Don't take your love away from me
Don't you leave my heart in misery
If you go then I'll be blue
Breaking up is hard to do
–Sedaka and Greenfield (Reference Sedaka and Greenfield1962)Just as we are driven to find meaning in life, we human beings are driven to find meaning in death. Our fear is that “death” makes life ultimately meaningless. The deeper truth is that death can never truly negate the meaning of one's life, but rather is an opportunity to affirm the meaning of our lives. The key is the attitude that one takes toward death while living a human, mortal life; a life punctuated, often sadly, by death.
I've just come home, on a Sunday afternoon in late February, from the funeral of a great scientist, a pioneer in cancer pain, a discoverer of previously unknown opioid receptors, and a good friend and colleague; the funeral comes a month after the death of another pioneer in palliative care and pain who was also a close friend and colleague. Both were remarkable men who I've known since my fellowship training days at Memorial Sloan Kettering Cancer Center (MSK) 34 years ago. But perhaps most painful was the death, some 24 hours ago, of the father of our beloved Associate Editor Allison Applebaum.
I had planned to write an editorial/essay on “A Meaningful Death” for this issue, but I find myself compelled to write about these three remarkable individuals who lived extraordinary and meaningful lives. Three deaths that do not negate the meaning of their lives, but rather affirm the meaning in their lives; their contributions, their gifts to us, and to all of humankind. These were pioneers in supportive care and song.
Richard Payne, MD
Rich Payne was a pioneer in neuro-oncology, cancer pain, and palliative care. He approached pain and suffering from moral, ethical, religious, and medical perspectives. After graduating from Yale College and Harvard Medical School, he trained in internal medicine at the Brigham and neurology at New York Presbyterian Hospital before joining the Pain Service at MSK to do a fellowship in neuro-oncology and pain with Kathy Foley. That's when I first met the remarkable Richard Payne. He personified the term “giant.” Rich was a bear of a man; a cuddly bear whose size was comforting and telegraphed competence and safety. We shared the care of hundreds of patients. I was in awe of his skills as a clinician, researcher, administrator, and communicator. Rich went on to do great things, ameliorating the suffering of hundreds of thousands of cancer patients through the impact of his clinical care, research, advocacy, and mentoring.
From 1992 through 1998, he was the Chief of the Pain and Symptom Management Section at MD Anderson Cancer Center. In 1998, he returned to MSK to become Chief of the Pain and Palliative Care service, where he held the Anne Burnett Tandy Chair in Neurology. In 2004, Rich joined the Duke Divinity School, where he led the Duke Institute on Care at the End of Life. When Rich died on January 3, 2019, he was the Esther Colliflower Professor Emeritus of Medicine and Divinity at Duke. Over the course of his career, he served as President of the American Pain Society and was on the board of the Hastings Center and the National Coalition of Cancer Survivors. Richard Payne's life was guided by love and the need to diminish suffering.
Gavril Pasternak, MD, PhD
I met Gav Pasternak on my first day of Fellowship in Psycho-oncology at MSK when I was assigned to be the psychiatric liaison to the Pain Service. I had done research on the analgesic properties of tricyclic antidepressants and presented at one of the Pain Service seminars. Gav quickly corrected me when I included the possibility that, in addition to serotonergic and noradrenergic properties of tricyclics, tricyclic drugs bound to opioid receptors. “Not in any relevant way, Bill!” he scolded me, with a smile barely perceptible behind his trademark giant walrus mustache.
Gav Pasternak's academic achievements are truly too many to list, but work was not Gav's sole passion. Gav loved his family, and he loved lacrosse. His passion for lacrosse gave rise to a program in New York City high schools that led to a pathway to college for hundreds of disadvantaged young people who never even imagined the possibility of attending college.
My most lasting personal memories of Gav will be moments from a shared trip to and from Sapporo, Japan, where we both were speaking at a conference. Thirty hours of travel in both directions. Hours in business class airline lounges. Eating ramen noodles for breakfast. Sharing 30 years of gossip and life lessons. For me, the greatest lesson Gav Pasternak taught me was to have the courage to keep living, giving and being creative, despite the knowledge of the proximity of death.
Stan Applebaum
On February 23, 2019, Stanley Applebaum, musician, arranger, conductor, composer, and the beloved 96-year-old father of our Associate Editor Allison Applebaum, died in Allison's arms.
Over a 50-year career, “Stan” Applebaum helped arrange, and compose more than 35 Top 10 hits and numerous No. 1 singles for artists such as Ben E. King, Bobby Vinton, Neil Sedaka, Connie Francis, and The Coasters. Stan was responsible for the arrangements and orchestrations of major hits such as “Stand By Me” and “Save the Last Dance for Me” by The Drifters, Ben E. King's “This Magic Moment,” and Neal Sedaka's “Breaking Up is Hard to Do.” He collaborated frequently with his wife, and Allison's mother, the pianist Diane Leslie. The New York Public Library for the Performing Arts houses Stan Applebaum's archives, which include more than 1,500 commercials, jingles, and songs he wrote and produced, resulting in four Clio Awards.
When I first met Stan, after the death of his precious wife, Diane, what was most striking to me were his eyes. Even in grief, and in poor health, Stan looked me straight in the eyes and the warmth, openness, generosity, and love just flowed effortlessly into the space between us and filled that space so that an extraordinarily human connection was instantly created. The air hummed, vibrated, as if a song had been created. A song about love, sadness, and the eternal nature of the connection created by a lifetime of love. A song about joy.
Stan Applebaum was a musician and his songs, like his love for Allison, will live on for as long as there is sound.
