A Man of Uncommon Influence Candy Tedeschi

Dr. Burton A. Krumholz 1928 - 2022

Editor’s Note: There is almost aninevitability to the multiplier effect generated by good people. Dr. Burton A. Krumholz was the embodiment of that phenomenon. An OB/GYN MD, Dr. Krumholz not only practiced medicine at the highest level of professionalism, he taught new doctors skills, which they would utilize through lifetimes in medicine. His professional achievements are many, but in the final analysis, a person’s contributions go far beyond lines ona CV. This particular aspect of Dr. Krumholz’s life story is about how he multiplied his beneficial influence on countless thousands of patients through the professionals he influenced, including my wife, Candy, in her case over the many years she has tended to patients as a gynecological nurse practitioner. Dr. Krumholz died on July 20th at the age of 93. Following are Candy’s thoughts on her more than four decades as a colleague and friend ofa very special man.

--Tony Tedeschi

A Man of Uncommon Influence

By Candy Tedeschi NP, Women’s Health

In 1979, after spending five years working as a nurse in a neonatal intensive care unit caring for premature babies, I was looking for something different. I interviewed with Dr. Burton A. Krumholz, who was the associate chair of obstetrics and gynecology at Long Island Jewish Medical Center. He offered me a position as a staff nurse on a New York State grant educating and caring for women who had been exposed to diethylstilbestrol during pregnancy. DES is a drug women took ostensibly to prevent miscarriages, but caused numerous problems in their daughters. DES exposure and the problems associated with it were new to me and I was constantly asking Dr. Krumholz many questions. He patiently answered them and gave me articles to read. Finally he had had it with all the questions. He told me I was a pain in the ass and I should go back to school to become a nurse practitioner and work with him in that capacity. So I did.

When I’d finished my class work, I did a preceptorship with him and at the hospital GYN clinic. When the residents found out I worked for Dr. Krumholz, they could not believe I could work with him. They called him a “grizzly bear.” I answered back that he was a “teddy bear.” OK, maybe in reality, he wasa grizzly bear with the residents, but Burt had a strong view of how residents should learn and he made sure they learned well. He wanted those he taught to go out into the community when they graduated and be able to practice the best of the latest in medicine.

Dr. Juliana Opatich, one of his past residents, said they dreaded when he gave grand rounds for them. “He would present a patient case,” she says, “then start asking questions. He’d begin with the medical students and work his way up to the senior residents. If no one got the correct answer, they got a lecture on that topic. Burt was always ahead of everyone else in the community in his specialty of diagnosing and caring for women with diseases of the lower genital tract, abnormal Pap tests, along with the treatment and care for those conditions.”

For doctors like Helen Greco, today chief of the division for benign obstetrics and gynecology at Long Island Jewish Medical Center, a professional relationship with Dr. Krumholz played a significant role, lasting decades.

“My memories of him span over 30 years,” she says. “I was a new resident and he was department vice chair. Immediately I came to know him as a revered educator and a renowned expert in the field of colposcopy and DES. He was tough on his residents with the expectation that your clinical skills, once mastered, would be equal to, or better than, those who had had the privilege of teaching you. This challenge he posed to each of us was at times bumpy, but the benefit of the experience far outweighed those bumpy moments.”

As hard as he was on residents, when they graduated and were out on their own, past residents would tell me that they were actually grateful, and loved and respected him for it. His influence was so universal, one of his past residents said that she would write in the patient’s chart when she was referring someone to him for treatment “refer to BAK.” When staff would ask her what’s a “BAK,” she’d answer, “Burton A. Krumholz of course.”

“Our relationship grew from studentteacher to that of colleagues and ultimately friends,” Dr. Greco explains. “He took on his role as mentor and leader in his field very

early in his career and continued to advance the medicine every day that he practiced. From my changing perspective, I learned from him that we are all lifetime learners, ever evolving to adopt to the current course, and willing to develop the practice needed to better the outcomes for our patients.”

If he were sometimes a hard person to deal with, he directed that hardness at specific targets. Case in point: he and I always tried to get the medical records before a new patient came in for her first office visit. Sadly, most women had very little knowledge of exactly why they were there. This particular patient had extensive records, which I reviewed before her visit and shared with Burt. He asked that I sit in on his interview with her.

As he asked her questions and she responded, I could tell by the tone of his voice that Burt was becoming more and more angry. It was making the woman more and more upset, until she started crying. I asked why she was crying and she said heis angry with me. He looked at her and told her he was not angry with her; he was angry at all the prior doctors who had mistreated her. That was typical of Burt. He hated when women were not get properly diagnosed and treated accordingly. He had the highest level of respect for women and how they were cared for.

On the professional side Burt was very active in local and national organizations like the American College of OB/GYN and positions in Nassau and Queens County, New York OB/GYN medical associations, including president. He had gotten interested in colposcopy while working at Nassau County Medical Center as chairman of OB/GYN when he opened a closet and found a machine called a colposcope, basically a fancy mobile microscope on a stand. He knew that it was a new part of evaluating women for abnormal Pap tests. It was a part of women’s health that was growing and much research was being done. He decided he wanted to be part of that research and education, so he joined the American Society of Colposcopy and Cervical Pathology (ASCCP) in the late 1960s as one of the early members of that organization. He was elected to the board of directors and held every position on the board until he became the president in 1992. He lectured all over the world and wrote numerous articles, which helped set the standards we have in place to this day.

Beyond his professional resume, Burt was a warm and loving man, dedicated to his family. When his children were camp age, he took off every summer to be camp doctor so he could be close to them. He like to speak of the accomplishments of his three daughters, two sons and three grandchildren. He loved to travel with his wife, Shelley, and talk about his golf and tennis games.

There are also many stories about the “grizzly bear’s” lighter side. Once, after giving a lecture in Southeast Asia, he was honored with an award but told in order to receive it he had to sing a song -- that it was a tradition. “I don’t sing,” he protested. Eventually, reluctantly, he sang “Happy Birthday.” A moment his wife, Shelley, wouldn’t let him forget.

Burt never stopped encouraging me to learn more, do more, be active in ASCCP. I’ m eternally grateful he pushed me to become the nurse practitioner I am today, with his influence demonstrated for the many patients I treat each year, as part of that army of healthcare providers who are better caregivers because of him.

In the words of Dr. Greco, “the lifetime of dedication, devotion to his family and circle of friends and colleagues, as well as his warm smile and turned up lab coat collar, will be forever etched in my fond memories of what I see when I picture my friend, colleague and teacher.”

Rest in peace, my friend.