Remembering Mel Rosenblatt, MD

MARLIN SCHUL, MD, MBA, RVT, FAVLS PRESIDENT, AVLS

It is with heavy hearts that we gather this year, missing our dear friend Mel Rosenblatt MD, FAVLS who passed away at the age of 60 following an 18-month battle with hepatic cancer. Mel was a giant in the field of venous and lymphatic disorders. He was humble, dedicated to faith and family, and an important visionary in the AVLS. Mel understood the importance of data collection in shaping care and establishing benchmarks. He created what has become the largest dialysis access registry and followed through on his knowledge in this space to support the ACP PRO 1.0 Venous Registry transition to AVLS PRO 2.0.

Mel Rosenblatt, MD, FAVLS

Dr. Rosenblatt was boarded in Interventional Radiology and dedicated much of his career to the practice of venous and lymphatic medicine. Mel has been an active and integral part of the American Vein & Lymphatic Society for the past two decades. Mel joined the Society in August of 2002, served on numerous committees and eventually rose to the Board of Directors in 2008. In 2009, Mel was accepted as a Fellow Member of the AVLS. Mel’s service and dedication to the Society led to his election as President in 2013-2014. Following his Presidency, Mel became the Chairman of the Foundation for Venous & Lymphatic Disease in 2015-2016 and has since served on the Board of Directors of the Foundation. In 2017, Mel represented our society in Wave 2 of MACRA cost measure development, helping to build further societal awareness. In 2018, Mel was granted the position of Honorary Member of the American Vein & Lymphatic Society. Earlier this summer he took a role in reviewing the query engine platform of the AVLS PRO 2.0 registry and affirmed it has the tools to effectively address our needs. Most recently, Mel served as the Honorary Chairman of the New Horizon Capital Initiative leading the charge to develop funding to support the growing and expanding mission and vision of the AVLS. Mel lead our Society by example through giving his time to serve, selflessly volunteering his expertise and talents, and financially committing to the mission. He continually strove to see more members involved in the society and nurtured them to collectively achieve the goals and objectives that would advance the field for the benefit of our patients.

The AVLS and FVLD will be planting a tree in memory of Mel in Israel. The family has asked that any contributions in his memory be made to the Foundation for Venous & Lymphatic Disease.

As we all mourn the passing of a great human being, colleague, husband, and father, we should do so knowing we are all better off for having known and worked alongside Mel for these many years. Consider how you may best honor Mel’s memory by making a difference and simply “doing one more thing” for the Society and the Foundation.

In these next pages, remember Mel as you read stories shared by colleagues and friends that reflect on all he accomplished and the great man that he was.

CATHERINE BURDGE, APRN:

I am the luckiest person.

I had the honor and privilege of working with Mel Rosenblatt as his nurse practitioner for 26 years. When I look for a physician to work with, I look for three qualities:

• A physician who is an expert at what he or she does

• A physician who loves his or her patients

• And a physician who is just a nice person

Mel possessed all three qualities.

Mel was a great physician. It was his very being. I first met Mel in 1993 when I was hired as the nurse practitioner for the section of Interventional Radiology at Yale - Mel’s practice group. I got to see firsthand his passion for patient care. He and his partners revolutionized the specialty of Interventional Radiology at Yale. They took procedures performed by surgeons out of the operating room and moved them to the interventional radiology suite where Mel and his partners would perform these procedures with more minimally invasive techniques. This reduced risk to the patient and allowed treatment in a more-timely fashion, many times the same day as the request for care.

This was a whole new concept in medicine. They changed the paradigm of care for the dialysis patient, the oncology patient, patients with vascular issues, and other patient populations. Mel and his partners were always available to care for their patients. They never said “no”. Weekends, nights - always available for their patients in need.

Let me tell you just a few of the other ways Mel influenced modern day medicine:

One procedure Mel performed was chest catheter placement. Patients receive treatments, such as chemotherapy, dialysis, and antibiotics, through implanted catheters. Mel changed the approach of catheter placement - through the internal jugular vein instead of the subclavian vein - a safer and more effective approach for the patient. Mel published this new approach in the medical literature and changed medical practice. The internal jugular vein approach for chest catheter placement is the medical model for this procedure.

Mel was an inventor, always thinking about how he could make treatment better for the patient. He invented a type of chest port, the Rosenblatt SlimPort. He named the port in honor of his father. This port, which received a patent in 1998, was created out of a need that he saw for his patients at Yale. Its small size, slim shape, and its dual lumen allows oncology patients to receive their care in a more comfortable and efficient way. It continues to be used around the world.

In 2003, Mel decided that he wanted to open his own practice to care for his patients. At that time, it was unheard of for an interventional radiologist to have a stand-alone practice - we were 1 of only 3 other interventional radiologists in the country who did this. While it was very difficult to succeed at this, Mel made it work. In fact, he made it work so well that his practice continues today at an extraordinary level of success, thanks to his dedication, expertise, the loyalty of referring clinicians and patients and the expert physician partners and devoted staff who he worked with every day.

Mel lectured on all of his accomplishments at our national specialty meetings. He headed up national workshops and committees. He was not only inspired to care for his patients, but to teach others how to care for patients in new and innovative ways. He did this every day in the clinical setting, as well. He was an outstanding teacher to his medical students, residents, fellows, and other clinicians. He had a love of learning and a love of teaching. Residents would apply to the Yale fellowship program specifically because they wanted to learn from Mel. To the very end, Mel was teaching his staff every day how to give the best care to our patients. His legacy will live on for our patients every day in our center.

Mel was a pioneer in the specialty of venous disease and was internationally known for his innovative techniques and unique approaches to a variety of venous syndromes. In 1999, he was the first in CT to perform a new minimally invasive procedure that changed the course of varicose vein treatment, and he was one of the researchers who got the device for the procedure FDA approved. This “first” is acknowledged on the timeline of “firsts” displayed at the entrance to Yale New Haven Hospital.

Mel continued to advance the art and science of venous disease treatment. He was President of the American College of Phlebology (now the AVLS), Chairman of its Foundation, and served repeatedly on the board of directors for both, as well as its numerous committees. His colleagues were always seeking his advice. “What would Mel do?” was the mantra. He was working on a new classification system of pelvic venous disease at the time of his passing. He is internationally known and was in demand to lecture at many medical conferences around the world.

The second quality - Love for his patients

Mel loved his patients and they loved him. They came from near and far and from around the world for his care, returning regularly if needed, for they knew that they would always receive the best care possible. So often they would call him Mel or Dr. Mel. He was so down to earth with them and they always felt so comfortable with him. They also called him “superstar,” “my hero,” “the best doctor ever.” “He cares about me,” “I won’t go anywhere else.” “I will travel far just have Dr. Mel take care of me.” Patients actually looked forward to coming to our center to see Dr. Mel and to receive his care. He was always there for them.

Mel combined his outstanding medical knowledge and creative instinct to give the most beautiful care to his patients. He would dare to perform procedures that other physicians wouldn’t even imagine, always taking into account patient and staff safety. He had a unique perspective on how the human body works, and his patients always benefited from this.

Mel would do anything to help his patients - he was on call 24/7. He would make house calls. He worked weekends. He would work each day until every patient who needed his help was cared for. That many times meant working late hours. But he got it all done with devotion to his patients. He always said, “Do what is right for the patient, no matter what it takes.” Mel said only 2 weeks ago, “I have tried to create a practice based on one primary goal, that was quality. I only wanted to deliver the best possible care to my patients and I only endeavored to do that.”

Mel raised the bar for his staff when it came to patient care, and we always strove to meet it. He demanded a lot from us when providing patient care and he made us all better clinicians. He never asked more from us than he demanded from himself. It was expected that the patients would receive the best care possible. Mel cared for his patients until just 3 weeks before he passed away. He was amazing - dedicating himself so beautifully to his patients while fighting his own battle.

The third quality to look for in a great doctor is for that person to be just plain nice. And Mel sure was that. He cared about all of his staff. When we had a problem, he wanted to help. If we had a medical issue or if a family member or a friend had a medical issue, he was always there to offer advice, review radiology films, and speak with clinicians for us.

Mel had a lot of fun in him, too. His sense of humor would get us through busy days at work. And he was always the life of the party outside of work, whether it was a staff get together or a get together with his international friends while at a medical society gathering.

On a personal note, Mel was my dearest friend. He was always there for my family and for me. His children and my children grew up together, and we will always be family to each other.

Mel was kind, considerate, generous, and always thoughtful. And he was a man of his word.

What more could you ask for in a leader, boss, colleague and friend?

As much as medicine and his career meant to him, there were other things in Mel’s life that he coveted. He was devoted to his religion and to his community. He always wanted to be there for his friends. And his family meant everything to him – his dear mother and father, his sisters, nephews, Sarah’s family, his cousin, and all of his in-laws – and Danielle, Jon, Matthew, Ahuva, and Daniel, and as Mel called her, “adorable Kira.” And most of all, Sarah, his soul mate and true love. She was by his side throughout his life, supporting him, and never left his side during his illness.

I could go on about Mel’s accomplishments, but please know that he touched ever so many people around the world, both personally and professionally and will continue to do so.

And so, as much as I call myself lucky, we all are lucky to have known Mel as colleague, mentor, friend, and family. May we all carry on his legacy - his love for humanity and his devotion to caring for each other in the best way possible.

STEPHEN DAUGHERTY, MD, FACS, FAVLS, RVT, RPHS:

I first became aware of Mel Rosenblatt as a talented teacher and lecturer about pelvic venous insufficiency. Much of what I learned about pelvic venous insufficiency outside the interventional suite I learned from Mel’s talks and from his thoughtful answers to questions. Although Mel’s most visible role to most attendees at the Annual Congresses of the American Vein & Lymphatic Society was his teaching, Mel distinguished himself as a leader among leaders. Leadership in any organization is all about analyzing present and future needs and challenges. It requires vision to anticipate the challenges and opportunities and to formulate solutions. Leading is hard work requiring human skills, financial skills, and business acumen. Mel was an accomplished leader of the American Vein & Lymphatic Society and our Foundation with uncommon skills supported by hard work and dedication to purpose. He will be sorely missed. We can look to Mel for his example in leadership as we continue his work.

STEVEN ELIAS, MD, FACS, FAVLS:

Three Letters, One Word

It couldn’t be more simple; 3 letters, 1 word: Mel. And that is Mel. Simple, Uncomplicated, Straightforward. It is fitting for a person such as Mel to have been given a short, unambiguous name. In the vein world there a few people who exist by a single moniker. Mel is one of those people. I am sure there are other “Mels” in the vein world but when Mel is mentioned, it only conjures up the visual of Mel Rosenblatt.

Many remember and will highlight Mel’s contributions to the care of patients with vein disease. And there are many contributions to list. I’ll leave that task to others. What I want to highlight is the process, the journey, the approach. The man thinks. He thinks in the abstract and the concrete. Over the years I have observed his thought process. One needs to pay attention to any talk Mel gives at any meeting. It starts out relatively simple and straightforward. Then it morphs into the semi-stream of consciousness realm. In the middle of the talk you are both confused and mesmerized. The conclusions sneak up on you. But when one of his talks ends you have been enlightened. I so enjoy listening. I don’t think he has actually constructed his talk in this manner. I think it is merely Mel being Mel, the unassuming intellectual passing his thoughts on to us. It couldn’t be more simple; 3 letters, 1 word: Mel. I thank you Mel for being Mel.

MARK FORRESTAL, MD, FAVLS & DEBBIE FOLEY, MD:

Mel walked into his first AVLS meeting and brought with him the depth and breadth of his clinical background and his academic expertise. He generously shared it with us gracefully and modestly, raising the AVLS’s reputation and credibility at every turn.

Mel embraced the investigation and treatment of uncommon but highly morbid venous malformations, giving hope and alleviating suffering for previously neglected patients.

Mel raised expectations for all members of the AVLS. His attention to the finest details was both inspiring and daunting, but he never asked anything of us that he did not demand of himself.

Mel’s unconditional support of me personally is a high point of my professional life; his loss is both painful and unfathomable.

To paraphrase the artist Banksy: “...they say you die twice. Once when you stop breathing and a second time when somebody says your name for the last time.”

I know that the name Mel Rosenblatt will be said at every gathering of the AVLS as long as the organization exists. The name will be quoted in the venous and lymphatic literature as long as caring physicians seek answers for challenging patients. And it will be said in our home whenever the topic is excellence.

Our sincerest condolences to Mel’s family.

HELANE FRONEK, MD, FACP, FAVLS:

In prior years, physicians were respected for their commitment to ethical behavior, integrity, collegiality, the continual pursuit of knowledge, and, above all, a dedication to doing the right thing for patients. Few people exemplified these traits more than Mel Rosenblatt. Mel accomplished many things and was respected by all of us for his intelligence, work ethic, kindness, love for his family and faith, and his desire to contribute to the people and institutions he believed in. All one had to do was ask, and Mel would find a way to say yes. I recall when a speaker wasn’t able to attend a meeting. Mel quietly took out a keychain full of flash drives containing innumerable power points he had created and filled in for the absent speaker in his typical humble way. There was a limitless expansiveness to Mel - adding another task to his plate was something he always seemed able to do. He did this graciously, without calling attention to the extra work or expecting additional acknowledgment. His recent note to the membership of the AVLS reflected the way Mel lived his life: if he believed in something, he worked hard to support it. Even with so little time left in his all too short life, he asked members to join with him in supporting a cause that was dear to him. His words were poignant. “Time is fleeting, your legacy is all you have – what will people say about you when you’re gone?” We will miss Mel – the person, the doctor, the colleague, the advocate – and we are sad that we didn’t have him in our lives and our profession for as long as we would have liked. His legacy, though, is well established. He will live on in his example of an ethical, purposeful, and humble life well lived; in the many kind, humorous and insightful interactions he had with so many of us; in the patients whose lives he touched and changed in such positive ways; in the medical advances he spearheaded; and in his family who he loved so much. Our organization, profession, and all of our lives are richer because of Mel.

NEIL KHILNANI, MD, FAVLS, FSIR:

I am profoundly sad that my colleague and good friend is leaving us much too soon. I have known Mel for 18 years; it was too short, and I will miss him a great deal.

The Mel I know possessed an amalgamation of glorious traits, any one of which would have distinguished someone as unforgettable. A devoted husband, father, son and member of his personal and professional communities, Mel was loved by most everyone who knew him. He was a master clinician, with a wonderful bedside manner and the ability to see beyond the obvious, often considering nuances that others only recognized years later. He was an insightful human who, like the best strategists and statesman, recognized the personal strengths of his colleagues and the downstream implications of decisions well before the rest of us. He was extremely clear thinking, able to synthesize multiple viewpoints and facts and facilitating creative and solutions to problems that seemed insurmountable. Mel was a leader by example, choosing to do things he believed in and hoping others would appreciate the benefits of doing similar things themselves.

To those of us who spent time with him at the AVLS, he was a caring and thoughtful friend, who was always there when you needed him, eager to help and quick to bestow praise on others even when he deserved it more. He was also adept at helping others to succeed with sage advice, candor and unquestioning support.

To Sarah, please accept my heartfelt condolences for you and your family’s incredible loss. I cannot fathom the sadness you must feel. I consider myself extremely lucky to have had you and Mel in my life.

MARK MEISSNER, MD:

“Rosenblatt’s Rules” for Life

I initially met Mel when we shared the podium discussing pelvic veins at the AVLS in 2008. He subsequently became not only my friend, but also my mentor in understanding the intricacies of pelvic venous disorders. Small but important insights, such as the value of direct puncture venography in understanding pelvic escape points have led to further advances in understanding and treating these disorders. Mel and I spent many hours together and despite learning most of what I know about pelvic veins from him, what Mel has taught me about life is perhaps more important. I have affectionately deemed Mel’s observation that you can frequently reflux contrast / sclerosant to the level of the broad ligament from a perineal puncture as “Rosenblatt’s rule.” With some editorial license, below is my personal impression of the way Mel lived and “Rosenblatt’s Rules for Life”,

1. Progress is made by sharing your insights and encouraging others to build upon them. Although the original great idea may have been yours, encourage and support others in building on it and making it better. Allow others to take the credit. Not always an easy thing to do, but clearly responsible both for a number of clinical advances as well the progress made in the AVLS under Mel’s leadership. The idea is what is important, not the fact that you thought of it. To me, this is leadership at its best.

2. Keep an open mind, be kind, respect others, and everyone wins. Mel and I have debated and disagreed on several issues over time – we frequently both move towards the middle and the outcome is far better than the views we started with. This only happens because Mel respectfully acknowledges other view points before you become convinced of the value of his insight.

3. Whatever you believe in, commit to it with all of your heart. Mel is a man of very deep faith, which, to my observation, he unwaveringly lives every minute of every day - no compromises. While we may not all share the same beliefs, we can all learn from Mel’s example. Have faith in what you believe and live every moment according.

I am truly fortunate to have known Mel and for him to have cared about me personally and we all continue to benefit from his leadership of the AVLS. I know that I am a better person for having Mel as a friend and we are a better organization. Godspeed my friend.

NICK MORRISON, MD, FACS, FAVLS, RPHS & TERRI MORRISON, RN, BS

To Mel, Sarah, their children and families:

Although Mel is far too humble to willingly accept the description of himself as “mentor,” I believe this term derived from Greek mythology is the essence of Mel’s character – “a wise and trusted counselor or teacher.” All of us in the field of phlebology who know Mel as an esteemed colleague would agree that it has been hugely beneficial to have Mel among us. His innovative nature is best exemplified by his description of the diagnosis and treatment of pelvic vein insufficiency - practitioners and thousands of patients have and will greatly benefit from his leadership in this area.

During long conversations at medical gatherings and one particularly memorable road trip with Mel, he taught me a great deal about Jewish history and religion. I looked forward to a trip with Mel and his family to the Middle East, but alas that will now not happen.

Some of us have been lucky enough to come to know Mel as a trusted friend. His intellectual honesty is absolute, and while his scientific rigor is high, he is always ready to question dogma as well as his own opinions, listen to alternative theories, and adopt a compromise position where it is needed.

Perhaps most importantly, Mel’s humanity is his biggest attribute. He has cared for patients, colleagues, and friends in a manner we all wish we could emulate. Few people have done it any better.

So, to Mel and Sarah I say thank you for being in our lives…it has been an enormous privilege.

MARLIN SCHUL, MD, MBA, RVT, FAVLS

Mel was a giant in the field of venous and lymphatic disorders. He was humble, dedicated to faith and family, and an important visionary in the history of AVLS. Mel understood the importance of data collection in shaping care and establishing benchmarks. He created what has become the largest dialysis access registry and followed through on his knowledge in this space to support the ACP PRO 1.0 Venous Registry transition to AVLS PRO 2.0. I look back quite fondly on times with Mel and laugh at the fun stories we created just sharing time with family. Mel will be deeply missed yet left a lasting legacy we should all embrace.

DIANA NEUHARDT, RPHS, RVT, FSVU

It was truly an honor to be friends with Mel Rosenblatt. I met Mel way back when, not even sure when, and we instantly connected with our numerous shared interests. Some of my beloved memories include the walks we took together with the group at meetings after sundown on Friday nights. Mel was generous, kind, and extremely creative, and one of his hobbies included working with wood. One day Mel, his wife Sarah, another friend Karen, and I were hiking while in Sedona. It was a beautiful day, sunny and the weather was priceless. As we were walking along, we all were all chatting except for Mel, who was distractedly looking at “wood pieces.” He would say, “Diana, can you mail me that wood?” (I would do it, and months later I received an incredible wood carved pen in the mail.) As we were finishing our hike, we wanted a photo of the four of us to memorialize the day, a “selfie.” Now of all the talents Mel had, selfie photography was not his strength. It was about the only thing I can think of that he wasn’t highly skilled or perfect at doing. The selfie involved more than a few minutes, many tries, extensive shaming, and much laughter. I am so grateful I kept every unfocused shot. (I’m sharing the infamous selfie that made the cut with this tribute.) Anytime I need a laugh, or to share Mel’s presence, I simply scroll to my pictures and there we are – well, most of us, anyway! My dear Mel, thank you for all the priceless memories.

KENNETH L (TRIP) TODD III, MD, FAVLS

If God ever made a true “gentleman physician,” it was Mel Rosenblatt. Mel was the guy who did the right thing regardless. No matter the sacrifice to himself or his time, Mel was going to stand for not just what was right for our society (AVLS), but society as a whole.

I first got to know Mel, and Sarah as well, when I asked him to sit on the program committee for the annual AVLS meeting in Naples.

His ability to steer the rest of the committee in the appropriate direction with an eye-roll and a wry smile became an ongoing point of great humor for the whole committee. Later, at a meeting in New Orleans during Mardis Gras, I bought lunch for Mel on Saturday. Over the two hour, lunch I did my best to explain how Mardis Gras has changed from a religious to a mostly secular event. I was not very successful. As we walked back to the hotel a typical Mardis Gras Parade passed by.

Mel, with that same wry smile said, “is this the religious or the secular part?” Mel was a fantastic physician, wonderful husband, father and unparalleled friend. He leaves a void that will never truly be filled.

STEVEN ZIMMET, MD, RPVI, RVT, FAVLS

I don’t remember the exact year I met Mel, but it was at an AVLS Annual Congress. I think it was the first time he had attended one of our meetings. I had heard Mel give a presentation, and of course it was immediately obvious how brilliant and talented he was, and he seemed to be such a great and kind person, which of course he was. I made it a point to meet him soon after and caught up with him as he was walking on a bridge. I’d hoped, as I’m sure others did after hearing his talk, that he’d get involved with AVLS.

Mel was a great communicator, and it was awe inspiring to hear Mel give a talk and to hear his comments about various initiatives being considered in the board room. At the ABVLM, we’re so very grateful that Mel has been with us from the start, doing tremendous work on the

Item Writer committee and on the Board.

It was always fun to sit next to Mel in meetings, as he would quietly analyze in great detail the presentation we were listening to. And it was a particular joy to be with him during the social aspect of the meetings. I always felt that Mel had a quiet but powerful joie de vivre.

We’ve been so lucky to have Mel’s leadership in the field and to know Mel personally. There are so many things to respect, appreciate and admire about Mel, including his integrity, intelligence, humility, equanimity, and service to others, to name a few. Mel’s passing is a tremendous loss for everyone, but we are so lucky to have known Mel and to have benefited from his many talents and friendship.