- In MemoriamSherwin B. Nuland (1930–2014)
The world of medicine and history suffered a loss with the death of Sherwin B. Nuland on March 3, 2014. The son of Russian Jewish immigrants, he changed his Yiddish name—Shepsel Ber Nudelman—yet preferred to be known as Shep. Raised in the Bronx, he had a difficult early life. His mother died when he was eleven, and his unpredictable father suffered from neurological complications of syphilis and often exploded with rage. Despite an unhappy childhood, his abilities were evident at an early age. He attended the prestigious Bronx High School of Science, graduated from New York University, and received his M.D. degree at the Yale School of Medicine where he also completed a residency in surgery.
An outstanding surgeon, Shep was associated with the Yale-New Haven Hospital from 1962 to 1991, and also served as a clinical professor of surgery at the Yale University School of Medicine. Although he became famous for his writings after leaving clinical practice, he was above all a caring physician devoted to his patients and their families. To be sure, he was sometimes hostile to some academic historians because he believed that they did not grasp the essential nature of clinical medicine and medical thought. Yet he and I always had a congenial and fruitful relationship, partly because we came from similar backgrounds. I too was a child of Jewish immigrants and raised in the Bronx, although my relationships with my parents were always close. Moreover, Shep felt that I never manifested hostility toward physicians.
In his early 40s Shep experienced a severe depression, perhaps because of guilt and shame that he attributed to his family circumstances. Institutionalized for more than a year, he was fortunate that a young resident psychiatrist overruled colleagues who had recommended a lobotomy and instead prescribed electroshock therapy. The treatment, as Shep noted in a memoir, was a success and he was able to resume his career.
Although pursuing his surgical career, his interests in medicine, history, and philosophy expanded. Retiring from medical practice in his early 60s, he launched a second career that brought him to national attention. His command of the written word was extraordinary, as were his interests. [End Page 494] In such journals as the American Scholar and the New Republic—to cite only a few—he wrote on a variety of subjects. At the same time he produced a series of memorable biographical books dealing with Maimonides, da Vinci, Semmelweis, and other prominent physicians. His most famous work was How We Die: Reflections on Life’s Final Chapter (1994), which received the National Book Award. Written in an iconoclastic style, the book presented a decidedly unromantic portrait of the processes by which life succumbs to the diseases associated with aging. It appeared at a time when American society was debating the ethical and legal issues associated with physician-assisted suicide as well as death with dignity. Death, he maintained, was rarely peaceful. Shep was especially critical of his medical colleagues. Too many of them, he believed, viewed death as the enemy and were prone to recommend aggressive and invasive therapies that had little or no chance of success but which prolonged intense suffering. Individual choice—not medical prescriptions—should govern the manner in which we die. Ideally individuals should die in a home rather than a hospital setting surrounded by loved ones. Written in an elegant style, How We Die remains a classic that will surely endure over time. His philosophy was best expressed in his Lost in America: A Journey With My Father (2003), which began with a line attributed to the great Jewish philosopher Philo of Alexandria: “Be kind, for everyone you meet is fighting a great battle.” No better epitaph describes his own life. [End Page 495]
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