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LEGENDS

Brendan M. Fox, MD
Clinical Professor of Surgery (Urology)
University of Connecticut Health Center
Farmington, Connecticut, USA

When asked to contribute to the “Legends in Urology” section of the Canadian Journal of Urology, I assumed that Dr. Gabriel Haas, then Editor-in-Chief, and Editorial Board member Dr. Grannum Sant wanted me to reprise my role as American Urological Association (AUA) Historian during which time I wrote several articles for AUA News entitled “Our Fallen Heroes” memorializing the lives and contributions of many luminaries in Urology. They included such icons as my personal hero, Wyland Leadbetter, as well as Willard Goodwin, John Duckett, Reed Nesbit, Victor Marshall, Charles Huggins, and many others who had passed on after magnificent careers. I was somewhat dumbfounded when I learned that I was to do an autobiographical piece. My incredulity was yet more profound when I realized that those who had authored similar articles before me had included such current day giants as Patrick Walsh, Mark Soloway, Darracott Vaughan, John Barry and others who have made significant contributions to our beloved discipline of Urology. With that background, having been just a “laborer in the vineyards,” bear with me as I, with a sense of humility and a touch of embarrassment, relate some of my history which hopefully will reflect my love for our specialty.

Early years

I am the son of an Irish immigrant, an educator who loved and valued education and instilled its importance in all of his six children. Despite no family history of a medical professional, I aspired to be a physician beginning in elementary school. I completed my premedical studies at the College of the Holy Cross in Massachusetts and my medical education at Tufts University School of Medicine in Boston. Subsequently, I completed 2 years of Internal Medicine residency before beginning 2 years of active military service as an “obligatory volunteer” (OBV), an interesting governmental oxymoron. While stationed at the Pentagon, I met a fellow OBV, Walter DeVault, who was preparing to begin his residency in Urology at the University of Virginia. He waxed eloquently about the wonders of Urology and how it combined the best aspects of medicine and surgery. After investigating, it did not take much time to determine that Urology was, indeed, the discipline that would best suit my hopes and dreams. Following military service I arrived in New Haven with my wonderful wife and three children where I received General Surgical training at Yale-New Haven Hospital from Dr. Gustave Lindskog. This was followed by Urology residency under the aegis of Drs. Richard Chute and Wyland Leadbetter in Boston, both champions of the art and science of medicine. I also had the privilege to work with Dr. W. Hardy Hendren at the Massachusetts General Hospital, where I was able to see and learn the best in surgical technique and its application in Pediatric Urology. Fellow residents with whom I worked during that period included John Donohue, Ben Gittes and Len Zinman, each of whom helped enormously in my development and became lifelong friends. I also was fortunate to rekindle a friendship with Dr. Joseph Dowd who became my mentor, confidante and best friend.

Practice years

Following residency, and now with five children, including two sets of twins, I returned to the city of my nativity, Hartford, Connecticut, to begin practice. It was not too long before I was fairly busy doing General Urology with a significant part of my work being in Pediatric Urology. Indeed, years later I had the honor of attending the weddings of a few of my pediatric patients. In 1968 Dr. Eugene Sigman was appointed chief of the new Division of Urology at the fledgling University of Connecticut School of Medicine. Gene asked Dr. Richard Spillane and me to help him initiate a Urology residency program at the University Health Center, with the plan to incorporate the best in academic and private practice Urology. From that time on until I “semi-retired” I had the privilege of working with and interacting with over sixty residents, many of whom stayed in the area as colleagues and friends after completion of their training. I suspect that I learned as much from the residents rotating through our service as they did from me. I hope that I was able to demonstrate for them, just as it had been for me, the importance of the art as well as the science of urology. Empathy and compassion for patients and their families are very important to me and I tried to pass that message along to our residents.

Also of importance to me was participation in our medical organizations and, by example, I tried to point out to the residents and my colleagues the necessity to have a voice “at the table.” Early on, I served on the Boards of Directors of our hospital, our county medical society, the state chapter of the American College of Surgeons, and the New England Section of the AUA.

AUA years

Subsequently, the New England Section appointed me to be its representative on the Mason Commission, formed by the AUA to examine the structure of the AUA and make recommendations for appropriate change. A year later in 1987, the New England Section appointed me to be its representative on the AUA Board of Directors, a post I held until 1993. During that period, many important decisions were made, including the establishment of the Practice Guidelines Committee which continues to produce increasingly significant contributions to our specialty. In 1997, I was elected to succeed Dr. Harry Lichtwardt as AUA Historian. During my tenure and with the help of several talented staff members, the year-long celebration of the AUA Centennial year of 2002 was planned and finally came to fruition. In 2003, I was elected President-elect following in the footsteps of the incomparable Dr. Martin Resnick. I had the privilege of traveling to several of our AUA sections and was impressed that our organization was blessed with many outstanding members who practice exemplary Urology. In addition, it was my honor to meet many of our esteemed international colleagues which made it clearly evident that Urology is, indeed, a global discipline and that the AUA is an international organization. The global reach of the AUA was made all the more apparent during continued travels and meetings in 2004-2005 as AUA President.

It was during this time that I embraced the Society of Urologic Nurses and Associates, an organization that had become somewhat estranged from the AUA and I also attempted to involve the Society of Government Service Urologists (SGSU) with the AUA. Over the years, many of their members had made major contributions to Urology and to our organization. I was surprised and pleased when I was made an honorary member of SGSU.

A significant accomplishment as AUA President, with input from many individuals, was the culmination of negotiations to bring the American Foundation of Urologic Diseases under the direction of the AUA, the new entity to be called the American Urological Association Foundation. Also, the initial leadership class of young urologists was convened. Two classes have followed, ensuring that our organization will be led by the best and the brightest in the years to come. It has been my honor to act as a mentor for these exceptional young people, all the while emphasizing the value of diplomacy, compromise when appropriate, and inclusion.

Final reflections

It has been a marvelous journey for me and my family. Needless to say, it would not have been possible were it not for my fantastic wife, Maureen, five wonderful children and spouses, and 12 beautiful grandchildren. And, of course, my understanding partners were very cooperative in supporting my efforts during those years. In my twilight years and with the blessing of current Chief of the Division, Peter Albertsen, I continue to see a few of my longstanding patients at the University Health Center and also do some volunteer “primary care” for some of the uninsured in our area. Despite all of the changes in medicine that are happening and are certain to come in the future, I continue to be optimistic for our specialty of Urology. It will require adaptation, cooperation, innovation, and hard work, all of which we have been able to do well throughout the years. I have never regretted my decision to pursue Urology for my life’s work. Urology is a special discipline and urologists are special people.

Brendan M. Fox, MD
Clinical Professor of Surgery (Urology)
University of Connecticut Health Center
Farmington, Connecticut, USA

© The Canadian Journal of Urology™; 17(3); June 2010 5150