Leo M. Cooney, Jr., MD, Humana Foundation Professor of Medicine (Geriatrics), will retire, effective July 1, 2020.
Cooney had decided to retire a year ago but wanted to make sure that his retirement was “done in a thoughtful way.” First, he wanted to make sure his patients would be taken care of. Cooney has a dual specialty in geriatrics and rheumatology, and worked closely with colleagues in the Sections of Geriatrics and Rheumatology, Allergy & Immunology who would be caring for this patients.
“I've been working with Dr. [Vaidehi] Chowdhary, who’s been fabulous, on transitioning my patients to four different rheumatologists,” explained Cooney. “I've been meeting with them and did summaries of all the patients. It is working well.”
Cooney also acknowledged that his own work partially led to his decision. “I have been working with Dr. Balcezak on the problems of older physicians and know that I had to stop sometime,” he joked. Cooney partnered with Thomas Balcezak, MD, executive vice president and chief clinical officer at Yale New Haven Hospital (YNHH) on cognitive testing of older clinicians, which was recently published in JAMA.
The Early Years
After earning his undergraduate degree from College of the Holy Cross, Cooney earned his medical degree from Yale School of Medicine (YSM) in 1969. He went to Boston City Hospital for his residency and then was drafted by the U.S. Army. He worked as director of the Outpatient Clinic at Fort Campbell, Ky. for two years and then returned to Boston for his chief resident year and fellowship. In 1976, Cooney returned to Yale and was named assistant professor of medicine.
In 1976, Cooney and others started a resident rotation in geriatrics, which continues to this day.
“A big part of what I have tried to do is to train general physicians. Medical students are great, but they change a lot as they go through training. If you want to influence someone's practice patterns, you want to get them during their residency or fellowship. So we have focused on resident training,” explained Cooney. “I have a particular interest because of my rheumatology background in doing the physical exam to find out two things: Number one, what's the source of the patient's pain? And number two, what's the source of their problems with mobility? The latter is a big issue in geriatrics. So I do spend a fair amount of my time at the bedside going over how to evaluate those two problems.
Vice Chair of Clinical Affairs Lynn Tanoue, MD, MBA, met Cooney was she was house staff. “Leo was smart, kind, and he would teach. You knew that you would learn something. I think a lot of us back then learned our joint and rheum exam from Leo. He’s been part of my Yale life. He is such a great doctor. He's just this superb clinician. And his patients love him. He really cares about the quality of the medicine.”
Joseph Craft, MD, Paul B. Beeson Professor of Medicine (Rheumatology) and professor of immunobiology, met Cooney in the summer of 1978.
“I first met Leo when I was a junior resident. I would go to the Continuing Care Unit to see Leo's patients at night and on weekends for emergencies. I was struck by how well they were taken care by Leo and the nurses in that unit” said Craft. “I then was a primary care internist for two years in the Primary Care Center, and started seeing a lot of patients with joint problems and rheumatic diseases. Leo taught me rheumatology. He is one of the reasons I went into rheumatology. So after I did my two years of primary care internal medicine, I became a rheumatology fellow and Leo continued to teach me.”
“As I got to know Leo over the years, I got to appreciate him as a colleague, because when I became a junior attending, I used to see patients in rheumatology clinic and Leo was always there. Any time I had a difficult patient, I would always ask Leo's advice. Another thing I came to appreciate was that Leo has extremely good judgment in terms of his building the geriatrics program here,” continued Craft.
Geriatrics Section Chief, Mary Tinetti, MD, Gladys Phillips Crofoot Professor of Medicine (Geriatrics) and Public Health credits Cooney as part of the reason she came to YSM in 1984.
“When I did my geriatric fellowship, Ron Miller was one of my co-fellows. He was from this area, and was being recruited by Dr. Cooney. I was looking around for programs and the draw to YSM was really a combination of things,” explained Tinetti. “My primary reason was the clinical research with Dr. Alvan Feinstein and Ralph Horowitz. But an equally driving force was that Dr. Cooney, whom I had never met before, was starting this new program in geriatrics. So the idea of being able to combine a newly-developed geriatrics program with world-class research was really wonderful. Leo was incredibly supportive of me doing the clinical research.”
Rising Through The Ranks
Cooney became associate professor in 1980, and full professor in 1987, when he was awarded a named professorship. From 1993-1999, he served as the section chief of General Internal Medicine.
During his time as section chief, he was recruiting Michael Green, MD, professor of medicine (general internal medicine) who was working in Boston, Mass. at the time. Unbeknownst to Cooney, Green’s girlfriend, Terri Fried, MD, professor of medicine (geriatrics), was working in geriatrics in Providence, R.I.. During Green’s interview, he asked Cooney where they should reside in between New Haven and Providence. Cooney proceeded to inquire about Fried’s career, and in 1995, both Green and Fried moved to New Haven and became faculty at YSM.
Fried considers Cooney one of her mentors. “Once I arrived here, Leo was my ultimate boss. We had a lot of contact with each other, especially early on, to make sure that I was going through the milestones of an early career in the way that it was supposed to be,” explained Fried. “I would give him my papers to read because if your work passed muster with Leo, then you knew that you were going be okay with either journal editors or grant reviewers. Leo will not mince words. He would be very honest with any of us who brought work to him, but because my work was so clinically-oriented, it was Mary Tinetti who suggested that I use Leo as a sounding board because, again, if it was good with him, then I was in good shape.”
Cooney is a compass, according to James Lai, MD, MHS, MSc, assistant professor of clinical medicine and associate chief of clinical affairs (Internal Medicine/Geriatrics).
“He gets straight to the point and points you in the right direction, and he says, ‘This is what you should do, this is the right way, this is the right direction you should go in,’” said Lai.
Patrick O’Connor, MD, MD, MPH, FACP, Dan Adams and Amanda Adams Professor of General Medicine and chief, General Internal Medicine, also credits Cooney as a mentor and trusts his advice.
“Leo is a true ‘mentor’s mentor,’” said O’Connor. “At a critical time early in my career, Leo gave me some ‘straight talk’ - some very specific and concrete advice on how to succeed at Yale and in academic medicine more broadly. Not only did I take his advice to heart, I have shared ‘The Cooney Way’ with generations of Yale trainees and faculty since. I was deeply honored when Leo handed me the reins of Yale General Internal Medicine and have tried my best to live up to his standards of what it means to be a great academic leader.”
After transitioning General Internal Medicine to O’Connor, Cooney led the newly created Section of Geriatric Medicine for 13 years. The section has grown to more than 25 faculty who are dedicated to improving the independence and quality of life of older adults through research, education, and clinical care, under the leadership of Cooney, and now Tinetti.
“If you talk about geriatrics, we wouldn't be here without Leo being the spur to get things started. He recruited all the initial people, brought in the VA which hadn't previously been part of the program. He expanded the program into the community,” said Tinetti.
“So many of us have come, and never left, and that's a big testament to Leo. I think the fact that he leaves behind a section as strong as we are despite being a small pool of geriatricians. We train our own, and then we invite them to stay with us. And whereas it might take three different people to do everything that Leo did, we are training really good people who can take on those narrower roles to be able to continue the work,” said Fried.
Impact of “The Cooney Way”
Tinetti described Cooney’s influence.
“His impact goes well beyond geriatrics,” said Tinetti. “I don't know if there's anybody who has bridged Yale New Haven Health and Yale School of Medicine, and particularly the Department of Medicine like Leo. He was the go-to person. Leo is the inspiration for everybody who's come along after him.”
Although no one can fill Cooney’s shoes, the Section of Geriatric Medicine has a strong base, due to his recruitment efforts.
“I don't think there is a single person who could fill in for Leo, but that's the bad news. The good news is that Leo has been very generous with his teaching, and so many of us, including myself, have learned from him,” noted Balcezak. “His legacy will be the people that he has trained, both other physicians and the non-physicians. But you know the thing that I'll miss the most is just his companionship, his collaboration, and his friendship, because again, no matter what the issue, he was always there to help.”
“When I think of the junior faculty, although there is not a single person who embodies all of Leo’s characteristics, I think Leo and Mary, either subconsciously or not, have chosen people that uphold the same kind of principles,” said Lai. “It’s going be one of these huge legacies. Our junior faculty work very hard and uphold principles of quality, but also have a passion for geriatrics like Leo does. He’s done an amazing thing for the field and for our status here at Yale. It is going be a challenge for me because I'm taking over some of his clinical and administrative roles. I feel like I have to be the ‘Leo Cooney’ in the room,” said Lai.
Cooney has won nearly every teaching award given within the Department of Internal Medicine, YSM, and YNHH. He was named YSM “Teacher of the Year” in 1981. For five years, he won the Geriatric Medicine Academic Award from the National Institute of Aging. In 1994, the American Geriatrics Society gave him the Nasher/Manning Award for his national contributions to Geriatric Medicine. He’s won other YSM teaching prizes, the Charles W. Bohmfalk Teaching Prize for outstanding contributions to the Clinical Science Teaching Program in 1994, the Alvan R. Feinstein Award for Outstanding Teacher of the Year of Clinical Skills in 2007, the Edwin C. Cadman Award from the Yale Primary Care Residency Program in 2010, and Teacher of the Year from the Yale New Haven Hospitalist Service in 2011. Cooney won the Connecticut Laureate Award from the American College of Physicians in 1996. In 2012, he was presented with the Denis W. Jahnigen Memorial Award from the American Geriatrics Society for a nationally recognized, distinguished career in geriatric education. In 2014, Cooney was honored as the recipient of the annual David J. Leffell Prize for Clinical Excellence which is bestowed on a Yale faculty member who best exemplifies clinical expertise, a commitment to teaching, and the highest standards of care and compassion for patients. In 2019, he was given the Distinguished Alumni Service Award from Association of Yale Alumni in Medicine.
In addition to his YSM roles, he served as president of the YNHH medical staff from 2008 – 2010. In addition, Cooney is a member of the American Geriatrics Society; he was president and chair of the Board of Directors from 1990 - 1992.
“If you ask Leo to help, he always says yes. Immediately and unequivocally. He is one of a kind,” said Balcezak. “He's promised me that he will stick around to help with our Late Career Practitioner Policy. He has been our leading light on that project.”
"Leo is for me, as well as for many others, the complete physician. He dispenses his towering command of medicine in a common-sense fashion leavened with his Gaelic wit and comforting manner. His counsel and attention have always been available to me, even though he was not my personal physician. He was unerring in his clinical judgment, which frequently included his wise recommendations to disregard what others would have acted upon. His clinical smarts are legendary and only exceeded by the fashion in which he has so unselfishly lived his life in the profession,” said long-time colleague Thomas Duffy, MD, professor emeritus of medicine (hematology).
Cooney will be missed for many reasons, but especially for his baseball knowledge, said Fried.
“The most fun thing with Leo was dissecting the Red Sox because I'm a Red Sox fan. I didn't have any natural aptitude in this, but my daughter and my husband are Red Sox all the time. So it was very gratifying to be able to come in the morning after a late game and dissect out what was happening and what the prospects were. Leo always had the key insights. It's so nice when you can start off a day with something that reminds us that there's a lot of stuff beyond the four walls of the hospital. I think that always makes us better people,” said Fried.
Despite all his accolades, Craft feels sorry for Cooney. “I know he still regrets John McNamara pulling Roger Clemens in the eighth inning for a pitch hitter in game 6 of 1986 World Series against the Mets. And not pitch hitting Don Baylor, his best hitter, with a man on second, instead using Mike Greenwell who struck out. Leo will always remember that play. But the Sox finally broke the curse in 2004; Leo was a happy man.”
It was just time, said Cooney about his retirement. “I still enjoy the work tremendously. It has been 44 wonderful years.”
The Section of Geriatrics strives to improve the health of older adults by providing exceptional patient care, training future leaders and innovators in aging, and engaging in cutting-edge research. To learn more about their mission, visit Geriatrics.