Lawrence R. De Geest

Une grande promenade, encore une fois

Remembering a great chef.

In a career spanning three decades, hundreds of journal articles and thousands of patients, laughter, for Dr. William “Bill” Warren, was not the best medicine, but it was a good tonic to go with it. Take the time he healed a bird who had flown into a window. How did you get it to fly again? his family asked. He paused a moment, hands folded on the table and his bushy eyebrows raised in reflection, and said, with the understatement he had mastered as a dinner-table storyteller, that it was a simply a matter of executing that most classic of medical methods, mouth-to-beak.

His passion for medicine and humor can be traced back to two letters. First was the letter accepting him to medical school at the University of Toronto. It is a privilege, the serious student wrote in his diary, to be given the opportunity to follow in my father’s footsteps. When he graduated in 1976, he received the second letter, this time from his father. In what would be a lifelong correspondence, father to son and doctor to doctor, he imparted a lasting gift. “Medicine is not always a joyous victory over a disease,” he wrote, “and I cannot but remember how much sadness and disappointment lies before you.” But who, his father asked, does not prefer laughter to tears?

Humor was a family tradition reaching back to his great-grandfather, Colonel Falkland Warren, a brigadier in the British army. In his memoirs, passed down through the family, he remembered in equal measure the horror of battles and joyful moments among friends. Like at the Battle of Cawnpore, in 1857, when they “spied a string of camels laden with rum kegs and, against the protest of the camelman, appropriated one of these.” Whether one told the joke or was at the other end did not matter. Humor was a way to face reality, stark and harsh, but sweet and fun, too. A way to cope, to carry on – as he would say, to make life just a little richer.

Dr. Warren graduated from the University of Toronto Medical School in 1976. After completing training in general surgery at the same institution in 1981, he took a fellowship in the department of pathology at Rush Presbyterian-St. Luke’s Medical Center in Chicago in 1982, followed by a a fellowship in cardiovascular-thoracic surgery under the direction of Dr. Hassan Najafi. In 1985 he joined the staff full-time. Full professorships in pathology and surgery followed, as did numerous academic and clinical accomplishments.

One of his major contributions was the reclassification of cell types of lung cancer. The paper, published in a leading pathology journal, reclassified neuroendocrine tumors (tumors that secrete important chemicals) of the lung using light and electron microscopy and immunohistochemistry. The study elucidated the origin and lineage of these tumors, which resulted in a significant impact on the treatment of patients with lung cancer.

In a letter to a friend, he reflected on this work, and how he first learned microscopy, the detailed imaging of cells that are stained to improve their contrast, as a medical student peering over the shoulders of experts. Staining those cells took lots of time, labor, luck and precision. Then, capturing the images took long hours in a dark room with his face in a microscope, carefully tracing the neuroendocrince cells that made up the tumors and looked like galaxies. He once took a picture that captured the entire complexity of the cell, the entire galaxy, a one-in-a-million shot that revealed new secrets and captured the attention of researchers. “Whenever I try to explain these amazing images to the cashier at a local Starbucks,” he wrote, “she gives me a puzzled look, but has never offered me a discount.”

Dr. Warren held many positions of leadership, including Director of General Thoracic Surgery at Rush and Division Head of Thoracic Surgery at Cook County Hospital. Though he received many national and international honors, he was especially proud of teaching awards given to him by his students. Deep down he cared. Healing was not just for window-struck birds or patients in hospital beds. One night when his friend and landscape architect mentioned a nagging throat pain over the phone while they discussed plans for a garden, Dr. Warren picked him up and took him to the hospital.

Before he was Dr. Warren, before he was Bill, he was Billy, the boy who accompanied his father on Sunday rounds at the hospital in his hometown of Toronto and announced to the nurses that he would be a pig farmer. He collected stamps and built model railroads. He studied the piano, and, for a brief time in the ninth grade, he played the tuba, because he was the only student big enough to carry it. Summers were spent at the family cottage in Muskoka. On hikes with his father he collected beetles and butterflies. He and older sister and younger brother had diving contests off the dock. In the evening they escaped to the bunkhouse to listen to Beatles and Beach Boys records.

Music, stamps and trains became lifelong hobbies. Bill regularly attended the opera with colleagues. Whenever he got his hands on a rare Beatles or Beach Boys recording, he sent it to friends so that when they came to visit, they could discuss it over a bottle of wine. The family stamp collection was carefully curated until his death. And when grandkids came to visit they were treated with a tour of the model train in the basement, a bird’s nest of tracks and wires, always a work in progress, though he insisted he knew where was each and every little thing.

Chicago brought not just professional success but personal joy as well. It was on a bus ride to a ski resort in Wisconsin that Bill sat next to Karen Kole, an accomplished tax attorney and law professor, the woman who would be his first wife. They settled in a historic house in River Forest and raised two sons, Michael and Tyler. They played tennis ball hockey in the schoolyard with sticks brought back from Canada. Summers were back in Muskoka, eating blackberry pies and teaching the kids to fish off the dock. Some of those fish were quite ugly and inedible, he conceded, but they put up a good fight. Karen fought, too, the multiple sclerosis that would eventually lead to her untimely death in 2006.

Bill’s father once called the operating room “that holiest of areas”. For Bill the kitchen was a close second. In the lonesome time after he lost Karen and the boys had moved out, he took to cooking. Following the school of French cuisine, he started simple with omelets. Pretty soon, bookshelves filled up with cooking magazines and cookbooks and the kitchen became the heart of his home. When visitors came, pots clanged, oven doors swung open and slammed shut, butter melted in pans, fans whirred over the range. And there was Bill, in his element, dressed in oven mitts and an apron, hair tussled and crisp white shirt rolled up at the sleeves, pockets stuffed with pens and eyeglasses, sipping a gin tonic as he prepared dinner.

He became friends with the Chicago-based French chef Patrick Chabert when he won a weekend cooking lesson in a raffle. Chef Chabert arrived for their first lesson expecting a clueless doctor. “Ok”, he sighed, “cut me that onion”. Bill chopped it expertly. Surprised, the chef raised the bar. “Fillet this fish”. Perfect again. Chabert looked at him incredulously. Who was this guy?

“He was a bon vivant”, Chabert said at Bill’s memorial, which he catered, carefully choosing dishes Bill would have approved of. “He liked to eat and talk about certain things.”

Cooking also brought him to his second wife, Martine Derom. Best friends, their courtship spilled over into her native Belgium, when he visited her family and spent an entire day cooking an elaborate dinner, not realizing his future mother-in-law, who also had a sense of humor, kept the salt in a jar labeled “Sugar”.

Bill and Martine cooked together, went on long road trips in Canada and France, talked for hours over Pinot Noir. They giggled in corners, danced in the kitchen, debated who fell asleep first during a movie. When his stepdaughter Sophie came for dinner, he made sure there was always applesauce, homemade with a splash of cognac, just the way she liked it. When she suffered a bad boyfriend, he left a voicemail on her phone, claiming to be Vito, a mobster. Speaking like a tough-guy, he said, all you have to do is give me the word, and I will take care of everything.

Humor never left him, not even when he began the long fight with cancer at the start of his retirement, and he was afraid that he would not realize his dreams of a second life, of long dinners with favorite company and summer wedding receptions in the house he loved. His sister came to visit one last time, and they remembered how they saw a clarinet concert in Toronto’s Massey Hall that sounded like a seagull dying. They caught the giggles until they laughed so hard tears rolled down their faces. When the concert ended, the conductor asked the audience to applaud the composer, who was seated right behind them.

Just like in his boyhood, he was a favorite among the nurses. When the treatments stopped and the end was close, they came in several times a day to see if there was anything they could bring. “Yes”, he said. “A scotch and soda.”

Bill was a reminder to those around him that there is always something to learn, someone new to learn from, an opportunity to seize, a good meal to be made. On a warm summer evening in Flanders with his family, ill though he was, he rose from the table after a long dinner and proposed a stroll in the dimming dusklight. Une grande promenade, he said, encore une fois. One more time.