Timeline: Milton D. Heifetz, MD (1921-2015), An American Story
In 1995, my dad was given the highest honor granted to a physician at Cedars-Sinai Medical Center in Los Angeles — The Pioneer of Medicine Award. This ceremony was attended by a significant percentage of our 2,000 physician medical staff, and I was given the privilege of introducing him. He was 74 years old at that time. This is how I began my remarks:
“In my line of work, when a son gets up and starts speaking about his father, the father is usually lying in a box in front of the podium. So dad, here’s a preview.”
The first recipient of the Cedars-Sinai Pioneer of Medicine award was Myron Printzmetal. My mom told a story about someone who asked Mrs. Printzmetal how it felt to have so famous a son. She said, “Which one? Prinz the doctor, or Prinz the lawyer?” You should know that virtually all of my life, I have been dealing with this question, “Heifetz the doctor, or Heifetz the violinist?”
The Early Years
Dad was raised in a tiny apartment on the west side of Chicago with his older brother and sister. During the depression, he slept on a roll away bed in the living room. His father, Oscar (Asher), came to America to escape Ukrainian pogroms and eventually brought his wife Mollie (Malka), his seven sisters and brothers and his father to America. Their children were Bernice, Harold and Milton, but we only knew them as Aunt Buzzy, Uncle Sonny and Uncle Mickey, my dad.
Dad was a bit of a loner as a kid. He loved to wander around the neighborhood daydreaming while winding an ever-growing ball of string. His daydreams led him to imagine that he was a Sioux Indian instead of a Jew from Chicago, so when he was 15, he joined a Native American dance troop. Years later, he would demonstrate the deer dance to his nine grandchildren around a campfire at the Northstar house. Back then, he was just this awkward kid whose innate cockiness would get him into serious trouble with the Irish boys in the neighborhood, requiring Uncle Sonny to rescue him on more than one occasion. Mollie was overprotective of her baby boy according to dad, so he had to sneak away to join the Boy Scouts. Eventually, he became an Eagle Scout and was probably more proud of his Order of the Arrow designation than his many academic professorships. He never got over the fact that we didn’t have a Boy Scout troop in Beverly Hills.
While all of us have spent extreme psychological and financial energy trying to get our children into fancy prep schools and big name colleges, my old man went to Theodor Hertzl Junior College for two years. He had the grades to get into a university and probably could have secured a scholarship, but he didn’t feel the need. He then went on to the University of Illinois to complete his undergraduate degree and continue on to their medical school. This was during World War II, so most of the med students were on active duty. Dad was in the Army.
One day in 1942, he got a call from his parents that they had received a letter from Sonny in Guadalcanal addressed to a girl he had met while at the University of Chicago before he was shipped out, and could he deliver it to her? Dad asked his fellow med student, Irv Greenberg, who had a car, if he would come along with him. So he and Irv delivered this letter to Betti Baron, a 17 year-old German refugee who came here at 13 and got a scholarship to the University of Chicago at 16. Betti thanked him for Sonny’s letter but didn’t pay much attention to Dad, telling her girlfriends instead how cool Greenberg was. Dad was instantly smitten. Betti had never had a real relationship with Sonny, so Dad reached deep and asked her out. They were married in 1943 when he was 23, and she was 18, starting a 73-year long grand adventure fueled by their undying love for each other.
On my first day at The Chicago Medical School in 1968, everyone showed up with their own brand new Nikon binocular microscopes with internal lighting except myself and one other guy. We both had the same AO Spencer monocular scopes with external light sources. His name was Brent Greenberg, Irv’s son. When mom and dad came out to visit, we all went to dinner with Brent’s parents. Brent had gone to New Trier High School, and dad immediately reverted to his poor inner city background and said something silly like, “Oh wow, that’s a really fancy place, isn’t it?” Mom and I traded glances and I said, “Pop, we all went to Beverly Hills High, remember?”
In the 1940’s, it was very difficult for Jewish medical students to get surgical residencies. However, Seventh Day Adventists harbored a soft spot for us, for many reasons, not the least of which was that our Shabbat was on Saturday like theirs. Dad was accepted at White Memorial Hospital, an Adventist hospital in Los Angeles for his training, and he never forgot them. As my parents embarked on extremely risky travel to remote areas of the world, such as New Guinea and Borneo, there was always an Adventist medical mission they would visit and help with. In 1966, they were in the Amazon at a remote mission hospital accessible only by canoe. Late one night, a tribesperson approached them carrying a lantern. A woman had been in labor for 48 hours, and they were worried she would die. So, a brain surgeon who had not delivered a baby in 20 years tromped off into the jungle, worried that he would be blamed for two deaths if he failed. He figured out the problem and successfully delivered a baby boy who they named Miltono.
After White Memorial, Dad struck out on his own in private practice. He initially had an office in Whittier and one in the Miracle Mile. We were living in Pasadena in a small two-bedroom house. I was four and Danny was two when Ronnie was born. We needed more room, so Dad rolled up his sleeves and built a room with his own two hands on evenings and weekends. He had never done anything like that before, but said “Why not,” and just did it. We then started learning that anything is possible.
Debbie was born when I was eight, and we needed to move. After placing our home on the market, he received numerous offers, including one from a Chinese professor from Cal Tech. Our neighbors approached my parents urging them to consider the fabric of the community. Dad had experienced similar roadblocks when buying the house in the first place. Recognizing the racist attitude he was being pressured to accept, he immediately signed the deal with the professor. Dad then closed the Whittier office, and we moved to Beverly Hills. He was petrified that we would become rich-kid, spoiled brats and persisted in telling us that we were poor. We didn’t figure it out until high school, but by then, his sense of values had stuck.
Challenging the Status Quo
Dad was never satisfied with the status quo. His neurosurgical skill was rapidly becoming known, but the tools available to him were inadequate. So, after a period of daydreaming about what to do about it, he enrolled at LA Trade Tech as a machinist student. Here was this 40-year-old brain surgeon standing side by side with inner city kids without the slightest degree of self-conscious concern. When he finished, he converted a downstairs room in our house into a metal shop with a high-speed lathe and a milling machine. He then built his own stereotactic brain device that would allow him to insert a probe through the skull into a specific spot deep in the brain, turn on liquid nitrogen and freeze a 5 millimeter area that would stop the tremors in a Parkinson’s disease patient. This was done 10 years before CAT scans had been invented, and we have a movie to prove it.
His capacity to explore the potential of the possible, and to be genuinely curious regarding absolutely everything, made me the envy of all of my friends. While their dads told them, “Don’t make a fool of yourself, don’t be stupid, you can’t do that, you’ll never amount to anything…” my dad would sit down with them and say, “ Yes, you can be a (fill in the blank). Enjoy your daydreams and run with them. Take a risk and don’t worry what people will say, including your dad!” He had an uncanny capacity to inspire almost anyone he would meet, from a taxi driver to a highly successful executive. He continued to do this any chance he got, amassing a slew of “adopted” children, some even in their 70s, who would bounce their ideas off of him and walk away empowered.
One evening in med school, I got a call from Dad. “Larry, can you meet me in two days in Iowa?” I said, “Sorry Dad, I’ve got tickets to BB King.” He responded, “No problem, Larry, it’s nothing.” That was the single worst decision I ever made in my entire life. My dad had come across a two-inch filler article in the Los Angeles Times about a hotel in Council Bluffs, Iowa, that was going to be demolished to become a parking lot. However, there were three murals in that hotel that had been painted by Grant Wood in the 1930’s, the painter of the iconic American Gothic painting. Dad called the manager of the hotel and said, “If I can remove them, can I have them?” The manager agreed.
Two days later, after having learned everything there was to know about mural technology in the 1930s, he was on a plane to Iowa. I could have driven there in six hours and met him. He brought all kinds of surgical tools with him, working all night by the light of a Coleman lantern, he had peeled the murals off of the walls with a four-inch paint scraper and had them rolled up. He was back in Los Angeles that afternoon and had a brief experience with international praise with headlines such as, “Way to Go, Doc!”
They had two of the murals hanging in their home for years. When my mom and dad sold their Beverly Hills home and moved to Northstar and Cambridge, they donated them back to the city of Council Bluffs for an enormous tax contribution. One of our favorite photos of the two of them is when they were being thanked by the Council Bluffs Town Council, with Mom smiling like a Cheshire cat.
Developing the Heifetz Aneurysm Clip
He kept daydreaming. In the 1970s, he decided to rethink how neurosurgeons approach aneurysms. After a few years of trial and error, the Weck Corporation released its Heifetz Aneurysm Clip System. For 15 years, that was the most advanced set of clips with the highest acceptance rate in the world, at least until Dad perfected the next version. He went on to develop a wide spectrum of instruments through his company — D & D Industries, short for Debbie and Daddy. The fact that the company is worth about $1.98 isn’t the point, as he would laughingly state.
He kept daydreaming. He was a critical thinker, unpersuaded by conventional norms. In 1975, he decided to take a risky position in favor of euthanasia and published The Right to Die. This came out at the time of the controversial Karen Quinlan case. He became a consultant on the case and was then invited to participate on numerous public forums including “The Constitution: A Delicate Balance,” where he traded punches with Justice Antonin Scalia, as well as on William F. Buckley’s “Firing Line.” The book contains a contract he wrote called “A Directive to My Physician,” which became the backbone for the “advance directive” everyone in the country is asked about when they are admitted to the hospital.
How did he steer his imagination? He didn’t. My mom did. She was like a steel cable holding down a hot air balloon. We all knew that without her rock-solid tethering, he’d explode in flames. She was his greatest ally, his protector and had absolutely no qualms about shooting anyone who would dare try to knock him off his pedestal. She reserved unlimited bragging rights; they were a hell of a team.
Sometimes his daydreams went sour. He was a sucker for “get rich quick” schemes, the best of which was in 1962 when he invested $10,000 in an oil company. Where were they drilling, you ask: the Mekong River Delta in Vietnam.
A Gifted Author and Scholar
His daydreams also resulted in the creation of numerous pieces of sculpture (one of which is in our cancer center), many books including Nuances of Neurosurgical Technique, published by the American Association of Neurological Surgeons (AANS), a book of Haiku poetry and a handheld mechanical historical planisphere on display at Harvard that lets you see the position of the stars at any date going back 25,000 years. He published A Walk Through the Heavens, teaching us how to easily find the constellations, and he even identified an astronomical guiding triangle to help locate Pegasus. When given the naming rights on that triangle, he chose “Zaydeh’s triangle”, his Yiddish name for Grandpa.He really is up there in the sky for his nine grandchildren and seven great-grandchildren.
Dad was convinced that surgeons should stop operating in their late 60s, not a very popular position. He stuck to his guns and retired from practice at 67. By that time, he was a very heavy hitter in the world of neurosurgery with regard to books, articles and devices under his belt. It was natural for him to accept a visiting professorship at Harvard University after he completed a year as a visiting scholar at the University of Oxford in ethics. With those credentials, his next career began.
He was also asked to teach a course in ethics at the Boston College Law School and did this for 15 years, getting a paycheck until he was 89. His expertise was applying basic biology to law and public policy. Until the day he died, he had been working on a treatise on global ethics. That daydream was not fulfilled, but the point was to dream.
The Real Deal
My mom died a little over three months ago, and my dad got through this period by trying to fool us into believing that he was okay. He would talk to mom, visit her grave and then tell us that she told him to straighten up and stop whining. He did exactly as he was told. Then, he had a massive cerebral hemorrhage. When I got to the hospital, the neurologist was at the bedside looking at his CT scan. I told him that dad was a neurosurgeon. He looked at the scan, looked back at the patient’s name, looked at me and said, “Heifetz? Clip? Oh man, this guy was the real deal.” Mom looked down and said, “Ha!”
Kranzler Chicago Review Course in Neurosurgery
Jan. 24-31, 2020; Chicago
46th Annual Richard Lende Winter Neurosurgery Conference
Jan. 31-Feb. 3, 2020; Snowbird, Utah
Third Annual Cedars Sinai Intracranial Hypotension Symposium
Feb. 8, 2020; Los Angeles
2020 Managing Coding and Reimbursement Challenges
Feb. 14-16, 2020; Las Vegas
13th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 21-23, 2020; Lake Buena Vista, Fla.