Portal de Periódicos da CAPES

Andrew Jay Drexler, in memoriam

2020; Wiley; Volume: 12; Issue: 10 Linguagem: Inglês

10.1111/1753-0407.13023

1753-0393

Carolyn Robertson, Zachary T. Bloomgarden,

Palliative Care and End-of-Life Issues

Opposing views of death are exemplified by two Chinese phrases: One phrase emphasizes the impermanence of life, 人死如灯灭，comparing a personʼs death to the extinguishing of a lamp, whose flame, once put out, simply no longer exists. The other phrase, however, 人死留名,reminds us that what remains is the individualʼs name - that which uniquely identified them in the minds and hearts of their friends, colleagues, family, and all those with whom they came in contact during their lifetime. This latter view can justly be said to apply to Dr. Andrew Drexler. Andyʼs role as a physician was, simply, that of a uniquely caring and attentive healer, using his special expertise in the understanding and treatment of diabetes in helping the many, many people who came to be his patients. He was a doctorʼs doctor, particularly in the sense of reminding all who knew him of the importance of being always available and of spending sufficient time with patients to work out the right approach to their own unique problems - and we all realized that in putting his patients first, he was expressing his deep conviction that this must be the essence of the role of the physician. Andyʼs father was a physician, and Andy determined early that this would be his path. He received his MD from the New York University School of Medicine in 1972, completed his residency in Internal Medicine at Barnes Hospital (1975-1976) and fellowship in Endocrinology at Washington University School of Medicine (1976-1978) in St. Louis, Missouri after spending 2 years at the National Institutes of Health in the Public Health Service at the Laboratory of Immunology, National Institute of Allergy and Infectious Diseases (1973-1975). In 1980, he joined the faculty of New York University School of Medicine (1980-1998), advancing to clinical associate professor in 1984. He was the director of the Diabetes Clinic in Bellevue Hospital (1980-1998), the director of the Diabetes Complications Center at the Rogosin Institute (1989-1992), and then after a period in private practice became the director of the Mount Sinai Diabetes Center in New York (1998-2002) (Figure 1A). In 2006, Dr. Drexler moved to Los Angeles to become director of the UCLA Gonda (Goldschmeid) Diabetes Center (2006-2016) and clinical professor of medicine at UCLA. In February 2016, he retired from academia and resumed private practice in Beverly Hills, California. In the early 80s, soon after he completed his fellowship, he returned to New York City where he joined the faculty of Rockefeller University (Figure 1B). While there he worked closely with Dr. Charles Peterson and with Dr. Lois Jovanovic, involved in groundbreaking programs for the management of type 1 pregnancy and intensive insulin regimes for type 1 diabetes, focused on patient self-care, glucose monitoring, and the attainment of tight control. Over the past four decades, he was involved in the management of about 700 pregnancies in women with type 1 diabetes with virtually no complications, either of the mothers or the offspring. In the 1990s, Dr. Drexler was responsible for facilitating the transfer of over 30 pancreas transplant patients with type 1 diabetes and end-stage renal disease in the New York area to centers in other parts of the country, as pancreas transplantation was not then easily accessible. Dr. Drexler was involved in the utilization of new pharmacological therapies for patients with type 2 diabetes and in teaching those strategies to other physicians. He was a leader in the development of integrated practice approaches emphasizing multispecialty, multidisciplinary approaches to patients with diabetes, with effective collaboration and teamwork focused on patient- rather than department-centered care. He was an early and persistent advocate of continuous glucose monitoring, smart pumps, and the use of computer software to help both patients and clinicians make sense of the diabetes. Andy enjoyed the study of history and delighted in seeing relationships of current events to those of the past, sharing this understanding with his friends. A lifetime bachelor, over the past few years Andy met Kim Jasper. Their plans to spend their lives together were tragically ended by his development of illness, paradoxically, in view of the complex interrelationship of diabetes and lipid metabolism a liposarcoma, and one that progressed all too rapidly. In illness, Andyʼs courage was a further example to us all, and just as he never relinquished his efforts to treat every one of his patients, he persevered in trying to understand and find the best treatments for his malignancy. In the words of the Roman poet Catullus, Frater, Ave atque vale: “Brother, hail and farewell,” hail, in the sense that we “salute” Andy as a special human being whose all-too-brief time helped so many others, and “farewell,” or “goodbye,” in our hope that the Eternal will remember and honor his name, as do we. 关于死亡，在中国有两句截然相反的话:一句话是“人死如灯灭” ，把一个人的死比作熄灭一盏灯，灯的火焰一旦熄灭就不复存在了，强调了生命的无常。另一句是“人死留名”，提醒我们留下的是这个人的名字——这个名字在他们的朋友、同事、家人和他们有生之年接触过的所有人的脑海和心中都是唯一的名字。后一种观点理所当然地适用于安德鲁·德雷克斯勒博士。安德鲁作为一名医生的角色很简单，就是一位独特的关怀者和细致的治疗师，利用他在理解和治疗糖尿病方面的专业知识来帮助许许多多病人。他是医生的医生，提醒所有认识他的人，时刻准备着花足够的时间与患者一起解决他们各自的问题。正如我们都认识到的，他通过将患者放在第一位，表达了他深深的信念，而这才是医生角色的本质。 安德鲁的父亲也是一名医生，而他很早就决定这也将是他的道路。他于1972年获得纽约大学医学院医学博士学位，1973年至1975年在美国国家过敏和传染病研究所免疫学实验室的公共卫生服务部门工作两年，1975年至1976年在巴恩斯医院(Barnes Hospital)完成内科住院医师实习，1976年至1978年在密苏里州圣路易斯市的华盛顿大学医学院，担任内分泌学研究员。他于1980年加入纽约大学医学院(1980-1998年)，1984年晋升为临床副教授。他曾任贝尔维尤医院(Bellevue Hospital)糖尿病诊所主任(1980-1998年)，罗戈辛研究所(Rogosin Institute)糖尿病并发症中心主任(1989-1992年)，经过一段时间的私人执业后，他成为纽约西奈山糖尿病中心(Mount Sinai Diabetes Center)的主任(1998-2002年)。2006年，德雷克斯勒博士移居洛杉矶，担任加州大学洛杉矶分校贡达糖尿病中心(Gonda Diabetes Center)主任(2006-2016年)和加州大学洛杉矶分校临床医学教授。2016年2月，他从学术界退休，重新开始在加利福尼亚州比佛利山(Beverly Hills)私人执业。 20世纪80年代初，在完成学业后不久，他回到了纽约市，成为洛克菲勒大学(Rockefeller University)的教职员工。他与Charles Peterson博士和Lois Jovanovic博士密切合作，参与了1型糖尿病的妊娠管理和1型糖尿病强化胰岛素治疗的开创性项目，重点关注患者自我护理、血糖监测和严格控制。在过去的40年里，他参与了大约700例1型糖尿病女性妊娠的管理，无论是母亲还是子女，几乎都没有任何并发症。在20世纪90年代，因为当时进行胰腺移植并不容易，安德鲁负责协助将纽约地区30多名患有1型糖尿病和终末期肾病、需要胰腺移植的患者转移到美国其他的地区中心。安德鲁还参与了对2型糖尿病患者使用新的药物疗法，并将这些策略传授给其他医生。他是综合实践的开创者，强调糖尿病患者的多学科、多专业诊治，有效的协作和专注于以患者为中心的护理，而不是以部门为中心的护理。他是持续血糖监测、使用智能泵和计算机软件辅助患者和临床医生的早期和长期倡导者。 安德鲁喜欢研究历史，也很高兴看到当前事件与过去事件的关系，并与他的朋友们分享了这种理解。他虽终生未娶，但在过去的几年里他认识了金·贾斯珀。他们共度一生的计划因他的病情发展而不幸终止。考虑到糖尿病和脂质代谢复杂的相互关系，他的脂肪肉瘤进展得太快了。在面对疾病时，安德鲁的勇气是我们所有人的又一榜样，就像他从未放弃治疗他的每一个病人一样，他坚持不懈地试图了解并找到治疗这种恶性肿瘤的最佳方法。 正如罗马诗人Catullus在《Frater, Ave atque vale》所说:“兄弟，致敬和永别”，我们向安德鲁“致敬”，因为他是一个特别的人，他短暂的生命帮助了这么多人，“永别”，或者说“再见”，我们希望永远记住并尊重他的名字，正如我们做的那样。