Curmudgeon: 1. A crusty, ill-tempered old man. 2. Anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner.1

During the recent Teacher’s Tournament on “Jeopardy,” host Alex Trebek asked the contestants if they had any favorite teachers while in school. It made me think of the many individuals who taught and mentored me along my road to becoming a radiologist (and a teacher myself). Five stand out. These men shared many traits. They were, in addition to being excellent teachers, honest, forthright and genuinely interested in their students. In addition, they were all recognized to some degree as being curmudgeons (see definition 2, above). Although they could be cantankerous at times, they readily warmed to those who showed interest in their work and those who were willing to learn from them.

Jon Winokur points out that curmudgeons are not malicious at heart. “They don’t hate mankind, just mankind’s excesses. They’re just as sensitive as the next guy. … They snarl at pretense and bite at hypocrisy out of a healthy sense of outrage. … Their weapons are irony, satire, sarcasm (and) ridicule. Their targets are pretense, pomposity, conformity (and) incompetence.”1 The list of famous curmudgeons include Winston Churchill, W.C. Fields, Groucho Marx, Mark Twain, and, in our time, George Will.

My list of curmudgeons who became mentors for me includes Joseph (Joe) M. Lapetina, George J. Baylin, William (Bill) F. Barry, Jr., John A. Gehweiler and Lawrence (Larry) A. Davis. Joe Lapetina was my mathematics and physics professor at Albany College of Pharmacy (ACP). Dr’s Baylin, Barry and Gehweiler were faculty during my radiology residency and staff days at Duke, and Larry Davis was faculty at the University of Louisville, where I had my first job post-residency.

Joe Lapetina had a long career spanning 47 years at ACP, rising from Assistant Professor to Dean of Academics, a post he held from 1982 to 1993, when he retired. Although of slight build, he was an imposing figure in the classroom, teaching two of the most difficult courses in the curriculum, mathematics and physics. If someone asked a foolish question, he would look at them as if to say, “Did you really ask me that?” His mantra was, “Plug it in, turn the crank, and the answer will appear.” Surprisingly, he stressed the principle of not worrying about the derivation of the equation but concentrating on the results. I will be the first to acknowledge that mathematics never appealed to me. The math course he taught initially was calculus, and I was totally lost. After failing his first quiz, I went to him after class one day and asked him if I needed a tutor. He asked me to come back at the end of the day and we spent the next two hours one-on-one, during which time he showed me how to understand the fundamentals of calculus (something I never needed to use after the course was finished). I earned a B in his class. The next year, I earned the only A in his physics course, something that would help me with radiation physics during my residency.

Joe became my favorite faculty member and an academic “Father Confessor.” When I was applying to medical school, I was trying to decide whether to go to SUNY Buffalo or SUNY Upstate (Syracuse). I went to see Joe and asked his opinion. He asked me what the plusses and minuses of each were. Buffalo was further from home and was notorious for its winters. However, I told him that when I went for my interviews, the people at Buffalo were much more friendly and gave me the impression that they really wanted me to attend. Joe said, “Well, you’ve got the answer. Plug it in and turn the crank.” When I told him I chose Buffalo, he smiled and said, “A wise choice.”

Years later, Joe and I served on the Board of Trustees of ACP. Joe chaired the Academic Affairs Committee, of which I also was a member. Most boards are rubber stamps for the decisions of the President or of the Executive Committee. Joe was the official curmudgeon of the board, often saying, “Now wait a minute, let’s talk this over.” And, on more than one occasion, the result of the discussion that followed resulted in the board not approving the measure or modifying it. Since his passing at age 95, in 2019, I have succeeded him as the senior board member and official board curmudgeon.

George Baylin was one of the original faculty members in the radiology department at Duke University Medical Center. George fit the mold of classic curmudgeon, crusty, gruff and to the point. However, all acknowledged he was a “radiologist’s radiologist,” comfortable in any area of diagnostic radiology. His total honesty may have resulted in his never being considered for chairmanship of the department despite his seniority, expertise and academic credentials. I’m certain this contributed to his curmudgeonly demeanor. Despite this, he loved teaching and had a wonderful sense of humor.

I met George during my first month of residency, where we spent the mornings in lectures on radiologic fundamentals, and the afternoons in one of the many reading rooms. Each first-year resident was required to spend one afternoon a week learning radiologic technique paired one-on-one with a technologist in the outpatient clinic. The reading room of the outpatient clinic was George’s domain, and he was an imposing figure with a flowing mane of white hair. I often wondered if he was the model for Dr. Emmett Brown, the mad scientist in the “Back to the Future” trilogy. George was a firm believer in the Socratic method, a form of argumentative dialogue based on asking and answering questions to stimulate critical thinking. Ordinarily, George would tell you his opinion and his reasoning for reaching that conclusion. However, if you asked him a question, he would reply with another question and the back-and-forth would continue until the questioner grasped the answer. The basis of the Socratic method is that the answer lies within the mind of the questioner and needs a bit of prompting (the additional questions) to come to the surface. It is a method I adopted from George and used not only when teaching residents and students, but also my sons and my Boy Scouts.

Bill Barry was the second most senior radiologist at Duke during my days there. Whereas George Baylin ran the outpatient reading room, Bill ran the “in-line reading room” in the main part of the hospital. This was the main reading room where all chest, bone and abdominal “plain films” were interpreted. It also was the area where the clinicians consulted the radiologists. Bill didn’t like being interrupted by non-radiologic residents, who he told to first consult his own residents. If we couldn’t answer the questions, then they should come to him. He made it clear that he consulted primarily with other clinical attendings. Although that attitude made him seem curmudgeonly, his goal was to give the radiology residents the opportunity to learn consultative skills. When we checked our work with him before finalizing our interpretation report, he would often ask, “Now why did you say that?” He used the same technique in our conferences where the residents were shown unknown cases. He, like Dr. Baylin, also was teaching us critical thinking. The annual award for excellence in teaching at Duke is named in his memory. Bill and I also shared a love of woodworking and he had a workshop that I envied. He offered to allow me to use some of his equipment, which, at the time, I had not acquired.

John Gehweiler was the bone radiologist at Duke. His special areas of interest were peripheral skeletal and spinal trauma, two areas I had considerable clinical experience in due to my service in the U.S. Air Force. John was my attending on my first resident rotation after orientation, and we hit it off immediately. I had actually met him during my interview the previous fall, when, the evening before the interview, I had come looking for the on-call resident, who was supposed to show me where to stay in one of the on-call rooms. John immediately noted my Air Force uniform and told me that he was an ex-Navy man and a kindred spirit.

John was a young curmudgeon, who often was at odds with the orthopaedic surgeons. However, John also was an expert in skeletal anatomy, particularly that of the spine. He introduced me to the concept of recognizing the mechanisms of injuries by the changes that could be seen on radiographs. This resulted in my developing the “fingerprint” concept – injuries due to a specific mechanism produce specific fracture/dislocation patterns that identify the mechanism and can alert the radiologist to additional injuries. These patterns are the “fingerprints.” And thus, John became one of my mentors.

John and I collaborated on at least a dozen papers. He wrote the definitive textbook on spine injury at the time, “The Radiology of Vertebral Trauma.”2 Years later, it served as the background for my own book on the subject, “Imaging of Vertebral Trauma,”3 in which I expanded his mechanistic concepts and applied his radiographic findings to CT and MRI. John also was responsible for me becoming a frequent speaker at national meetings of the American Roentgen Ray Society. John had been giving a refresher course on spine trauma for several years. It was the same talk I had heard many times. One year, he called me the morning of his talk and told me he was ill and unable to give the talk. He asked me to use his slides and give the talk. When I expressed my doubts, he told me that I knew as much about the subject as he did. I gave the talk after explaining to the packed conference room that John was ill and unable to give the talk. I realized how successful I had been when I was invited back to give another course the next year. And that began my national exposure in academia, for which I will always be grateful to John.

I first met Larry Davis in 1971, while a second-year resident, when I attended a categorical course on pediatric radiology at the University of Minnesota, in which he was faculty. There were several things that I gleaned from that first encounter. First and foremost, he was an excellent lecturer and teacher. Next was his no-nonsense approach to dealing with difficult diagnostic problems. Finally, I appreciated his affability, when he was willing to elaborate on one of the many points in his talks with me, a lowly resident. I also saw his curmudgeonly side when I witnessed him dressing down another faculty member, well known for his pomposity and controversial views. Larry reminded him that the course was not the place to tout one’s personal agenda. He also pointed out that students tend to believe what their instructors tell them, and he reminded the man of his responsibilities as a teacher. This was the first piece of Larry’s advice that I have personally taken to heart, one of many tidbits I would learn from him.

In 1973, I moved to Louisville and joined the faculty at the medical school. Larry’s presence there was one of the factors that influenced my decision to come to the U of L. Shortly after my arrival, I paid him a visit at his office in Children’s Hospital of Louisville. Like anyone just out of residency, and with my board exam behind me, I was typical – on top of the world, more than a little arrogant, and ready to make an immediate impact on academic radiology. After Larry and I exchanged the social niceties, he told me something I passed on to my fellows when they began their fellowships after their residencies. In a matter-of-fact way he said, in his gravelly voice, “Today, your real education begins.” How right he was.

The three years I spent in Louisville included numerous visits to Larry’s “shop” at Children’s. He always had time for me and was more than willing to consult on difficult pediatric cases we encountered across the street at Louisville General Hospital. In those three years, I learned more pediatric radiology from those consultations and from attending his conferences than during my residency. He was like a giant oyster, spewing pearls to all who were willing to gather them and commit them to heart. His approach to his profession as well as to life were guided by two principles – practicality and honesty. This was reflected in his writing, which was concise and to the point. In 1973, he published the second edition of his textbook “Pediatric Radiology”4 with his colleague Loretta Shearer as co-author. This wonderful little book, less than 300 pages long, was filled with page after page of diagnostic pearls for its readers. The book took the information contained in the more encyclopedic text by Pittsburgh’s John Caffey and boiled off all the fat to leave the cream.

Larry had no tolerance for phonies, fools, sloppy work, or sloppy thinking. He particularly disliked pomposity. Pity the individual, be he (or she) an attending, a medical student or a dean, who tried to impress him with their own importance. His quick wit and rapier sharp tongue could easily deflate any stuffed shirt who made mistake of crossing his path. And he always did it with class. He frequently said, “Choose your battles carefully, picking those you know you can win. But, always make sure you are doing the right thing.”

Larry and I had several connections. We’re both Leos. As I mentioned, he influenced my coming to Louisville. He was a valued colleague, friend and mentor. And finally, he married my mother-in-law in 1980 a few years after his first wife died.

Five curmudgeons, who became my good friends, influenced my professional career and my outlook on life. I miss them all. Am I a curmudgeon? I’d say yes, in the context of the second definition. When I retired, my partners presented me with the picture shown below, that was used on a CME brochure.

 

 

 

 

 

References

  1. Winokur J. The Portable Curmudgeon. New York, New American Library, 1987.
  2. Gehweiler JA Jr, Osborne RL Jr, Becker RF. The Radiology of Vertebral Trauma. Philadelphia, WB Saunders Co, 1980.
  3. Daffner RH. Imaging of Vertebral Trauma, 3rd ed. Cambridge, UK, Cambridge University Press, 2011.
  4. Davis LA, Shearer LT. Pediatric Radiology, 2nd ed. Baltimore, Williams & Wilkins Co. 1973.
Author profile
Richard H. Daffner, MD, FACR

Dr. Daffner is a retired radiologist who practiced at Allegheny General Hospital for more than 30 years. He is emeritus clinical professor of Radiology at Temple University School of Medicine and is the author of nine textbooks.