Time - and the P Wave - Marches On...

One of the stalwarts of Emergency Medicine at the Detroit Medical Center, Dr. William A. Berk is retiring from clinical practice. He has helped to educate hundreds upon hundreds of medical students, residents and attendings both locally; as well as internationally during his time in Kingston, Jamaica. Dr. Berk's contribution to his patients, medical education, administration and medical informatics is broad and deep and will leave a large void to fill.

Originally from Long Island, NY, Bill came to Michigan to attend the University of Michigan School of Medicine, graduating in 1979 and then going on to complete an Internal Medicine internship and residency in 1982. He began his clinical career in July of 1982 at the long-closed Wayne County General Hospital in Westland, MI, practicing Emergency Medicine as well as being on the Internal Medicine staff and becoming Board Certified in both. Dr. Berk had a brief stint at Detroit Receiving from '84-'85 before following his desire to practice at an indigent public hospital in a developing nation. He and his wife, Dr. Judith Anderson (a noted hematologist and coagulation expert) moved to Jamaica to practice at Kingston Public Hospital where they worked for two years. One of the papers that came out of that experience (Berk WA. Emergency Medicine in the third world: Two years as director of Kingston (Jamaica, West Indies) Casualty Department. Ann Emerg Med 18:567-572, 1989.) is very interesting to read. It is ironic that Dr. Berk was faced with the same shortage of supplies and staff, long waits for patients to be brought back to be seen, lack of ICU beds and difficult working conditions at both the beginning and end of his career. It would seem that a multibillion-dollar corporation cannot outperform a poor developing nation's public hospital either. Another paper that came from that experience regarding wound repair (Berk WA, Osbourn DD, Taylor DD. Evaluation of the "Golden Period" for wound repair: 204 cases from a third world emergency department. Ann Emerg Med 17:496-500, 1988) is still apropos today.

Bill Berk's career has landed on virtually all areas of adult medicine, but unlike the dangers of the 'R on T phenomenon', the results have been universally positive. (Bad ECG joke in Berk's honor) First and foremost, he is an excellent and compassionate clinician. I can clearly still see him in my memory rounding on 100% of existing patients handed off during sign outeven back in the day when that might have been considered a good idea, but was not expected unless a patient was being discharged by the resident. I wonder how many PEER Review events he prevented by practicing in this manner!

Mentioning PEER Review, Bill led the way in our department in running a proper CQI process and did so for many years. While it was never fun to receive one of his requests for a review of one's care, it was never malicious or frivolous and it was focused on each of us learning and growing in our practice and for our patient's safety. In my experience having been a member of the committee as well as requesting reviews of care from other departments when I was the Medical Director of Observation, no other department is in the same league as ours when it comes to PEER Review.

Bill is also a patient and passionate teacher, both at the bedside or in the lecture hall. His knowledge of ECG interpretation is on par (or better?) than many cardiologists. The desire of the residents, medical students and PAs to learn ECGs from him grew from a didactic lecture at conference every month or two when I was a resident, to a formal elective that many residents considered mandatory to their education. My residency class voted him the Outstanding Teacher of the Year. Although not exactly a teaching award, Bill Berk also won the Dayanandan Award. For those diminishing numbers of us who knew Dr. Daya, I can think of no greater award to receive and Bill is absolutely worthy.

Dr. Berk has been involved in hospital administration for most of his career, serving on hospital and DMC committees, as well as a couple of terms as DRH Chief of Staff where he worked very hard to improve conditions for our patients, for the staff and physicians, and the hospitals themselves. He was, of course, Vice Chief of Emergency Medicine at DRH for several years as well. I learned a lot from him when I served on a few committees over the years and as Observation Director. Perhaps most crucial, I learned patience and to stop and think for a minute (or hour, or day, or week!) before blurting out an emotional response that I would have regretted.

Perhaps the most thankless of his roles is his job as a leader in medical informatics for our Department and the DMC, helping to bridge the gap between the 'Zeroes and Ones' people and us clinicians. Bill very patiently helped us to acclimate to EMR and later to Dragon voice recognition. The adoption of an EMR was difficult to the analog era staff although it was generally seen as necessary, but Dragon was a Herculean task! It was certainly reassuring to know he was fighting for us to improve the digital systems that are an everyday part of medical practice.

I could go on, but I promised Dr. Berk that I would keep this biography simple and not too verbose or awkward, although I probably failed. He is among the top four or five physicians who have molded me over the past 34 years and it's hard to reign that in. Sorry, Bill. Although I have a feeling that he will stay busy, Dr. Berk should have more time for his family, to continue to hone his wickedly dry wit, to follow our local sports teams, (of which he is an avid and knowledgeable fan), as well as to cheer on the NY Yankees. Well, no one's perfect!

Philip A. Lewalski
Editor-In-Chief