A farewell to a medical giant and a great humanitarian: Thomas Starzl, M.D. PhD.

We went to Dr. Thomas Starzl’s memorial service at Heinz Memorial Chapel on March 11, 2017.  It was to celebrate a life of a medical giant and a great humanitarian.  We arrived at the chapel one hour before the service beginning at 1pm to guarantee a seat. After more than 400 or probably 500 people crowded into the chapel, many could only stand in the back.  Katy, representing the World Journal (世界日報), was sent to the press section and couldn’t get a good spot as the reporters from various agencies have been there for hours.

We went on behalf of Dr. Dr. Chao-Long Chen, (陳肇隆醫師), a Dr. Starzl’s protégé

We went to this “Homegoing Celebration” not only to pay the respect to the father of liver transplant but also to represent Dr. Chao-Long Chen, (陳肇隆醫師, a Dr. Starzl’s protégé) who couldn’t make the trip from Taiwan.

The service was followed by a reception at the Cathedral of Learning Tower across the lawn from the Heinz Chapel.  Thus we had a chance to talk with Joy Starzl, the wife and soul mate to Dr. Starzl, “whose love propelled him throughout their 36 years together.” (quoted from the statement in the memorial service program).

I have written about a special event of celebrating Joy’s birthday (when Dr. Chen was trained under Dr.Starzl at the University of Pittsburgh in 1983) that earned Dr. Chen a title of “Master Cook” from Dr. Starzl.

grand celebration of a 90th birthday party: Dr. Chao-Long Chen, Dr. Thomas Starzl and Joy Starzl

“Giants in medicine: Dr. Thomas Starzl (father of liver transplant) and Dr. Chao-Long Chen 陳肇隆醫師 (father of liver transplant in Asia)” 

http://doctorjytsai.blogspot.com/2016/03/giants-in-medicine-dr-thomas-starzl.html

Joy Starzl: an amazing lady

Joy was indeed an amazing lady as Dr. Chen told us; she treated us as if we were Dr. Chen, reminiscing the fond memory of event that happened long ago. She vividly remembers the great work that Dr. Chen, the master chef, turned out on her birthday party for more than 100 people.  She kept reminding us not to forget to ask Dr. Chen about the recipe for his delicious soup.

Dr. Chen was glad that he came to attend Dr. Starzl’s 90^th birthday party last year. We showed Joy many of the photos taken at the grand party of birthday celebration that Dr. Chen sent us.  Katy also showed the report of Dr. Starzl in the World Journal (世界日報).  Thus we shared a brief moment of fun and joy at the time of sorrow.

What Carl Sandburg felt about Lincoln is what I did Starzl

Being a history buff and medicine man, I am naturally interested in the history of medicine (limited to modern medicine as my first love is still science). History of organ transplant is one of the topics I have been reading for years. I have read every article about Dr. Starzl in Pittsburgh Post-Gazette, NY Times, or even in Scientific American that I could lay my hand.  His more scholarly articles, especially about advanced immunology, are beyond me.  I have read many chapters in Dr. Starzl’s autobiography more than two or three times, “The Puzzle People: Memoirs of a Transplant Surgeon”.

When interviewed at the time Carl Sandburg just finished his monumental Lincoln (2,400 pages 1,200,000 words), he said “That son-of-a-gun Lincoln grows on me,” he was shaken, he felt as if he “was parting with him [Lincoln], after all those years, like people who had live with him.  When Lincoln died, for a time light went out for me, the tears came.”

I never met with Dr. Starzl and yesterday was the first time we met and talked with Joy Starzl, but what Carl Sandburg felt about Lincoln is what I did Starzl.  After many years of reading him and about him, “that son-of-a-gun Starzl grows on me.”  Like Dr. Chen uttered, “震驚、不捨、衰悼” upon hearing the passing of Dr. Starzl.

 From the many speakers of “Words of Remembrance” we learned the many aspects of a great life other than his achievements in medical field.  For those interested in Dr. Starzl’s professional achievements, one can read the post I mentioned above and below.

“Cyclosporine brought the liver transplants out of dark age: The stories related to Professor Jean Borel, Dr. Thomas Starzl and Dr. Chao-Long Chen (陳肇隆醫師)”

http://doctorjytsai.blogspot.com/2017/01/cyclosporine-brought-liver-transplants.html

The legacy of a transplant pioneer and a true humanitarian

It is difficult to measure Dr. Starzl’s immense contribution, as the former Pitt Chancellor, Mark Nordenberg, said, “We cannot know how many lives Tom already has saved, directly and indirectly. But we do know that lives will continue to be saved for as long as we can imagine because of his work. . . Dr. Starzl was a true gift to humanity.”  This is also reflected by what Dr. Chen said of his mentor, “今後仍有無數病人與家庭受惠， 是醫學史上偉大的開創者與恩師”.

He is better known as the father of liver transplant; it is less well known he also single-handedly saved the kidney transplant fate in 1963.

After returning to Taiwan, Dr. Chen has since become the father of liver transplant in Asia and has trained hundreds, if not more, of transplant surgeons from various countries across the world.  It is very gratifying for Dr. Starzl to know what Dr. Chen’s team has achieved.  Whatever Dr. Starzl sowed, It reaped through the work of Dr. Chao-Long (陳肇隆醫師), 李伯皇醫師 and 鄭隆賓醫師. 
The torch was passed. The light didn't, doesn't and will not go out.

Dr. Chen personally knows many fellows from all over the world trained under Dr. Starzl and have since established their own liver transplant centers in their respective countries.  I am personally aware that two other liver transplant surgeons (台灣大學醫學院外科教授李伯皇醫師 and 台中中國醫藥大學附設醫院器官移植中心院長鄭隆賓醫師) in Taiwan were also trained by Dr. Starzl.

A great intellectual, a loving husband, father and grandfather and a humanitarian

His grandson, Ravi, talked about the time he spent together with grandfather, many of the topics were apparently esoteric and abstract that were difficult to understand, he said “I loved my grandpa.  In our time together, we spoke about things in dimensions and ways that were often difficult for others to understand.”  Dr. Starzl was not afraid to challenge his grandson, as Ravi continued, “Yet no matter how deep, abstract or esoteric the intellectual constructs we would build became, neither my grandpa nor I ever feared the other could not follow. Our minds crossed the thresholds of alien worlds effortlessly. We were dolphins playing in a sea of information.”

The service program statement said he had “an expansive knowledge of an appreciation for all music from classical to modern jazz,” we saw a photo of him playing trumpet.  “He enjoyed watching and analyzing movies, often researching their production and topic matter for hours, both before and after repeated viewings.”

 I am glad that I share this characteristic with him.  I do not watch movies often, but I “studied” some old classic movies, the likes of Casablanca, The Big Country and Duel in the Sun.  To study Casablanca I had to read Ingrid Bergman’s biography.  I have watched and studied one of the last scenes (“I will be there” by Tom Joad, played by Henry Fonda) of The Grapes of Wrath numerous times.  I have read and studied George Eliot’s Middlemarch for many years and still haven’t finished yet, but have read many chapters many times.  I have read several books about George Eliot and Middlemarch and studied many characters in depth.  It is fun to search all archaic articles about Eliot in NY Times.

This post is not about myself; but to show you why and how I appreciate and respect Dr. Starzl, for his being a great doctor, an intellectual, and a relentless knowledge seeker.  Many of the anecdotes and personal experiences of the speakers can attest to it.

Seeing the sad Chooloo next do Joy Starzl, my heart was heavy (photo credit: PGH Tribune)

Dr. Starzl’s love to his family and friends extended to his many canine companions, including Bevo, Thor, Maggie, Tiki, Shelby, Basta, Chooloo, and Ophelia (is it from Hamlet?).  Chooloo sat in the front row with the family.  Seeing the sad Chooloo my heart was heavy.

Taps and flag presentation from U.S. Navy Honor Guard

After serving in the Navy (1944-45), he earned a B.A. degree in 1947 from Westminster College (at Fulton Missouri) where he served as Churchill’s go-fer [running errand] for Winston Churchill when he went to delivered his famous Iron Curtain speech on March 5, 1946.  He then obtained his M.D. and Ph.D. from Northwestern University before he went to Johns Hopkins for post-graduate training.

This is why we saw a solemn Taps and Flag presentation to the family, Joy Starzl, by U.S. Navy Honor Guard.

Dr. Starzl put Pittsburgh in medical map of the world

Dr. Starzl came to University of Pittsburgh on January 1, 1981 and has since created a legend and legacy, putting Pittsburgh in the medical map of the world.

John Fung M.D. Ph.D.

Sen. Bob Casey also attended the memorial service. His father, former PA Governor Robert P. Casey, received a heart and liver transplant in 1993 by Dr. John Fung, who also spoke at the memorial service.  Dr. Starzl retired from the surgery in 1990, but continued to be active doing research in the Transplantation Institute that now bears his name.  He did come back to do a baboon-to-human liver transplant in 1992.

Sen. Bob Casey shaking hands with the former and current Pitt Chancellors (photo credit to Pittsburgh Tribune)

Dr. Starzl arrived at Pittsburgh at the end of 1980 and Joy joined him shortly thereafter, in his Puzzle People, we read “When she [Joy] walked down the center of aisle in an orange and yellow gown, there was silence then a thunderous ovation.  We were in the right city.”

It is of interest and significant to mention that Burl Osborn, the published of Dallas Morning News sent a professional photographer for their wedding.  Burl Osborn received a kidney transplant by Dr. Starzl in 1966 about 15 years before the wedding and lived on to become the publisher.

Starzl was chosen Pittsburgh Man of the Year in Science and Medicine in 11/1981.  I also saw a photo of him throwing the baseball to open a Pittsburgh Pirates game.  The Pittsburgh Chancellor also mentioned how Dr. Starzl received a tumultuous standing ovation when he showed up in the university game.

A compassionate humanitarian: a touching testimony from a kidney transplant survivor

During his talk, a successful kidney survivor (Hollis Hurd) recalled one day in the hospital when Dr. Starzl grabbed him from behind telling many nurses around that he was his favorite patient.  Hurd ended the talk by saying “Doc, when I see you again, and I know I will, I will be hugging you and telling everyone you are my favorite physician. And it will be true. It may sound crazy, but I can't wait.”

In a 7/7/1992 article at NY Times, Lawrence Altman wrote, “In advancing the frontiers of surgery, he sometimes fell short of the perfection he sought. Many patients died. Other surgical colleagues could protect themselves by excusing their errors or by quickly erasing bad memories, he wrote in an autobiography to be published this year. By contrast, he wrote, he still painfully remembers patients who died many years ago.”

We read in the NY Times obituary of 3/5/2017 that it was the death of Stormke Jones at age of 13 in 1990 that took its toll emotionally, the exhaustive Starzl decided to call it quit from surgery in 1990, stating it was “an uncompromisingly difficult life.”  Few people could grab the truth of what kind of a life a medical pioneer and a sensitive and compassionate humanitarian went through.

A great compassionate doctor treats each and every patient as a person with a precious life, not as a “case”.

Happy birthday to you, Dr. Starzl

Yesterday (March 11) would have been Dr. Starzl’s 91^st birthday, at the end of Joy’s talk, she kindly asked everyone inside the chapel to sing “Happy Birthday” to Dr. Starzl. All rose to sing a “Happy Birthday” chorus; it was quite an emotional moment.

John Fung,M.D. Ph.D. (credit to Pittsburgh Tribune)

photographers at work

photographers at work

Lincoln spoke at Gettysburg on Nov. 19, 1863, still reverberates today

Reading Lincoln and Churchill led me to discover the beauty of the English language.  Churchill was a Nobel literature laureate, Lincoln would have been one were the Nobel Prize available in his time.

Lincoln is a great man, but what made him great?  His moral courage and gift for words would be among the many characteristics.

Without Lincoln speaking to consecrate Gettysburg battlefield ground on November 19, 1863, Gettysburg Battle wouldn’t be so well known to the whole world.  One can be ignorant to the Civil War, but one always knows Gettysburg Address.

How wrong Lincoln was when he said, “The world will little note, nor long remember what we say here, but it can never forget what they did here.”  What he said here had since belonged to the ages, like Edwin Stanton (Lincoln’s War Secretary) said of Lincoln when he drew his last breath, “Now he belongs to the ages.”

Great writers are skilled in using plain simple words; Churchill and Lincoln are no exceptions. A November 17, 2013 NY Times Editorial pointed out Lincoln used “here” eight times in the “270 words or so” (there are several versions of the speech); seven of them in the last paragraph and one in the second paragraph.  Of some 270 words about two-thirds are single syllable, only a half-dozen four-syllable.

But, in a larger sense, we can not dedicate -- we can not consecrate -- we can not hallow -- this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us -- that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion -- that we here highly resolve that these dead shall not have died in vain -- that this nation, under God, shall have a new birth of freedom -- and that government of the people, by the people, for the people, shall not perish from the earth.

We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live.

Yet these 270 some words are “woven into 10 complicated sentences” that only a man of letter can master.  One also noticed the repetitive triplets: “we cannot dedicate, we cannot consecrate, we cannot hallow this ground.”

Everett [the key note speaker of the consecrated dedication, a great orator of his days] wrote Lincoln a day after, “I shall be glad, if I could flatter myself, that I came close to the central idea of the occasion, in two hours, as you did in two minutes.” To which Lincoln replied, “In our respective parts yesterday, you could not have been excused to make a short address, nor I a long one. I am pleased to know that, in your judgment, the little did I say was not entirely a failure. . . . Our sick boy [Tad], for whom you kindly inquire, we hope is past the worst.”

The day before Lincoln left for Gettysburg (by train), Tad (their son) was sick and doctors had no idea what ailed him.  Mary was still mourned for Willie [another son, Willie, who died at White House not too long ago].  Many historians were not nice to Mary; some even made up the story saying Mary threw herself on the floor in an outburst of tantrum, trying to prevent Lincoln from leaving.

Nothing is further from the truth.  Mary sent her husband a telegram the same afternoon when Lincoln left saying “The doctor has just left.  We hope dear Taddie is slightly better.  Will send you a telegram in the morning.”  Mary was apparently trying to comfort and alleviate Lincoln’s anxiety so he could do a good job; a good job indeed.  The second telegram arrived at ten o’clock Nov. 19, just before Lincoln left Wills house [where Lincoln stayed the night before.  Prof. Pan also drove us to see the house], as Stanton [Lincoln’s War Secretary] told Lincoln that “Grant was staring a big battle at Chattanooga.  Mrs. Lincoln reports your son’s health as a great deal better and he will be out today.”

Lincoln apparently also told Everett that their son, Tad, was sick when he left White House and that’s why Everett “kindly inquire” in his letter to Lincoln.

I took every chance to defend for Mary Lincoln, even on the occasion of Gettysburg Address.  Mary often time traveled with her husband.  She missed the chance of hearing the greatest speech of all time simply because she was a loving mother.

Unfortunately we didn’t have the photo of his delivering of the speech at Gettysburg.  The great orator, Edward Everett, was to blame.  After hearing Everett spoke for two hours, the photographer took it easy slowly preparing his equipment (dry plates, black box on a tripod, etc.) when Lincoln began to speak. Bending and hiding his head under the hood, he heard Lincoln said, “Government of the people, by the people, for the people shall not perish from Earth”

William Safire once wrote of a “speech made on May 29, 1850—thirteen years before the Gettysburg Address—by Theodore Parker at an antislavery convention in Boston, calling for ‘a democracy, that is, a government of all the people, by all the people, for all the people. . .’ ”

Everett’s 13000-word oration is classical as Lincoln’s 270 some-word sermon is biblical. Some point out that “Four score and seven years ago” is coming from Genesis 16:16, “Abram was four score and six years old when his son Ishmael was born.”

(Those who believe in predestination also point out that Lincoln is the 16^th President, who lived in 1600 Pennsylvania Avenue. And his first name is Abraham—Genesis 16:16 “Abram was . . .”)

We do not see words like “Union”, “slavery” or “Constitution”, but “nation” was mentioned four times.  We also see many religious words, such as “conceived in liberty”, “hallow”, “consecrated”, and “that this nation, under God, shall have a new birth of freedom”.

I still have much to say, but this post is already too long for Lincoln’s compact, poetic prose; a timeless work that made America of what she is today.  It may not be just a coincidence that Gettysburg Battle ended on July 4 as America was born again with “a new birth of freedom”.

Should Gen. George Meade pursue the retreating Gen. Robert Lee’s Army of Northern Virginia following the Battle of Gettysburg?

No one planned the Battle of Gettysburg; it just happened.  Gen. Robert Lee was on his way to Harrisburg, PA.  His thinking was if the South were able to take Harrisburg, Philadelphia, Baltimore or even Washington, there would be European recognition.  Carl Sandburg wrote in his Lincoln,

Lee rode his horse along roads winding through bright summer landscapes to find himself suddenly looking at the smoke of a battle he had not ordered or planned.  Some of his marching divisions had become entangled with enemy columns, traded shots, and a battle had begun that was to swirl around the little town of Gettysburg.  Lee could draw away or carry on; he decided to carry on.

Nor did Gen. George Meade plan this as he was just appointed by Lincoln to command the Army of Potomac three days earlier.

Reading General Meade’s congratulatory order to the Army of Potomac after the battle was won, when it came to “driving the invaders from our soil”, Lincoln exclaimed “Drive the invaders from our soil. My God! Is that all?”  Lincoln wrote an angry letter to Meade that he never sent, saying "Why should we censure a man who has done so much for his country because he did not do a little more?"

Based on the fact that more people would die after Gettysburg Battle than before, one may agree that Lincoln was probably right that Meade probably should have hot pursued the retreating Lee from Gettysburg.

I read an article in NY Times that was published on 9/8/1890, twenty-seven years after the event.  Col. Taggart recalled his conversation with Gen. Meade that occurred eight years after the battle.  The following is what Col. Taggart wrote,

I asked him [Gen. Meade] whether with all the knowledge he had subsequently received of the strength and movements of the Confederate Army and of his ability to attack Lee on his retreat, he felt that he was justified in doing as he did after the battle.  He replied in nearly these words: “I am fully convinced that the course I pursued was right.  If I had attempted to attack Lee on his retreat, in the stronghold along the Potomac, the result might have been disastrous to the Union cause and all the fruits of our victory have been lost.  It was too great a risk to take and I am satisfied I did right in not forcing another battle at that time, in the exhausted condition of our troop.  You know how hard Gen. Lee tried to crush Gen. McClellan’s army in the Seven Days Battle, but he failed to do it under much more favorable circumstances than those that existed with the Union troops after the Battle of Gettysburg.”

The second day after Lee’s surrendered at Appomattox on April 9, 1865, Lee and Grant met again.  On the way back to his headquarter, Lee met Gen. Meade (they had ‘met’ at Gettysburg and some other battles).  Meade took off his cap to Lee, who recognized Meade (Grant, Lee and Meade were all West Pointers and who all served at Mexican-American War.) and said, “But what are you doing with all that gray in your beard?”  Meade smiled to his own friend in old days, “You have to answer for most of it!”  They then rode together toward Confederate headquarters.  Healing of the national wound has already begun.