Jim Viney, MD
I was a Fellow in Pediatric Anesthesia and Intensive Care at CHOP in 1982. Later in that year my father took a business trip by airplane. He sat next to a very friendly kind man and they struck up an interesting conversation. When he was asked about his family he related that his son ( me) was working at CHOP in Pediatric Anesthesia and gave him my name. Jack replied that he also worked there and knew me and had kind things to say and gave my father his name . It wasn’t until he talked to me and I told him who Jack was that he knew he was my boss and the Department Chairman . Jack was always friendly, knowledgeable, kind and unpretentious.
Summary of very similar statements from John Fiadjoe MD, Lynne Maxwell MD, Peter Davis MD, Anne Lynn MD, Aubrey Maze MD, Mark Rogers MD, Greg Hammer MD, Mark Rockoff MD, Mohamed Rehman MD, David Cohen MD, Frank McGowan MD, Joe Tobin MD, Steve Hall MD, Lynn Martin MD, and many, many others:
“I remember him fondly, always had words of support and encouragement, a kind leader who changed our specialty and always dedicated to his patients! May he Rest In Peace”.
“Such a loss of an amazing physician, mentor and friend”.
“Truly one of the fathers of our specialty, and of pediatric critical care. A gentle man in our interactions. I hope someone plays piano at his memorial since he loved it”.
“We have lost a GIANT in our field, and the founder of our program. Such a mensch------a reminder of how we all should be”.
“He was always committed to doing THE RIGHT THING!”
Jim Steven, MD
While many can speak to Jack as an inspirational and visionary leader, his management of Department faculty meetings exposed conflicts between his most deep-seated values. Based on his medical compass, ethical convictions and extensive network of colleagues within CHOP and across the globe, he always had a strong sense as to where the Department should go. But he also embodied a Quaker-like belief that he should value the opinions of his faculty and come to complete consensus. While these dueling imperatives were workable when the faculty numbered fewer than 10 physicians, it was already straining when I joined as the 12th member and by the time we grew to 20 faculty, it became extremely cumbersome. No human can achieve complete consensus of 20 physicians on almost any topic, but Jack would remained undaunted. Faculty meetings stretched for hours into the evening as he meticulously sought everyone’s opinion and then tried to persuade each person to the conclusion he had already reached. If he was unable to achieve complete consensus after extended debate, he tabled the matter for the next meeting. During the ensuing interval, he lobbied every individual he had not already convinced. Ultimately, he always achieved enough of a veneer of consensus to proceed with his plan. Fortunately, we enjoyed each other’s company so the hours spent in that conference room were at least an effective team-building exercise. We always knew when a controversial topic was on the agenda by the extent of catering ordered for the meeting.
Robert Berg MD
When I arrived at CHOP in 2008, Jack was 78 year old and officially retired, but often present. Nevertheless, Jack soon established his relationship as my friend, colleague, and mentor. And my life was forever enriched. Among the many stories he told me, the following might resonate with some of you.
“In June of 1960, I rotated for the first time to Children's Hospital, and Len supervised me. He was the chief on my first case, an inguinal hernia, I remember vividly. He told me everything, he essentially did the case with me as the robot, but I was a little bit nervous because the baby was only about six months old. He said "do this, do that, don't do this," I was completely guided. Anyway, when we take this little baby to the recovery room, he was extubated, started crying, they gave him a sugar water bottle to suck on and Len patted me on the back and said ‘Jack, you did a fine job there.’ Up to that point in the Penn residency, no one had ever said I had done a fine job. No one had ever said anything complimentary that I recall, and I thought ‘I love this man! I think I would like to work for this guy.’ “
Like many of his stories, he was teaching me while seeming to simply reminisce. Jack learned from Len, and was eager to encourage me to learn, as well. And I did.
Thanks, Jack for continuing to be my friend, colleague and mentor.
Mark Schreiner MD
I met Jack Downes in 1980 when I was a second year pediatric resident at CHOP rotating through the PICU. I was interested in a critical care fellowship and was told I needed to speak to Jack. I thought he was so old because he had gray/white hair. In fact, he was in his late 40s. To me, he looked the same for most of the rest of his life, perpetually energetic and kind. Jack talked me into do doing an anesthesia residency instead of simply doing a one-year critical care fellowship. Despite my misgivings (and my wife’s protests) I agreed. He simply called up Harry Wolman, chair at Penn, and arranged my residency over the phone while I sat in his office.
Jack knew how to get things done. When CHOP was about to move into its new hospital in 1974, he and Russ Raphaely toured their new space. Noticing that none of the offices in the building had furniture, Jack and Russ went down to the loading dock and attached signs to desks and chairs directing them to the Anesthesia Offices on the 4th floor. On the first day the hospital opened, the Anesthesia and Critical Care Department was fully functional while virtually none of the rest of the CHOP offices were not. When asked how they had pulled it off, Jack ascribed it to pure luck. Jack always looked ahead, planned and never relied on luck.
As a 2nd year anesthesia resident and upcoming fellow, I was invited with my wife to Jack’s annual Halloween party at his house. As we approached the door, Jack opened it. My wife said “Hi Jack, I’m Janet.” I was so mortified that my wife would call my future boss by his first name. Jack showed no sign anything was amiss and welcomed us to his house. He was gracious, humble and without pretense. What one saw was who he was.
When I was a fellow, I had an oral presentation at the SCCM in San Francisco; Jack was the co-author (see November 18 PAAD for more details). We barely had our slides made in time but I hadn’t rehearsed or planned how to respond to questions. We were to meet the day before the presentation at 1:00. I ran into Jack at 10:30 or 11:00 and he suggested we get started early so we could go to the afternoon sessions. Off we headed to his rented apartment (he preferred to not stay in hotels if possible, preferring the quiet of smaller places). When we arrived, he began his search for his glasses; we couldn’t start without them. Couldn’t find them. Off he headed to retrace his steps from the morning. At noon, he returned sans glasses. Finally admitting defeat he picked up has brief case to get out his notes and there were his glasses, on the bed under the brief case. Given the time, Jack suggested we go out and get a bite to eat before embarking on our work. Instead of the suggested burgers and fries, I was shepherded into a sushi restaurant and had by first ever sushi. By the time we were done and back to the apartment, it was after 1:00, our original meeting time. When you with Jack, you always needed to allow time to be elastic. He was a man who couldn’t be hurried.
In early 1984 I was in the lobby with my two young daughters while my wife visited her father next door at HUP. Jack paged me and asked to see me right away. I brought the girls upstairs and while they attacked his office computer (an Apple IIe clone) and drew pictures while lying on the floor, he tried to talk me into a job at CHOP. I would have said yes to anything, working with Jack and his colleagues was my wildest dream. Eventually, before his office was destroyed, he told me that he would provide the rest of the details in writing (never happened). I can’t think of anyone else who would attempt a job interview under those circumstances.
As a young faculty member, Jack called me into his office for an old-dad talk, his name for a dressing down. He told me I had to stop teasing Pina Templeton because she believed that what I was saying was true and not just “humor”. Even when forced to reprimand, Jack did it in the kindest, gentlest way.
The stories go on and on but you get the idea of what a unique and quirky man Jack was. For his kindness, mentoring and directing me to the most rewarding career I could ever imagine, I will be forever grateful and I will cherish having the privilege of having him as teacher, mentor, boss and friend.
Mark Helfaer MD
I think about Jack with love and admiration. He stood for priorities that I also try to emulate: family, friends, medicine, children, and social responsibility. His work dedicated to the well-being of people in general and children in particular harmonized with his values. His brilliance as a teacher, mentor and role model for me were operationalized by doing the next right thing every day. His life inspired me by attraction, not promotion. My regret is that I didn’t have the opportunity to tell him this directly enough. I will miss Jack Downes as one of my best beacons.
Mike Broennle, MD
Late in 1969 I was an MGH resident leaning toward doing a 3 month Ped Anes rotation at CHOP. I had heard that Jack Downes, the magnet to go to CHOP, was considering moving to Toronto Sick Kids. I delayed my decision until I learned JJD was NOT going to Toronto. So I spent 1-3/1970 at CHOP as an affiliating resident. No regrets. Not only JJD but exposed to Russ Raphaely, Skip Ellison (part time), and KW Terry Lee (then a “super fellow”). Len Bachman was then the department chief. I left imagining Ped Anes as a career, reinforced by time spent with Eric Furman at the MGH.
In preparation for coming to CHOP I saw an image of cross country skiers in Philly so I brought my cross country skis. During those 3 month affiliations, the MGH residents lived in an old residence that was part of CHOP’s block on Bainbridge Street and ate all our meals in the CHOP cafeteria. I must have mentioned cross country skiing to Jack. He invited me to come to his house on a Friday after work, then joined him and his 4 delightful children on Saturday for a day trip to a ski area in the Pocono Mountains. It turned out to be a rainy day at the ski area, not favorable for cross country skiing so I stayed in the lodge which smelled of wet wool. All the Downes skied and we returned to Philly late that afternoon. Jack was active outside of work; he was a runner and sought opportunities to ski including several years when the department hosted a winter CME meeting out west at Vail.
This was so typical of Jack Downes, trying to include lonesome resident in an enjoyable experience.
That rotation established relationships that resulted in an offer to come to CHOP on the staff in 8/73 where JJD was now the Director of Anesthesiology Division (of Surgery). I was now one of 4 full time staff staffing 4 operating rooms, 6 pediatric ICU beds, and providing respiratory care to infants in the neonatal ICU. Our focus shifted to the move to the “new” CHOP on the Penn campus in 6/74. We entered an era of rapid growth in the number of staff, fellows, and residents.
Vijay Srinivasan, MBBS MS FAAP FCCM
Remembering a Gentle Giant – Jack Downes Where does one start with remembering a giant such as Dr. Downes? My earliest memory of him was when I was a rather callow and nervous new fellow at CHOP and he gave us a talk on the history of pediatric critical care medicine (PCCM). I was in awe of him as he described with great passion and undimmed enthusiasm how PCCM started as a nascent specialty and grew into its present multifaceted field of great repute. What struck me the most about his talk was how freely he acknowledged and credited so many individuals – physicians, nurses, respiratory therapists; mentors, trainees, specialists from other disciplines and so on – with the growth of this incredible specialty that touches every sick child in some shape or manner. I hesitantly sidled up to him after his talk with a question unsure if he would be willing to give his time to an unknown fellow. Right away, he put me at ease and spent a lot of time answering my questions with great humility and curiosity as he acknowledged the many unknowns in our specialty and shared his excitement for the future. And just like that, I became a diehard JJD fan and enthusiast!! After many such random encounters with Dr. Downes over the years, my next abiding memory of him was when I was a new attending on service in the Progressive Care Unit (where we care for technology dependent children with complex chronic illnesses). Early one afternoon after rounds, I felt a tap on my shoulder and turned around to see Dr. Downes. I smartly snapped to attention and asked him how I could help him. Dr. Downes in his customary gentle way asked me how one of his patients who he had followed for many years was doing – he joked that he was Dr. Marcus Welby with his one patient on the unit! I updated him and then quietly followed him to his patient. I was struck by the warmth and deep connection that Dr. Downes had with his patient as he spent time at the bedside – in that moment, he taught me the power of a meaningful relationship in a most profound and endearing manner. As he left, he thanked me (!) and gave me his cell phone number to provide him with regular updates on his patient. I jealously treasured his phone number as a prized possession and felt that I had won the jackpot! Yet another wonderful memory was when my wife and I lived in the city and used to walk to Rittenhouse Square on weekends. On one such stroll, we ran into Dr. Downes and got talking for over an hour at the street corner and exchanged many anecdotes and stories of CHOP and Philadelphia. Dr. Downes shared many memorable stories of his days and did not think anything at all of giving so generously of his wisdom and experiences. We parted reluctantly after a great and enriching discussion with Dr. Downes which made our evening so much more splendid and special! As a faculty member, I regularly emailed Dr. Downes who took great pride and enthusiasm in my accomplishments – big and small. I always found myself trying to find reasons to email Dr. Downes so that I could hear from him. Over the years, I saved his emails which were usually a treasure trove of details and nuggets of information of PCCM at CHOP and beyond – and are one of my cherished memories of him. My most enduring memory of Dr. Downes was when I saw him again as an older and wiser faculty member during one of my final chance meetings with him. We got talking about what mattered to us in our professional and personal lives and realized that we shared many more common interests than I had appreciated. Both of us learned that we were passionate about medical student education through the longitudinal professionalism Doctoring program at Penn Medicine which he had facilitated for many years. We excitedly talked about the importance of nutrition in critical illness and he lamented that we had not paid much attention previously but was very happy when he learned that we were beginning to increase our focus on research, quality improvement and education in this area. He also talked with great humility about the undiscovered gaps in our scientific knowledge and imperfections in our medical therapies with many children requiring extended hospitalizations in the Progressive Care Unit with technology dependence due to their chronic illness and co-morbidities. He stated in his characteristic and compelling manner that we owe our time and expertise to care for these most vulnerable and deprived of our pediatric survivors of critical illness with passion and dedication long after the resolution of their acute critical illness in the intensive care unit. My most poignant glimpse of him though was when we discovered that we both have four children each. As I showed him photos of my young children, he grew wistful and started tearing up. He paused silently and then told me that he wished he could have spent more time with his children when they were younger but could not do so due to the demands and expectations of our profession. As we parted, he told me to enjoy my children throughout their lives and always be present for them. As I walked away thinking about Dr. Downes – the physician, the scientist, the educator, the leader, the pioneer, the husband, and the father – I knew that I had just experienced a saint and a Renaissance man who gave so generously and willingly of his life to make our world a better place. As I write this reflection, I am choking up and feel the aching void left behind by his loss as I simultaneously smile and ask myself “What would Jack do?” and try to follow the example he has set for all of us.
Donald L. Boyer, MD, MSEd
5-star rating from Jack!
I’m sure we all sought to make Jack proud and to gain his highest praise in our fields. While I don’t know where I landed in has assessment of my critical care abilities, I do know he gave me a 5-star rating as his “personal Uber driver.” Jack loved to celebrate our fellows and, year after year, he would join us for the year-end celebration at Bob Berg’s house, celebrating our graduating fellows. Living in the city, there was frequently a call for a volunteer to drive Jack between his condo and Bob’s/Ro’s house and it was always an honor to fill in, getting to share the 30-minute ride with Jack and hear more of his stories. My first time pulling up, Jack referred to me as his “personal Uber” and upon dropping him off later that night, he graciously extended me a “5-star rating,” a joke that I look back on and remember fondly to this day. My only regret is that those rides weren’t longer and I didn’t have more time to hear Jack’s stories and share more rides with him. This pioneer will be missed greatly!
Wynne Morrison, MD
When I was critical care fellowship director at CHOP, I always asked Jack to come talk with the fellows about the history of pediatric critical care. His talks were always fascinating and filled with amazing stories. His knowledge of history was expansive, and thoughtfully presented. The challenge was that Jack knew so much, that he was unable to cover everything he wanted to cover in the allotted hour, even with several fairly explicit requests. And if you knew Jack, you know that cutting him off was not likely to be effective. We finally ended up splitting the talk into “History of PCCM, Part 1” & “History of PCCM, Part 2” so that the fellows wouldn’t be pulled out of the unit for too long. Those who made it only to Part 1 probably wondered sometimes why their “History of PCCM” lecture only made it from Galen to World War I, but I absolutely kept inviting him back every year.
Jack remained so connected to everything at CHOP, even long into his retirement. He cared about the patients, the people, and our plans for the future. He would call if a patient he knew from decades before was admitted. I loved getting those calls.
Jay Deshpande MD
A vast number of colleagues, trainees and others will recall the great many contributions Jack Downes made to establish and advance the practices of pediatric critical care and pediatric anesthesiology during his career. Jack’s impact on the two specialties cannot be overstated. For me, Jack had a profound personal impact as he shared stories of his personal professional growth, the challenges the professional demands posed for him and his family, and lessons he learned. As a trainee at the beginning of my career, Jack’s stories brought to light the oft-ignored human side of academic career path and the importance of keeping those we value (family, friends) in the forefront as we make choices along the way.
I well remember Jack as the gracious, kind and professional senior physician, who taught me the evolving science and art of critical care for children; Jack, who advised me about professional demeanor and comportment (“always wear a coat and tie. If no one else is dressed up and you’re overdressed, you can always take them off”); Jack, who had the presence of a physician and leader in a meeting. Jack also had a fun side, including enjoying a variety of music – including country music! When Jack came to Nashville as visiting professor to Vanderbilt, my wife and I got 4 tickets to sit on stage at the Grand Ole Opry. Joanne and Jack (dressed in casual country) were excited, fully engrossed in the Charlie Daniels Band concert and dancing in the seats! During breaks, Joanne and Jack were fully at ease exchanging stories with Charlie Daniels’ mother who was sitting next to us. That night reinforced our impression we held of Jack and Joanne – Philadelphia sophisticates, yes – and, also fully versatile and interested in the breadth of life’s experiences. Here’s a virtual toast to celebrate and thank Jack Downes, pioneer, caring physician, innovator, and friend.
Howard Zucker MD, Commissioner of Health New York State
A Breath No More, But the Air of Legacy:
There are those who are larger than life. There are those who possess a moral compass that makes them the North Star for so many others. In our profession they are the embodiment of what it is to be the consummate physician, the healer of others – bringing wellness to generations of children. To me, that was John J. (“Jack”) Downes, M.D.
My first encounter with Dr. Downes came as an impressionable and timid young medical student on the pediatric anesthesiology/critical care medicine elective rotation at CHOP in 1981. As I joined rounds, a sense of awe struck me in my initial conversation as his erudite manner, his comprehensive grasp of the specialty and his analytic approach to problems blanketed the intensive care unit with passion and professionalism. Later that week, he introduced me to a young boy on a ventilator and using the Socratic method probed my understanding of respiratory physiology. I could feel my heart racing and sweaty palms for one never wants to embarrass themself, and surely not in front of a person you so admire. With warmth of heart and mastery of knowledge, he took me through an algorithmic decision tree with the precision and artistry of the anatomical branching of the airways. Upon the conclusion of the rotation, I said to myself, “one day I want to be like Jack Downes and run a pediatric ICU.” Six years later I would become one of his fellows on my way to that goal.
Jack taught me more than pediatric critical care medicine and pediatric anesthesiology. He taught me what it is to be a role model, to invest in people, to believe in others, to stand by principles and to lead. For that I am eternally grateful. These attributes have helped me in worlds far beyond the ICU and OR doors. His legacy was about healing and teaching, about training and researching. He was about questioning the unknown and remaining uneasy until the answers were found.
One evening while I was the fellow on call, a baby born with a tracheoesophageal fistula was headed to the operating room. My knowledge of respiratory physiology had exponentially increased by that time! Jack was intimately involved in the discussions as this neonate was the grandchild of a member of the board of directors of the hospital. When the board member asked Jack to do the anesthesia, he politely refused and said that he has the best faculty and best fellows and he trusts them implicitly to deliver superb care. And though he hovered about in the OR suite, he stood true to his words. The newborn did splendidly. As we transported the baby back to the ICU, he turned to me and made that smile we all knew when he was proud of the performance of his protégées.
Throughout the 40 years since my days as a medical student, I always felt a wonderful sense of comfort knowing I could turn to Jack for his sage advice. As the years went by that advice morphed from medicine into the many challenges we face in life. He was there for the joys and hardships – a true friend! Though the world of pediatric critical care and pediatric anesthesiology has had a shadow cast upon it with Jack’s passing, it is but an eclipse. For the brightness he shined on all those he trained and treated will be everlasting, as he saw all of us as his professional sons and daughters. Through us, we carry his light - his wisdom and passion, empathy and academic excellence. I think it is an understatement to say that we will all terribly miss you Jack - you were a father to generations of doctors.
Scott Cook-Sather MD
Jack was the wise man I consulted with the big questions. Always with an open door, ear, mind and heart. We played piano, had great meals together, and laughed. I know I wasn’t alone in connecting with him. He was a leader and a friend who wasn’t afraid to blend those roles. I am sad for all of us
Maryam Y. Naim, M.D., M.S.C.E.
My memories of him are as a critical care fellow at CHOP from 2004-2007. Dr. Downes was a truly giant in our field. I got to know him when I would care for his ventilator dependent patients in the ICU. Dr. Downes not only knew every detail of their complex medical issues but he knew the child, their likes (and dislikes), their family, their successes, and their challenges including complex social and economic dynamics. He was such an incredible advocate for the critically ill child in every way not only as a physician but someone who cared for them not only through their hospitalization but also though their life. He was an exceptional teacher, the type that makes you love to learn and to looks at every problem as an opportunity to gain knowledge and not an impediment. Getting to know him gave me the sense of being part of the larger mission to advance our field and care for the most vulnerable of children.
The video from 50 years of our department at CHOP captures this spirit. Dr. Downes will be sorely missed but his legacy lives in every one of us and the sick children we care for. Here’s the link:
Charles Dean Kurth, MD, FAAP; Robert Berg, MD; Wynne Morrison, MD; Vinay Nadkarni, MD; Andrew Costarino, MD; Todd Kilbaugh, MD wrote this beautiful obituary…
It is with sadness and a multitude of fond memories that we inform you that Dr. John J. “Jack” Downes, died peacefully at the age of 91, on Friday December 17, 2021. Jack served as Anesthesiologist-in-Chief at the Children’s Hospital of Philadelphia (1972-1996). He was a trailblazing giant in the fields of Anesthesiology and Critical Care Medicine for more than half a century: a visionary pioneer, a master clinician, a rigorous educator, an inspirational leader, and a true gentleman. We mourn his death while we also appreciate and celebrate our good fortune to know Jack as friend, colleague and mentor over the last 60 years.
Jack came to the University of Pennsylvania for his residency training in anesthesiology in 1959 and was subsequently recruited to the Children’s Hospital of Philadelphia in 1963. He developed a multidisciplinary approach to caring for seriously ill hospitalized children, whether following surgery or with life-threatening medical illnesses. His early defining moment was in January 1967, when he inaugurated The Children’s Hospital of Philadelphia’s pediatric intensive care unit–the first of its kind in North America. He was instrumental in fostering early training programs and research programs in his field. He and his colleagues inspired and trained multiple generations of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that will endure far into the future. Jack was a tireless advocate for improving healthcare for children, and his persistent efforts led the Commonwealth of Pennsylvania to fund a pioneering home care program for the care of technology dependent children in the 1970’s. In what became his trademark as a leader, he often reminisced that ‘I held on (sometimes by my fingernails) until others fell away, even if it sometimes took several years!’ He was always a passionate advocate for the Children’s Hospital of Philadelphia, an institution that shares his dedication to advancing state-of-the-art clinical care, cutting edge discovery and rigorous interdisciplinary training to optimize outcomes for ill and injured children.
Jack will always be remembered for his utter devotion to his patients. He worked hard to make sure that every child had access to the best care possible, no matter what their background, disability, or ability to pay. He approached medicine as a moral calling. An avid student of the history of medicine, he navigated an era of rapid change in healthcare and an explosion of technology with the patient always at the center. Even following his retirement, he was a frequent visitor to Pediatrics and Anesthesiology Grand Rounds. His learned presentations on the history of Pediatric Anesthesiology and Pediatric Critical Care Medicine were a special treasure for trainees and faculty alike. He taught us the value of strategic vision, dedication and critically reflecting on our practice to continuously learn.
Those who were lucky enough to work with him, or just to meet him, will always remember his genuine curiosity, sincere humanity, keen insight and steadfast devotion to patients, colleagues, and his family. We are privileged to remember the beautiful moments we experienced with him, and how those moments will continue to influence us and make us better healthcare providers and better people.
Myron Yaster MD
A final word. When I learned that Jack died, I immediately sent the news out to all of you via the PAAD and shared one of my personal experiences with him. There has been an extraordinary outpouring of love and respect that I’ve posted over the last 2 days. The late and greatly missed Ron Litman, who started the PAAD, was one of Jack’s students, mentees, colleagues and friends and would have been so happy to see the PAAD used in this way. I’m going to close out these responses with my own final Jack story, sort of.
Like many of you, over the course of a lifetime, I’ve attended a lot of happy occasions. Two of my personal standouts involved Jack, his “surprise” 60th birthday party (his secretary actually put it on his calendar knowing he wouldn’t look at it) and the 50th anniversary of the CHOP anesthesia and critical care medicine department. They were fantastic; a celebration of Jack, the group, the Children’s Hospital, each other…we were all just so happy to share the experience and most importantly Jack was still alive to celebrate with us and bask in the glow of our affection for him. Unfortunately, this type of love fest celebrating an individual while they are alive usually doesn’t happen often…when it does it’s usually a wake or a memorial service. So in light of all that’s happened in the last year, let’s pledge to get together in person to celebrate each other, and of course, Jack… and at that time let’s hoist one in his memory. (and according to Frank McGowan Bill and Dean are paying.)