“The model of civility, graciousness, and caring”

In Spring 2022, one of the Rx Foundation’s founding trustees, Dr. Howard Hiatt, was elected Trustee Emeritus in recognition of his two decades of service to the Foundation.

Dr. Hiatt is known for his extraordinary record as a mentor and his many accomplishments in the medical field, with the latter including his participation as a young researcher on the team that discovered messenger RNA and his innovative leadership as Chief of Medicine at Beth Israel Deaconess Medical Center. He also spent 12 years as Dean of the Harvard School of Public Health and co-founded the Division of Social Medicine and Health Inequalities at BWH. (You can read more about Howard in this excellent biography by Mark Rosenberg).

At the Rx Foundation, Howard provided expert guidance from the Foundation’s earliest days as one of its three original trustees. Meeting at a repurposed card table with fellow trustees Serena Hatch, Rx’s founder, and her husband, Frank Hatch, in the Hatches’ Boston apartment, he helped the foundation identify and support emerging leaders and organizations committed to advancing health care delivery and health equity.

Talk about Dr. Hiatt with those who know him, however, and rather than reciting his many accomplishments, they are likely to tell you about the personal impact he has had on their lives. The biography by Mark Rosenberg bears this out, as do the following comments I gathered from Rx trustees. The portrait that emerges from these and other sources is that not only of a gifted leader, but also of a devoted mentor and stalwart friend.

Dr. Heidi Behforouz (Medical Director of L.A. County Housing for Health), who was closely supported by Howard in the Prevention and Access to Care and Treatment program that brought care to low-income families in the Roxbury neighborhood of Boston in the 1990s, shared:

“I remember that when I was transitioning from Partner in Health’s Prevention and Access to Care and Treatment program, and filled with sadness and anxiety and frustration, Howie was very careful to be in touch and not let me forget that I still had friends and supporters and people who believed in me.  He guided me in his gentle, ego-boosting, and compassionate way and always asked what HE could do for me. He was one of the few who asked, “how are you doing Heidi…really?” and wanted a full account- no holds barred- and listened without defensiveness or the need to solve my problems. He pushed me to think beyond my discomfort and encouraged me to identify what I needed to be successful AND happy and go for it. Despite everything going on in his life…he made a special point to come and visit me in LA twice during my first two years here…to see how things were going and lend his eyes/ear/heart to my new work and life. That is the kind of mentor and friend you rarely rarely experience and that I aspire to be”.

Dr. Matthew Liang, Harvard Professor and Rx Trustee, shared:

“So many encounters and meetings one-on-one or by phone come back over the years; and every one was like yesterday. He hasn’t changed; we have only aged. I first heard and saw him in the audience, as an Harvard Medical School, 1969, 3rd year medical student about to see patients for the first time in our fresh white coats and brand-new stethoscopes starting “Introduction to Medicine” at the Beth Israel Deaconess Medical Center, where he was Chief of Medicine with a unmatched academic pedigree and reputation.

I’m sure our group was the least momentous concern in that role that day. It’s something I only appreciated later when faced with the daily decisions about what came first on one’s TO DO list when one cared for patients. But he was obviously fully engaged and talking to us as individuals and as equals.

His words have been forgotten but what stayed was his aura, his care for details. What still arrests me is his cadence, voice, gravitas, absolute integrity, humanity, and sense for justice. For us total novices, his lofty aspirations for what medicine can and should do, later echoed in his classic, 1975 essay, Protecting the Medical Commons: Who Is Responsible? in the New England Journal, need rereading by novice or seasoned every time things look dire in health equality and disparities”.

In Mark Rosenberg’s biography, Dr. Don Berwick, President Emeritus of the Institute for Healthcare Improvement, echoed similar sentiments, sharing that Howard “is the model of civility, graciousness, and caring”.

For his part, George Hatch, Rx’s current board president, highlights Howard’s pivotal role in establishing a project to help Navajo Nation improve the capacity of its public health system, starting with trainings for its longstanding network of community health representatives. The organization that resulted, Community Outreach & Patient Empowerment (COPE) in Gallup, NM, has partnered with the tribal government to help redress a range of historical health inequalities and is laying groundwork for similar collaborations with other Native communities. George describes Howard’s impact this way:

“In co-creating COPE, Howard brought all of his powers of persuasion and inspiration to bear. He helped ensure the involvement of BWH and Partners in Health, advocated for early Rx Foundation grant support and recruited an extraordinary mentee, Dr. Sonya Shin, to lead COPE in its first decade of life. As is so often the case, he also became directly and personally involved, serving until recently as a beloved member of COPE’s majority-Navajo board.

During his many visits to Gallup, Howard—in his quiet-yet-persuasive Howardian way—would coax key initiatives into being. A notable one was COPE’s program to improve access to fresh fruits and vegetables on the reservation, where one in three Navajo is diabetic or pre-diabetic. Under this COPE Fruit and Vegetable Prescription Program (FVRx), clinic providers and community health representatives engage with vulnerable community members on dietary issues and provide them monthly vouchers they can use to buy fresh fruits and vegetables in local stores.

Many examples like this one help explain why, in our resolution electing this wonderful board colleague and friend as an honorary trustee, we referred to Rx as ‘largely Howard-powered’ and to Howard himself as Rx’s ‘inspirer-in-chief.’ ”

We are deeply grateful for his decades of service, mentorship, and, most of all, friendship. Thank you, Dr. Howard Hiatt!

Green Arrows

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