Jeffrey A. Gudin, MD

As a surgical intern, I found myself sitting on the edge of a patient’s bed--a 60-year-old school teacher crying in pain following a large abdominal surgery--trying to convince her to “hang in there and wait” for her next suboptimal dose of pain medication. Every-6-hour IM Demerol^®/Vistaril^® was the illogical norm, and I soon developed a passion for pain management and the relief of suffering.

I was always interested in the spine as a source of health and pain, and targeted my early training towards orthopedic surgery. I was doing spine surgery research in Albany as a medical student. In between surgical cases, I met the anesthesia-based pain management team who seemed to be having too much fun. Their schedule was filled with a whole day of various pain relieving injections. After interacting with them, hearing the patient stories, and seeing just what a remarkable difference these pain doctors made, I decided that my personality, knowledge, and talents were a great fit for the specialty.

It started with...this may sound corny, but it started with my dad. He taught me the importance of family structure and values. As the son of poor immigrants, he wanted a better life for his family and always had the vision and drive to pursue success. As most elders do, he often reminded us of our heritage and just how poor we once were: that to support us he delivered and picked up cloth diapers during the day and pumped gas at night! He worked hard, was the ultimate salesman and jack-of-all-trades. He was an engineer who knew how to take things apart and make them work. He was also a true New Yorker (go Brooklyn!). I think with his engineering mind he would have made a great physician, but instead he became a great businessman. After losing his job following medical leave for an MI, he subsequently built and ran a large telecommunications company. He unfortunately died of CAD at the young age of 69.

Clinically it started at Albany Medical College more than 25 years ago with an anesthesiologist and visionary in the world of pain. He saw my passion for pain management and recommended the program at Yale under the direction of another mentor, Dr. Lloyd Saberski, who still practices in New Haven.

At Yale, I had the opportunity to train with worldrenowned pain clinicians and researchers, such as:

Luke Kitahata, a famous Japanese neurosurgeon who survived numerous bombings while living in Tokyo during World War II to later become a surgeon, neurosurgeon, anesthesiologist, inventor, teacher, lecturer, author, and administrator. Although academically brilliant, Luke taught me the humanistic values of being a physician, that each patient deserved my utmost caring, attention, and respect.

I also have to recognize Dr. Ann Berger, whose passion drove her from nursing to oncology to palliative care; she is a pioneer, and now chief of the world-renowned Pain and Palliative Care Service at the NIH Clinical Center. She taught me the utility of high dose opioids and would stop at nothing to give her patients relief. Ann's patients always managed to smile no matter how bad their disease--she had that effect on people. Her clinical care demonstrated (or exemplified?) that it's the doctor/patient interaction that means the most to successful outcomes of any disease state, even those with terminal illness.

When Sir Isaac Newton paid homage to his intellectual predecessors he said, “If I have seen further than others, it was only by standing upon the shoulders of giants.” I am honored to have the shoulders of colleagues like Lynn Webster, Steve Passik, Mike Brennan, and Sri Nalamachu surrounding me. They have been great mentors to me over the years whether they realize it or not!

For most that is a difficult question, but for me, it’s easy: a teacher. Anyone who has spent time with me has witnessed the passion that I have for teaching others. It brings a sense of gratification that doesn’t always come from the clinical practice of medicine.

Probably my sense of humor. This will probably sound crazy but I crack myself up all the time! People in the hospital make fun of me that I’m always smiling. I sometimes wish it were contagious! I find it incredible to watch our 2 1/2-year-old twins doing the same thing. I guess genetically we find life funny.

Let’s see, a number of things come to mind: board certification in anesthesiology, then pain management, then addiction medicine, and then hospice and palliative care. Being a certified medical acupuncturist. The honor of having traveled to more than 20 countries as visiting professor and invited lecturer. But my greatest achievement is something most people take for granted: having children and being a father. It’s something I had always dreamed about, and having happened late in life it has given me a sense of purpose, meaning, and more enjoyment than I ever thought possible.

Italian.

Book: The last book that I had time to read was Being Mortal by Atul Gawande. This is a must read for all clinicians, especially as we ourselves age. It certainly helps put life in perspective. The book describes the need to change the way we counsel patients to help them define and achieve what matters to them most. Being Mortal is a valuable contribution to the growing literature on aging, death, and dying. It certainly made me stop and examine how life (and death) often takes us by surprise and what I would want for myself, my patients, and my family. Gawande is a gifted storyteller, and there are some funny, stirring, and even tear-inducing passages that will change the way you think about life.

Movie: Boy, that is a tough one. When I think back at the movies I will watch over and over again they include Gladiator and The Shawshank Redemption. There is always Goodfellas, The Godfather, The Silence of the Lambs, and Forrest Gump. I recently saw Life is Beautiful on an airplane, and then came home and watched it again. It must be that sense of humor thing. Roberto Benigni's performance was incredible and it brings a tear to my eye just thinking of it.

Music: Get a hold of my iPod and you had better be a fan of all music types! From Metallica to Manilow, and I'm not kidding. Being a drummer, guitar and wanna-be piano player, I listen to Stevie Ray Vaughn, Diana Krall, and lots of Zeppelin. My Sirius radio favorites include The Highway, The Coffee House, The Blues, and Classic Vinyl. (Okay, CNBC and Howard Stern are in there as well!)

One of my last slides in my chronic pain presentation quotes: “People don’t care how much you know, until they know how much you care.” My dad would always tell us “Measure twice…cut once.” But I usually quote a sign hanging by my desk: “Life is 10% what happens to us and 90% how we react to it.”

One of my last slides in my chronic pain presentation quotes: “People don’t care how much you know, until they know how much you care.” My dad would always tell us “Measure twice…cut once.” But I usually quote a sign hanging by my desk: “Life is 10% what happens to us and 90% how we react to it.”