Dr. Norman G. Levinsky:
Great Teacher Remembered Forever
Recently a memorial service was held at Boston University for Dr. Norman Levinsky, a great medical school professor, teacher, clinician, and researcher. About 300 of his mentees gathered together from all parts of the country to pay homage to this great teacher. Dr. Levinsky was praised during the eulogy for never repeating a question or an answer. Instead he presented it in four or five different ways so that if you didn't understand it one way you would get it the second, third or fourth way. By the time he was finished, you understood the concept.
Dr. William Couser,
Belding Scribner Professor of Medicine from Seattle, delivered
the eulogy that poignantly described what so many felt. It
helped to shed light on my ongoing lifelong question: “What
are the ingredients of a great teacher, one who can help
to shape and influence the lives of others?”
William G. Couser, M.D.
I'd like to speak about Norman's role in career development with examples from my own career. It was about 32 years ago that I first met Norman Levinsky in person, when I was about half as old and perhaps less than half as wise as I am now! His influence on my life and career in medicine after that was enormous.
The BU renal service, run by Norman, was busy and active and my first exposure to Norman was viewing him from afar as an intense pied piper-like figure leading a team of students, residents and fellows through the underground caverns of the Boston City Hospital (BCH).
The Harvard service that I was part of, in contrast, had one faculty member, one fellow, myself—and no patients. And so, unencumbered by clinical duties, I began my career as a nephrologist at the BCH by becoming the world's expert on renal disease in the guinea pig, the only mammals with renal disease at BCH that were not taken care of by Norman. And so began my career in renal research which has lasted now for over 30 years.
My next encounter was a more personal one. After a brief sojourn to the University of Chicago to complete the fellowship, I yearned to return to Boston. So I wrote to Norman to inquire about possible faculty positions at BU where he by then served as both Chairman of Medicine and Chief of the Renal Section. He invited me to meet with him for the first time in the spring of 1973 in a restaurant at Haddon Hall in Atlantic City. Norman sat down and, as a waitress approached, told me our conversation would not be of sufficient duration to bother to order any food. He asked me what I wanted to do. I said I wanted to continue a career in renal research in Boston. Without batting an eye, he told me I was, in his view, quite inadequately trained to do any meaningful research. But before I could leave, he went on to say that he already had three excellent faculty doing research but only one, Dr. Beldon Idelson, taking care of patients. Since Beldon was getting too busy, he offered me a junior faculty position at BU as Beldon's assistant.
But there was an important caveat which was that, although he would not pay me to do research, he would allow me to use the Renal Section research facilities in my spare time on nights and weekends to pursue my strange interests in the immunology of renal disease, a discipline about which he readily admitted to knowing nothing. Whether it was just to prove him wrong, or for more enlightened reasons, I accepted the job on the spot, and Norman got up, thanked me for meeting with him and left me at the table!
The 10 years that followed before I left BU to Head the Division of Nephrology at the University of Washington in Seattle in 1982, were some of the happiest and most productive of my professional career. I remember many things from them, most related in one way or another to Norman.
Like touring the facilities in the old blue building on Albany Street where we worked in those days with Norman, who told me at least three times that I must remember that any commitments made by him were only likely to be good for 6-7 years, the average tenure of a Chairman of Medicine in those days. He retired from that position some 30 years later in 2000.
I remember how hard I worked in my little laboratory space in the blue building on most nights and weekends, partly because I really loved the research, but partly, I have to admit, because I so desperately wanted to prove that Norman was wrong in his assessment of my research abilities!
My research progressed, and I published a few papers and got my own grant funding from the NIH, and as that happened Norman very slowly but very fairly allowed me to give up a month of clinical responsibilities to do research.
And I remember the annual evaluations we all had with Norman. On the dreaded day, his secretary Janet would call to say that “Dr. Levinsky wants to meet with you at 4 pm to discuss your annual evaluation.” We all hated these sessions, which were characterized by one person, like putting on a wet bathing suit in a cold room. We all assembled on the fourth floor to support the summoned person before he or she went down to Norman's office, and then we all waited for the always precise 30 minutes to pick up the pieces afterward. And I would go into those meetings each year cautiously optimistic that my 4 papers and new grant would get me Norman's approval and a 10 percent pay raise. And I'd always be told that 4 could have been 5, that the new grant could have been larger or longer, and that “By the way, Bill, although your teaching evaluations were generally very good, one resident did write an evaluation saying your teaching was terrible!” And you can guess what happened in the next year. There were 6 papers instead of 4, a second new grant and perfect teaching evaluations.
There is a very thin line between many human emotions, love and hate, fear and exaltation, joy and sorrow. And it is at a point closest to that line that inspiration lives, not at the margins. With respect to his role as a mentor and developer of young people, Norman walked that line like no one else I've ever met. We all had this intense and consuming love/hate relationship with Norman because he had this uncanny way of perceiving in each of us what we were capable of and letting us know what that was. With Norman, the prize was always just out of reach, the rabbit just ahead of your nose, the bar always one inch higher than you thought you could jump. But it takes more than just being able to confront people with their unfulfilled potential to get results. It would be easy to characterize the things he said as being insensitive statements from a person in a position of authority and some took it that way.
But to me, and I think I speak for my colleagues as well, they were inspirational. And they were inspirational not just because Norman was the Chairman. They were inspirational, and empowering, because Norman was the most honest and fair and ethical man I have ever met in medicine. His own standards were so high, and we respected him so much, that we all jumped higher, ran faster and worked harder to live up to his standards and expectations. And in doing so we grew, each of us grew, and the whole of the Renal Section at BU became greater than the sum of the parts.
Very high expectations delivered in a way that was carefully calculated to get your attention by someone who you so respected that no mountain was too high to climb, inspired us to live up to what he asked of us.
I will close with just a final comment. The film that won the Oscar in 2002 for best picture, and won a Tony award before that for best Broadway show, was Chicago. My favorite song in Chicago is called “Class” and begins “What ever happened to fair dealing, and pure ethics, and old values and fine morals” and I would add honest evaluations, and fair treatment? What ever happened to class?
Norman Levinsky was class. And because
he was, and because so many of us were made better by it, Norman will live
forever in the careers in medicine of each of us he touched, and even further
beyond us because of the generations and careers that we touch. Very few
people will ever leave that kind of legacy.#