Louis Del Guercio, MD (1929–2013)

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Critical care lost a great friend when Louis Del Guercio died on March 8th. Dr. Del Guercio was one of two surgeons who helped establish the Society for Critical Care Medicine (SCCM). He was the sixth president—one of only ten surgeons—to lead SCCM. Dr. Del Guercio established one of the first surgical critical care training programs and was absolute that surgeons must lead in critical care. He was a consummate technical thoracic surgeon who operated until the day he retired, believing surgeons lost credibility when no longer operating.
A true student, Dr. Del Guercio believed physiology saved lives. His 1980 JAMA article1 that stratified elderly preoperative patients over a variety of physiologies with early use of pulmonary artery catheters revolutionized preoperative care. This was the basis for our 1990 article,2 demonstrating that early physiologic monitoring saved lives in injured elderly patients. Long before catheter-based therapy was accepted, Dr. Del Guercio developed splenic artery and coronary vein occlusion to treat bleeding esophageal varices.3
At a time when promotion was based on rigorous academics, he rose from instructor to professor in 11 years. In 1976, he became chairman at New York Medical College/Westchester Medical Center and transformed a sleepy rural center into a powerhouse academic center, retiring in 2002. During his career, he published more than 320 articles. He was an artist. Every operative note was accompanied with an anatomically correct, visually impressive picture. A copy was given to the referring physician and the surgical resident. Later in life, he painted water colors, a number of which were published in several books.
Dr. Del Guercio made intensive care unit rounds seven days a week at 7:00 AM, followed by breakfast with the house staff. On July 1, 1983, when I became his fellow, I noticed the only available seat was next to him. When he lit up his trademark, terrible smelling cigar, I understood why that seat was open.
Dr. Del Guercio was an avid fisherman living on the water. On the occasional summer Saturday, the telephone would ring at precisely 7:00 AM. He would ask me if everything was okay. While it was rarely true, my response was always, “Yes sir.” “Okay, I think I’m going to go cast a few. Call me for problems,” he would say. I quickly realized that he did not carry a beeper. Clearly, I was on my own. I made sure everything was okay.
The house staff were extensions of Dr. Del Guercio’s family. When one of us would not meet his standards, he would simply shake his head. He taught me to be kind, fair, and always give people a second chance, traits that I try to emulate. He knew what we needed even when we did not. Ten months into my fellowship, Dr. Del Guercio told me to look at a job at Kings County Hospital. I really wanted to live and work in Manhattan. He shook his head and asked me if I owned a car, if I had a set of maps, and if I could find Kings County Hospital. I replied yes. He replied, “Why are you still sitting here?” I walked into Kings County and stayed there for 14 years.
At age 60, he volunteered for the first Gulf War. He was commissioned a colonel, led the 320th evacuation hospital and was awarded the US Army Commendation Medal. After retirement, he and his sons walked a 500-mile pilgrimage to pray at the tomb of St. James in Spain for one of his grandsons who was physically challenged. Three years later, his grandson was able to walk.
I had dinner with him several years ago.
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