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.
I came across your blog posting today while casting around trying to make sense of this terrible and heinous act. Mike and I were research fellows at Duke University Medical Center in the late 90’s, and I can attest both to the quality of the man and the doctor. We hadn’t been in touch for several years but I always remembered him and some crazy road trips we took. My heart goes out to his pregnant wife and 3 young kids and let all physicians and health care providers who go about their daily jobs in peace and security.
Brian I am so very sorry for the loss of your friend. Knowing him personally makes this even harder. My condolences. M
It seems as though our inalienable right to pursue happiness somehow morphed into a sense of entitlement that our happiness is inevitable, and woe to those who are perceived as obstacles to that.
“One man’s death diminishes me”. Any man’s. But the death of this cardiac surgeon diminishes me more than the death of the “madman” who killed him. Am I a hypocrite? Shocking and terribly, terribly sad.
I am saddened by the death of this gifted doctor. The “art” of medicine is not always the outcomes we desire. The lack of affordable morphine in Jamaica and many countries in Africa also saddens me. I cannot imagine my Mom’s passing without the blessed relief of morphine.
From what little I read about the situation, it seems as though the gunman was upset about the medical system. And frankly, I can totally understand that frustration, having had some pretty miserable dealings myself when dealing with my sister and parents and their hospital experiences. The tragedy here is that it was taken out on the doctor.
And you think doctors themselves aren’t frustrated with dealing with the system, both as patients and as physicians? I am more aware of those frustrations than most, as the mother of a child with a life threatening illness, and as a physician wading through the maze of insurances and authorizations to give patients the care they need. The difference is that most of us don’t kill people. M
How sad. I have friends who where close to a murder/suicide at the University of Washington Med. Center in June of 2000. It involved a failing resident and his supervisor, pathologist Rodger Haggitt. Unfortunately the inhumanity of our medical system (and/or medical training) can have tragic results when combined with a bit of mental instability.
So sad! I know there are still people out there ( I’ve heard them myself) who think doctors don’t want to have diseases cured for fear they would lose their job. How can people not realize that those in the medical profession are human and have family members who also get sick. It would make me extremely happy if all cancers were cured and the need for oncologists ended!
Dr. Fielding:
I read your blog today with interest. I have been observing this phenomenon myself for years. There is a distinctive American brand of thinking that boarders almost on entitlement that, as you observe, “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.” I recall a cartoon i saw in my med school years of the grim reaper giving the finger to the CDC. And a headline from the satirical Onion that announced “World’s Mortality is still 100%”. Its funny because it flies in the face of the American world-view. I have worked at BWH. I am also a radiation oncologist. Many things about your blog resonated. Thank you.
Thank you Stephanie! We’ve probably crossed paths at ASTRO. I retired from UCSD last year, and am waiting to get bored enough to get my New Mexico license. So far that hasn’t happened. If you haven’t been reading the blog all along, you might appreciate the essay “Cancer Is Not A Lifestyle.” M
thanks for the reply. I will check it out.
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.
================================================
Please feel free to use the above text when forwarding.
Please remove the content below and remove the sender’s email/name.
================================================
Hi Miranda,
Will you please consider help to spread the word about this effort? Every time something like this happens, we mourn the loss of a colleague — and we force ourselves to go to work the next day to take care of our patients. Let’s try to do *something*, even if it’s a small effort to take steps in the right direction.
Alan
Thank you for your comments and this information. I will pass this on both through this blog and my Facebook and Twitter pages. M
I edited the blog post so that your comment is now on the front page along with the blog. Hopefully this will help get the word out. Thank you.
Be compassionate, know these threats exist. Federal protection of all healthcare facilities while idealistic will not happen.
Thank God for our 2nd amendment rights, learn to shoot and get a concealed carry permit!
A very sad and tragic occurrence. But having a Dr carrying a concealed weapon does not necessarily prevent such a tragedy. It just makes it possible for some other insane person to grab it and start shooting. One doesn’t usually know when someone comes up to them and shoots them at close range. There is no time to be that quick draw, sharp shooting cowboy. I wish people would realize this fact. Easy access to guns is part of this problem, as well as the belief that one is entitled to only have good things happen to them and their loved ones. We are a violent culture here in the US. When we are depressed, grab a gun and start shooting. SIGH
It’s already illegal in every state to threaten violence. Threatening a VA doctor is a federal crime because he/she works in a federal institution. It’s not necessary to make doctors a federally protected class or make a federal case out of every threatening statement in order to get legal help. In fact, it might increase the resentment patients’ families already feel toward the often overweening power of the medical industry, which is rightly or wrongly interpreted as belonging to “the doctors”. You probably wouldn’t like the suggestion that it simultaneously be made a federal crime to threaten patients with denial of insurance coverage if they check out AMA to avoid a procedure that’s unnecessary or inconsistent with their values.
I am concerned that, without a legal definition, the proposal is not definitive enough for cohesive understanding for a vote.
I just saw this. This is so powerful. Especially your last paragraph:
“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 let us do our jobs.”
We need to have sympathy and understanding for doctors as much as you do for patients.
David Couper