In Memoriam–Dr. Michael Davidson

In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news.  One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the Cancer Center the evening before to finish up paperwork.  With his back to his ever open door, he sat at his desk never once considering that he was in danger.  A disgruntled relative of a former patient surprised him from behind, and beat him viciously over the head and body causing broken bones and contusions, and leaving him for dead.  He managed to call for help, and he survived after spending two weeks in the hospital.  He returned to his practice of treating cancer patients after a long convalescence—after all, it was his calling in life.  He died many years later, suddenly at age 69.  I do not know if that beating years earlier contributed to his early death but the knowledge of it certainly changed my life.  I worked late, and was alone in many offices at night after that, but I remained cautious and vigilant about security, never again taking safety for granted.

Yesterday I got a hasty text message from my daughter, who is a second year internal medicine resident at Boston’s Beth Israel Deaconess Medical Center.  She told me that a doctor at Brigham and Women’s Hospital, a fellow Harvard teaching hospital, had been shot at work and that the hospital was on lock down.  She didn’t know how much was in the news yet, but wanted to let me know since I had trained and worked at these hospitals.  I was as shocked as she was, but I should not have been.  The doctor, Michael Davidson, was a highly respected young cardiovascular surgeon—a rising star in his career, and a husband with three children at home.  The gunman, having sought out Dr. Davidson, fired two shots at close range before retreating to an exam room and taking his own life.  Dr. Davidson was given immediate medical attention by his colleagues at his own hospital, one of the top trauma centers in Boston.  He died of his injuries late last night.  As it turns out, the shooter, Stephen Pasceri, had no history of violence and his gun was licensed.  But he did have a history of dissatisfaction with the “medical system” and sadly his mother had been a patient of Dr. Davidson’s, and had passed away two months ago.  Not much has been said in the news about her, but such is the nature of cardiovascular surgery—these doctors do not operate on healthy patients and not every outcome is successful.

When I visited the Hope Institute in Jamaica in 2013, I saw many patients dying of cancer, without the benefits of affordable chemotherapy, state of the art radiation therapy and even without a readily available supply of morphine.  But I did not see anger, in the patients or their relatives, who were cared for under the loving guidance of Dr. Dingle Spence.   Here in America, quite the opposite is true: we have come to believe that every disease is curable, that every outcome should be positive, and that death, in the words of Dylan Thomas, shall have no dominion.  Most of us, however do not take to the wards fully armed, looking for our doctors. Today I am in despair for his wife, for his children, for the surgical residents he would have taught, and for the thousands of patients that Dr. Davidson could have helped if his life had not been taken.

When we graduate from medical school, we take the Hippocratic Oath, which in the modern version not only exhorts us to heal the sick but to exhibit warmth, sympathy and understanding.  Let our patients and their families extend those same traits to us as we complete our daily rounds.  Let our clinics and hospitals be places of healing, and not of killing.  Please, please let us do our jobs.

Addendum January 22, 2015.  This was submitted by a colleague in the Comments section but I want to bring it forward to the actual page.  Please take the time to read and consider signing.

Dear colleagues,

The violent death in Boston of Dr. Michael J. Davidson, an inspiring cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for, is a senseless and horrible tragedy.

There was an incident in the past where a patient at a VA hospital made a threat to shoot a physician.

VA physicians are federal employees. Federal employees have enhanced legal protection against violence. The threat of violence toward a federal employee by itself is illegal. Police officers were able to conduct an investigation and speak with the patient. Once the patient understood that the threats could lead to prison, the volatile situation was defused.

Laws protecting federal employees against violence provide an additional tool to help direct an individual away from violence. Unfortunately, this protection does not extend universally to all healthcare providers.

The White House has a “crowd-sourcing” system where the executive office reviews proposals with at least 100,000 signatures obtained within a 30 day period.

http://wh.gov/i220E asks that the legal protections against violence currently provided to federal employees be extended to all healthcare providers.

While no law reduces risks to zero, our effort would be well worth the energy if it could prevent even one senseless death.

Please take a moment to sign this petition, and consider spreading the word. Everyone can sign this petition including your friends and family.

Thanks.

Veterans Day

IN FLANDERS FIELDS
JOHN McCRAE, PHYSICIAN, WARRIOR, POET

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

Earlier today:

As I am writing this, it is nearly the eleventh hour of the eleventh day of the eleventh month—Armistice Day in 1918, celebrated as Remembrance Day in Great Britain and Veterans Day here. Solemn ceremonies are taking place across the country and all over the world to honor the fallen and to celebrate the living. Reading and watching some of the news stories about these events brings not only tears but also memories to me of a different kind of war—the war in Vietnam. I came of age during the height of that conflict. My friends and I listened as student deferments ended in 1971 and the results of the first draft lottery without them were called out in our college football stadium. We were the “Hell, No, We Won’t Go!” generation.

 
Insulated as I was by my sex and the fact that I was lucky enough to grow up in a family that could send me and my siblings to college, I had no direct contact with those who actually served until much later when I was in medical school. In 1976 I was on Dr. Michael DeBakey’s cardiovascular surgery service as part of my general surgery rotation. The cardiac fellow was a man named Denny—I’ve long ago forgotten his last name, but I’ll never forget a certain day in the operating room. The fellows, who had already completed their general surgery training, were responsible for opening and closing the chest, and then assisting the “boss”, Dr. DeBakey himself, during the bypass surgery or valve replacement. There is always a certain amount of banter in an operating room, especially during non critical parts of the operation, and on that particular day the talk turned to the prosecution of Vietnam war criminals. Considering that I was completely ignorant on the subject, I should have remained silent. But instead I voiced my opinion that the “baby killers” should all go to jail. At that particular moment, the heretofore mild mannered and quiet surgical fellow raised his head, glared at me and said, “You don’t have ANY idea what you are talking about. I was there. I flew the helicopters that carried the wounded from battle. I saw things that you will never see in your life. Now get the hell out of my operating room.” Sometimes humiliation is truly the best teaching tool.

 
More than thirty years later, I live in a military town. Many of my colleagues and some of my best friends have served, and continue to serve both on active duty and in the reserves. I have worked hard to establish a good relationship with the VA Hospital here, and so I am privileged to treat veterans in my practice. They are treated with the best technology available, but even more importantly they are treated with the respect they deserve for having served their country. I have cared for many of them– retired generals who are West Point graduates and enlisted men from small midwestern towns, veterans who are homeless and those who have been tremendously successful businessmen, lawyers and teachers. But when I treat a Vietnam veteran, I feel a special sense of responsibility though our parallel lives were lived through very different prisms, our histories unshared. There but for the grace of God….

 
A heartfelt thank you to all of our veterans.