25 Years Later

This story has a beginning but no end.  I moved to Hawaii in 1977 to work at the University of Hawaii - John A Burns School of Medicine in the Department of Pediatrics, Division of Neonatal Medicine. For some reason beyond anyone's comprehension, the Division Director I was recruited by, Michael, left shortly after my arrival for the Virgin Islands leaving us stranded with a load of clinical duty.  Several months later, he thankfully returned back to Hawaii, but quickly reversed his decision and returned for good to the mainland where he settled in San Diego - UCSD, then to Miami - U Miami, and God only knows where he is now residing...maybe back in the Virgin Islands! Another neonatologist, Rod, joined the Division 6 months before me;10 years later he was unsatisfied with what he was doing, and so he wandered down the hall to the Pediatric Intensive Care Unit where he worked for a while before finding his way down two flights to the Pediatric Emergency Department where he has remained ever since.  

By default, I was left holding the bag, becoming the Division Director of Neonatology with zilch experience right out of fellowship, while lacking any administrative training or academic credentials. About the only thing I could do to impress myself was to say............When I was at UCSD (where I did my training) we did it this way... In the end, nature and natural ability had a way of determining ones effectiveness as a leader.  Rather than toot my horn, let me just say that I did not do a bad job. At least most of the time, I ruled by consensus!.

Recruitment began to fill gaps in coverage and to care for an increasing census of sick newborn infants needing round the clock attention. By the time the neonatology recruits stopped trickling in, we had a group of 12 FTE's.  At first we came cheap until we stopped growing in numbers and then we started growing in volume.  1987 brought us two recruits, whose faces are depicted above.  Ken, on the left, was a local boy who completed his pediatric training at the University of Iowa.  A consummate gentleman and a soft spoken intellectual, Ken was a very well trained academic and a fine clinician.  He was a freebie to us in the sense that we didn't have to really put on the charm to get him to accept a position.  He was after all, a local boy coming home.  This was incentive enough.

Somehow, he was assigned call duty his first day at work. I won't take credit for this insensitivity.  In any case, he looked so young and out of place as compared to the rest of us (as we were worn down by 10 years and an endless stream of night call duty), his first few orders were questioned by the nurses to the extent that I was called to review them personally.  Needless to say, Ken very swiftly impressed everyone in the Unit and rose to the top of the food chain as history has determined - rising to Division Director (replacing me), to KMS CMO, and now to Pediatric Department Chair.

The other gentlemen above was recruited as a Neonatal Fellow as mentioned in 1987.  We call him Bala, short for Balaraman.  Bala continues to remind me that he knows that he was not our first choice of fellow picks.  Another gentle soul, very caring and hard working, he very quickly assimilated into the Division after his fellowship and also rose up the food chain of leadership.  From fellow to Division member to Division Director to Vice Chair of the Department of Pediatrics.

I taught Bala everything I knew about computers...that must have taken 45 minutes.  I remember impressing Bala with my knowledge of DOS, but that session was the last session anyone had to teach anything about computers to Bala.  From there on, he was the master.  An incredibly intelligent man with a photo memory, he was the only neonatologist who never used notes when we made afternoon check out rounds.  He captured every detail of every baby in that sinkhole of a mind he has.  He would not only remember demographics, but every conceivable laboratory value.  I would never let him get away with just what he was willing to share.  When he barked out the latest blood gas done a few hours before, I would demand the blood gas values from the previous day.  With chart in hand, I would check the accuracy of his instant response.  Yes, he was and is truly an amazing human, blessed with incredible intellect and capacity.  

I was very close to both Bala and Ken.....we had loads of fun together, not only working our best to improve the care of the high risk babies at Kapiolani but also for the entire state, to bring the latest of technology to Hawaii, to remain current on the latest treatments through research and education, to continue to participate in a joint fellowship program that Frank Smith at Tripler and I started about 30 years ago. We had loads of fun at Tripler's Department of Clinical Investigation where we did all of our research using in vivo, ex vivo and in vitro models.  We worked as hard in our research as we did in the NICU.  Those were the good times!

Of course, my career did not stand still, as opportunities found their way to me, much in the same way that I became Division Director -without really deserving them.  I resigned my Division Director role at around 2000 and fortunately Ken was there to take over.  I had already accepted the role of Director of the Clinical Research Center in 1995 (very interesting story goes along with this invitation), but then in 2000, I became the Director of Clinical Research at JABSOM where I served three Deans (Dean Cadman anointment me with an unofficial title of Associate Dean of Research).  I then moved to the Vice Chancellors' Office where I worked in research infrastructure including in the Office of Compliance. I retired in 2007, was privileged to be nominated for Professor Emeritus, and have continued to work at about a 50% effort. I have filled a variety of roles including my favorite one in the Department of Pediatrics in order to keep active and act as a resource to others. This indeed has has brought me great pleasure and personal satisfaction.

I could go on for many pages, but this is a sickeningly long blog so I need to find some closure.  OK, the cartoon above was part of a card that was given to both Bala and Ken for Bosses Day (also  

included Jennifer who was cut out of the picture for the purposes of this writing).  Standing there as the staff gloated over their bosses embarrassment over being fussed over, it suddenly struck me that Bala and Ken were not only their boss but also my boss as well.

Indeed, life has come full circle.  I was at one time the uncontested boss of the Division that included Ken and Bala, but now I am some disposable part time faculty member completely at the mercy of these prior subordinates.  There is truly a glaring message here!  Not only for me but for those many decades my junior who might not be able to connect the dots of their life to notice how connected the dots can be.