Honoring Dr. Todd Stern

I’ve been fortunate to have the same enjoyable, productive, and satisfying job since I finished my training. To a great extent, I owe this to wonderful colleagues who doubled as incredible mentors during the first 10-15 years of my career. I have already written about four of them in this space. Halina Brukner, Diane Altkorn, Scott Stern, and Mark Siegler have all retired in the past five years. Next month, Todd Stern, the last of the group that was a constant source of support, will take down his shingle and abandon me. This is an homage to Dr. Stern and hopefully a reminder of the myriad ways one can mentor.

When I arrived at the University of Chicago, with clinical responsibilities in my own practice, an urgent care, and on the inpatient service, I moved into the office next to Dr. Stern’s. I was about as well-trained as possible. I’d done a medicine residency and a year as a primary care chief resident. I had also done my share of moonlighting as the overnight “doc in house” at a community hospital and as an urgent care doctor at a multispecialty private practice.

Still, I realized pretty quickly that I had a lot to learn.

At the end of every clinic session, I’d knock on Todd’s door, my schedule in hand, with a list of questions I’d jotted down next to patients’ names. How do I test for this diagnosis? Would you add anything to this differential diagnosis? Which neurologist here do you trust? Do you think I did the right thing? Todd was unceasingly patient and kind, even when he would look a little pained and say, “Well, I might reconsider that decision.”

Todd even put me on his exam table and examined me one morning. I’d felt a bit off all weekend, with no real appetite. During my session precepting the residents on Monday morning, I developed abdominal pain and realized my right lower quadrant was pretty tender. Todd courteously examined my abdomen and seconded my proposed diagnosis. By evening, I was in the OR having my appendix out.

What I surmised about Todd from his answers to my questions proved true as I worked with him in the years that followed. While I started to be known as an “evidence-based medicine guy,” Todd walked the walk. More than anybody with whom I have worked, he practiced from the evidence. Despite (or maybe because of) his deep and extensive knowledge base, he was always searching the literature for answers to diagnostic or management questions. By doing so, he framed decisions in terms of uncertainty. Are we struggling here because we don’t know the answer, or because there is no known answer? Can we present the patient with a suggested course of therapy, or is this decision purely a matter of preference?

After realizing that the added privacy of having a doctor outside your institution was far outweighed by the benefits of being cared for by a colleague, I asked if Dr. Stern would see me as a patient. Todd has been a master at caring for an internist/colleague. He was collegial while doctorly at visits. He knew when and how to assuage the anxiety of an internist who knows too much and when to evaluate my concerns. He comfortably separated our doctor/patient relationship from our colleague/colleague relationship from our relationship as friends.

Dr. Stern has also been a model of carving his own career path. While he was active in critical administrative roles at the medical center, he never seemed motivated by the titles and trinkets dangled before faculty. Todd scheduled his clinics so that he could get his work done efficiently and get home. He was a model of a doctor, working at an academic medical center, whose primary activities were caring for patients and training housestaff.

Todd’s teaching was brilliant. Anytime I precepted resident clinics with Todd, I was sure to learn from him, usually as he quoted or pulled essential studies. He also reliably alternated between serious teaching and serious humor. He used humor to support residents and make his teaching points stickier. Not surprisingly, our internal medicine residents gave Todd the Faculty Award for Resident Teaching four times.

Those of you who have been reading Sensible Medicine may have a sense of Todd’s humor. Dr. Stern has written a couple of pieces for us: one about the absurdity of video visits and one about the humor of ICD-10. Todd kept us all afloat during the pandemic, emailing occasional poems to the entire Section of General Internal Medicine. The one I still think about concerned the relentless donning and doffing of PPE:

Our PPE, we don and doff.

We put it on, we take it off.

More donning and doffing is in the offing.

If only it could stop the coughing.

Our new best friends are Don and Doff.

We have fallen under their spell.

Whatever happened to On and Off?

Perhaps they are unwell.

I will miss Dr. Stern as a mentor, a role model, and as my doctor. He reminds me that selflessness and generosity are the hallmarks of outstanding mentorship. He will come to mind when I advise trainees about the diverse ways one can craft a career in academic medicine. I will also always be grateful to him for making my career possible and for making it better.