We are international

I first met Joseph (Yossi) Michaeli in 1989. He was a visiting scientist working in the laboratory of Paul Marks, then the president of Memorial Sloan-Kettering Cancer Center. Burton Lee, one of the country?s original multiple myeloma specialists, had left MSKCC to become the White House Physician under George Bush, leaving a void that still needed to be filled. Yossi was destined to fill that role, but needed to go back and complete some requirements demanded of a foreign-trained physician. I was doing my Leukemia Service rotations, as a first year fellow, and along came this guy to join us. He was not a very imposing physical presence, a little, slightly stooped-shouldered Israeli with a friendly face. The physician in charge of our rotation was Dr. Tim Gee. He was one of those old time MDs who had an almost personal understanding of their disease, the way it smelled, moved, reacted. In any case, Tim Gee also took care of more patients with acute leukemia than anyone in the country. This made for a very large and difficult service. But there was Yossi whose understanding of leukemia paralleled that of the great Tim Gee. Yossi could quote literature in the way of one with a photographic memory. Telling you the journal, the year and even from which side of the page a piece of information had come. I learned more from this unassuming little intruder than I did from our very busy professor. I remember coming home to my wife, Rena, who knew Yossi already from the lab, and telling her it was scary working with this guy. No one can really know this much about so many different things.

When that year finished, Yossi became a clinical faculty member at MSKCC. This was the start of what would later become the Multiple Myeloma Service. Up until that point, no physician had really taken a specialized interest in MM. Yossi saw this as a niche in critical need of upgrading and threw himself into it with abandon. At the same time, I had completed my first year of fellowship training and needed to make a decision about with which physician I should affiliate. Now, MSKCC is filled with physicians of national and international reputations. Yossi was just starting out, but the choice was a no-brainer. I had no doubts that he was not only brilliant as a physician, but would be equally so as a teacher. Thus began my relationship with him as a teacher and pupil.

The MM Service at MSKCC grew exponentially. It became the fastest growing clinical program in medicine at the institution. At the end of the following academic year, a new fellow, Ruben Neisvizky, joined us. The three of us, under Yossi?s guidance, developed one of the largest MM programs in the country. MSKCC is not always the most hospitable environment and Yossi had to fight for everything. He was tenacious. He didn?t care with whom he fought. He knew in his heart what was right, what his patients needed, and would go after it full tilt. When he saw something he thought was inappropriate, he was not the type to say, ?Don?t worry, there are more important battles to be fought. Dr. So-and-so or administrator what?s-his-name won?t like it if we make an issue out of this.? Yossi was always filled with a sense of moral indignation. Everybody should think that his patients were as important as he did. Everyone should be working as hard as he was to better their situation. Since no one was as passionate as Yossi, a lot of time was spent with the higher ups wishing Yossi would just shut up and leave them alone.

I think he learned a lot of his attitude when he was a solider in Israel, where every skirmish had such great significance and so many innocents were depending on you. He really saw MM as a great war and to lose this war was to let down an entire people. I think as important a lesson that Ruben and I learned from Yossi was the sense of moral indignation and the need to do battle on the side of what was righteous. That beyond the insights into the biology of disease, there were very clear-cut rights and wrongs. You were either a good guy or a bad guy. And it was very hard to wear the mantle of good guy. It required hard work, ethics and compassion.

Yossi was my mentor. Ruben said it beautifully in his eulogy to Yossi. He gave away a part of his soul when he filled his role of teacher. He gave you a sense of the importance of his mission and allowed you to take it on as your own. This was not limited to Ruben and me. It was felt by all of us who worked with him. Linda Tatum, our administrative assistant, Margaret Kuhn our RN, Joanne Santoro, our oncology nurse and all of the social workers, data managers, clinic staff and office staff took on Yossi?s passion. Many of our patients took up the ?cause? ? working tirelessly to raise money and awareness.

Unfortunately, in 1992 Yossi became ill. He had some respiratory problems that no one could explain and the search for the cause eventually became worse than the disease. After some terrible complications, Yossi was unable to work. MSKCC hired first me, and then Ruben, to help care for Yossi?s patients and our own. After taking nearly a year to recuperate, Yossi came back to work. The three of us were a team. We argued and debated treatment strategies, laboratory research, protocols, politics and sports, but Yossi was always the leader. Yossi?s health was never very good after that. He was always short of breath, and things were a struggle for him. He never used this as an excuse to take it easy or slow down. He did his best to hide his own physical problems from his patients and colleagues. I think he redoubled his efforts and pushed himself closer to his limits because he knew that he was sick and that his time might be limited.

Yossi, Ruben and I continued to work together for the next three years. To my dismay, it became clear that our careers would soon take us in different directions. As much as we all wanted to continue working together, it wasn?t going to happen at MSKCC. I left in 1995 to join the Myeloma and Transplant Center at the Arkansas Cancer Research Center. Ruben left to join the MSKCC facility on Long Island. Finally, Yossi himself left to join the staff at Cornell Medical School. Despite being in different parts of the world, Yossi and I remained very close personally and professionally. He was still my mentor despite my being in Arkansas, the Mecca for myeloma.

Yossi?s death on May 20, 2001 (27 Iyar, 5761) will leave, for me, an unfillable void. I always knew that Yossi would do his best to advise me and protect me. Whether he was busy with his patient care responsibilities, administrative work or his own profound health issues, I always knew I could rely on him. I think Yossi?s patients had much the same feeling, although their need was obviously much greater. I no longer have that man of great intelligence, integrity and determination, as a guide and advocate. He is no longer there to discuss patient problems, offer career advice, help with protocol development or offer insights into scientific issues. Yet none of these are the most important issues to me. More important to me, I have lost a friend. A true and dear friend.

 related articles