By Melanie Marshall
Tireless compassion, unswerving commitment and the “bright light” of palliative care were celebrated Jan. 9 as the California State University Shiley Institute for Palliative Care honored two remarkable physicians whose inspiring work has transformed care for seriously ill patients and their families throughout San Diego County.
Kimberly Bower, MD, and Gary Buckholz, MD, FAAHPM, were named recipients of the Institute’s 2nd annual Doris A. Howell, MD, Award for Advancing Palliative Care, during a ceremony held at the Institute’s headquarters at California State University San Marcos. Dr. Buckholz is a nationally recognized physician/educator and Clinical Professor at UC San Diego School of Medicine, and Dr. Bower is Chief of Palliative Medicine at Rady Children’s Hospital-San Diego. The awards celebration was hosted by university President Dr. Karen Haynes and the Institute’s Executive Director Jennifer Moore Ballentine.
“It is our delight to be honoring two extraordinary pioneers in palliative care,” Ballentine said. “Their work has greatly enriched the field, contributed to the careers of many stellar clinicians, and significantly improved care for seriously ill children and adults in our region.”
The award is named for Dr. Howell, a legendary physician and pioneer in pediatric hematology, oncology and community medicine who began her career in 1949, and in 1977 founded San Diego Hospice and the Institute for Palliative Medicine (SDHIPM). Through her groundbreaking work, Dr. Howell was instrumental in developing the model of primary care medicine as we know it – one that views each patient as a whole person. A generous donation in Dr. Howell’s honor by philanthropist Darlene Marcos Shiley accompanies the annual award and is bestowed on a local healthcare organization selected by each recipient. This year, the gift will go to UC San Diego Foundation and Rady Children’s Hospital Foundation.
Legacy of Love, Palliative Care Leadership
The 2017 honorees said they first met Dr. Howell more than a decade ago, when they began fellowships at SDHIPM. Both credited her with inspiring them to pursue palliative medicine – a passion and a calling that has shaped their life together (they are married) and led to deeper meaning, grace and joy in their work.
“When I think about people who have inspired me, moved me and lifted me up when things get difficult, Doris Howell is one of the first people who come to mind,” Dr. Bower said in accepting the award. “Her loving presence and her ability to say ‘you can do this’ has meant the world to me. Recognizing that she is a woman who went through medical school when there weren’t many women in medical school; that she practiced oncology at a time when many, many children with cancer died, and that she sat with those families… I’ve always thought, ‘If Doris could do it, I can do it; if she could persevere, then I can persevere.’”
Bringing “Light” to Vulnerable Patients
Dr. Buckholz said Dr. Howell paved the way for generations of palliative care providers to support patients in a powerful way. He compared palliative care to the sunshine that sometimes breaks through clouds during a big storm, such as one that had pummeled the region earlier in the day.
“I’m really blessed to be doing palliative care and grateful to be doing palliative care,” Dr. Buckholz said, adding that he had been fairly disillusioned with medicine before discovering palliative care. “I don’t know how many of you were out (in the rain) today when the sun broke through, but that’s how I see palliative care within healthcare: a bright light that pushes through the clouds. There’s a lot of darkness out there that seriously ill patients and families are experiencing, and I hope that with really good palliative care, they feel the light…”
Educating New Palliative Care Clinicians
Dr. Buckholz has been a driving force in training physicians in Hospice and Palliative Medicine (HPM) for more than a decade, according to Kyle Edmonds, Assistant Professor and Medical Director for Quality at UCSD, one of two doctors who nominated him for the award. Dr. Buckholz is part of the Doris A. Howell Palliative Care Consultation Service at UC San Diego Health, and serves as Hospice and Palliative Medicine Fellowship Director for UC San Diego/Scripps Health. He is also the Scripps Hospice Medical Director, and was previously Hospice and Palliative Medicine Fellowship Director at SDHIPM.
“Following the abrupt closure of San Diego Hospice, (Dr. Buckholz) ensured the continuation of that year’s class of physician fellows and has since organized one of the only physician training fellowship in the country that is shared by two major competing organizations,” Edmonds said. “His educational leadership has ensured there are well-placed and well-trained HPM physicians across the country. He is no doubt a major figure in the field, and a San Diego pioneer.”
Bill Mitchell, MD, Director of the Doris A. Howell Palliative Care Consultation Service for UCSD Health, attended the awards ceremony and said Dr. Buckholz’s contributions have benefitted countless patients and families. “In addition to providing great patient care, he’s had a profound role in training upcoming palliative care physicians and providers,” Dr. Mitchell said. “When you think of all the patients those clinicians will reach, you get a sense Dr. Buckholz’s impact.”
Inspiring Collaboration, Compassion
Dr. Bower has been a leader in pediatric palliative care for many years. She began a fellowship at SDHIPM in 2004, and from July 2005 to June 2006, served as SDHIPM’s chief fellow, with a focus on building skills in pediatric palliative medicine and working on international initiatives. She went on to become the agency’s Pediatric Medical Director. When she joined Rady Children’s Hospital-San Diego, an inpatient palliative team had operated there for years, but no community-based program was in place.
“Dr. Bower created the first home-based pediatric palliative care program in Southern California, as well as Rady’s first Palliative Care Clinic,” said Robin Short, RN, BSN, one of two nurses who nominated Bower for the award. “Her dedication and hard work has helped reduce hospital days for our palliative care patients by more than 55%, which allows children to have their symptoms managed and receive their care at home, which is so important during this time.”
JoAnne Auger, RN, CHPPN, said: “Dr. Bower leads by example, inspiring collaboration, respect, and excellence in the multi-disciplinary care team. I look to her often for her pediatric palliative medical expertise, as well as her leadership and experience. But perhaps more importantly, I look to her for her compassionate presence, her ability to listen and comfort.”
Rady Children’s Hospital-San Diego Senior Vice President for Care Redesign Charles Davis, MD, also attended the awards ceremony, calling Bower “incredibly passionate and committed. Seeing her in action is incredible. I couldn’t speak more highly about her and her commitment to patients.”
Creating Vital Palliative Care Workforce
Speaking to a room full of clinicians, dignitaries and Institute staff who attended the award ceremony, Dr. Haynes took time to highlight the dramatic growth of the Institute over the past five years – expanding from a staff of one to 21, and from six online courses to more than 101. She said the vital work to advance and expand palliative care is far from over.
“There continue to be healthcare disparities associated with our aging population,” Dr. Haynes said. “In addition, we are challenged to provide access to increasingly diverse and underserved populations with complex health needs. This requires us to overcome obstacles, improve workforce development and increase community awareness. (To) help ’change the world’s healthcare model’…we need your ongoing support and engagement. We welcome your enrollment in our courses, your contributions of expertise, (and) …your help spreading the word of our work and of our accomplishments.”
“Palliative care is the answer to changing the journey of serious and chronic illness that so many of us will face—and change it for the better,” Dr. Haynes said. “I am pleased that one of the important forces for making this change a reality had its creation here, and has its home here, at Cal State San Marcos.”
Gratitude for Team Approach, Financial Support
Both Dr. Bower and Dr. Buckholz thanked the Institute and Dr. Haynes for the award and for working to expand palliative care, and also thanked Darlene Marcos Shiley for her generosity and commitment to advancing palliative care. “The fact that Darlene Shiley supports the award financially means so much,” Dr. Bower said. “It shows patients and families going through a very hard time that the community cares about them and wants to make things better for them.”
The awardees also praised their palliative care colleagues, and the healthcare organizations and leadership that support their programs, saying the work wouldn’t be possible without the shared efforts of the devoted and compassionate people who make it happen. They also thanked their daughters, Makayla and Megan, who accompanied them to the awards ceremony.
This is the second consecutive year the Howell awards have resulted in a tie: In 2016, the honorees were Daniel R. Hoefer, MD, Chief Medical Officer Outpatient Palliative Care and Associate Medical Director at Sharp HospiceCare; and Suzi K. Johnson, MPH, RN, Vice President at Sharp HealthCare.