“Towards the end of my first year at Johns Hopkins Medical school, we got the word that the admissions committee had admitted a new member to our class—a Rhode’s Scholar no less. . . . after a year of vying for a position with some of the most competitive medical students on the planet, I was not happy to be faced with the challenge of a ‘Rhodesian.’ But when he actually appeared on the scene, hostility evaporated in the warmth and humor of Clif Cleaveland’s unique personality.”
—From the forward by O. Thomas Feagen found in the book, “Sacred Space: Stories of a Life in Medicine,” by Dr. Clif Cleaveland.
Dr. Cleaveland, Rhodes Scholar, author, columnist, past president of the American College of Physicians, and beloved physician and teacher is a gentle and uplifting presence in our community, according to many who know him. His combination of empathy and intelligence coalesced into a practice that could well be called an amalgamation of art and medicine. Art, they say, reflects life. And so it is with Cleaveland. In his words, “No image of medicine speaks to me more powerfully than ‘The Doctor’ painted by the famed British social realist Samuel Luke Fildes.” It is shown on the cover of his book.
While this evocative visual imagery is powerful, listening may be the strongest hallmark of Dr. Cleaveland’s style as a physician and educator. He opened his practice here in 1971, and his patients remember him as a partner in what he calls a “sacred space,” an intimate bond between doctor and patient where listening forms the fiber of healing.
“In the space there are no barriers of race, gender, religion or political persuasion,” says Cleaveland. “The overriding concern is the care and safe passage of the person who is in distress.” In, Sacred Place, he says of himself and his colleagues, “Intonations of speech and facial expression tell us what lies beyond our patients’ descriptions of their symptoms and fears.”
John Collins, a retired gastroenterologist, describes Dr.Cleaveland’s style and presence from the perspective of a former patient. “He would offer a genuine handshake, look you in the eye and lend a keen, patient ear when he talked with you. He was a fine internist with a genuine and deep concern for his patients.”
Although retired, Cleaveland keeps a close eye on what’s happening in the world of medicine. He shares the results of his vibrant curiosity every Tuesday in his “To Your Health” column that appears in the Chattanooga Times Free Press. Some of his observations on the progression and direction of today’s medicine reflect optimism.
“Striking advances have occurred in imaging and in treatment of malignant diseases. These advances parallel what is going on in the rest of the country. Many malignancies that once had predicted a limited life expectancy are becoming responsive to careful, long-term management. Remarkable advances in the treatment of acute stroke at the Erlanger Stroke Center have transformed the outlook for victims of this complex and varied disorder.
Affordability of care is a major challenge in our region, Cleaveland believes. “A few legislators blocked expansion of Medicaid, a political decision that I still do not understand. Rapidly escalating costs of prescription drugs stress the budgets of everyone, insured or not. Drug manufacturers can raise prices of medications at will with little regard for the impact on the consumer. Hospital and physician charges are regulated, he says. “Why not medications?
“Cost, quality, and access are the three inter-related challenges in health care. We are meeting the second and third of these challenges better than the first. A variety of demonstration projects are underway, thanks to the Affordable Care Act. From these, I think we will find the means to rein in costs.”
On the academic side of the coin, Cleaveland has been teaching in the honors program at UTC since 2004. Dr. Greg O’Dea, Associate Dean of the Honors College and UC Foundation Professor of English at UTC says, “Clif’s contributions to the Honors College include, ‘Development of Scientific Thought’, a course he taught for 10 years or so, was just what the title says—it surveys the development of science as a body and habit of human thought, from the early inquiries of the ancient world to contemporary investigations and methods.” The course was enormously successful. Many students routinely referred to it as a favorite of their undergraduate careers.
[pullquote] “Hospital and physician charges are regulated. Why not medications?
-Dr. Clif Cleaveland[/pullquote]
Cleaveland has gone on to develop a new course to focus on ‘Biology, Medicine, and Public Health’—an investigation of the intersections of those areas over the centuries.” O’Dea continues, “What I’ve always admired about Clif as a teacher is his real interest in and care for his students and their well-being—something that he carries over from his practice as a physician. Anyone who knows him knows that Clif out-reads us all, and he is constantly seeking out new ideas and material to enrich student learning. He is, simply, a master teacher.”
Linda Frost, Dean of the Honors College at UTC, puts it this way, “Clif is magic! He is so generous, kind—a truly impossible combination of graces. As a teacher in UTC’s Honors College his presence has infused confidence, curiosity, and a gentle sprit in many students, including one who has moved on to become a Rhodes scholar.”
Creating opportunities for enlightenment doesn’t end on the UTC campus. Collaborating with George Connor, a gifted professor of literature at UTC, he originated a retreat at Fall Creek Falls in 1988, described by the program director Greg O’Dea as, “a weekend-long agreement, among 30 or so healthcare professionals that the study of humanities is vital to the practice of medicine.”
Each weekend is organized around a guiding theme; participants read fiction, poetry, drama and essays beforehand, coming together to discuss ideas essential to the fundamental business of caring for other human beings. The conversations call for a kind of thinking that physicians are not often called upon to engage in, routinely.
“Reading in the humanities has taught me more about my patients than any course or text in science..,” adds Dr. Cleaveland.
Perhaps this quote from Rhodes Scholar, Robert Fisher, now at Oxford, sums it up best, “Dr. Cleaveland was one of the most thoughtful professors I encountered at UTC. When I spoke, I always felt like he was actively listening and genuinely interested in what I had to say. He was also one of the first people to tell me that I should think about applying for the Rhodes Scholarship, and in typical Dr. Cleaveland fashion, he checked in with me throughout the entire application process. In fact, he continues to check in with me to this day, even though I am thousands of miles away. That doesn’t surprise me though—with Dr. Cleaveland you get the sense that even though you may be out of sight, you are truly never out of mind. Others will likely mention how accomplished he is or how brilliant, but what strikes me most about him is that in the midst of it all, he still finds time to meaningfully ask, ‘how are you?’”
Photography by Clay Miller