Gastroenterologist remembered for clinical acumen and devotion to the humanities

Family, friends, and colleagues gathered during this year’s reunion to remember the ever-listening ear, wicked wit, and booming voice of Howard M. Spiro, M.D., who founded and led the gastroenterology section in the Department of Internal Medicine from 1955 to 1982, and later founded the Program for Humanities in Medicine. Spiro died on March 11 in the Connecticut Hospice in Branford, Conn. He was 87.

Spiro came to Yale in 1955 to establish a nationally recognized academic research section of gastroenterology. His goal was to incorporate both medical and psychological concerns in the teaching and provision of patient care. Ten years later Spiro established the Yale-Affiliated Gastroenterology Program, an educational collaboration among fellowship training programs in south-central Connecticut. Spiro was also a prolific writer and established the Yale Program for Humanities in Medicine in 1982, which brought physicians, historians, writers, photographers, journalists, artists, and playwrights to the medical school to discuss topics at the intersections of medicine and the humanities.

Many of the speakers at the memorial service attributed their presence at Yale to Spiro, and praised his mastery of the doctor-patient relationship and graceful acceptance of death. “Death helps define what can be called, only after it is over, a good life,” Spiro once said, as remembered by Michael Bennick, M.D., associate clinical professor of medicine.

Vincent A. DeLuca Jr., M.D., a gastroenterologist who worked on the faculty with Spiro, said that every morning he passes a tree whose knots and bark form a face that reminds him of Spiro. “Good morning, Howard,” he greets the tree.

Marvin Chun, Ph.D., professor of psychology and master of Berkeley College, also had a story about trees as he recalled how Spiro nurtured the college’s seedlings into saplings. Spiro, a fellow of the college for many years, organized Berkeley’s scholarly programming and facilitated his wife Marian’s pioneering of the college’s woodshop, encouraging students to explore their artisanal talents.

Chun said scores of premeds were inspired by Spiro’s “gift for the art of healing.”

Frank Troncale, M.D., formerly on the faculty in digestive diseases, said Spiro was “like an uncle” to him. He remembered Spiro’s excellent skills in patient care and his emphasis on listening to patients, which Troncale called “pretty revolutionary” for the early 1970s. Several speakers recalled Spiro reminding his students and colleagues that the eye is for accuracy and the ear is for the truth. “What’s best for the patient?” was the question in Spiro’s mind—not what is in the financial interest of the attending physician.

Troncale also noted Spiro’s teaching ability—there was never a case that he couldn’t figure out. Once he sat down with a patient, he could draw out the nuances of their history that others had missed. Troncale recalled how Spiro learned just enough Spanish to give a lecture in Colombia. The next day, a local newspaper hailed him as “Bochica”—the savior of the people—because, like the local god, he sported a beard.

Cyrus Kapadia, M.D., professor of internal medicine (digestive diseases) and former director of the Residency Training Program in Internal Medicine, read Psalm 23, which Spiro had asked him to do when he heard Kapadia read it at the memorial service of another friend. “Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me,” the psalm reads. Rabbi James Ponet, the Howard M. Holtzmann Jewish Chaplain at Yale and director of the Joseph Slifka Center for Jewish Life, said that Spiro knew how to be the “thou” in this passage “whose presence makes death not frightening.”

Rosemarie L. Fisher, M.D., professor of internal medicine (digestive diseases), associate dean of graduate medical education, and professor of pediatrics, shared happy memories: eating baked beans made with molasses and curry powder; sailing; and lively tailgate parties before football games. Though a 1944 graduate of Harvard College and a 1947 graduate of Harvard Medical School, Spiro became a loyal Bulldogs fan, Fisher recalled.

“My father was not a modest man,” Spiro’s son, Philip M. Spiro, M.D. ’83, joked, provoking laughter from the audience. Illustrating his father’s “reverence of irreverence,” Spiro noted that his father’s original request was to be cremated and to have his ashes scattered from a plane when the wind was blowing towards New Haven. “Ever the pestering gadfly,” Philip Spiro said that his father wanted to “get into people’s eyes for one last time.”

Philip Spiro asked the audience members to do four things in memory of his father—to learn something new and apply it to their lives; to find an accepted truth and challenge it, caring as little as possible about what others think; to consider their own death and to talk about it with loved ones; and finally, to break up into small groups, have a drink and talk about his father, knowing that in doing so they were doing what his father loved best.

As is fitting, the service was followed by refreshments and conversation.