FISHING LESSONS: A Tribute to Michael C. Lesch M.D. (1939-2008)

By Lawrence L. Michaelis M.D., FACS

The call came on Good Friday afternoon. Mike Lesch had been found dead in bed during a fishing trip to Argentina. He had asked me to go with him, but wading in those rivers would now be too rough for me and my prosthetic hip. I made some calls and was relieved that at least he died peacefully doing what he liked, but that was no tonic for the pain of his untimely death. He had a great deal more he wanted to do and the vibrancy to accomplish it.

We met in 1975 on our way to Northwestern; he was the new head of cardiology, I was hired to start up cardiac surgery, and in those days the specialties were really joined at the waist. He took the train down to DC and we had a long lunch and started to get to know one another. Mike grew up in NYC, the only son of parents whose extended families suffered great losses in the Holocaust. He was already a household name in medicine, having discovered an important eponymous genetic disease while a medical student. Columbia, Johns Hopkins, and Harvard were his stomping grounds. I was raised in a Midwestern Catholic environment, went to medical school at Indiana, and trained at Virginia. He rowed, played basketball, and loved the Knicks and Yankees. I played golf and tennis, loved the Cubs, Bears, Indiana basketball, and Coach Bob Knight. Mike thought that Notre Dame was a church in Paris.

In spite of our vastly different backgrounds, along the way we had both spent a number of years at the NIH, had known many of the same people, and had similar views on what we thought we could accomplish in our new jobs. So we started our lunch discussing the new professional obligations awaiting us, whom we might recruit, shared possibilities in research, and the like. Then we both discovered our shared passion for fishing and immediately the relationship got onto a whole new level. We were hooked and spent the rest of the afternoon talking about wet flies, the Chesapeake Bay, and our shared love of the rivers, lakes, and especially the peoples of the high North, especially the Inuit and their culture and art.

By my reckoning we spent over half a year of our lives fishing together, mostly in the High Arctic but lots of other places – Outer Banks, Canada, Florida Keys, Bahamas, Mexico, South America, and Arkansas (which was more foreign to him than Rio Chico in Venezuela). While in Chicago we could run over to the Mississippi River for a day; on these trips he first saw corn fields, set foot in Iowa, and ate at Wendy’s, where he had, I am sure, his only triple cheeseburger. We had our favorite Chinese restaurants (he loved garlic eggplant) in towns like Yellowknife or Manaus where we had to overnight waiting for planes that might fly out to fishing locations once or twice a week – weather permitting.

Mike knew my family and I knew his; we did a few things socially but it was mainly work in the early years. We both knew and respected each other’s fathers who were even more dissimilar than we. His father was a rabbinical scholar who escaped a Bolshevik conscription camp in Poland prior to WWII, somehow got to the United States through Mexico, and eventually moved to NYC where he married an American and began a new and successful life. My Dad, a physician, was born and raised in Indiana and happily he accompanied us on a few trips. Several times we took our sons fishing with us, but school requirements and schedules were tight so often it was just the two of us, sometimes with some guys one or the other of us knew.

As the years passed, Mike left Chicago and eventually was back in New York as professor and chairman of medicine at a major academic medical center. As the years went by we saw each other less frequently but there was the occasional email or call and we kept fishing together, but less frequently. When we got together, it as if we had seen each other the day before; the friendship was so strong and the understanding of each other so complete that the bond was never broken.

Over the span of 30+ years, Mike and I spent countless days flying into remote locations, sitting in the uncomfortable tattered boats common to isolated fishing camps, wading unknown streams, sipping Irish whisky straight from the bottle, eating mediocre food, and spending nights in cabins and tents that were always way too cold or too hot. Invariably we would bunk together, initially an act of mercy on his part to spare others from my snoring but soon it was more about our late night conversations. We talked about our families and their histories, how we grew up, religion, food and wine, old times and old friends, funny things that happened while we were fishing (which always got more outrageous and funnier over the years, after all we were fishermen…), and jokes, lots of jokes. We used to say we were like a couple of prison inmates – you know the story – they know each other’s jokes so well that one guy only has to say: “#28” and the other fellow breaks up in laughter.

You get to know someone real well when you fish with him. This is not the first or last time you will hear that said but, believe me, it is the truth. Fishing brings out a man’s character and his values, his manners, and how he copes with adversity like those inevitable travel delays, bad weather, and the not infrequent lack of the expected abundance of fish (“You should have been here last week Doc” or “The wind she come up, the fish they go down.”). And then there were the strangers with whom you are oft times put together on these kinds of  trips and the occasional one who can be amazingly obnoxious – which for us was always happy fodder for more of our fishing stories.

On the technical side Mike taught me a lot about the mechanics of fly fishing, to file the barbs off of hooks so not to hurt the fish (99% of which we released), tips on reading streams, and how to double haul to better throw a line into the wind. I taught him about knots, bass, how to roll cast under bushes, bonefish, junk food, and how to get along with good old boys. When fishing, we would often stop and just watch the other guy cast or reel in a fish. Usually we stopped mid day for lunch and a brief nap. We tried to fly fish whenever possible, sometimes to the dismay of some of our companions who wanted big fish in big numbers (“meat fisherman”). To us it was the how, not the how many or how large. I think it is fair to say that for us fishing trips were more about the journey than the destination.

And we had that other special thing that I think only guys really understand; for example, how you can sit in a boat for hours at a time and say nothing but still feel intimately connected. Maybe someone provides a grunt or two now and then. Out of the blue, you might ask about whether he has heard anything from an old patient or friend, or recount a silly occurrence from long ago, or one of you tries speaking Spanish to a Brazilian guide or French to an Inuit and you both break out laughing. Sometimes we would read the poems of Robert Service or Kipling in the evenings and, the next day while eating a shore lunch, would see how well we could quote them.

In addition, our fishing itself was a lot more than catching fish. We both loved the water and its environs. We stopped to look at the sky, at flowers, and at animals or their tracks: birds of every kind that live on the tundra in the summer or are on winter migrating grounds; water fowl on flyways; bears and sea mammals; beavers and otters; alligators, turtles and cayman; and the like. Once, in the arctic, we were chased by a herd of angry musk oxen and barely escaped by getting back in our johnboat and poling out through an icy shoreline. Another time, on the Mississippi near the Palisades, we inadvertently disturbed a very large golden eagle that then angrily dive bombed us for about 15 minutes nearly knocking Mike out of the boat. The last time we were together, fishing had turned off one afternoon so we tried counting all of the kinds of fish we had caught together, about 30, and the birds we had seen which ended up very close to 100.

But I experienced far more than outdoor recreation and travel adventures with Mike. I learned about his love and unwavering pride of Judaism. I was raised with a deep respect for Jews, for their keen intellect, love of education and learning, their wisdom and toughness, but there was far more that Mike taught me: about the interweaving of religion, tradition, family, and friends with daily life that is so intimate a part of the Jewish experience; about the rhythms of the Jewish seasons and how they survive from generation to generation; the beauty of the Old Testament; and about Israel -- not so much a place, but a spiritual homeland.

I learned how he coped with prejudice, death, personal setbacks, and, every bit as important, joy, and how he dealt with them as a man and as a Jew. I respected the purity and intensity of his love for his wife, children, and grandchildren; the devotion he had for his parents and his friends (many); his inquisitive mind and outgoing personality; and his complete lack of prejudice. Mike treated everyone he met with respect and dignity. But, more than anything, I admired his absolute dedication to being the epitome of the complete physician. The older I got, the more I appreciated how precious a trait he had cultivated within himself, the discipline it required, and his passion in passing this along to those he trained.

From the first day I worked with Mike, I knew he was a special physician. No matter who it was, a U.S. senator who had sought him out or a destitute drug addict who got assigned to Mike’s service, he gave only superb care and he poured every ounce of his knowledge and experience into HIS patient. It was a sacred trust with him; if in the middle of the night or on a weekend, one of his patients needed surgery, transfer to an ICU, or had a sudden deterioration, he dropped everything and was physically there to oversee things, nothing else mattered but that patient. To this day I can still vividly see him in scrubs, looking over the ether screen, thinking along with me on a tough case and then trotting back and forth to a worried family helping them cope with the uncertainty of a critical patient in the OR. One of my surgical colleagues recounted a time at the Peter Bent Brigham in Boston when he was called for an emergency surgical procedure and when he arrived Mike had already set up the instruments and started the skin incision in order to speed things up. Not many cardiologists do that sort of thing these days.

On our last fishing trip together we were deep in the Amazon jungle trying to sleep in a rickety and narrow pontoon boat with a makeshift tent over the top. It was hot and buggy and we could hear a lot of nasty critters outside. We were talking about our fears that some of today’s young doctors lacked some of the dedication mentioned above. I asked him why he thought he still did what he did. After all, he was now a senior leader of an outstanding medical center with very important duties and responsibilities, and he was not getting any younger. Others could get up in the middle of the night.

He told me: “Larry, if I didn’t care for patients this way, how could I expect students, residents, or my younger associates to do so? We are first of all physicians, nothing more and nothing less. I would want my doctor to be with me if I was in trouble, wouldn’t you? So how could I live with myself if I didn’t act this way? If only a few of the people I train continue to treat patients the way I do, then I have done my job. Never forget the words Rabbi and Doctor mean the same thing – Teacher.”

Mike, I think you knew of the deep affection and respect I always had for you. As Kipling wrote: “So I’ll meet you later on, to the place where you have gone”… in your case, I am sure, that will be a spot with big blue skies, gentle breezes, purple sunsets, and virgin streams filled with lots of strong hungry fish. I shall miss you but I will keep remembering the many lessons you taught me. 

In the meantime, keep a tight line and remember good old # 28….*** For you who don’t know, that’s the one where the guy finally gets thrown out of the bar and his talking dog looks up at him and says: “DiMaggio?”

Michael C. Lesch, M.D. (1939-2008), was professor of medicine at Columbia and chairman of Medicine at St. Luke’s-Roosevelt Hospital Center in New York. Earlier in his career he had been associate professor of medicine at Harvard and attending physician at the Peter Bent Brigham Hospital in Boston; professor of medicine and chief of cardiology at Northwestern University Medical School and Northwestern Memorial Hospital in Chicago; and chairman of medicine at Henry Ford Hospital and Medical Center in Detroit. He was a Master of the American College of Physicians.

Lawrence L. Michaelis, M.D., FACS, was professor of surgery and chief of cardiothoracic surgery at Northwestern University Medical School and Northwestern Memorial Hospital where he later served as chief medical officer and associate dean of the medical school.