Monday, August 19, 2013

Remembering David Solomon

Emerald Bay - Lake Tahoe

I am in Lake Tahoe for a leadership retreat for the scholars in the Dennis W. Jahnigen and T. Franklin Williams Career Development Awards programs.   These awards were established about 10 years ago to support surgical and medical specialists who wish to conduct research on the geriatrics aspects of their specialties.   The agenda is chock full of inspiring talks and there is lots of time built in for networking.  There are three people missing from this meeting. 

The first two -- Dennis W. Jahnigen and T. Franklin Williams (for whom the awards were named) -- have been long gone from our ranks.  Both would be proud of these scholars who embody a vision for health care where all clinicians are providing high-quality, patient-centered health care to older adults no matter their specialty.   Both would be delighted that the National Institute on Aging has created an awards program that is supporting current and future scholars as existing funding winds down – the Grants for Early Medical/SurgicalSpecialists’ Transition to Aging Research (GEMSSTAR) program.

David Solomon is also missing from this meeting.   David died early last month and it is still hard for me to fathom a world without him.  I got the news while on vacation in Alaska and my initial intake of the information was followed by a flurry of email exchanges about how to notify our members and the most appropriate tributes.  As with the loss of my own father, sorrow was mitigated by activity. 

David’s career is littered with honors and achievements that I have seen chronicled in obituaries and tributes from his peers.  I have mulled over what I would want to say about this man who was blown into my life by sheer circumstances and who helped to shape so much of how I think about health care for older adults.

It is particularly fitting that I would finally be putting pen to paper in such a bucolic setting (Lake Tahoe) while surrounded by the Scholars who are the embodiment of the fourth phase of his long and distinguished career.   A phase in which he devoted himself to increasing the expertise of all clinicians to care for older adults by leading the Geriatrics-for-Specialists Initiative (GSI) at the American Geriatrics Society (AGS).  That he undertook this effort in his 70s and was a substantive presence in our work well into his 80s is a testament to his absolute commitment to improving care of older adults.   He was the center of our efforts and at meetings he would be surrounded by Scholars and project leaders.   His 2009 talk to a gathering of the ten specialties and geriatricians participating in the GSI was an inspiration to us all.

This has been a long and meandering lead in to what I have really been wanting to write about when it comes to David.  Truth be told, what I will miss most about David has very little to do with his academic achievements or the way he led the GSI.  What I’ll miss most are the things that made him a very special human being. 

He loved Ronnie and his family.  I used to love to see David and Ronnie together at meetings.  They had such a wonderful way of being with each other and she could always be counted on to rein him in if he wandered too far afield.  I had the luxury of meeting him later in life – after his kids were grown.  I am sure that there were moments in his career where he struggled with work life balance but I got the sense that he and Ronnie struggled together on that front.  He would often say that he was only able to have the successes that he had because he had married a very smart woman.  There was a strength in their relationship that was palpable.  It was clear that theirs was a love match that was born to last through thick and thin.

He listened to everyone.  I first experienced this in 1999 when David led a retreat of the GSI interdisciplinary leadership group in identifying barriers and solutions to increasing geriatrics expertise of surgical and related medical specialists.  He won my absolute devotion that day when he set the ground rules that everyone would participate – no matter their credentials or their role in the project.   And we did.  That was not an aberration of this meeting, David was one of those individuals who really valued everyone – you would never catch him splitting the team into physicians and others.  For him, everyone was important and every voice needed to be heard.

He was all in.  If David took on a project, he jumped in feet first and committed himself heart and soul to the effort.  In 1998, he took over leadership of the GSI from Dennis Jahnigen just as we were embarking on Phase II.  I had been hired as a half-time consultant to AGS to fill in for an AGS staffer who was out on maternity leave.   David was a man on fire when it came to getting Phase II underway and we soon had a plan together for recruiting an additional five specialties to participate in our work which leads me to my next point.

He asked smart questions.  I was talking about how I had started to write this piece to one of David’s mentees (and a dear friend of mine) today and she remarked that his questions were because he was always seeking the truth.  To that I would add that David didn’t just ask questions but he asked the right questions.  The question we came up with for recruiting specialists was in response to the statement that every clinician makes when we asked about older adults, “I take care of them all the time.”  We would then ask, “Well, how do they do after surgery?”  There’d be a pause and then a small voice on the other end would inevitably say, tell me a bit more about the work that you are doing.  I learned that asking questions can lead to good outcomes. 

He was indefatigable.  If David encountered a barrier, he’d just try another angle of attack until he was successful.   This is an invaluable trait to have in your arsenal when you are setting out to change the world or just your small corner of it.

He wasn’t afraid to say he was wrong.  Personally, I think that one of the hardest things to do in life is say “I was wrong” and so admire David for his ability to admit – and learn from mistakes.  Our work together was stronger because he could do that.  It’s something I need to learn to do better.

He had patience and an eye for the future.   I remember David saying to me that the GSI effort that we were working on together was too late to make a difference in his own care as an older adult.  He was doing it because he thought that we could change the future.  He recognized that it would take a lot of elbow grease and that we needed to be patient. He lived to see the flowering of some of the early seeds we planted – including over 80 young investigators choosing to apply for Jahnigen Scholars (and now GEMSSTAR) awards and pursue research related to care of older adults.

He got excited about small victories.  All too often in life, we look for the big wins when we should be looking for where we can take an incremental step forward.  Through the way he worked, David taught me how to be an incrementalist and to look not just for ways in which to make big leaps forward but for ways to take incremental steps that together form the foundation for the big breakthrough.  It’s an approach I use every day and he gets the lion’s share of the credit for teaching me to think this way.

He was humble.  For David, it was never about owning an idea and having people know it was his.  It was always about how best to move that idea forward.  Sometimes that meant that he was the best person for the job.  More often it meant identifying a champion and handing the baton off to that person to advance our goals.  In a sprawling effort like the GSI, that was key to our success and a lesson that I think more of us should learn.  I have blogged on my personal blog about this character trait – it’s one that I share with David – and that it can make it hard to untangle your personal role in a project if you are always about “we” and not so much about “I.”  At the end of the day, I’ve concluded that it is the right way to be and looking at what David accomplished in his career only solidifies that sense for me.

He cared enough to share a piece of himself.  Very early on in our working together, a very dear friend of mine committed suicide.  David called to express his condolences but more important than that was that he shared his own personal experience with suicide.  In doing so, he helped me to take the first step on the road to healing.  That was a real gift that he gave me that day and I’ll never forget it.

About three years ago, David confessed to me that he had done a background check on me upon receiving my resume from AGS.  After all, he had just taken over leadership of an important initiative and was almost immediately having to cope with a stranger as staff.  He had noted where my first job was and called that boss who just happened to be his medical school roommate!  Fortunately, the answer he got satisfied him otherwise our roads might have diverged.

I am grateful that I got to work with David Solomon.  If there was one thing that I would want the Scholars at this meeting to think about when they think about their careers it would be that they should care deeply about what they want their life’s work to be and recognize that the path to a long and storied career starts with who you are as a human being.  Humility, curiosity, and patience (to name just a few traits) will serve you well on the road to success.

Rest in peace David Solomon, rest in peace.  I miss you.  

California Sunset

by: Nancy Lundebjerg


Jim Pacala said...

This is a fantastic piece that really captures Dr. Solomon. Thank you for sharing.

Alex Smith said...

Hi Nancy,
Thank you for this memory. I enjoyed the meeting in Tahoe. It seems this should have gone out to participants, or been a toast at one of the meals. Did you take the pictures?

Nancy Lundebjerg said...

Thanks Jim and Alex. Alex, we are sending it out to the whole Geriatrics-for-Specialists list this week or next. I will inquire as to whether Kelly would like to send out to Williams. I wrote it at the meeting -- something about being surrounded by all you folks finally allowed me to sit down and collect my thoughts. Photos are mine -- from a growing collection. nancy