ROY K. GREENBERG, M.D.
1964 - 2013
Roy Greenberg was born November 9 in 1964 and died at home in Cleveland, Ohio on December 7 in 2013 after a long and difficult illness. His untimely passing at the height of his creative and immensely productive professional career is a great loss to surgery, to humanity and to endovascular therapies of all kinds.
He was born to Don and Iris Greenberg in Ithaca, New York where his Father taught and did research at Cornell University and his Mother taught science. He grew up in upstate New York with his sister Jane and brother Eric. Roy attended Cornell where he received his BA in 1987, then attended medical school at the University of Cincinnati graduating with Alpha Omega Alpha honors in 1992. His surgery residency was at the University of Rochester as was his Chief Residency year. Early in his surgical career he was captivated by the possibilities of decreasing the morbidities of vascular surgery with endovascular therapies and in 1997-1998 he spent time as an interventional radiology fellow, partially at the University of Rochester and traveling to Malmo Sweden for further training. Returning to Rochester he finished his formal vascular surgical fellowship in 1999.
Following completion of his Vascular Surgery fellowship, Roy was recruited to the Cleveland Clinic and into the Department of Vascular Surgery by Kenneth Ouriel MD, one of his mentors from Rochester, also receiving an appointment in the Department of Biomedical Engineering of Case Western Reserve Medical School. These were the early days of exploration of endovascular therapies for structural cardiovascular problems of all kinds, and Roy was a perfect fit for this huge shift in paradigm. My first meeting with Roy was in front of an x-ray view box looking at films of a patient with an aortic dissection and his thought experiments as to how it might be possible to treat the complex aortic disease we were looking at with endovascular approaches seemed so unique in concept that I wondered what I had stumbled into. I found, with the passage of time, that what I had stumbled into was not a guy with a gimmick, but a man that combined genius, imagination, the discipline of grinding out practical and realistic solutions to problems and the compassion to give of himself to both his patients and colleagues.
The word “genius” is overused in the world of today, but Roy was one of the few to deserve the term. He was able to conceive of things that were not just new applications of previous concepts, but that were truly new concepts, the new clay to be molded. Most of his unique contributions were in the area of the endovascular treatment of complex aortic disease, and in this arena his combination of clinical and engineering skills stood alone. His arrival at he Cleveland Clinic set off an era of collaboration between Vascular and Cardiothoracic surgery and a hybridization of open and endovascular techniques that changed the way we viewed the choices for patients with aortic disease, increasing the pool of reliably treatable patients and contributing to decreasing their risk in a major way. In addition, his mind ranged beyond aortic disease, to structural heart disease and other areas one would think to be far from his core experience. I believe Roy was the first clinically to place a percutaneous heart valve in an adult in this country when he engineered a valve that could be placed at the junction of the inferior vena cava and right atrium and then carried out the procedure to treat a patient with severe tricuspid regurgitation and ascites caused by radiation heart disease. His ability to combine the imagination of new ways of addressing difficult problems with the practical ability to turn them into reality was like no other. The many ideas produced by his fertile mind that were turned into devices and patents are testimony to his remarkable combination of abilities to define a problem and to engineer a solution.
These talents were magnified by his remarkable openness to new ideas from others and his attention to people from many different backgrounds. The concepts of endovascular therapy touch a myriad of specialties and are world-wide. Roy welcomed all, listened to all and learned from all. He was able to employ ideas gleaned from the experience not just of vascular surgeons, but also cardiologists, radiologists and neurologists, and even from outside of medicine, getting ideas for endovascular stenting from the way that plumbing and heating ducts worked. The openness of his mind was immensely important to the administrative structure of the Cleveland Clinic as well. During his career we were attempting to move from a “tool based” traditional departmental structure to an organ system based approach. In pursuit of this goal, we created the Heart and Vascular Institute, a structure that combined the Departments of Cardiology, Cardiothoracic Surgery, and Vascular Surgery into a single division. That someone of his stature helped to champion and take his place in such a structure was of great importance in wending though the inevitable conflicts and insecurities such a major change engendered. His enthusiasm for teaching and in helping to bring cardiothoracic surgeons into the endovascular fold was also extremely important for the development if endovascular cardiothoracic surgery as a subspecialty.
Roy’s widespread impact is obvious from the breadth of the academic societies he was inducted into, and his many publications, lectures and awards. In addition to the American Surgical Association he was a Distinguished Fellow of the Society for Vascular Surgery, a Fellow of the American College of Surgeons, a Fellow of the American College of Cardiology, a member of the American Association for Thoracic Surgery and the Society for Interventional Radiology. He published over 170 scientific papers, 41 book chapters, lectured and taught around the world, received multiple awards including the Cleveland Clinic Master Clinician and Innovator awards, and was selected as Orator for the Australia-New Zealand Vascular Society and to give the Kinmoth Lecture of the Vascular Society of Great Britain and Ireland.
Mostly, however, he saw himself, as a doctor and a doer. Not particularly concerned with whatever administrative position he might or might not occupy, his focus was the art of surgery, innovation to make surgery better, and the impact it could have to help patients.
Roy’s charisma was part of his genius. People were drawn to him and his openness. In a room full of people at a meeting the crowd was rapidly centered around Roy. He was a crossroads where new ideas mingled, swirled and came out better. Roy created interaction, mainly because he was just a really good guy, whether standing before a view box, dressed in scrubs and a lead apron, gracing a podium or having a beer after a meeting.
He was a prime example that proved that genius and medical excellence are not incompatible with humanity, and humility. He saw his greatest mission as being a good husband and father, and Alicea, his wife and his two boys Zachery and Lucas were loved and paid attention to in ways we all can emulate.
Roy’s illness was prolonged and difficult. In the beginning none could believe this loss would have to be sustained. But we are surgeons and we know that tragedy is part of life. We certainly should hope that we will be favored with more Roy Greenbergs. That with time there will be among us those that are able to combine surgical skill, intellectual genius, grace, humanity and compassion in ways that may be similar. But there never will be better.
BRUCE W. LYTLE, M.D.