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On Christmas Day, 2008, Dr. Alan D. Hilgenberg, 64, co-director of the Thoracic Aortic Center at the Massachusetts General Hospital and Clinical Professor of Surgery at Harvard Medical School, died after a difficult fight against pancreatic cancer.
Alan Dean Hilgenberg was born September 29, 1944 in Parkston, South Dakota; we were less than three months apart in age. His father was a music director and his mother was, and still is, a church organist and piano teacher. Not unexpectedly, Alan played in his high school band and in recent years frequently attended concerts at Boston’s Symphony Hall. His love of music lives on in the career of his son Matthew, an accomplished professional musician in New York City.
After attending the University of South Dakota, Alan entered the University of Michigan Medical School. Following graduation with honors in 1969, he came to the Massachusetts General Hospital as a surgical intern. In the middle of his general surgery training he fulfilled his military obligation in the Army Medical Corps at Fort Sam Houston as an instructor of Special Forces medics.
Dr. Hilgenberg returned to the MGH and finished his general surgical training in 1975 and then followed me as Chief Resident in Cardiac Surgery in 1976. He spent the next four years with a cardiothoracic surgical group headed by Dr. W. Gerald Rainer in Denver, Colorado.
In 1981 Alan was recruited back to the MGH, ostensibly to succeed Hermes Grillo as the Chief of General Thoracic Surgery. However, to maintain his cardiac surgical skills and because there was no immediate opening on the MGH Cardiac Surgery staff, he assumed the leadership of our satellite practice at the Mount Auburn Hospital, where he became the Chief of Thoracic and Cardiovascular Surgery in 1983. A few years later Alan began working part-time at the MGH in cardiac surgery as he gradually gave up his general thoracic surgical practice. When our group withdrew from the Mount Auburn Hospital in 1996, he became a fulltime cardiac surgeon at the MGH. In 2006 he was promoted to Clinical Professor of Surgery at Harvard Medical School.
Dr. Alan Hilgenberg was a consummate clinical surgeon, who combined great native intelligence, excellent training, technical facility, a continuing desire to learn, mature clinical judgment, and meticulous surgical technique with an exemplary work ethic and true compassion for his patients. His operations were a testament to careful planning, attention to detail and consistent technical achievement.
Unlike some surgeons, Alan surprisingly did not allow music in his operating room, but filled the void with continual banter about the patient, the disease, the operation he was doing, or local and world events.
Cardiologists appreciated Alan’s great talent and integrity and truly enjoyed working with him. Nurses, physician assistants and other support personnel found Alan to be approachable and respectful of their contributions to the care of his patients. He was also concerned about them as people and friends, not just as caregivers.
Although Alan was comfortable doing all types of adult cardiac surgery, in the middle of his career he specialized in the surgical treatment of aneurysms of the thoracic aorta. He learned and developed new techniques, focusing his practice on those challenging cases. In recent years he devoted himself to teaching residents those techniques, at which he was a master. Most of his recent contributions to the cardiac surgical literature were dedicated to issues related to the surgery of the thoracic aorta.
In the mid 1990’s I suggested to Dr. Austen, the Chief of Surgery, that he ought to ask Alan to initiate a Thoracic Aortic Center at the MGH. Prior to that time, the care of those patients had been fragmented and inconsistent. Working closely with Dr. Eric Isselbacher from Cardiology and Dr. Richard Cambria from Vascular Surgery, Alan co-founded the MGH Thoracic Aortic Center in 1999. With Alan’s leadership it became a true jewel in the MGH crown. Referring physicians loved the concept, patients received focused care, and the surgical results were superb.
Alan’s love of medicine and his devotion to the profession live on in his daughter, Dr. Sarah Hilgenberg, a recent graduate of Stanford Medical School.
Outside the hospital, Alan had a great love of ocean sailing, especially the challenges and opportunities created by this exhilarating hobby. Over time Alan became a good chef, and in recent years we all enjoyed cooking together. His performance in the kitchen mirrored his performance in the operating room – careful planning, meticulous technique almost to the point of being fussy and continual banter. Alan was also a connoisseur of fine wine, an interest that lives on in the life of his son Mark, a vintner in California.
In 2001 Alan married Dr. Anne Kolker, an anesthesiologist who trained at the MGH but practiced at Memorial Sloan-Kettering in New York. These two very accomplished physicians were able to maintain and grow their relationship despite continuing to work during the week in their separate institutions and then spending long weekends together in Boston, Connecticut or New York. During his recent ordeal, Alan proclaimed Anne to be his guardian angel.
Alan and I reveled in our Midwestern roots and shared experiences, including both of us going to Southampton, England for cardiac and thoracic surgical training. Those experiences often evoked humorous recollections, which always made Alan laugh, something he loved to do. When he would tell jokes or humorous stories, not uncommonly he would start chuckling as the story began, begin laughing openly as the story evolved, and then shake with laughter as he anticipated the punch line that was yet to be delivered.
In his later years as a self-described, “senior, gray-haired cardiac surgeon,” and as he anticipated retirement, he became more outspoken, often expressing his concerns about medicine in general and our specialty in particular in no uncertain terms. His facial expressions frequently betrayed his thoughts. Alan could not abide hypocrisy and with his newfound freedom, felt more comfortable speaking his mind.
In 1969 Elisabeth Kübler-Ross published a book entitled, “On Death and Dying,” in which she described the five steps of grieving – denial, anger, bargaining, depression and finally acceptance. On Sunday, September 28, 2008 Alan called me at home within an hour of learning the diagnosis of his terrible disease. He was already at acceptance.
In his final trying months Alan showed a new dimension of fortitude and equanimity to family and friends. He openly shared the sorrows and joys of the process with anyone who would ask. Recently, he had an opportunity at the MGH to publicly express his great appreciation for all the love, support and encouragement that he received from colleagues and friends.
As with my father, Alan’s father ingrained in him an important Midwestern admonition –“remember where you come from” – and Alan never forgot. He was a kind, thoughtful, generous and caring man, who as a surgeon saved and gave enhanced life to thousands of patients, while at the same time teaching a new generation of cardiac surgeons. Inside, he was a sensitive person, a trait particularly evident twice in his life, first following the tragic death of his father and second with the illness one of his children faced several years ago. He was always there when others needed his help. He loved his family, was proud of his children and their accomplishments, and appreciated his friends.
Alan Hilgenberg was my closest colleague and dear friend, and now he is gone; I am convinced to a better place.
The family suggests memorial contributions in Alan’s name to the Thoracic Aortic Center at the Massachusetts General Hospital, Development Office, 55 Fruit Street, Boston, MA 02114.
Cary W. Akins, M.D.
Department of Surgery
Massachusetts General Hospital
Boston, MA USA