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Legacy and communication in palliative and end-of-life care: Honoring Dr. J. Randall Curtis

Published online by Cambridge University Press:  18 April 2023

William E. Rosa*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Rachel A. Hadler
Affiliation:
Department of Anesthesia, University of Iowa Hospital and Clinics, Iowa City, IA, USA
Elizabeth Dzeng
Affiliation:
Division of Hospital Medicine, University of California, San Francisco, CA, USA Cicely Saunders Institute, King’s College London, London, UK
Donald R. Sullivan
Affiliation:
Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health and Science University, Portland, OR, USA Center to Improve Veteran Involvement in Care (CIVIC), Portland-Veterans Affairs Medical Center, Portland, OR, USA
Andrew S. Epstein
Affiliation:
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA Weill Cornell Medical College, New York, NY, USA
Judith E. Nelson
Affiliation:
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA Weill Cornell Medical College, New York, NY, USA
*
Corresponding author: William E. Rosa; Email: rosaw@mskcc.org
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Abstract

Type
Guest Editorial
Copyright
© The Author(s), 2023. Published by Cambridge University Press.

The Latin roots of the words “legacy” and “communication” are cousins of sorts: Legatus means “ambassador” or “delegated person,” while communicare means “to share.” In gifting a personal and professional legacy, there is communication of ideas, ideals, and information through trusted delegates. The enduring legacy of Dr. J. Randall (“Randy”) Curtis is communication itself, as a means of expressing concern for those who are suffering from life-limiting illness – both the patients and their loved ones. For Randy, compassionate, person-centered communication throughout serious illness, critical care, and end-of-life settings was his guiding principle as a research priority and practice of excellence.

Randy died on February 6, 2023, of amyotrophic lateral sclerosis (ALS). We mourn this loss, along with colleagues around the world and the family he loved, above all. He transcended specialties with his commitment to mentorship, courage to lead from the heart, scientific innovation, and deep desire to create academic cultures rooted in kindness, collegiality, and love (Boss et al. Reference Boss, Creutzfeldt and Fausto2022; Butler et al. Reference Butler, O’Hare and Wong2022; Dzeng et al. Reference Dzeng, Merel and Kross2022; Hua et al. Reference Hua, Wunsch and Aslakson2022; McDermott et al. Reference McDermott, Coats and Bernacki2022). There are countless multidisciplinary ambassadors – clinicians, researchers, educators, trainees, administrators, and leaders – who are inspired by Randy’s legacy and actively seek to carry on his important work. His overriding commitment to human betterment in all stages of illness through systematic development and evaluation of empathic communication that honors and prioritizes the value of personhood resonates throughout the maxims and truths recognized by his mentees. Randy was clear: “Enrich your life”; “When you feel out of work-life balance, you’re probably right”; and “Live every day like you have a terminal illness” (Rosenberg et al. Reference Rosenberg, Engelberg and Kross2022).

Randy was known for his selflessness, generosity with his time, pragmatism, and quality of his advice. He graced and gifted us and countless others with his mentorship on issues across and beyond the academic spectrum. He was approachable, personable, and available, despite the many demands on his time. Randy’s feedback, whether in private or in group settings, was always accompanied by genuine intellectual curiosity for the mentee, the work, and the field.

To Randy, mentorship was inextricably linked with communication. He was a master of communication, with patients, families, and his mentees alike. Even when ALS had robbed him of his most important communication tool – his voice – he was still able to convey his broadest support and happiness around our accomplishments with words of joy IN ALL CAPS, punctuated by his trademark exclamation points!!! For the inevitable times when difficult conflicts or hard truths needed to be discussed, he was skilled in his ability to genuinely focus solely on the mentee’s well-being and interests. He always delivered his advice sensitively and positively. Randy’s gift was his ability to see the connections between serious illness communication and mentoring – that they were not distinct entities but rather goals of care/career conversations that draw upon the same skills and capacities for human connection.

Randy derived great personal joy from seeing others succeed and one of his greatest strengths was his collaborative spirit. As evidenced by his Festschrift published in the Journal of Pain and Symptom Management (Volume 63, Issue 6), these collaborations were incredibly impactful to those who worked with him and stretched around the world. While most successful scientists foster collaborations, to Randy these collaborations more closely resembled friendships where he seemed more invested in the person than the products. As he explained to us in his own words, “[W]ork with people you like or even love” (Curtis Reference Curtis2022). He would email at all hours of the day or night, congratulating mentees on a recently published article or grant awarded (with many exclamation points added). During the inevitable times when our grants were not successful, he would remind us of the R01 he submitted 8 times before being funded, which gave much-needed encouragement to continue persevering. Given all the trials and tribulations of academic medicine, these small encouragements were enormously meaningful and a further testament to Randy’s unparalleled commitment to his mentees. He prioritized this role even in the last months, and even days, of his life.

In this issue of Palliative & Supportive Care, we feature a conceptual article that Randy collaborated on with Drs. William Rosa and Crystal Brown, “Race Conscious Serious Illness Communication: An Interpersonal Tool to Dismantle Racism in Practice and Research.” Drs. Rosa, Brown, and Curtis focus on how to best use person- and community-centered communication as a tool to dismantle racism while fostering authentic relationships and creating safe spaces to address the complex and harmful consequences of racism (both historical and ongoing) on patient and family well-being. Using Public Health Critical Race Praxis as a framework, the authors offer recommendations to acknowledge racial dynamics within the patient–clinician encounter and promote antiracist palliative care in both clinical encounters and scientific endeavors.

We are all forever indebted to Randy for his mentorship and friendship, and the privilege of serving among the many ambassadors of his legacy. Each and all, separately and together, we strive to be Randy’s delegates – helping patients with serious illness and their families feel heard and valued, reassuring them that they will not be abandoned. We hope to honor his memory in our ongoing efforts to embrace compassion at the intersection of science and person- and family-centered care, asking research questions that can strengthen the evidentiary foundation and helping to nurture the next generation of palliative care researchers and leaders. Randy will live on as an extraordinary leader who has shared from his heart, intellect, and experiential wisdom in ways that have changed us and our fields forever.

Competing interests

None declared.

References

Boss, RD, Creutzfeldt, CJ, Fausto, JA, et al. (2022) Leading from the heart. Journal of Pain and Symptom Management 63(6), e645e646. doi:10.1016/j.jpainsymman.2022.02.012CrossRefGoogle ScholarPubMed
Butler, CR, O’Hare, AM and Wong, SPY (2022) Supporting scholarship in palliative care across the medical specialties. Journal of Pain and Symptom Management 63(6), e665e666. doi:10.1016/j.jpainsymman.2022.02.007CrossRefGoogle ScholarPubMed
Curtis, JR (2022) Life lessons after a career in intensive care medicine. Intensive Care Medicine 48(2), 257258. doi:10.1007/s00134-021-06567-zCrossRefGoogle ScholarPubMed
Dzeng, E, Merel, SE and Kross, EK (2022) J. Randall Curtis’s legacy and scientific contributions to palliative care in critical care. Journal of Pain and Symptom Management 63(6), e587e593. doi:10.1016/j.jpainsymman.2022.02.335CrossRefGoogle ScholarPubMed
Hua, M, Wunsch, H and Aslakson, RA (2022) Transformational leaders transcend specialities. Journal of Pain and Symptom Management 63(6), e647e648. doi:10.1016/j.jpainsymman.2022.02.339CrossRefGoogle ScholarPubMed
McDermott, CL, Coats, H, Bernacki, GM, et al. (2022) What does it mean to be an excellent mentor? J. Randall “Randy” Curtis’ living legacy. Journal of Pain and Symptom Management 63(6), e657e659. doi:10.1016/j.jpainsymman.2022.02.020CrossRefGoogle Scholar
Rosenberg, AR, Engelberg, RA and Kross, EK (2022) Truths, principles, maxims, and other smart things we learned from J. Randall Curtis. Journal of Pain and Symptom Management 63(6), e595e600. doi:10.1016/j.jpainsymman.2021.12.028CrossRefGoogle ScholarPubMed