Lesson Three: The Healing Death of Dr. Joseph M. Foley, MD (1916-2012)

 

On Wednesday, July 11, 2012, with son Drew away in Costa Rica for a few weeks, my wife and I headed for a vacation to Cleveland, where she had not visited with her old friends for a year. After twenty years we had moved from Cleveland to Stony Brook in July of 2008, a big move that took a couple of years to adjust to. I had a plan: focus on writing for a few days in my favourite hamlet of Chagrin Falls. In other words, I did not want to get in touch with or see any of my many old friends. We drove west on Rt. 80 that afternoon and about 9 p.m. made it to the Best Western in Lewisburg on Rt. 215, which is right off 80 (Exit 210) half way between the George Washington Bridge and Cleveland. We spent the night and headed for Cleveland at sunrise with four hours to go.

That morning, as we were driving past Youngstown, Ohio, I experienced a strong intuition that the first thing I should do in Cleveland was to visit my 96-year-old friend and mentor Dr. Joseph M. Foley, MD. So when we arrived about 2 pm on July 12th we drove over to Joe’s house on Berkshire Road in Cleveland Heights right away before checking in at the hotel, and I knocked on the door. Joe’s loyal and loving son, Stephen Foley, answered and showed me into the pantry where Joe was bed ridden and looked very frail. I knew he was in decline when I had stopped in to see him on May 4, a couple of months earlier, with Dr. Susan Wentz. At that time Joe was not walking, but he was fairly lucid of mind, at least when I told him about a dozen Irish jokes that he had taught me over the 20 years. Today he could no longer remember much. So every joke was hilarious for him. “Hey Joe, what’s the definition of hospitality?” “Tell me, Stephen.” “You make someone feel perfectly at home while you be a’wishin they were.” The jokes got Joe in touch with himself and his memories of Boston Latin School, of his parents in Dorchester, MA, of his father the garbage collector, of his days at Holy Cross and Harvard Medical School, and of Utah Beach at Normandy. Mirth seemed to touch Joe’s soul, and put him back in touch with his life story. But now, two months later, Joe Foley, the man who recruited me as a younger philosopher from Fordham-Marymount to the Case Western School of Medicine in 1988, was clearly ready to head off into the arms of his Maker.

I was Joe’s last visitor as he died at 5:37 a.m. the next morning, Friday July 13, with his daughter Celia Foley by his side on the morning shift. She, Steve and Mara were all back in the old home looking out for their dad. Celia told me two days later that for the last several hours of his life, Joe had his armed stretched upwards and was asking if he could be moved closer to the light. He was ready for a new adventure.

Joe Foley was 96. He was born in 1916 to immigrants from Ireland. He grew up poor. As Regina Brett pointed out in her article about Dr. Foley in the Cleveland Plain Dealer (A2) on July 14, there was a professor at Harvard who, noting Joe’s intelligence and limited means, took him to the medical school finance office and instructed them to cover him until graduation. In 1961 Joe moved from the Harvard faculty to Cleveland to become Chair the Neurology Department at then Western Reserve University. He became president of the American Academy of Neurology and of the American Neurological Association. He trained Joe Martin, MD, who went on to the Deanship of Harvard Medical School for many years.

One of Joe’s protégés, James Corbett, is now Chairman of the Neurology Department at the University of Mississippi in Jackson. “I remember when a woman came into the emergency room with severe headaches and no obvious neurologic signs of a disorder,” says Corbett. “The staff assumed she was crazy, and decided to transfer her to a psychiatric ward. While she was waiting to be transferred, she died. She had had a brain tumor that swelled up and then herniated. Not long after, we all gathered in the small auditorium where we had grand rounds, and all of us, internists, psychologists, and neurologists, were beating our breasts and wringing our hands and saying, Mea culpa, mea culpa, we missed this brain tumor, and Joe stood up and said, ‘What is wrong about what happened to this woman is not that she had a brain tumor that would have killed her anyway. It was that she was treated as if she were crazy. She died without anybody consoling her or showing her true concern or respect. That’s what we need to learn from this.’ I never forgot that. I just love the man and I try to emulate him. I have an open door, because he always had an open door.”

I owe my 20 years at Case Western to Joe. He was a member of the search committee that interviewed me for my job at Case Western Reserve, and I still recall how we sat down on a soft, cracked red leather bench in the lobby of Hanna Pavilion, the psychiatric unit of University Hospitals, and talked of everything from euthanasia, neurological illnesses such as Alzheimer’s, and the Nuremberg Code. After meeting Joe, I knew I would take the job if it were offered. When I moved to Cleveland in June of 1988, Joe took me under his wing and introduced me to everyone in town who knew anything about older folks with dementia. One morning in the clinic Joe said to me, “You know, you have to call them by name and expect a response! It may not come, but expect it, because sometimes it will, and they deserve to have names and be called by those names, however demented they are. And speak directly to them, and above all, bend down and make eye contact. There is more there than you might think sometimes.” Joe, with his moral sense of inclusion, was always a marvelous model for me.

One morning we drove together south across Rt. 80 to Mount Vernon, Ohio, where the state has a large institution for those people with the most severe forms of retardation. Inside we were surrounded by patients, most of then incontinent, incapable of speech, malformed of limb, and in various ways difficult to behold. It was pure mayhem. And suddenly a disheveled man in his 40s stood up and said, “Hello, Doctor Foley!” And of a group of about 20 patients in the room, nearly half of them chimed in with big smiles, in unison, “Dr. Foley, Dr. Foley.” And Joe took their hands, each one of them, and spoke slowly and lovingly to each one, and at the end of our stay, that mayhem had literally turned to peace.

Joe saved a lot of people, from people with cognitive disabilities to soldiers wounded on the shores of Normandy:
“We had only our bare hands and backpacks when we went in against enemy fire,” recalled the then 90-year-old Dr. Foley of the invasion of Normandy, where at age 28 he served as head doctor and navy medic in the Second Beach Battalion at Utah Beach, the strip right next to Omaha Beach, and where the bullets were nearly as thick. Joe earned both the French Croix de Guerre and the U.S. Bronze Star. It was June 6 and 6:40 a.m. when he got off a small boat in three of water while machine guns exploded around him. Within minutes, Foley and his eight men set up an aid station and a flag, and within an hour “we were taking casualties.” Foley found a bulldozer and dug a massive hole under the seawall, which became their permanent AID station for the next month. “I made it through in great part because of loyalty to the doctors I was with,” he recalls. “Your buddies are the ones whose respect you cherish. I had to have whatever it took to give confidence to the men working with me. On a beachhead like that you have God’s own number of physical and mental casualties. But I felt that each one of those people was very important. I had affection for every single person with whom I dealt.” Some of these men showed unthinkable courage and good humor, even to the very end: Joe recalls an infantry captain he’d trained with, whom he’d often kidded. “I’d assure him that the infantry was composed of a group of mental defectives, and he’d assure me that the navy was utterly incapable of working on shore. We shared a lot of good-humored banter. In my third hour on the beach he came to my AID station with a great gash in his carotid artery and a huge hole in his liver. He said, ‘Am I going to make it?’ I said, ‘I wish I could say you are, but you’re not.’ He grinned at me and said, ‘Isn’t it just my luck when I need a real doctor to have a quack like you around.’ He died with that grin on his face.”

Joe saw a lot of suffering in life, not only at Normandy, but in the loss of two of his six children. He coped with mirth and love, or as he used to say, with hilaritas and caritas – hilariousness and God’s unconditional love. Joe said often, “Make sure you love people and behave in a way that you can be loved.”

On Tuesday, July 17, 2012, at St. Ann’s Church in Cleveland Heights, where Joe went to Mass each morning in his old age, I attended his crowded funeral service. Joe had designated me to read at his funeral the passage from St. Paul’s Letter to the Philippians (1:8-11). It reads as follows:

“This is my prayer for you: that your love will grow more and more;
that you will have knowledge and understanding with your love; that
you will see the difference between good and bad and will choose the good;
that you will be pure and without wrong for the coming of Christ; that you
will be filled with the good things produced in your life by Christ to bring glory
and praise to God.”

I felt like I was speaking on Joe’s behalf, for this was truly his message to the several hundred gathered there from every walk of life and background.

As I was heading back to New York on Rt. 80 that afternoon and getting past the Milesburg exit in Pennsylvania I imagined Joe’s voice laughing a bit and saying “Well Stephen, my boy, just my Irish luck to die on a Friday the 13th .”

Joe saved me in a way too. I refer above to the “healing” dying of Dr. Foley. For me it turned out that way. In June of 2008 I had left Cleveland in part because of the attraction of an interesting new position in New York, in part because life is a journey, and in part because the politics and economics of the department I worked in the medical school did not look promising despite my 20 years of exemplary service. The newer Department Chair was a rather cynical and aggressively atheistic psychiatrist who simply could not have been expected to appreciate my more idealistic and spiritual style of mind. When he told me to pay my own salary entirely, I figured that I am an American and that I don’t work for nothing. The message was clear as a bell. I needed to move on, but that awareness was painful mostly because I was so much a part of the Greater Cleveland community. Two decades creates a lot of ties that bind. I felt betrayed, but regardless, we had different visions and I had to find higher ground, which I did.

Now four years later, on July 17 after Joe’s funeral that morning, I was gratified to have read at his funeral, by being mentioned in the eulogy as one of two people Joe was especially proud of mentoring, and by seeing a church full of hundreds of people many of whom went out of their way after the service to say how much they missed me. Clevelanders are generally very generous folks and I continue to benefit from their loyalty.

As my wife and I drove east on Rt. 80 that afternoon to get back to Stony Brook, I felt for the first time in four years a profound sense of peace and closure about having to leave Cleveland. Somehow, in Dr. Foley’s passing, in the ritual of his funeral, and in the sincere appreciation of so many people toward me, I felt healed from the residual dark emotions that betrayal can create. Dr. Foley was a healer even in his dying.

Lesson 3: When you have a strong intuition on Rt. 80, take it seriously. It might just free you from some useless emotional rumination that gets in the way of your usual creativity, mirth and kindness. Thank you Dr. Foley.

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