[Sent – 2 December 2019 to the 170+ surgeons et al of our Surgical
Ethics (Education) Consortium]
Greetings from St. Louis and WashU. I
trust your Thanksgiving was refreshing. In keeping with this season celebrating
gratitude, I want to introduce you to a physician – Sheldon Korones, MD
(1924-2013) -- whose presence radically (i.e., to the root) altered my personal
life and my professional experience. Dr. Korones was one of the first generation
of academic physicians who in the 1960s pioneered the formation of the
neonatology specialty. In 1968 he left a lucrative private pediatric practice to
establish an intensive care unit for critically ill newborns at Memphis’ Charity
Hospital. I hope the narrative below will prompt you to be mindful of
physicians/surgeons who have been similarly pivotal for you.
I first
met ‘Dr. K’ through an introduction arranged by the first physician to invite me
to collaborate in the early 1980s -- Thomas Elkins, MD, a young Ob/Gyn physician
who had recently completed his Navy obligation after residency. As he
transitioned into an academic career with the University of Tennessee Memphis
Medical School’s Obstetrics and Gynecology Department, Tom looked to Dr. Korones
as a mentor. Tom soon discovered that Dr. Korones had barred the medical
school’s medical ethicists from his still novel neonatal intensive care unit
after they repeatedly stayed on rounds only long enough to find some
controversial case about which to write, never to return to test their ethical
analysis with Dr. Korones or his neonatal staff. Tom hoped my being a historian
might earn a second look from Shelly.
I came to that first meeting
hoping to be oriented to the ethical strains peculiar to the care of critically
ill newborns. We quickly found our way to a even deeper and more profound place
as we shared our stories. After a few meetings, Shelly invited me to spend a
sabbatical -- the first six months of 1986 – at his side. I discovered him to be
a physician very seasoned in the struggle to be humane toward disadvantaged and
vulnerable patients. As a wall-hanging reminded him and every person who entered
his office --
“Some children may dance to the joyous music of the lyre, while elsewhere
other children only cling to existence. They are all ours.”
After completing his pediatrics residency in 1954 at Boston General Hospital,
Shelly and his wife Judy moved to Memphis where he joined a medical school
friend in a private pediatric practice. Every day he faced a severe social
contrast. He spent his mornings at Charity Hospital; his afternoons, at his
private (“carriage”) practice. His morning patients – babies born into poverty –
were dying in infancy at twice the rate of his afternoon patients – babies born
into privilege. Memphians, as was true across the South, remained entrenched in
discrimination and in injustices when he made the decision in 1967 to leave
private practice in order to devote himself to his Charity Hospital patients.
E.g., --
Medical students and residents who, while rounding with him at Charity Hospital, repeatedly expressed disrespect for their indigent patients by asking a defensive Shelly, “How should we treat a private patient with this condition?”
Caucasian parents who told Shelly, “We would rather our baby die than be taken to that ‘nigger’ hospital.”
A fellow physician from whom he expected support who whispered to Shelly, “It’s too dark for me on this side of the restaurant.”
Philanthropists who counseled Shelly, “You’ll never raise money from this city for those babies.”
This jagged contrast ate at Shelly’s conscience. As did a noble theme first planted in him by his grandfather -- Nachman Gogel -- in whose shadow he was raised on New York City’s Lower East Side.
Shelly’s instinct to respond to crushing oppression formed from this oft-repeated childhood scene. It is 1930. Six-year-old Shelly is nestled in front of a Fada Radio, listening attentively to the day’s episodes of Jack Armstrong. The stubble-bearded Nachman locks the dark green doors of his nearby blacksmith shop. Walking around the corner, he climbs a flight of steps to the landing of a modest five-room ‘railroad flat’. Shelly eagerly meets his grandfather in front of the dining room buffet. With unequal strides, they make their way to the living room where Nachman settles into his chair. The stocky lad begins his nightly ritual. Pulling off the heavy work boots and socks, Shelly runs his fingers over each foot’s single chunk of nailless flesh that had once been separate toes. Shelly prods Nachman to repeat yet again the painful memories always just a thought away. Conversing in Yiddish, they reenact an old Russian proverb that says, “A child’s education begins with his grandfather’s education.”
“Papa, tell me again what happened to your toes.”With these few words, Nachman’s attention would drift to 1880s Czarist Russia, to the peasant village of Mogilyov. Jewish parents in the hundreds of villages like Mogilyov stopped at nothing to keep their boys from being snatched by the marauding Cossacks who enforced the Czar’s harsh conscription laws. Conscription for Jewish boys meant more than military service. It meant to be brutally stripped of their identity. In far away military schools, they were severely beaten, forced to violate dietary traditions, and even denied food. One freezing winter night, young Nachman Gogel suffered severe frostbite in the woods while hiding from the Cossacks.
“My son, Cossacks chased me. I hid in the forest for a long time. My toes froze off in my shoes.”
The year 1968 is remembered more often for the death of noble themes than the birth of noble themes: January -- The Tet Offensive shatters reassuring interpretations of the Vietnam conflict. February -- The Turner Commission releases its warning that two separate and unequal societies -- one black and one white -- remain entrenched in the United States. March -- President Johnson announces he will not seek reelection. April -- Martin Luther King is fatally wounded on the balcony of the Lorraine Hotel in Memphis. Riots leave over 100 cities in flames. June -- Robert Kennedy is fatally wounded on the night he wins the California primary. August -- The processes of democracy virtually collapse at the Chicago Democratic convention.
Overshadowed by such disheartening headlines, Shelly announced 1 July 1968 to the medical school and to the city his intention to create at Memphis’ Charity Hospital an intensive care unit for critically ill newborns. The scenario still looks quixotic. A physician with an uneasy conscience who dared to dream. A city polarized and embarrassed. A medical school and city hospital with neither plan nor funds for newborn intensive care. Skeptical local philanthropists before whom Shelly peddled his vision in vain. And yet three years later -- with the support of the local media, a persistent local journalist, some diligent nurses, an encouraging Pediatrics Department chairman, a new Charity Hospital board, a strategically placed Children’s Bureau official in Washington, a courageous rabbi, a few faithful friends, and an unwavering family -- The Newborn Center had been established.
The story continued to unfold as Shelly neared eighty years old still as the point-person for The Newborn Center. Critically ill babies received state-of-the-art care there, regardless of socio-economic or ethnic distinctions. They were referred to by names or personal pronouns rather than by bed numbers, disorders, or illnesses. Even the sickest of the babies were given every plausible chance to defy the odds.
Back in 1985, Shelly waited patiently as I adapted my historian’s mental/analytical habits to the medical education/practice sphere that would in time become the well-defined framework within which a special friendship and a firm professional partnership formed between us. Beginning with that first conversation, Shelly and I spent hundreds of hours together – in the intensive care unit, in his office, or at his kitchen table -- reconstructing his professional biography . . . and sorting through my experience with my first wife as multiple sclerosis relentlessly undermined her humanity. He never flinched as I chronicled my reactions to her tragic deterioration. I had no more devoted friend during the increasingly dark months before she died (d. 1987). In the midst of the individuals who comprised my most intimate ‘community’ stood this pioneering pediatrician for whom I had utmost respect and appreciation.
In my office hangs a photograph of a hand cradling the tiny head of a prematurely born baby. The inscription on the back -- “To Doug, consummate comrade-in-arms and dear friend. Shelly.” And so we were for more than thirty years.
Doug
