2005 Lifetime Achievement Award Page 3

Presented to Robert J. Levine, MD

Bob Levine Award 3I have known Bob Levine since the Spring of 1975 when he interviewed me, at Jay Katz’s suggestion, for a seat on the Yale IRB (known as the Human Investigation Committee (HIC)). At the time, I knew marginally more about research law, ethics, and regulations than I did about astrophysics. Thirty years later, Bob and Jay remain the major forces behind my academic career, and I still don’t know anything about astrophysics.

Bob’s intellectual prowess and scholarship are quite apparent when you read the work before you, so I would like to introduce you to some other things about Bob.

Bob is probably the best teacher I have ever known. His concern for his students and advisees, and his ability to figure out what they know and what they need to learn without having them feel threatened in the process, is a rare and remarkable talent. He can be quite critical about laziness or inattention, but if a student has tried to figure it out and really doesn’t know, he is infinitely patient with helping him or her find out without revealing the answer. Although I had taken Jay Katz’s course on “Human Experimentation,” it was all a theoretical construct. Bob taught me practically everything I know about the realities of human subjects research without ever having me in a class. First, I learned a lot at every HIC meeting. As the Chair, he taught us not only the rules, but the ethical principles behind them.

When Bob began IRB: A Review of Human Subjects Research, I felt as if I were its grandmother. Since, at first, it was not high on the prestige list for writers, he needed all the help that he could get, and so I wrote an article for almost every issue in its first year. Working with me on those articles, he taught me more than I could ever have learned in any other way about both writing and clinical research. I know that his thesis advisees consider him the most important force in their medical educations.

When I taught a seminar for law and medical students on legal issues in pediatrics, I always asked Bob to come talk to them about informed consent – and to tell them how he explained to a three year old what he was going to do to remove a bee stinger from her lip, and what she could do to tell him if it hurt, and if it did, that he would stop. It is not only a charming example of a good physician’s approach to a young patient, but it taught my students more about the real meaning of autonomy than any articles I could have assigned.

I would not have been able to begin the career I now enjoy so much if Bob has not been there to teach me about research and, more important, about being a teacher. As I got to know Bob, we became friends as well as colleagues. In the tough times of my life since then, he has always been there to advise, to help, and to comfort as necessary.Bob Levine Award 2

In March of 1981, my father, who was still practicing law, was diagnosed with glioblastoma. He and my mother came from their home in South Carolina to Yale-New Haven for confirmation of the diagnosis and for what was intended to be palliative radiation. Before my parents arrived in New Haven, I asked Bob to be my father’s doctor. He answered, “But I don’t know anything about brain tumors,” to which I responded, “Go look it up in a book. What you do know better than anybody is how to be a doctor.” The neurosurgeons quickly lost interest when there was nothing they could fix, and the plan, to provide palliative radiation and let my father die at home which was what he wanted, collapsed when he had a pulmonary embolism and couldn’t be moved. We settled in for what turned out to be a 3½ month journey. My mother and I basically created, because Bob insisted that we be allowed to do so, a one-room hospice in the middle of a tertiary care institution, and Bob took care of his patient, of my mother, and of me. He and my father had long discussions about death, baseball, religion, the daily news, ethics, and anything else Dad wanted to talk about, and it never occurred to either of my parents that Bob might have something else to do.

My snapshot of a moment to explain what Bob was like as a physician and a friend is the night my father died. It was shortly before midnight. When the call came, my mother, my son, who had just finished his freshman year in college, and I met Bob at the hospital. (I later found out that the head nurse on the unit had never heard, in a long career, of an Attending who actually came to the hospital in the middle of the night to meet with the family when a patient died.) My father’s body was still in his bed, and the four of us gathered to say goodbye. We sat and began to talk about him, and what we remembered, and some of it was funny, so we laughed as well as cried. When we were ready to leave, about 45 minutes after we got there, Bob opened the door for us. Several nurses who had been listening at the closed door to find out why we were laughing at such a time seemed glued to the floor in embarrassment. Bob never batted an eye, smiled at them, and said, "That’s the way they do it in the South." There was an audible, "Ohhhh….”

These are some of the many reasons why the dedication to the 2nd edition of my Legal Issues in Pediatrics and Adolescent Medicine reads, “With gratitude and affection for Jay Katz and Robert J. Levine, incomparable scholars and teachers and, most of all, supportive friends."

Angela Roddey Holder, LLM
Professor of the Practice of Medical Ethics
Center for the Study of Medical Ethics and Humanities
Duke University School of Medicine
December 4, 2005