biggest booster, Tony admitted he was concerned at the time about who would watch their small children.

“She said, ‘We’ll figure it out — I have to do this,’ “ he said, adding, “I’m proud of her forever.”

DES DAUGHTERS

Candy graduated from Mount Sinai’s nursing program at City College of New York and by 1975 was working in the neonatal unit of Long Island Jewish Hospital in New Hyde Park, now known as Long Island Jewish Medical Center.

Five years later, she was looking for a new challenge and found one in a six-month job helping screen women whose mothers had taken diethylstilbestrol when they were pregnant.

What began as a temporary job, funded by a grant, turned into lifelong work with patients known as “DES daughters” and the start of an important collaboration with Dr. Burton Krumholz.

Krumholz helped oversee the department of obstetrics and gynecology at LIJ and was renowned for his expertise in health conditions stemming from abnormal Pap test results, the use of a colposcope (a kind of microscope) to look for cancerous cells on the cervix, and the impact of DES, which is a synthetic form of the hormone estrogen.

“DES was given to pregnant women from the 1940s until 1971,” said Candy Tedeschi. “Doctors would give it to women who had a threat of miscarriage or bleeding, and sometimes they gave it to women to make a normal pregnancy more ‘normal.’ ”

Years later, doctors discovered the daughters of women who took DES were getting rare forms of cervical or vaginal cancer, she said.

DES daughters have “about 40 times the risk of developing clear cell adenocarcinoma of the lower genital tract as unexposed women (women who were not exposed prenatally)” according to the National Cancer Institute.

Even though it is still considered rare, some of the women were young when they were diagnosed and the risk goes up as they get older.

These women are also more likely to have cervical precancers.

A MENTOR’S NUDGE

Krumholz received a grant in 1979 to screen women from Nassau, Suffolk and Queens at LIJ and Nassau County Medical Center, now known as Nassau University Medical Center.

Tedeschi immersed herself in the topic, reading about how drug manufacturers did not have to prove their products were safe and effective until the 1962 amendments to the Federal Food, Drug and Cosmetic Act. DES had been given to millions of women without scientific studies to prove it was safe.

“It’s not like today,” she said. “There were no double-blind studies.”

Even more troubling, some pregnant women were unknowingly part of a DES clinical trial in the 1950s, when they were given the drug or a placebo. Even though more of the DES mothers had miscarriages and small babies, the drug remained in use until 1971.

“I was fascinated,” Tedeschi said. “I kept asking questions and asking questions.”

One day, Krumholz good-naturedly told her that she was getting to be a pain with all her questions and suggested she go back to school and become a nurse practitioner.

She did.

‘WHY AM I SEEING AN NP?’

Through a one-year joint program between SUNY Downstate and Planned Parenthood, Tedeschi trained to be a nurse practitioner. She graduated from the program in 1984.

The scope of nurse practitioners’ work broadened over the years with a major legislative change in New York that went into effect in 1989 allowing them to order medical tests and write prescriptions.

There are currently about 270,000 nurse practitioners in the United States, and 20,000 in the state, according to the Nurse Practitioner Association of New York State.

But in the early 1980s, the leadership at LIJ wasn’t sure how nurse practitioners fit into the system, Tedeschi said.

“I was only the second nurse practitioner at LIJ,” she said. “Quite frankly, they didn’t know what to do with us.”

She continued to work with women, performing gynecological exams. If one of her patients became pregnant, she would refer her to an obstetrician.

“Sometimes the patients would get a lecture from the gynecologist about why they aren’t seeing a doctor instead of an NP,” Tedeschi said. “But then they would say my name and they would say, ‘Well, she’s OK,’ ”

Tedeschi sat with pathologists as they examined Pap tests or biopsies from her patients, and her interest in DES continued to grow.

EMPOWERING PATIENTS

Katie Capitulo, who was Tedeschi’s boss as director of obstetrics, gynecology and ambulatory nursing at LIJ Hospital in the 1990s, called her “kind, caring and patient-centered” and someone who never stopped wanting to learn more about her field. In more recent years, she and her daughters were patients of Tedeschi.

“There are a lot of people in practice who are knowledgeable but don’t go out of their way to get to know the patient,” said Capitulo. “Candy cared about every patient and every colleague. She made sure they had the best information that was available, and she empowered them.”

Tedeschi said getting to know her patients and encouraging them to ask questions was a crucial part of their care.

“I wanted to know about their families and not treat them like a disease or condition,” she said.

And she was a fierce advocate for them. One of her DES daughter patients was just 16 when she was diagnosed with clear cell adenocarcinoma, and Tedeschi stayed with her every step of the way.

“I went with her to Memorial Sloan Kettering [Cancer Center],” she said. “They let me be with her during pre-op and post-op. I took care of her until I retired.”

Tony Tedeschi remembers running into the woman, now a lawyer, at a restaurant.

“She got up and said, ‘That woman saved my life!’ “

Candy Tedeschi shared her knowledge with other providers through training and lectures across the country. For years, she would travel to Albuquerque annually to train doctors at the federal Indian Health Service, which provides medical care to American Indians and Alaska Natives.

‘I RETIRED VERY HAPPY’

She credits Krumholz for supporting and mentoring her until his retirement. He passed away in 2022 at the age of 93.

“He always encouraged me to move forward and do more,” she said.

In the months since her retirement, Tedeschi has been happy to spend time with Tony, their children and grandchildren, archive family photos and learn how to crochet. She assists her daughter at craft fairs where she sells hand-crocheted items and has plans to continue her active lifestyle.

“My goal as a nurse practitioner was not just to do good patient care but to educate and make sure my patients knew how to ask questions and demand the health care they deserved,” she said. “I retired very happy. I wanted to be a nurse and I was a nurse.”