Pallawi Torka, MD
first day of fellowship, a terrified fellow, and a strict attending.
The inpatient leukemia rotation is considered to be a true test of resilience, requiring both mental and physical prowess. The patients are extremely sick, clinical situations can go south in a heartbeat, hours are long, and emotions run high. On top of that, this was my first rotation in fellowship. New colleagues, an unknown electronic medical record system, and science fiction–esque chemotherapy regimens led to a perfect cocktail that would have made the best of heads spin.
Am I making excuses? My attending, Dr Meir Wetzler, had no time for excuses or tardiness. Rather than ramping up gradually and letting this neophyte find her wits, he just looked at me with a matter-of-factness that conveyed “The job needs to be done—just do it!”
Initially I resented this outlook and considered his expectations unreal, until I realized that even after decades of practice, he held himself to the same high standards. He stayed at work as late as I did, and when I would come in the next morning, evidence of his industry would be flooding my mailbox I literally had no clue when he slept or ate.
Soon, after realizing what a nitwit I was, like a good fellow, I sought solace in Harrison’s Principles of Internal Medicine, that good old friend from residency days who could teach me a bit about hematology. I didn’t know what other textbook to turn to. I opened to the chapter on chronic myeloid leukemia (CML). Lo and behold, my attending was the author! Instantly, my respect for him soared exponentially. This distinguished person, rock star of his world, worked night and day unassumingly, with no airs whatsoever. I want to be like that someday! And that was the moment when in my mind our relationship changed from attending–fellow to mentor–mentee; my leukemia attending physician became my ideal, someone I aspired to emulate from there on.
Of course, it was not all smooth sailing. Dr Wetzler’s teaching style was old-school. We would gather around a table and he would draw quickly and ask pointed questions, most of which, despite my years of training, had me stumped. Embarrassment is a great motivator to read more. To this date, amid all that I have learned and forgotten, I still remember what he taught during those sessions—the lock-and-key analogy of various tyrosine kinase inhibitors in CML, their bizarre adverse effects how the Philadelphia chromosome is differentl mutated in CML and acute lymphoblastic leukemia, and the list goes on.
I cannot say that humility was his strongest suit, but he was quick to admit his limits. When challenged with questions outside his expertise, he would have no qualms admitting, “I am sorry. I am not up-to-date with the literature on this topic.” Of course, he wouldn’t just leave it at that. If he thought the question was significant enough, he would study the evidence until he found the answer or call in an expert. As he said often, being thorough is very important in oncology.
It was not all work and no play with this dynamo. I was shocked to learn that this sprightly man was also a triathlete. Of course, sedentary me decided to draw the line at emulating him right there. Every year, this dignified professor enthusiastically participated in oddball charity events like the Gelatin Splash, which involved wearing a funky costume and jumping into 2000 gallons of red gelatin! Some of his avatars for the splash included the Mad Hatter, Kinky Boots, Gru from Despicable Me, Genie from Aladdin, and, of course, Superman. He would throw himself wholeheartedly into any undertaking if it resulted in the betterment of his patients. His enthusiasm was so infectious that the whole division got involved with his shenanigans and the costume contest became a summer staple.
A common refrain on everyone’s lips was “How does he find the time?” And that’s where his leadership skills kicked in. Dr Wetzler was a true team player. He loved his team, and his team loved him right back. He was a taskmaster and demanded the best from everyone every single day, but behind that tough exterior was a heart of gold—he would be the first person to answer a call for help.
After I finished my leukemia rotation, I saw less and less of him. At times when our paths crossed, even though our interactions were brief, he always left me with a snippet of knowledge. Over time, lymphoma became my calling, I found new mentors and moved on, and thoughts of my first mentor slowly faded. Two years later, tragedy struck. Dr Wetzler met with a fatal accident while skiing and was gone, just like that, leaving behind a gaping wound in the hearts of all whom he had touched. This article is supposed to be about what I felt and how I coped. The truth is that for the first few days, I didn’t feel a thing. I suppose I was sad about the loss and what it meant to my institute, his family and patients, and the leukemia community in general, but I was just numb emotionally. My mind, on the contrary, was spinning.