A Few Words.

379 NO ONE WOULD BEGRUDGE an Irishman with a drink for saying a few words . . . a few words too many perhaps . . . neither well-told jokes, nor an invocation, nor words of delirium or reproof . . . (academy presidents have thus entertained the board in the past) but a few words to encourage hope for the future, positivity and energy sufficient to our task . . . in order to prepare us for an unbelievable and incredible year. We were informed early by our competent executive director that 2000 would be a “difficult year to get through.” Well, we made it through! 2001 will be a grand year for our Academy. It has been well said that people do not care how much you know, until they know how much you care. I care, passionately, about the dying and their families. I care about doctors, nurses, and others who care for them, as do you yourselves. My story is one of a medical family with deep Irish Catholic roots (although I’m seventh generation now) with early experiences with death. I was born in the Canadian capital city hospital while my father was training for obstetrics. He had married my mother, a nurse. Somehow he escaped after 2 years in Seminary from the church’s call, to which his two brothers and one of his sisters had responded. His own saintly mother, I think, had prayed and hoped that all five of her children should enter the religious life. My mother died at age 47 (my own age) leaving five children ages 17 to 8 in Detroit. She died an extremely painful death. My father worked and drank himself to death by age 58, while I was an internal medicine resident. My wife, Janice (a pediatric physical therapist and hospice volunteer) was 7 months pregnant. It would come as no surprise that I was drawn to the needs of the very ill and their families during my training and that I spent several elective periods at Hospice of Michigan. I attended the second Academy meeting at Ayrlie House in 1985 as a Medical Oncology fellow. On completion of my training, I went straight into full-time hospice medicine, despite being warned by one of the attending oncologists that I was throwing my career away. By that time I had become disillusioned by the overtreatment of advanced cancer diseases and the under treatment of suffering; Janice supported and encouraged my interest in hospice. My daughter, Rebecca, was born at that time. Seven months later she died after a week of intensive care—apparently of acute appendicitis. I doubted whether I could continue in the work, yet how could I go back to what I was taught and role modeled in the cancer center. Caring for the dying had permanently changed me. I thought I must quit medicine altogether—or decide to be the best I could be in hospice. With this resolve (and the help of my own little saint in Heaven) I met with the medical director of St. Christopher’s at the time, Dr. Tom West, who was lecturing in Windsor. He helped me set up a palliative medicine fellowship in the United Kingdom. Taking leave without pay, my family and I spent 3 months over there learning from the early pioneers of this field. I am forever indebted to the staff of St. Francis Hospice (Essex) and Dr. Anthony Smith. Hospice and palliative medicine became my grief work and the Academy my support group as well as the place where I could become my best. This now is my ninth year on the board and am honored and humbled to serve as president. My wife says, “Now that you are in charge, you shouldn’t have to work. Others will do the work, right?” She is right, of course. Good leadership is the ability to get work done through others. I plan to work hard with others. Personal Reflection