Norwich — Dr. Dennis McCullough, a renowned geriatric physician and leading proponent of the “slow medicine” movement, died after suffering a heart attack on Friday in Bar Harbor, Maine. He was 72.
With more than 40 years of experience in family and community medicine, McCullough held positions at the Geisel School of Medicine and Dartmouth-Hitchcock Medical Center. But he was best known for his work with seniors and their families.
“He was an enormously connected listener,” said Joanne Sandberg-Cook, a nurse practitioner who worked closely with McCullough at Kendal at Hanover, a retirement community offering long-term care.
It was at Kendal where McCullough developed an approach referred to as slow medicine, which he offered as an alternative to a system that struck him as uniquely unprepared to help elderly people and their loved ones make health care decisions toward the end of life. Conventional medicine, he believed, was too fast, mechanical and doctor-driven.
“Taking time for listening and understanding — much less time for interactions with families — is not paid for and hence not usually undertaken in today’s corporate medical environment,” he wrote in an essay for the Spring 2008 issue of Dartmouth Medicine. “Patients are briskly shunted off for various kinds of expensive but Medicare-covered tests and procedures or quickly put on medications based on rapidly made decisions and standardized protocols.”
“Despite intending to do the best work we can, we face a medical-care system that seems to work at odds with our parents’ stated desires and wishes — ‘to die at home,’ ‘to let go when the time comes,’ ‘to avoid the suffering I have seen my friends go through,’ ” he wrote.
By contrast, slow medicine allows “family, friends and neighbors (to) team up with an elder and with health-care providers — including visiting nurses and other home-based care providers — to improve the quality of care and avoid inappropriate, sometimes harmful care,” he wrote in that essay.
“It’s just a thoughtful slowing down of the (medical) process,” Sandberg-Cook said.
Using the approach, teams at Kendal would listen to seniors about their concerns and work with them to determine the best course of treatment.
McCullough urged medical professionals to take the time to listen to patients, interact with families and work collaboratively. His book, My Mother, Your Mother: Embracing “Slow Medicine” led to international speaking trips and was used in Japan, South Korea and Brazil.
“His bottom line is this: It is up to friends and relatives to rescue the elderly from standard medical care. And slow medicine, like slow food, involves a lot of hard work,” a New York Times reviewer wrote of his book. “Readers who sign on will acquire a staggering list of tasks to perform, some of which may be just as tiring and tear-producing as chopping onions.”
Just like his method, McCullough was “collaborative, thoughtful and convinced” he was doing good, Sandberg-Cook said. “He was a man with strong convictions.”
Much of McCullough’s resilience was passed down from his mother, who raised two children as a single mother in Michigan’s Upper Peninsula, said Pamela Harrison, his wife.
“Dennis was the sort of young boy who knew at the age of 12 that he wanted to be a doctor,” she said.
It was his athleticism that provided him the opportunity to pursue his dreams. When McCullough was 16, his local hockey team won a national championship, beating out Northeast teams and garnering the attention of Harvard recruiters.
The university enrolled him in Phillips Academy in Andover, Mass., and he graduated with a full scholarship at Harvard. While attending a party in medical school, he met Harrison.
“We were fast in love by the end of the week,” she said of their meeting in 1969.
The two married in 1971, and McCullough saved up elective classes so the two could travel. The couple ventured to Finland, England and Uganda, where McCullough helped treat some of the first HIV patients.
The two eventually made their way to Norwich, where McCullough joined the practice of Dr. Hugh Bower, a community-oriented physician who once drove sled dogs to visit patients in Newfoundland.
“The two of them hit it off and had 11 years together,” Harrison said.
McCullough later worked at the Geisel School of Medicine, where he met Dr. Peter Mason. The two worked to build a residency program for family physicians. They later worked together in a private practice.
“His values have always shown through his caring about patients, his compassion, and he always went the extra distance for patients,” Mason said.
When McCullough left the practice to join Kendal, Mason said he inherited patients grieving the loss of a great doctor.
“I had all these wonderful patients that understood their health care needed to be a partnership,” he said. “(McCullough) set a standard the rest of us have to live up to.”
For the past three years, McCullough worked to develop the Upper Valley Community Nursing Project, which connects seniors to community or parish nurses.
“I think Dennis really saw this project as a culmination, in some ways, of so many thoughts he had about the health care system,” said Laurie Harding, the project’s co-founder and the former director of the Visiting Nurse and Hospice for Vermont and New Hampshire. “The focus was really listening to older people as they aged in their community.”
Eight communities now have a parish nurse, who doesn’t provide direct care but rather helps patients navigate the health care system to find proper treatments.
Harding said the project will continue, but McCullough’s presence and advocacy will be missed.
“I think that his philosophy of slow medicine would benefit us all if we could adapt it,” she said. “It’s a matter of listening to what people want and need, and trying to provide care accordingly.”
To his family, McCullough will be remembered as a stoic athlete who rarely complained and had a lively sense of humor.
“He was the love of my life and my best friend for almost 45 years,” Harrison said. “We were still playing tennis together as a mixed doubles team.”
McCullough had two grandchildren under 3 years old, and one, Calvin Dennis, was named after him.
“He was just so proud to have his name carried on and just to be a grandfather,” Harrison said. “It was one of the greatest joys in his life.”
Tim Camerato can be reached at firstname.lastname@example.org or 603-727-3223.