I. (Israel) David Todres

(Israel) David Todres, Professor of Paediatrics (Anaesthesia) at Harvard Medical School, died at his home of lymphoma on Sept. 26, 2008. He was 73.

Born in South Africa where his parents immigrated from Lithuania, David obtained his undergraduate and medical school education at the University of Cape Town. As a medical student in the late 1950’s, he worked with a pioneering pediatrician and anesthesiologist who were treating neonatal tetanus in babies with tracheostomy and curare, which was one of the first successful uses of mechanical ventilation in a series of neonates. After his postgraduate training, largely in pediatrics, he spent several years in England in anesthesiology, first at the Radcliffe Infirmary in Oxford including in its adult intensive care unit and then at the Hospital for Sick Children in London. After briefly returning to Cape Town to serve as a Consultant in Pediatrics and Anesthesia, he moved to Montefiore Hospital in New York City in 1969 and became the Director of both pediatric anesthesia and the medical-surgical intensive care unit and an Associate Professor of Anesthesiology at the Albert Einstein College of Medicine of Yeshiva University.

In 1971 he relocated to Boston to become one of the co-founders of the neonatal and pediatric intensive care units at the Massachusetts General Hospital (MGH). It was a daring thing to do since the MGH at that time had no obstetrical service and only a small pediatric service. The impetus was that the MGH Department of Anesthesia had a few years earlier established the first respiratory care unit in the country, helping demonstrate the enormous benefit of intensive care for adults. It certainly seemed appropriate to extend this concept to infants and children, and David helped develop at the MGH one of the early and premier intensive care units for children in the world. He was deeply involved in all aspects of patient care and was widely known as a master clinician and teacher. In recognition, he soon was appointed the units’ Director and served in that role for the next twenty years.

David developed a special interest and expertise in bioethics because of the complex problems that were becoming apparent as increasing technologic innovations were used to treat younger, smaller and sicker children who were surviving illnesses that had previously been fatal. Calm under all circumstances, his wise and reasoned approach to sick patients went well beyond invasive catheters, laboratory values, and drug lists and always addressed the cultural values of the family. He was a deeply spiritual man, knowledgeable in his Jewish faith as well as other faiths, for which he had profound respect. He incorporated this into his approach to medicine and, through the example of his own gentle manner and everyday humility, he taught residents how to communicate with patients and their families in the most trying of circumstances. Rather than focus on the negative, David approached life with unending optimism whether dealing with critically ill children or his own, ultimately fatal, illness which included multiple rounds of chemotherapy, radiation and a stem cell transplant. He established a pediatric-oriented bioethics program at the MGH and was an active participant in the bioethics program at Harvard Medical School. Until the time of his death, he served as the Chief of the Ethics Unit of the Massachusetts General Hospital for Children.

David was board-certified in pediatrics, neonatology, anesthesiology, and critical care medicine and was a Fellow of the Faculty of Anaesthetists of the Royal College of Physicians and Surgeons of England. He was the author of more than 150 original reports and review articles. In addition, he was one of the co-authors of the book “A Practice of Anesthesia for Infants and Children” now in its 4th edition and another, “Critical Care of Infants and Children.” In the later stages of his career he devoted increasing time to the Program in Medical Education at Harvard Medical School where he directed the Steering Committee for the Comprehensive Examination (OSCE) for fourth-year medical students. He served on numerous national committees including the Task Force of the American Heart Association for Advanced Pediatric Life Support and the Committee on Bioethics of the Society of Critical Care Medicine. He received widespread recognition in the form of many prestigious awards, including the first Distinguished Career Award from the Critical Care Section of the American Academy of Pediatrics and the Grenvik Family Award for Ethics in Critical Care Medicine as well as the Presidential Citation from the Society of Critical Care Medicine.

Finally, David was well versed in classic literature and loved the arts whether visiting museums or dabbling in painting and sculpture. His relationships with trainees at all levels revealed his unusual warmth, from resident interviews, to clinical rounds, to the book group he established to explore medicine, art and culture. His lectures were replete with deep knowledge and delivered with so much enthusiasm it was impossible not to get interested in the topic. With his incomparable South African accent, shock of curly gray hair, and wonderful smile, he made an indelible impression on all who had the great pleasure of getting to know this most kind and gentle man. He is survived by his wife of nearly twenty years, Judith Sharlin, and their son Hillel, of Waban, MA; three children from a prior marriage (Jonathan of Atlanta, GA, Nadia of Readsboro, VT and Rachelle and her son, John Jeremiah of Malden, MA), and his brother, Hymie of Perth, Australia. A memorial lectureship in pediatric medical ethics has been established at the MGH in his honor.

Mark Rockoff, M.D. (Chair)
Ronald Arky, M.D.
John Downes, M.D.
Michael Epstein, M.D.
Edward Lowenstein, M.D.
Jonathan Todres, J.D.
Robert Truog, M.D.