In June 1968, the ABPN issued its first set of certificates in Neurology with Special Qualifications in Child Neurology (Charles Barlow received Certificate #1, Arnold Gold #6, Isabelle Rapin #9). Less than a year later, an ad agency in Richmond launched one of the most iconic tourism marketing campaigns of all-time with the tagline, “Virginia is for Lovers.”
The connection might not seem obvious at first glance, but had you been with me at Jack Pellock’s funeral in Richmond the third Saturday morning in May, or driven north to Charlottesville that afternoon to stroll around Monticello with Rob Rust, two weeks after he retired, you might have spotted it. As different as these two squires from the Commonwealth of Virginia were in temperament and appearance, both nurtured and generously shared with colleagues a vast wealth of knowledge in the unfolding mysteries of neurological development and disorders, Both richly personified Ray Bradbury’s oft- quoted credo: “Do what you love and love what you do.” And, both are, or were, not “merely” respected and revered, but genuinely and unabashedly loved by their colleagues, as witness Larry Morton’s wonderful tribute to Jack posted on the CNS website, and Phillip Pearl’s splendid profile of Rob Rust, published in the October 2015 CNS Connections in tandem with his receiving the Blue Bird Circle Training Director Award (also available on the website).
Physicians in general, and pediatric neurologists in particular, have a chronic tendency to communicate in acronyms. When texting and Twitter came along, they were ready for it. It should come as no surprise, then, that two three-letter acronyms spring immediately to mind when talking about Jack and Rob – JOY and AWE – with two more springing up along the way: PLA and PLW.
When I think of Jack, the word “joy” materializes almost unbidden: “joy” as in “a sense of wellbeing,” “exuberance,” or “a source or cause of delight”. The acronym serves equally well: “JOY as in “Just Offer Yourself.” Jack didn’t wait for someone else to fill a void or need. If there was a role he could fill, or a service he could provide, he didn’t hesitate to make the offer and never failed to follow through and make good on it.
- As a respectful and well respected partner to and provocateur among pharmaceutical companies, Jack lobbied tirelessly and effectively for increased pediatric labeling and treatment options for children with epilepsy.
- As a past president of the American Epilepsy Society and
past and present board member, respectively, of the Child Neurology Society and the Child Neurology Foundation, Jack generously offered his time, energy and vision to each in a manner that made plain to all that they were stronger standing and working together toward their complimentary missions than they were competing with each other and struggling apart.
- As the longtime friend and protege of Kiffin Penry, Jack carried on his legacy, enriching the epilepsy training of two generations of child neurologists, dating back to the mid-90s, by bringing together an impressive stable of experts in the field to stage a two-day epilepsy seminar for PGY5 residents immediately before the CNS Annual Meeting. Jack hoped that in time this would become a fully integrated feature of CNS annual meeting programming. And while he harbored no illusions that the transition from a pharma-funded satellite model to a Society-funded training and networking program might take time to fully evolve, he believed it was not merely worthwhile, but essential.
“These seminars aren’t just about competence,” he told me last year at the CNS meeting. “They’re about networking and building community.” He didn’t say it, but I will: as an extension of Jack himself, they were about continuing to cultivate a “JOYful” community (“Just Offer Yourself”) of general and subspecialty pediatric neurologists including, but not limited to epileptologists. A community of “dual citizens” willing to remain fully engaged with each other, to stay in meaningful conversation with each other, to continue offering their time and talents to each other for the common good. Switching gears (and few could do that better), Jack touched on Rob Rust in the same conversation, rueing the fact that he had to leave the meeting early (but for the best of all reasons: his daughter’s wedding) and would miss seeing Rob receive the Outstanding Training Director Award on Friday morning. “Rob had all of us thinking for years that being bald was somehow a marker of how bright you were,” Jack remarked while playfully rubbing his chemo-smoothed pate, “Imagine my disappointment when I didn’t just catch up with Rob, but blew by him, only to find out I still wasn’t half as smart!”
If it were “simply” a matter of smarts, the word “awe”might not serve our purposes so well as, say, “envy” or “amazement.” Where the word “awe” fits so well with Rob – as both word and acronym – is in its ability to suggest scope and scale, silence and reflection, a sense of humility and humanity, of being centered, soulful, and grounded. Of being as willing to listen as to speak. I am thinking here of some comments Rob made as a panelist addressing junior members at the 40th CNS Annual Meeting in Savannah in 2011 (the clip is available on the CNS Website “Careers – Getting On” section: “Handling Stress and Anxiety, Personally and Professionally; your own, your patients…”).
“The one most important question to ask is right at the end of your history,” Rob quietly asserts – “And what else?” – repeating the question after each halting, tentative response (from the parents); “And what else? And what else?” Finally, the parents may say, ‘Well, there’s nothing else.’”
“But many times,” Rob observes, “whether this is a first visit or the patient has been with you for many years, they may look at each other and say, ‘We were thinking of getting a divorce,’ or ‘Should we put our child in an institution?’ It takes that long sometimes for that to come up. So if you can ask that ‘What Else’ question, you’ll be doing everybody a favor.”
Classic Rob. An almost zen-like sensitivity and core-consistency of character that marries the well-honed professional skills involved in listening to a patient with a lifelong personal disposition toward listening patiently…to everyone, thereby “Doing everybody a favor.” And the lesson learned over time applies not solely to the clinical exam, but translates more broadly to the manner in which one approaches and adapts to parallel situations in one’s own life and the lives of those one shares time and space with on a regular, even daily basis: medical students and residents beset with anxiety; colleagues besieged and burned out by a rapidly, almost chaotically changing set of professional and cultural guidelines, rules and expectations. And, above all, family members.
So, “AWE,” then: “And What Else?” The question asked gathering patient histories is also the sine qua non of the professional calling Rob initially started out pursuing in his youth. When I visited Rob last fall in Charlottesville and got the two-hour “Grand Tour” of the most beautiful college campus in America, (including a lingering pause by the bench where he proposed to Betsy), we stood together in the small parking lot separating his current office from the building housing the History Department twenty yards away. “I guess I haven’t made much progress in 40 years, have I?” he mused, wonderingly.
What struck me at that moment was how, one way or another, we seemed destined to meet in this very parking lot. As an undergraduate at the University of Minnesota, I leaned strongly toward going to graduate school in History at the University of Virginia; Rob may well have ended up being my graduate advisor. Instead, seduced by film, fiction and femmes fatales, then ensnared by a part-time job in Ken Swaiman’s Division of Pediatric Neurology, I somehow found myself, thirty some years later, with the CNS. However improbable and indirect the route, Rob and I met and became friends. Through the years we have ended up sharing many conversations about American History – in Charlottesville, at Appomattox Courthouse, at Monticello, as well as at a couple dozen CNS meetings – that we might otherwise have had daily at UVA or yearly at AHA annual meetings. Either way, the general theme of those wide ranging conversations might still most usefully be encoded using a third acronym: “PLA,” shorthand for “the Possibilities of Life in America.”
What began for Rob as an academic career in History spent asking the question, “And What Else?” relative to “the Possibilities of Life in America,” became instead a calling spent asking the same question of patients, parents and fellow pediatric neurologists: what are “the Possibilities of Life in America” for children with neurological diseases or disorders and how might they be improved upon? That question, or challenge, is not or need not be limited to America, of course; no more so, certainly, than the declarations of rights and freedoms issuing from the Sage of Monticello were or still are.
Three weeks before seeing Rob in Charlottesville, at a meeting of the International Child Neurology Association board of directors in Amsterdam, I talked about “PLA” while presenting the CNS proposal to host a joint CNS-ICNA meeting in San Diego in 2020. Noting Rob’s commitment to international child neurology – his multiple trips worldwide to deliver lectures, conduct clinics, and lead grand rounds, and his service on the ICNA Board of Directors – I suggested that once again, Rob was leading, training, and inspiring his colleagues in child neurology, young and old, by expanding the scope of “PLA” (the “Possibilities of Life in America”) to “PLW (the “Possibilities of Life in the World”) for children, their families, and the community of child neurologists engaged in research, advocacy, and direct medical care on their behalf. I mentioned as well how easily, and appropriately Rob’s signature “AWE” question might also lend itself to another variation on “PLW”: the Possibility of Learning from (or with) the World,” a possibility CNS members were increasingly ready and willing to embrace.
Louis Sullivan, the great American architect (“Father of Skyscrapers”) once noted, “In a democracy there can be but one fundamental test of citizenship, namely: Are you using such gifts as you possess for or against the people?” In following their call to be child neurologists, Rob and Jack met and mastered that test with a sense of JOY and AWE, extending the Possibilities of Life in America to the World. Doing what they loved and loving what they do, they earned the respect, admiration – and love – of their colleagues and their communities.
Driving back to Richmond from Charlottesville on I64 before the next morning’s flight home, I slowed down to follow a pick-up for a few miles, halfway wondering if I had fallen asleep and was dreaming. For there, improbably, centered above its license plate, was the classic bumper sticker: