Words for a friend

Last week my mentor and friend Dr. Joe Meek passed away. Today I had the real honor of delivering some words at his funeral. This is what I said:

Over the last few weeks, near the end as Joe was declining I called Bette a few times to warn her I was coming around. A couple of those times I got her answering machine. I’m in the bad habit of hanging up on most people’s answering machines or voicemails. I just prefer to try again later. But I didn’t hang up on hers. I listened. Because the message on the Meek family answering machine was recorded by Joe. Some people have the ability to bring the pulse in the room down a few beats, to calm us down just by the way they sound, or the way they interact with others. It turns out that Joe Meek’s ability to do this extends beyond death. I found comfort in hearing his strong voice telling me to leave a message.

Most of us set out to accomplish something in our short lives, even if it’s just the simple pursuit of happiness. But I don’t need to tell you that Joe accomplished more than most. He married Bette young and had kids, Tom, Nancy, and Kathy. Then he spent the rest of his life talking about them. Or at least the years from 2001 through 2019. I can’t speak for the time before then. But I have my suspicions. He was a Lt. Commander in the United States Navy. As an endocrine fellow at Scripps he discovered that Graves disease, the most common cause of an overactive thyroid gland, was the result of a confused immune system. It was the beginning of a life-long love affair with the thyroid gland. Bette was his wife, but that little butterfly shaped gland in at the base of your neck? That was his mistress. He studied dizziness in astronauts in the Mercury space program and once appeared in Life magazine examining astronaut Scott Carpenter. He was department chair of Internal Medicine, then Vice Chancellor to Academic Affairs, then medical school dean. He was a delegate to the American Medical Society and the Director of Rural Health Care and Outreach. He not only earned the University of Kansas Distinguished Service Medallion; he had at least one award named after him, which may be the most apt description of all, since he never seemed to meet a leadership position he didn’t like: Alpha Omega Alpha, Kansas Medical Society, Medical Society of Sedgwick County, Wichita Grand Opera, Sedgwick County Zoo, and others. Depending on your tastes or your line of work some of these acronyms and organizations may not mean anything to you. Don’t worry about it. It doesn’t matter. What matters is how his position in those organizations reflected his life’s philosophy. He considered himself so privileged. Not in the high income, private school, trust fund sense. Privileged in the sense that he had these opportunities. Joe once told me that there are people in the world that wanted to be somebody, but who didn’t want to do anything. “Justin, don’t be one of those people,” he said. In retrospect, I have to wonder what it was that I said or did that made him say that!

He did it all without ever taking himself too seriously. If you don’t mind, let’s all geek out about hormones for a minute. Remember: he discovered thyroid stimulating immunoglobulin, the antibody that confused immune systems make that overactivates the thyroid gland. But his paper describing TSI only beat a competing paper into the literature by a few weeks. Once, while humoring my questions on his discovery, he confided in me that he thought the main reason his paper was published in the Proceedings of the National Academy of Sciences a few weeks before Joseph Kriss’s competing paper in the Journal of Clinical Endocrinology and Metabolism was that his own mentor had a contact within the National Academy that expedited editorial review and the penning of the accompanying editorial. He thought this was hilarious. But it says something about his character that from then on, he happily shared credit for the discovery with Dr. Kriss. And that picture in Life magazine? The one of he and astronaut Scott Carpenter? He loved to tell the story of how hard they’d worked to get a good camera angle for the photographer once the initial data collection was complete. And it is a dashing picture. There’s just something about those Navy whites.

I loved his sense of humor, but I admired his enthusiasm. He struck you as the happiest person alive. He was immune to questions of fashion. He flashed his crooked-toothed smile at everyone--and I do mean everyone--he met. He was not a creature of irony. He was sincere to a fault. The act of engaging in our cultural default setting for David Letterman-esque cool, ironic snark would have been like a trip to Mars. Because in my experience with him he almost always took people at face value. I say almost. Once as a student, I reported to him that a patient’s chief complaint was “an impending sense of doom.” He looked at me as he put his hand on the door to go into her room and said, stone-faced, “Justin, she’s not the only one.” But seriously: he operated in good faith, and he expected the same from others. I can’t imagine that anyone else’s opinion of his vocal love for opera or medical history or brown loafers or obscure thyroid diseases ever crossed his mind. I have no doubt that people--maybe even some in this room--had periodic dustups with Joe Meek. That’s the cost of doing business in leadership. But if you managed to make yourself a lasting enemy of Joe Meek’s, I’m not saying you’re a bad person, but I’d encourage a sincere evaluation of your life philosophy. There. I said it.

That makes him sound boring. He wasn’t. He and Bette shared the trait of being great storytellers. Fifty years of medical students, residents and fellows--not to mention patients--know how much he loved to tell the story of Dr. Hashimoto, the so-called “thyroid hero of Japan.” And of Robert Graves, whose grave--ironically--he’d visited in Dublin. I actually stole that joke from Dr. Meek, and I’ve used it over and over. It goes like this: Graves disease doesn’t mean you’re going to the grave. It’s just a guy’s name. Okay. So maybe he wasn’t a comedian. But he was funny. He used words that I’d never heard anyone use before. You may know somebody who routinely uses the phrase “to wit.” It means something like “that is to say.” But I dare you to find another person who uses the word “folderol.” That’s f-o-l-d-e-r-o-l. It means “a trivial or nonsensical fuss.” He pronounced “helicopter” “heel-i-copter.” He sprinkled these kinds of words into conversation the way most of us reflexively use “like.” The effect was thrilling. Even through the ravages of a degenerative neurologic disease and sometimes through swollen lips and bandages from accidents and falls, he routinely told me stories that made me giddy.

He once told me a story about a brittle diabetic he’d taken care of named Dora. Even though I’m not sharing it with you today, he still knew her last name, decades later. He wasn’t sure that was a good sign. Dora was in the hospital a lot because of complications of her diabetes, and one day she asked Dr. Meek: “We raise a lot of our own vegetables. Can I bring you in some vegetables?” He wasn’t sure if it was a peace offering or a way to try to get special treatment. But he said yes, stressing to her that it was not a requirement, and she said, “I’ll discuss it with mother, and I’ll bring you in something.” And so Dora showed up to her next appointment with a sack of Brussels sprouts. Not long after, Dora’s mother began calling Bette and Joe’s home phone. One time she called in the middle of the day and Bette answered and said, “Ma’am, he’s at the medical center, and I do not welcome you calling his home like this.” Mother said, “Mrs. Meek, you remember them Brussel sprouts?” Bette’s abject lack of gratitude for the Brussels sprouts was a joke between Bette and Joe after that. Joe admitted in confidence that the Brussels sprouts were really, really good.

He was my portal into a different era. Like a time machine. I don’t mean just to say that he was old. But he had once taken care of a patient who had been cared for at age eight by Dr. Arthur Hertzler, the famed Horse and Buggy Doctor from Halstead. Dr. Hertzler had told the patient’s mother that the daughter needed a goiter operation, and the mother said, “Well, should we make arrangements at your hospital for surgery?” And Dr. Hertzler said, “Madam, I said your daughter had a goiter and it needs to come out!” So mom served as the anesthesiologist, presumably with ether, and Hertzler did the thyroidectomy on the kitchen table. When Dr. Meek took over her care sixty years later she was in good health, with no complications of her procedure. He remembered her name, too.

It was all a reflection of his sense of wonder. He once told me regarding his discovery of TSI, and this is a direct quote: “Leaps forward in medicine were sitting there, just below the surface, waiting to be unearthed.” In clinic he would stand behind patients with his fingers delicately around their necks, feeling the thyroid gland. When a patient swallowed and he felt a thyroid nodule move under his fingers, Dr. Meek would sometimes say “There it is!” And then he’d almost always reassure the patient that it was only a matter of getting a needle biopsy to diagnose the problem, and that it wasn’t a big deal, and that most people with thyroid cancer--if that’s what it was--did just fine.

One time we saw a patient together that had acromegaly, a pituitary condition of excess growth hormone. All that extra growth hormone causes the hands and feet to enlarge, and causes the patient’s skin to take on a particular texture. He and I were examining the patient, and he put my hand over the patient’s and said, “Feel this, Justin. It’s like she’s made out of warm dough.” The patient asked “Is that okay?” And he said, “It’s great.” And then he reassured her that we would get to the bottom of her pituitary issue, and that she would do okay. And she did.

That confidence came with experience. Like any doctor, he often saw patients for whom there was no simple answer. They had problems that were hard to fix. Bad eyes from pituitary tumors or Graves disease. Metastatic thyroid cancer. He would evaluate them and simply lay it out there: We don’t have a perfect answer for you. We have a lot of bad options and one decent option, and the decent option is the one we’re going with. Modern-day practitioners trained in shared decision making--that’s the generally sound principle that patients should have more of a say in their own care--would have raised an eyebrow at this. But I think there was comfort in that approach for a lot of patients. Because this wasn’t some stranger telling them the bad news. He’d never met a stranger. Most of these patients had already been on the business end of one of his so-called “hundred-dollar hugs,” as the nurses called them. So by the time the hard decision making really kicked in I think people thought, “That’s okay. I know Dr. Meek. I know he’s got my best interest at heart. I know that my friend wants the best for me.” Or my group, or my organization. In preparing for this I spoke to a couple docs in town who’d worked with Dr. Meek. He’d had the same effect on them. They would go to him with a tough decision about a patient or their career, and he would have an answer, often quickly, based completely off his own instincts and extensive experience. And more times than not his instincts were right.

In saying my own goodbyes to Joe over the last year or so, I was struck by his dignity in the face of an illness that spared him nothing, dignity least of all. The disease even took his voice, then his laugh, then his crooked-toothed smile. But to the end he insisted on brown loafers, slacks, and a tucked-in shirt. Maybe he was a fashion icon after all.

“I don’t fear death,” he told me once, though he did say how much he would miss seeing friends, his kids and grandkids, and Bette. But I’m comforted by the thought that old endocrinologists never really die. If cowboys ride off into the sunset, endocrinologists just shuffle off into a bright hospital-fluorescent light. And if there is justice in the universe, someday we’ll meet again. He’ll be under that fluorescent light in a perfectly pressed white coat and brown loafers, telling the staff about Dr. Hashimoto, the thyroid hero of Japan, and patiently waiting for the arrival of the next data set.