May 3rd, 2012
I humbly write what cathartically emanates from me regarding UCLA’s Dr. E. Richard Brown, who passed away on April 20, 2012. Rick Brown, as he was known to most of us, expressed truly important, yet difficult social justice concepts in way that almost soothed the soul with heartfelt logic…leaving one with seedlings of ideas that each person could nurture, own and embrace as change for the betterment of humankind.
What can one say about a person who profoundly and fundamentally shaped a young person into a professional? Moreover, what right does one person, an early mentee nonetheless, have to even attempt this when the mentor was such a visionary and giving, yet principled and strong entity who touched not just hundreds, or thousands, but perhaps millions of lives?
Hopefully, my sharing will bring forth sides that others are feeling. To hold Rick in our hearts and propel our Public Health purpose forward, I write this at the request of several who stated that they wanted to be able to hold these stories that brought tears of joy to their eyes as I retold just a few of many moments with Rick Brown. It is my intent to honestly honor not only a great man, but his family, of blood relatives and those who became part of the Public Health family to which he committed his life.
Meeting A Future Mentor, Colleague, And Friend
Dr. E. Richard Brown was the person I was told to contact for the best match when I was considering an early decision full scholarship for a Masters in Public Health at Columbia versus the UCLA School of Public Health Behavioral Sciences and Health Education MPH. At this point, Rick made his first compelling argument to me back in December of 1985, stating that of course I could conduct my MPH internship in Norway, as I had set my heart upon.
This was only the beginning of a truly dynamic push-me-pull-you type of relationship because in 1986 when I began at UCLA, he approached me and said “You have a really funky combination of skills with Urban Planning plus Visual Arts/Media from UCSD (1986)…and I need you to come work for me on this new project where we will show the California State legislature just what the statistics on the uninsured mean in pie charts.” Although I protested that I already had an outside job, Rick persisted and in early 1987, I became the first Research Assistant on the Californians Without Health Insurance Project.
So with one of the original Macintosh computers (without a hard disk) we began to illustrate the magnitude and diversity of those who lacked insurance and consequently access to health care. Initially, I despised the concept of working on health insurance; yet working alongside Rick breathed such life into to what had been dry, dull, effete, and tiresome subject that I rapidly finished my MPH so that I could continue on for a PhD in Health Services Research and Policy Analysis, where Rick also held an appointment. (This was back in the days just before the UCLA School of Public Health Departmentalized and then later split into various other segments).
The grand irony was that even prior to completing my MPH in 1988, not only was I Rick’s graduate Research Assistant, I was already a Teaching Assistant in Health Services (first for Dr. Robert Valdez and then for Dr. Paul Torrens, who mentored me well in the art of didactic learning). During the late 1980s and early 1990s, scientists were still very much in silos and specialization was still viewed as the key to success. The UCLA faculty, along with our RAND colleagues, were building a truly pioneering, interdisciplinary team science program; the Pew Memorial Trust significantly aided this by awarding me and several other incredibly talented colleagues three year Health Policy Fellowships. We health policy fellows trained alongside the clinical Robert Wood Johnson fellows and even had an experimental rotation through clinical care.
Building Interdisciplinary Bridges
The fellowship allowed me to continue on Rick’s projects through the lean years (Pew required OJT — On the Job Training) and helped establish the earliest form of the California Health Interview Survey as the first state add-on to the National Health Interview Survey. The team that Rick assembled then (and later within the UCLA Center for Health Policy Study) included biostatisticians, epidemiologists, sociologists, demographers, political scientists, physicians, nurses, chiropractors, dentists, pharmacists, economists, computer scientists, urban planners, and those of us who ultimately grew into Health Services Researchers and Policy Analysts who still can’t name a single discipline. Even to this day at the National Institutes of Health (NIH), we are still breaking down the old silos and enabling extramural institutions to collaborate beyond their previous comfort zone.
Building bridges takes more than just academics though, and Rick instinctively knew this as he invited entire graduate courses and cohorts to his house for potluck dinners. My family house sat for the Brown family and hosted a real Thanksgiving dinner in their lovely home; we also, ran up a large vet bill to have one of their big cats treated for a massive infection that holiday. Alas, life and its trials are what build connection. Yes, I admired the man who served as technical council multiple White House administrations, but it was his tireless devotion to improve humanity that changed my soul.
It would be deceitful to say that this mentor-mentee, advisor-advisee, colleague to colleague, and friend to friend relationship flawlessly sailed through time. Rick often chided me that my writing was similar to a large spiraled candy that one had to encircle over and over and over again, but that eventually I did get to the point and a very good one. During my doctoral program, with Rick as my chair, I left his office sobbing after nearly each chapter review. He sternly informed me that I was too inflammatory or too verbose or used too much jargon in my writing. And, being who I am and having the respect I had and have for Rick, I took each critique as though I had failed.
For me, initially writing was like giving birth, and despite now having three wonderful children (including my first in my doctoral program), I was not good at birthing and had very arduously long, back labors resulting in surgical birth. Even while I was in active labor, Rick came down the hall in the Center for Health Sciences and chastised me that I had not yet relented to an epidural after 36 hours; I protested that I knew very well what all the iatrogenic issues were with childbirth. Yet after 48 hours of exhausting labor, he and his loving family greeted our new son with a succulent bowl of fruit. Rick and Marianne gave us the book How To Raise A Mensch (by Debra Haffner-no relation); this child is now graduating from UCSB with a Biopsychology degree and is a true mensch (as are his two younger brothers).
To be fair, all of the writing hurdles Rick required me to either go around, under, or build a bridge over served to shape a life-long ability to communicate. Additionally, Rick’s mantra of “Focus, Chris focus” has long embedded in my brain. During the two final chapter reviews, Rick wrote, “These are the best pieces of writing you have ever turned in! EXCELLENT.” Truth be told, I wanted to frame that comment more than my diploma. In 1992,
I defended my dissertation on the uninsured (later published in JAMA and the Journal for the Poor and Underserved) before a multi-disciplinary team: Drs. E. Richard Brown, Gerald Kominski, William Shonick, Stephan Wallace and Paul Ong. Having now advised plenty of students and heard many horror stories, I have come to appreciate how well Rick facilitated the input of this diverse committee. When the time arrived for my doctoral hooding ceremony, our toddler ran down the aisle to be with someone he had come to trust as a grandparent. As I held our two year old, Dean Susan Scrimshaw handed my doctoral diploma to me and Rick placed the hood over … not at all phrased by a toddler in my arms.
Many life events filled the years between when I graduated from UCLA in 1992. When Rick ran for (and won) the position as President of the American Public Health Association, I rallied the forces that I could from my faculty position at Oregon State University. Several more moves and years abroad made it harder to stay connected, but we did see each other at the annual APHA meetings. Rick admitted that he was relieved to see that I had finally settled down with the perfect position at NIH and our relationship entered a new phase where I was only beginning to realize just how well he, UCLA, and my various experiences had trained me to assist in analyzing the upheavals in our health system.
A Visceral Sense Loss
However, nothing could have prepared me for the deep sense of familial loss—true grief –that my gripped by body, clenched my throat, and spilled forth gushes of tears when I received the email of Rick’s stroke while giving a talk in Kentucky. I cannot say that I have ever had such a visceral reaction to a single death — perhaps to the massive loss of colleagues in Haiti, but never for a single life. And, I truly believe it is because the reaction was/is that of an enormous collective of humans whose lives Rick Brown forever changed.
No, I will not write bullet points, nor will I draw a pie chart for this … perhaps I should, but after nearly 26 years I am living and working, utilizing what he taught me through the most effective mechanism…involvement — presence with people, participation in our profession, persistence with Public Health problems, and practice toward perfection.
The opinions expressed in this column are strictly my own and do not necessarily represent those of any the organizations with which I am affiliated.