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Tom Duffy; master diagnostician, caring healer, and supporter of the humanities

Yale Medicine Magazine, 2014 - Autumn


To Lisa Sanders, M.D. ’97, HS ’00, he shared Sherlock Holmes’ knack for solving new cases based on a vast mental library of old ones. A former student described him as “more Oslerian than Osler,” referring to Sir William Osler, M.D., a founder of Johns Hopkins Hospital. Or he could be medicine’s Babe Ruth, the same former student suggested, given that Johns Hopkins allowed Yale to steal away this talented physician in 1976. Samuel O. Thier, M.D., former chair of internal medicine at Yale, thought him rather Edwardian. Another physician presented two photographs side-by-side. With his black, round-rimmed glasses, this doctor bore a striking resemblance to James Joyce. All of these physicians had gathered to honor the work and legacy of Thomas P. Duffy, M.D., emeritus professor of medicine (hematology), at a daylong symposium in March. Duffy listened, and chuckled occasionally as the presentations and photographs created a portrait of him as a polymath doctor with a boundless passion for medicine, ethics, and the humanities.

Where to begin when summarizing a person’s life work? David Hellmann, M.D., professor of medicine at Johns Hopkins, started with Duffy’s medical school application. A first-generation American of Irish parents, Duffy—fresh out of college in 1957—showed a propensity for medicine. “The aim of education is the development of the whole man, to a mature, cultured, and competent individual with strong moral values. … A doctor must possess a broad intelligence, maturity, social ability, and initiative,” the Brooklyn native wrote in his admissions essay, which was projected on a screen for the audience. The admissions team at Johns Hopkins waited only a day after Duffy’s interview to send him their acceptance offer.

After a hematology fellowship at Hopkins, Duffy became chief medical resident in the Osler Medical Service program between 1970 and 1971. Duffy carried his own microscope, Hellmann explained, so that he could examine patient fluids immediately. Stephen McPhee, M.D., a former student of Duffy’s at Hopkins who is now an emeritus professor of medicine at the University of California, San Francisco, said the master gave him simple advice: “Follow your patients like a hawk and they will teach you what you need to know about medicine.”

When Thier arrived at Yale in 1975 as chair of internal medicine, one of his tasks was to build a world-class hematology team. A year later, based on a recommendation from a member of the Hopkins faculty, he invited Duffy to Yale for an interview. Though impressed by Duffy’s credentials, Thier found him “too stiff and formal.” Thier asked the young physician, who was wearing a bow tie and had parted his hair exactly so, why all the stuffiness. “Sir,” Duffy replied, “I had always been assured that Yale was the universe of preppydom. But you are all dressed like out of an L.L. Bean catalog!” Fashion habits aside, Thier offered Duffy a job. After two years as an assistant professor at Yale, Duffy rejected an offer from Thier of a promotion to associate professor. “I may have met your standards,” Duffy said, “but I haven’t met mine.” (He accepted it one year later.)

From 1976 onward, Duffy established himself as a sought-after mentor, hematologist, and diagnostician. In a long list of teaching awards, the Leonard Tow Humanism Award stands out for the breathless comments that appeared in the nominations. Paraphrasing the students’ comments, Thier said that Duffy showed that he cared in the way that he listened to patients. Students saw his presence as a boost of motivation and enthusiasm in an occupation rife with burnout.

Current students echoed those sentiments. “You want to follow him around to learn everything and try to understand how his brain works,” said second-year medical student Eunice Martins of New Jersey, who attended the symposium. “If ever there’s a really difficult case, then he’s the only one who can solve it,” added second-year student Bobby Rosen of New York.

Speakers also recalled Duffy, one of the earliest physicians in the field of bioethics and a founding member of the ethics committee at Yale-New Haven Hospital, as a physician known for his empathetic patient care. Fred J. Schiffman, M.D., HS ’79, FW ’81, the Sigal Family Professor of Humanistic Medicine at Brown University, described Duffy sitting on a leukemia patient’s bed and spoon-feeding him Jell-O. Such humanistic care, Schiffman said, is under assault in today’s technology-driven medical environment. Bernard Forget, M.D., professor emeritus of internal medicine, highlighted the encyclopedic, yet concise, knowledge Duffy regularly conveyed to patients and colleagues. He noted that medical students who did not plan to specialize in hematology nonetheless jockeyed to be placed on rotations with him so they could absorb his diagnosis techniques.

Sanders, associate professor of medicine, author of the Diagnosis column for The New York Times Magazine, and a former student of Duffy’s, said that as a medical student at Yale, she remembered Duffy attending all of the resident report meetings. Describing him as a “collector of knowledge about patients,” she recalled comments by Hellman that when Duffy was chief resident at Johns Hopkins, he would do rounds on every single patient in Osler Medical Service on Saturdays, just to learn more about their conditions and medicine in general. Sanders also recalled having Duffy as a neighbor in New Haven. She witnessed Duffy, a consummate gardener, tending his plants and even, at times, chopping wood. “This is a guy who tries to master everything,” she said.

At the end of the symposium, the normally effusive Duffy stood at front of the room and admitted he was speechless. Though he has emeritus in his title, Duffy looks likely to remain active at the medical school. Later that month he was spotted congratulating students on Match Day.