SYNAPSES PAUL KIELL, MD ’56 Smuts assigned Ernst to develop the “non-European” medical school system for South Africa — at that time considered a very liberal change to the apartheid system South Africa had put in place prior to Smuts’ time. But after Smuts was succeeded by a pro-apartheid opponent, harsh racial policies were institutionalized in South Africa, and the Jokls emigrated to the United States in 1951, where Ernst served as a faculty member of the University of Kentucky for the rest of his life. From 1952 to 1964, Dr. Jokl was a professor of neurology and sports medicine and director of the university’s Medical Rehabilitation Center. He was named distinguished professor in 1964 and distinguished professor emeritus in 1995. He was also director of the university’s Exercise Research Laboratory and a consultant and team physician for the United States Olympic Committee (USOC). Titles, papers, accomplishments are fine to memorialize a person, but it is the person that transcends the data that I remember most. Dr. Jokl was a Renaissance man: the physician, historian, writer, musician, researcher, aviator, professor, civil rights activist marching in the streets of a southern city during the early ’60s. Dr. Jokl in his office at the University of Kentucky. He sprinkled his lectures with touches of art and music, but always demanded scientific backing. “‘All poodles are dogs’ does not mean that all dogs are poodles,” he would caution his listeners, and “association does not mean causation.” Your conclusions had to be logical and scientifically valid. In late 1989, I was visiting the Jokls at their modest home in Lexington, Kentucky. Ernst drove me in their 1960s Volkswagen to a local bookstore in town, sat me down in the store, and then went off on an errand somewhere. To this day, I think he just wanted to see what book I would read. I came upon a book about the history of baseball and began to read about the Black Sox scandal of the early 1920s. In the middle of my reading I sensed him looking over my shoulder: “Paul,” — he pronounced it ‘pole’ — “a man of your background, reading a book about baseball. Acch!” Then, “Come, we must leave!” He must have gotten over it pretty quickly because he never mentioned it again. A pianist who loved and played Bach piano pieces, he also never responded to my trying to introduce him to the likes of Jelly Roll Morton or Fats Waller. Then there was his precious library at home. He was showing it off to me and my college friend Stu, who had driven in from Louisville to pick me up for our trip to Tennessee, where we would run in the Smoky CHICAGO MEDICAL SCHOOL 51
NON-FICTION PAUL KIELL, MD ’56 Mountain Marathon. Ernst’s face was beaming as he picked selections out of his case of vintage books, always accompanied by the phrase, “Did you ever see such a…” Stu made a motion to take one of the books out of the case, but Ernst stopped him somehow as if to say, “You must not touch!” (Or maybe he actually said that). His lectures at sports medicine conferences were an integration of art and science. He attributed the rise in recreational exercise to elimination of childhood illnesses, more leisure time, and adequate nutrition. As for art, he would show the 16th century painting by Lucas Cranach entitled Fountain of Youth. With a screen displaying the painting, he would narrate that the older women would jump into the water and emerge on the other side as young maidens and then go to the tents to meet their lovers “only to make the same mistakes again.” That line, recited after just a short pause, would always reward him with a good laugh from his audience. Having heard those words a number of times, I remember once, sitting next to my friend Ralph at our annual New York City Marathon lecture, I whispered those very words to Ralph just before Dr. Jokl said the oft-repeated phrase, both of us giggling at the same time when the words actually came out, lowering our heads so Ernst wouldn’t see or hear our muffled laughter. Ernst passed away in 1997, and a December 21, 1997, obituary summarizing his professional life stated that Ernst Jokl had helped create the discipline of sports medicine in three countries. He had helped found the American College of Sports Medicine and UNESCO’s International Council of Sport Science and Physical Education, and he had authored or edited 27 books and published 261 scientific articles. I last saw Ernst in the early summer of 1997. He was 90 years old at the time. Every five years, his son Peter would arrange a two-day celebration for him in Lexington. A highlight of each of these tributes was Ernst playing a Bach piano piece. I remember being outside with the group that warm late June morning readying to leave. I was saying goodbye to Erica. She held my hand (strong grip) for an extended time and was saying something to me that I could barely hear given the immediate ambient outdoor sounds. I could, however, read her feelings, and I was glad to know that she was happy I was there. But I do remember Ernst another time when I visited. We were talking about courage. Ernst was using his hands, holding up one of five fingers. “You only meet five truly brave people in a lifetime,” Ernst said, motioning affectionally to Erica, “and she’s one of them.” ■ 52 ROSALIND FR ANKLIN UNIVERSITY
SYNAPSES JEROME LEVITAN, MD ’56 Joey’s Story: The Power of Empathy Time and past history has been good to me and for me. I practiced obstetrics and gynecology in an atmosphere of non-competition, where fellow colleagues helped each other in a time of need while caring for their own or other patients. During my professional life I was fortunate enough to pass on my own experiences and knowledge to younger OBs, residents, interns, and students. If only one thing stood out in my mind, it was to advise them not only to listen to what patients were saying to you, but to listen to how it was being said. In today’s world, the most frequent complaint I hear from my friends and neighbors is that the physicians they see do not see them. Literally. When in their offices, the physicians are often turned away from the patient, facing a screen and consumed with recording what is being said to them. They are not listening to how it is being said. The development of our medical expertise has made remarkable strides possible in patient care over the past six decades, but there has been a price paid for all the technology and modern therapeutics: the doctor-patient relationship has deteriorated to an automated cyber-reactive encounter. I draw upon my own experience as an obstetrician. When a woman calls me at 4:00 a.m. saying that she thinks she is in labor, and she describes irregular “pains,” contractions coming sporadically, and membranes being intact, and she is speaking coolly, calm and collected — my response was invariably, “Keep a record of all that and call me in one hour.” On the other hand, if she is breathless, grunting, and concerned — my instructions were, “Head directly to the hospital; I’ll be there waiting for you.” This approach of “listening” may seem anecdotal, but it has served me — and others I’ve taught — well through the years. ***** My career has been particularly generous to me. I’ve served my patients, my hospital, and my community in the various roles of Chair of the Department of OB/Gyn, President of the Medical Staff, Chairman of the Medical Board, member of the Board of Trustees, and one of the three lead physicians in a large hospital system in downtown Chicago. My participation on many committees has been rewarding to me in my own education, as well as serving patients’ well-being and safety. For all this I thank Chicago Medical School for the foundation, insight, and comradery instilled in me during my most formative years. However, all of the above is not what drove me to write this article. I am forever grateful to CMS, Dr. John J. Sheinin, his staff, and my fellow colleagues for instilling in me a vision to which I have adhered. And so, I am now going to relate a true story which I hope will encourage others to realize that there is hope for the future of relationships between individuals. CHICAGO MEDICAL SCHOOL 53
NON-FICTION JEROME LEVITAN, MD ’56 “Joey’s Story” is a lesson in empathy, concern, compassion, and an intuitive characteristic — seen in few and to be admired by all — as relating to a fourteen-year-old neighbor of mine. I have known Joey for many years. He is a remarkable young man who has an unbelievably dedicated father in a single parent role. During a conversation with Joey’s father, he related this moving story about Joey and the amazing depth of compassion he showed. ***** Joey has Diabetes Insipidus. He was first diagnosed at age eight. After many searches and consultations, his doctors reached the conclusion that the site of his tumor made it inoperable. Subsequently, he was treated at a top-tier hospital in New York. He has had radiation and chemotherapy, and has suffered all of the many complications associated with them — including the complete loss of his hair. Through it all, he has consistently maintained a courageous outlook, and today he is in remission and doing well. He continues to be followed closely at various hospitals quarterly and annually. In the spring of 2018, when he was thirteen and a half years old, during one of his visits to his oncologist, the following occurred. Joey and his dad arrived at a Boston clinic, signed in, and walked out to an outdoor veranda while they waited to be seen. After seating themselves, Joey saw a young eleven-year-old girl seated with her mother and father. She was weeping and moaning uncontrollably. Without any prompting, Joey went over to speak with her. He asked, “Why are you so upset?” She answered, “I can’t take all the finger sticks to get blood and it really hurts all the time.” Joey then went on to explain that he too was a patient there, for six long months and counting. He told her that he had the same problem and was able to have the lab technician draw blood from a tube in his arm. “When I was upset I would jog around this building on that path,” he told her, pointing, “and when I was tired and feeling better I would come back here.” He then asked the girl, “Would you like to take a jog with me?” She promptly said yes, and after a number of turns outside they came back. The girl had a smile on her face from ear to ear, and she was holding Joey’s hand. If a 14-year-old could have the presence of mind to recognize a problem — and to reach out and solve it in this particular manner — then there is hope that our future healers can do the same. It may be a reach for some to understand the implications of this encounter. It reminded me of something which was instilled in me and many of my classmates on the day when Dean John J. Sheinin spoke to us at 710 South Wolcott Avenue at CMS during our first year of medical school. He said in a very somber tone 54 ROSALIND FR ANKLIN UNIVERSITY
SYNAPSES JEROME LEVITAN, MD ’56 and with a most serious visage, “Look to your left. Now look to your right.” He took a deep breath and followed with, “I want you to know that I expect each of you to be at graduation four years from now.” ***** A few months ago, Joey attended a seminar by a woman who spoke on the topic of hair replacement for those who had had chemotherapy and lost their hair. The subject matter highlighted the cosmetics of the program and how the woman became involved in the production of the prostheses. At the end of the program, Joey went up to her and discussed the need for children’s hair pieces. He explained to her that when he lost his hair, he was embarrassed to be seen in public, and therefore he did not participate in various activities and programs that he might have. So, he suggested that she consider making a new hat — the kind of cap which many people wear in public, but with hair showing from underneath. It could come in many styles and hair colors. This hat would give youngsters a means to participate in public without the stigma of alopecia. The woman thought this was a marvelous idea, and at the present time they are being manufactured and are called “Joe’s Hats.” ■ CHICAGO MEDICAL SCHOOL 55
NON-FICTION JOHN KOSANOVICH, MD ’78 The Journey The phone rang as I walked through the door, and a chill came over me when the somber voice said, “You have to come back right now. It’s time.” “I am on my way,” I replied, and condensed a trip that normally takes ten minutes down to three. Walking into the room, I saw that the bed was encircled by members of the staff, all of whom had participated in his care over the prior 120 days and were now part of his extended family. I made my way to the head of the bed and as he took his final breath I leaned over and whispered, “It’s okay, we love you.” My father died on September 11, 2011, ending a journey that had started only 120 days previously. It was a process for me that rekindled memories of years gone by and gave me a new perspective on living, loving, and dying. The Journey, as I now refer to it, began when I noticed abnormalities in my father’s routine labs ordered by his Primary Care physician. Being a Nephrologist, the increased microalbuminuria level caused me to call his physician, suggesting that further evaluation was needed. My father was diagnosed with primary amyloidosis, and shortly after treatment was initiated, he suffered a TIA, requiring hospitalization. After heparin was started, he suffered an intracranial bleed, resulting in unilateral paralysis and difficulty speaking. He was then transferred to a transitional care unit, where he spent the last 100 days of his life. The staff became enamored with him, enjoying his sense of humor and appreciating his genuine sense of gratitude towards them for the care he was receiving. I became a permanent fixture in the unit, learning a lot about his daily care. This was not what one learns in medical school or residency. I learned how to operate a Hoyer lift and a specialty bed. I learned how to feed him without making a mess or burning him. I learned how to properly suction him and do oral care. In fact, I became so proficient at these and other tasks that the nurses joked about wanting me to pull shifts! During this time I wasn’t an executive of the hospital. I was just John, Bill’s son. Throughout the 120-day journey there were many special moments, particularly during the first half when my father still connected and we could talk. These moments were emotional, humorous, and reflective. One emotional moment occurred on a Saturday morning when I was feeding my dad in the gathering room. My frustration was showing, due to the difficulty in getting him to cooperate. Another visitor looked over at us and said, “You must be his son.” “I can tell,” he added softly, “because I can see a father’s love in his eyes for you.” My eyes welled with tears. The humorous moments were many, whether it was the banter he carried on with the nurses or the fun we had bringing him in Killian’s beer. A particular moment still makes me chuckle. My father’s roommate was a small man who had the unusual habit of saying “Oh yeah” every time the nurses or assistants would touch him. It didn’t matter where they touched the man. One morning the assistants were helping the man get cleaned up and dressed. The curtain was closed 56 ROSALIND FR ANKLIN UNIVERSITY
SYNAPSES JOHN KOSANOVICH, MD ’78 between him and my Dad. The man would yell out “OH yeah” with each touch. One of the assistants couldn’t help herself and started giggling. My father yelled out, “Hey, what is going on over there?” The nursing assistants finished up and came around the curtain, where they observed my father waving his right arm in the air. They asked him if he had a question and he said, “Yes, I have a question. Am I next?” The reflective times underscored my father’s perspective on life and dying. When it was just the two of us sitting and talking, he often would come up with words of wisdom. Three key “pearls” emerged from our discussions. 1. Just do stuff. He stated this, elaborating that one should not hesitate if there is something you might want to do. Take that trip. Take that course. Get involved. Don’t let time or opportunity pass you by. 2. Don’t take your family for granted. His words: “You never really appreciate your family until something like this happens.” 3. Life is life. He stated this during the later stage of his journey, reflecting on what had happened to him and at that point accepting it. During the last week of my father’s life, Tom, the night nurse who cared for him, gave me this excerpt from the writings of Saint Theresa of Lisieux. She died of an illness at an early age, and many of her writings reflect the acceptance of eventual death. My mind takes flight to eternity, time is about to end! In a little while my soul will leave the earth, will end its exile…… I am about to enter into the abode of the elect, to see beauties that the eye of man has never seen, to listen to harmonies the ear has never heard. My father’s journey ended. How fortunate I was to be able to share those 120 days with him. Life is life. ■ CHICAGO MEDICAL SCHOOL 57
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