Off Deadline: Following the footsteps of a remarkable physician

Passing of Dr. R. Hewlett Lee signifies more than loss of a major voice in the field of medicine

The passing last week of Dr. R. Hewlett Lee -- almost universally known by his nickname, Hewey -- signifies more than the loss of a major voice in the broad field of medicine, both in medical practice and in economic policy.

He was not just "a physician's physician," as one colleague called him; he was a "kind person's kind person," as well as being a phenomenally skilled surgeon and pioneer in how to treat women with breast cancer.

He led the way in involving women fully in decision-making about their treatment alternatives, and along with radiation oncologists and chemotherapists tested and pushed alternatives to then-standard full mastectomies that commonly included removal of muscle.

When Lee received a "Lifetimes of Achievement" award in 2000, Bill Miller of Stanford University -- from which Lee graduated with honors and a Phi Beta Kappa key in spite of carrying an immense 30-unit academic load -- described him as larger than life.

"Encapsulating physician R. Hewlett Lee in a paragraph or two is a bit like trying to reduce Handel's 'Messiah' to a few bars," Miller wrote. (Read Russel Hewlett Lee: Larger than life).

During his career he fought tenaciously to assure quality care and, as important, for broader access to care for moderate and lower-income people, of all ages. Miller described how Lee fit with his remarkable family, as the youngest of four sons of Palo Alto Clinic founder Dr. Russel V.A. Lee, with a younger sister -- all of whom received medical degrees. (Details of his life can be found here.)

But the broader themes can often be lost in details, or their power sapped by too many words.

"I really hate controversy, but I always seem to get into the middle of it," he once told me in a conversation/interview, encapsulating a lifelong dilemma.

He helped lead the charge statewide to curtail abuses in the over-selling of health plans and the under-treatment of enrolled patients in the free-for-all days of inadequate regulations governing the plans. And he co-founded plans designed to extend access to health coverage and treatment to more people, especially those who couldn't afford to pay for ballooning costs of care, medications and equipment.

As president of the Santa Clara County Medical Society he led the society to become the first medical society in the nation to oppose the Vietnam War when he saw how health-related resources were being siphoned away to fund the war.

In short, he cared -- strongly.

He once told me that one of the things that irritated him the most was when he saw people driving past an accident without stopping to help.

Thinking of him being irritated is a trick. His kindness, humor, zest for life and respect for others is recalled by patients and colleagues of all levels.

Personally, he loved color photography of the natural environment. And he loved limericks, including the mischievous and racy ones.

His knowledge of health policy and issues was matched only by that of his elder brother, Philip R. Lee, who also practiced for a time at the clinic before being named head of the Institute for Health Policy Studies at the University of California, San Francisco -- now bearing his name.

During my 18-year tenure at the Palo Alto Medical Foundation, between full-time journalism jobs, one of my tasks as director of public affairs was to deal with media coverage of biennial national conferences on health policy and economics. At one conference, I received an urgent call from a young woman radio journalist who asked if I could brief her on issues in health care and medicine, as she was on a tight deadline for a three-minute news spot.

It was during the peak of the failed health-reform effort of the early years of Bill Clinton's presidency, with many complex issues being debated. The effort was spearheaded by a task force headed up by Hillary Clinton and Ira Magaziner, an aide to President Clinton who became known for his blunt domineering rather than consensus-building approach.

"How many hours do you have?" I asked. I invited her over, gave her a quick nutshell of major issues, then looked around for someone for her to interview for the broadcast. In the hallway, I saw Hewey and Phil walking back from lunch together.

Hewey was supportive of the Clinton reform initiative but Phil was opposed, as I recall, because he felt too much had been given away to pro-reform liberals for it to be an even-handed reform.

I approached them and steered them into the press room, introduced them to the young woman and said they needed to do a three-minute on-the-record debate on health reform for her. Witnessing the give and take by two knowledgeable and brilliant men in the next three minutes, in which they covered all the major and many minor issues, was an astonishing experience.

The radio station editors were so impressed they had her stay for about five hours, doing several more radio spots with speakers and panelists.

Once I was engaged with one of the leading nurses in putting together a booklet about breast cancer, including its emotional side effects -- seldom addressed in medical literature at the time. Hewey was our principal physician adviser on the booklet. One day we asked him whether we should include a chapter on sex after mastectomy or breast-cancer treatment.

He laughed, waved his hands and said that soon after an operation or treatment he asked his women patients to come in with their spouse or significant other. He then advised the partner to be sure to give the woman a shoulder massage every evening.

"Soon they're fooling around and there's no problem," he said. We didn't include the chapter, but we learned what "role model" truly meant.

Former Weekly Editor Jay Thorwaldson can be emailed at and/or He also writes periodic blogs at

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