By David A. Kulber, MD, FACS

In the song by the Talking Heads, “Once in a Lifetime,” David Byrne inflects, “You may ask yourself, how did I get here?” As I approach my 25th year in practice, no longer the “young gun,” I find myself looking around at my surroundings both at home and at the office, asking the same question. As we age, time has a way of speeding up, and once we become aware that we are on the clock, moments, especially the good ones, become more precious

I first met Myles Cohen when I was a general surgery resident at Cedars Sinai. My first impression as an intern was that he was intense and had expectations of residents beyond the pale. I was intimidated and had cold sweats whenever I was around him. His reputation went well beyond that of a superb hand surgeon. He was known as a person of integrity and principle, guided by the pursuit of excellence in everything he did, no matter how menial the task. He led by example, and in turn, every hospital committee wanted him as their chair. At the end of my residency, it was clear to me my focus was to be good enough to join Myles Cohen in practice. I went off to the east coast for additional training in plastic surgery and a hand surgery fellowship. At the ASSH meeting in San Francisco, I had lunch with Dr. Cohen and inquired about a job. Afterward, he sent me a several-page, handwritten letter in detail discussing all of the economic challenges that doctors face. It was overwhelming but accurate as to how medicine has subsequently unfolded.

When I joined Dr. Cohen the following year, he informed me that he would be in practice for just 3 to 5 more years, and then he would retire to spend time with his lovely wife and childhood sweetheart, Cita. Dr. Cohen is soft-spoken, very measured, and keeps his cards close to the vest (yet he has an inner warmth that is welcoming). I am more vocal, with my heart out on my sleeve, and the younger version of me seemingly had no filter. I was not only very concerned about measuring up but also about the chemistry. From day one he treated me not as a junior partner but as a colleague and friend. It was not until I worked with Dr. Cohen did I truly learn the art of medicine. I ran every case by him, and he helped me with the more difficult ones. My learning curve on every level was vertical not only in the operating room but how to treat people and patients with respect, look them in the eye and listen, and the skill of training residents and fellows.

Dr. Cohen suffered from cardiac issues since the age of 27, and while in denial at times, he knew everyday was special. We both knew we were on the clock, and we made a point to touch base daily. I had a deep desire to get Dr. Cohen’s approval. It was not easily earned but readily given when deserved. Our enjoyment of practicing hand surgery, operating together, and sharing cases blossomed and the 5 years until retirement was put off again and again. Twenty-three years later, it was with mixed emotions that Dr. Cohen retired at age 77. Along the way we expanded our practice to 6 physicians and two PAs, started a hand fellowship, and published several papers. Whenever in a bind I often ask myself, what would Dr. Cohen do? On their last visit, I am happy to report that Dr. Cohen and Cita appeared quite happy and healthy living in Denver close to their children. Sitting in what I still refer to as Dr. Cohen’s office, I know how I got here…on the shoulders of a giant.