Sunday, June 26, 2016

Turning 70: 3 score and 10: The Golden Years can Kiss my Ass

Age is strictly a case of mind over matter. If you don't mind, it doesn't matter.          
Jack Benny

When you are on a long anticipated trip and its about two thirds over, its a special moment when you can look both forward and backward in time knowing you will have enough occasion to shape the remaining part of the trip whist rehashing the experiences of the first two parts.  And that’s how turning 70 feels to me, wishing dearly that I will remain to see the light of day and that my age will find its way to approach triple digits.

Pleas'd to look forward, pleas'd to look behind, and count each birthday with a grateful mind.
Alexander Pope

I am long on ideas, but short on time. I expect to live to be only about a hundred.
Thomas Alva Edison

This is of course was not the historical perspective as preached by the Bible or by Mark Twain on his famous 70th birthday speech.  (and of course he had no idea that his life would last only 4 ½ years longer).  Taking those thoughts literally, I am to be freed from any restraint in speech and behavior on the day on, and for those that follow my 70th birthday landmark.

Psalm 90:10 King James Version
The days of our years are threescore years and ten; and if by reason of strength they be fourscore years, yet is their strength labour and sorrow; for it is soon cut off, and we fly away.
And from Mark Twain; remarking on his 70th birthday. Threescore years and ten!  It is the Scriptural statute of limitations. After that, you owe no active duties; for you the strenuous life is over. You are a time-expired man, to use Kipling’s military phrase: You have served your term, well or less well, and you are mustered out. You are become an honorary member of the republic, you are emancipated, compulsions are not for you, not any bugle-call but “lights out.” You pay the time-worn duty bills if you choose, or decline if you prefer-and without prejudice-for they are not legally collectable.

Alas few humans will admit that turning 70 is a welcome landmark. Surely most of us would rather wallow eternally in the excesses of the 20’s and 30’s where anything in life is possible and even significant errors in judgment can be rectified, injuries healed, all without permanent residua or stigma.  And maybe others would feel more settled at 40 or 50 with a little grey, and the knowledge that they have proven themselves worthy, reached their goals, created artwork or empires or mechanical gismos or simply had a fulfilling relationship resulting in a genetic legacy.

But empirically, turning 70 finds one breaking down mentally and physically.  Turning 70 means scary times when the slightest ailment can turn into cancer, the slighted injury can go unhealed, and the slighted chore can be a nightmare to complete. So why do I exclaim that I have never been as happy in my life as I am NOW, at 69, only a few months from turning 70.

Its that most mornings I wake up looking forward to the day. My heart is light, and the day lies ahead with me placed squarely in the drivers seat.  Never before have I had such freedom of movement and thought. There was always something I HAD to do. The day disappeared, lost in the focus and dedication that was needed in fulfilling task after task.  Very seldom did I have the freedom of doing anything just for me.  And when it came time for me to have my time, it felt rushed, fleeting and incomplete.  My life was structured, busy, multidimensional, satisfying, important and all consuming.  But my life passed me like a gust of wind, directed and unstoppable, overpowering, fleeting and invisible.

Life is better now. I treasure most days unless something goes wrong and I have to redirect my plans.  Most days I have so much time to think and plan and waste and nap and eat and even enough time to get my work done.  Today is a good day.  Tomorrow will be an adventure.

I never have valued celebrating any event or occasion.   I never really had an official retirement party mostly because I pressed my work friends to not plan one. I was really not good a remembering or celebrating birthdays or wanting to take the effort to properly prepare for and celebrate Christmas or Easter or even the 4th of July.  If it weren’t for my wife, every day in my married life would have been the same!

Things have changed and I now want to celebrate my 70th birthday in November.  I will have several events to mark this day – one in Honolulu and one in New Jersey.  The one on the East Coast is intended as a proxy for getting my entire family together in one room - at a Lebanese restaurant with my sisters and their families and even a belly dancer.  I fear my sister’s age and want to get together while we are still here on earth to enjoy each other’s company. 

The event in Honolulu has another purpose.  It is to truly celebrate the already spent six decades of my life, including the fortunes and misfortunes, my health and position, and the ever-present opportunities to enjoy new chapters in my life which I hope is far from over.  It is also to send a message to my friends that there is life after work and that everyone should consider some form of retirement before it’s too late to do so.  Of course, I will have to endure a litany of roasting and outlandish comments that will be the highlight of the evening’s entertainment.  And for that part, I look forward to hearing from my friends what embarrassing memories they have dredged up from the deep recesses of their minds.

No one is so old as to think he cannot live one more year.
Marcus T. Cicero

Dr. Seuss on the golden age 
The golden years have come at last,
Why don't I feel this is a blast?

I cannot see, I cannot pee.
I cannot chew. What can I do?

My memory shrinks. My hearing stinks.
No sense of smell..I look like hell.

My body's drooping, got trouble pooping.
And people ask, "Why am I stooping?"

The golden years have come at last.
The golden years can kiss my ass.

Sunday, May 29, 2016

Dr Sherrel Leyton Hammar: Personal Reflections

Dr. Hammar shown with a smile on his face and a keen sense of humor

I remember the first time that I met Sherrel Leyton Hammar was when I interviewed for my first and longest lasting position at JABSOM, starting as Assistant Professor in the Department to begin in the Summer of 1977.  It was hard to get over the gloomy ambience of the musty, dark, stain carpeted and draped office stuffed with a massive, solid wood desk that was afforded a person of importance like the Chair of Pediatrics, then located at Kauikeolani Childrens Hospital on Kuakini Street.  For those of you who are too young to know, this is the current site of the Rehab Hospital.  The office was located in a makeshift room off of the beaten tract of the hospital that was ostensibly never intended for this purpose. I felt like I was entering a mausoleum. Truly the office reminded me of some backdoor office of a loan shark, a gang lord, or a scheming shyster. 


But moments into the interview, the charm, sincerity and gentle professionalism of Dr. Hammar kicked in and I was lulled into a zone of comfort and trust which allowed for an interactive discussion with the end product concluding in my acceptance of the position being offered for $40,000/yr to dedicate the next 25 years of my life as a neonatal intensive care doctor.  And I was excited with the prospect of moving within a year (Sept, 1978) from that old relic of a broken down leaking hospital structure infected with insects, broken down infrastructure, and crippled elevators to a brand new children’s facility that would combine Kapiolani Maternity Hospital with Kauikeolani Children’s. After two iterations, this was called Kapiolani Medical Center for Women and Children (KMCWC).  Hence, in the interim, I could stand anything for one year.  (Fast-forward - we are about to repeat history with the completion of a new building at KMCWC to house all of pediatric and neonatal intensive care 38 years later.)


Coming from the East coast, my approach has always been confrontational.  You don’t like something, speak out!  You don’t like someone, fire him or her!  Sort of like Donald Trump without steroids.  Dr. Hammar…… I always called him Dr. Hammar…… it came naturally……. was not a confrontationist.  At first I thought this was a sign of weakness, but later I realized that it was one of Dr. Hammar’s true skills in being able to time and temper his decisions and directives with the wisdom of knowing what and when to say things at the right moment.  Many of the problems facing him disappeared when left to their own logical conclusion without a heavy hand or any administrative directive shinning a bad light on his otherwise gentlemanly demeanor.  He believed that most blustering machinations from misfits of the department and elsewhere would eventually implode.  Just give folks enough rope and they will hang themselves. This was indeed one big lesson that I learned from Dr. Hammar.


We spent endless early morning hours talking story in Dr Hammar’s office.  He dearly loved to hear gossip and to relive embarrassing moments, particularly involving the few irksome faculty members who seemed to forever demand his attention and response. He always attached unflattering nicknames to the ones that were particular thorns in his side. But he did so with a soft and gentle voice, a smile on his face, and dressed predictably in his signature short sleeve white shirt and tie. No matter what the circumstance, Dr. Hammar was always dignified and concerned. He was able to disguise his own emotions and biases within the confines of his strict code of proper behavior.  You might say that Dr. Hammar was the father of PC, at least for the Department of Pediatrics and maybe as far stretching as JABSOM.


Dr. Hammar was habitually found sitting in his office sipping his coffee, reading the newspaper, signing documents, on the phone to the mainland, or talking to his favorite confidents such as Bob Wiebe. His door was usually wide open, begging for an audience to share in the morning news, the latest gossip sprinkled with discussions of serious business of the day.  Everyone was invited but because of the ridiculous hours of these encounters, few took advantage of these joyous moments of discourse, sarcasm, discussion, discovery, entertainment and folly. 


Dr. Hammar was very intelligent, articulate, quick witted, and because of his mask of dignity and self-respect, he choose his words carefully not to insult or enflame even the most outrageous encounters and combatants.  Rather his pent up true feelings were stored and tightly bound until the Pediatric Resident’s end of the year dinner.  I would never miss this yearly event.  Dr. Hammar’s would leave no mishap of the previous academic year unaccounted for. Indeed, the biting, sarcastic, and entertaining annual address promised to expose even the most innocent of mishaps, misadventures, and acts of outright stupidity.  His presentation was always polished; carefully worded, witty, engaging and hilarious that left little to the imagination.  It was the highlight of the night that everyone looked forward to.  And it was dearly missed in the later years of Dr. Hammar’s tenure as Chair as his wit, energy and combative spirit dimmed with time and decades of hard labor at his job.  


Sherrel Hammar was more than just my Department Chair.  He was my friend. He was there for me when my wife developed breast cancer. He was compassionate, supportive, and understanding over the last four years of her life as I powerlessly witnessed the progressive deterioration in her condition. He shared many of the challenges in his life, both professionally and personally which I will not repeat here. The point is that Dr. Hammar displayed his humanity, not only acting as a department chair but also as a human in need of kindness and understanding.  Clearly there were many challenges in Dr. Hammar’s life, just like the rest of us.  He seemed to take the bad with the good dedicating his energy and attention fully to his role as the Department Chair and later to the Interim Dean of JABSOM.


Several of us were invited to his home on various occasions.  I forget exactly when, but at some point in time, he moved from the windward side (if my memory serves me I think it was a condominium called Windward Passage) to a condominium called the Sovereign, located a few buildings from the Central Union Church, literally a stones throw from KMCWC.  It was a neatly furnished condo filled with artwork of his own making, well lit, spacious, and comfortable and in a perfect location. But for reasons unknown, the opportunity for Dr. Hammar to catch a little fresh air walking the few minutes from the condo to his office was squandered.  Indeed, every day including Saturday, he faithfully drove the one block from his condo to the hospital parking lot.  I suspect that he was reserving any unnecessary energy that he might expend on the short stroll for more important matters of the day.


As a result of this routine, Dr. Hammar’s cars were a hot item for those in his inner circle.  He would always sell his car after several years of use using blue book values to determine price and offer it to anyone interested.  Consider how little Dr. Hammar drove, and the fact that 98% of the time, his car was immaculate and protected from the elements in condo and hospital garages. I was particularly in love with a red Honda prelude that had around 10,000 miles on it. Even as a used car, it looked brand new.  Dr. Hammar eventually sold it to another faculty member. To this day, I am disappointed with Dr. Hammar’s decision not to sell his beautiful car to me! 


Dr. Hammar’s couch potato routine did little to enhance his fitness in the later years of his life at JABSOM.  He eventually joined the Honolulu Club and for a few years attempted to reverse the ravages of his sluggard ways.  I witnessed his valiant attempt to stimulate his cardiovascular system and for a while I saw him regularly at the Honolulu club giving it his best shot.


Invariably Dr. Hammar aged like the rest of us, and there was no disguising the effect of time on Dr. Hammar’s appearance.  I’m not sure whether accepting the role of Interim Dean was a good idea for him personally because this was a time of real instability and uncertainty at JABSOM. Dr. Hammar had to valiantly confront a vast array of internal and external challenges in keeping JABSOM safe from extinction.  In my view, his tenure as Dean was the most challenging time for JABSOM and his contribution was little appreciated or recognized as he successfully transitioned his deanship to the Cadman. 


Dr. Hammar was not a confrontationist.  He had to weather a lot of outrageous assaults from disgruntled academics and community members.  He did so valiantly taking the high road at every turn.  Maybe Donald Trump could learn something from Dr. Hammar’s approach. But Dr. Hammar was neither thin skinned or thick skinned.  He was human and felt pain when it was inflicted but knew better how to handle it than most of us.


Dr. Hammar had a great office and a private bathroom that was only his to use. I figured that you had to be really important to have your own bathroom and always considered this a measure of success and status.  For some reason, I was given access to this bathroom only once in my career.  There displayed in plain sight was a framed quotation next to the lavatory which said something to the effect that “ I have been yelled at, insulted, chocked, embarrassed, kicked, slapped, etc, etc, and the only reason I stick around is to see what will happen next”.  This statement framed pretty much of what Dr. Hammar thought about his existence at JABSOM. But he weathered the storm with a smile on his face, an inner confidence and the wisdom of knowing how to get the job done.  He also understood the cost that one must endure in a leadership position.  And in the end, Dr. Hammar had the last word and the last laugh. He was a great productive academic, a valuable member of our medical community, and an effective educator and a visionary leader of physicians.


Lets not forget the life and contributions of Sherrel Leyton Hammar, M.D.

Thursday, May 26, 2016

Sherrel Leyton Hammar: 1931 - 2016 - RIP - UPDATED

Posted On May 24th, 2016 - Honolulu Star-Advertiser

May 17, 2016 

Sherrel Leyton Hammar, 84, of Honolulu, a pediatrician and chief of pediatrics at Kapiolani Medical Center as well as chairman of the Department of Pediatrics, University of Hawaii, died in Honolulu. He was born in Caldwell, Idaho. He is survived by wife Shirley G. Hammar, daughter Kathryn H. Pryor and three grandchildren. No services. Donations suggested to John A. Burns School of Medicine, University of Hawaii, or Kapiolani Medical Center for Women & Children. No services.

Saddened by the terse and anemic obituary above, I would like to share some of my thoughts and the words of other faculty members and staff who have volunteered to contribute to this blog.   Moreover, I will incorporate the comments of others that come forth in the future, which I hope happens.  Anyone interested in contributing to a permanent memory of Dr. Hammar and his life, please let me know…

What he looked like when in the 70's and 80's

Guessing this is from U Washington days where he trained in
Adolescent Medicine

With Dr. Gwen Nagua
With wife Shirley
From present Dept Chair, Ken Nakamura:

Good morning,
            I wanted all to know that our beloved former Pediatric Department Chair, Dr. Sherrel Hammar, passed away on Tuesday, May 17.  Dr. Hammar was the third Pediatric Dept Chair, serving in this role from 1973-1996.  In addition, he served as interim Dean of the School of Medicine from 1996 to 1999 and many credit his leadership for “saving” the medical school where at that time in the mid- to late- 90’s, there was increasing pressure to close the medical school. 
            Dr. Hammar was the consummate kind and gentle man, with a deep commitment to medical education.  Who can forget “Hammar rounds” with the med students?  During his 23 years as the Dept Chair, scores of pediatricians were trained in his program, many of whom are still caring for patients in our state. 
            We are forever grateful for the examples he set for us in his personal and professional life.  We owe much to him and must carry on his legacy.  At his request, there are no plans for a service. 

Ken Nakamura MD

From previous Dept Chair, Raul Rudoy:

Dr Hammar was my benefactor and my mentor. He shaped my view of my academic carrier and helped me to further my interest in medicine and in life in general.

The Academic community of Hawaii will always remember him as a man who wore many hats, as the man that was able and willing to help by taking a challenging position to protect and advance our Medical School. He developed the Adolescent Medicine program, was the Chairman of the Department of Pediatrics, the Pediatric Residency program director, the Director of the Pediatric Medical Students Clerkship and for a while the Dean of the medical School.

On Saturday morning it was common to see him down the hall of the medical wards talking with the students and sharing his knowledge. Dr. Hammar’s rounds where events full of excitement, competition and some fear. Hamma’s rounds become the training ground for the real world of medicine that each one of the students aspired to conquer

I was fortunate to work with him during many years and I particularly remember the time when our training program was on probation. Under his direction the program flourished, probation was removed and we became very competitive. I so his actions as a testament to his motivation and commitment to the Department of Pediatrics and I learned from him that hard work really, really pays back.

I will miss him

Raul Rudoy

Robert Pantell: I served on Several AAP Committees with Sherrel. He was wise and his views always  valued and  respected. We also marveled at his ability to make conference calls that were often set at times convenient  for  those on the East Coast.

A more personal note from Ken Nakamura: Dr Hammar was a very early riser.  I’m trying to mimic his circadian office hours.  He was usually in his office before everyone else except the neonatologists who started rounding at 3:30 am back in the day.  I remember many quiet mornings when I was able to speak to him privately and without interruption as dawn was appearing.  I learned a lot and treasure those times. 


Lorraine Hirazumi: Dr. Hammar was truly a great gentleman and leader.  I will, forever, be grateful for what he has done for me in my career. 

David Easa: Sherrel Hammar recruited me to JABSOM in 1977 with his authority as the Department Chair of Pediatrics. While not versed in Neonatal Intensive Care or even interested in entering through its doors, he was truly a wonderful leader, mentor, role model, friend and an engaging and ethical human being who arguably created the best clinical department at JABSOM during his lengthy 23-year tenure as the Department Chair.  Others will speak to all of his accomplishments, which were many.


What amazed me was the way he was able to piece together a relatively large department - for the time - composed of General Pediatricians and Subspecialty Pediatric physicians with little to no funding by convincing hospital administrators Richard Davi and Paul Cook over the need for funding MD’s to care for Hawaii’s hospitalized children. And he did this at a time when there was no billing for professional services for hospital-based physicians.


Likewise, he was able to leverage the few FTE’s the medical school provided the Department by slicing and dicing these FTE’s into small fractions dolled out carefully for the maximum benefit.  And he was able to do this without yelling and screaming, scheming or lying, which he never resorted to.  Indeed, he almost never raised his voice. He was the consummate gentleman and one that was respected throughout JABSOM and the community.


Others will claim a special relationship built upon the early morning informal chats in his office, fueled by a few cups of coffee, and facilitated by an open door policy producing friendly and light hearted chatter and discussion. Indeed, anything could be discussed and everything would spark a light-hearted laugh or two.


I came to his office each morning to seek his council and learn the latest department gossip. I came as often as possible after my early morning NICU rounds, which roughly took from 4am to 6am.  I knew he would usually show up in his office at 6am, or a few minutes earlier.  His routine was so predicable that when he was sick or out of town, it felt very odd and lonely to see his door closed knowing that there was no one behind the door.  I felt cheated when he was not in town or on days that I was not able to find my way to his 7th floor corner office for my daily fix.


Dr. Hammer always calmed my nerves, advised me prudently on how to handle a particular situation – professional or personal, and always acted in a caring way and was never judgmental.  I always felt that my day started on the right foot after a few minutes in his office. He never really solved my problems but comforted and calmed me while offering a careful and conservative measured response.  He taught me that doing nothing was often better than doing something and I witnessed proof of this approach time and time again.  He never meddled or tried to micromanage my leadership in the Neonatal Division, but I always sought and appreciated his wisdom and sage advice. 


This period of my career as the Director of Neonatology was the most enjoyable, gratifying but simultaneously the most stressful time of my life.  Let it be clear that Dr. Hammar contributed greatly to my success and happiness.  Indeed, he was a great man, a great leader, a great role model and a great human being!  He was also a good friend and I wish very much for his memory to live on………..stay tuned for another blog authored by me to add a little more color to my observations of Dr. Hammar’s life.  I also wish for others to come forward to add their vignettes.