Clif Cleaveland wins Champions of Health Care Lifetime Achievement Award

Chattanooga Times Free Press (TN)

Sep. 1--Clifton R. "Clif" Cleaveland, M.D., hung up his stethoscope in 2004, but he has never stopped listening to the human heart.

Dr. Cleaveland, 82, who practiced internal medicine in Chattanooga for 33 years and became a writer and teacher after "retirement," is held in almost reverential regard by his former patients and colleagues.

(Read more about how we're recognizing the Chattanooga area health care champions.)

"As a patient as a young adult and into my 40s, he provided holistic care, always caring about me not just as a diagnosis to treat but a person to embrace," said Julie Van Valkenburg, of Signal Mountain. "He had a profound influence on my life, and I miss him and love him dearly."

The line of friends and admirers who stepped forward to endorse Cleaveland for the Champions of Health Care Lifetime Achievement Award was long and passionate. Most pointed to his shimmering resume -- he is a former Rhodes Scholar and past president of the American College of Physicians -- before offering adjectives such as "brilliant," "compassionate," "warm." Some have even called him a "Renaissance man."

For his part, Cleaveland, says, with characteristic modesty, that he gained just as much from his patients as they got from him.

"I encountered some of the most incredible people, who were pushing uphill against terrible disabilities or bad cancers," Cleaveland says. "These patients taught me about courage and steadfastness. I saw people who had bucked tough odds all of their lives. I saw some of the most honorable aspects of human character."

In recent years, Cleaveland has authored a weekly column, "To Your Health," published in the Times Free Press which covers medical trends, health policy and other topics gleaned from his wide experience and readings. Until recently, he has taught undergraduate classes at the University of Tennessee at Chattanooga, primarily to students in the Honors College. He is one of the founders of the Tennessee Literature and Medicine Seminar, an annual retreat designed to help physicians connect to the humanities.

"Dr. Cleaveland, more than any other person I have never known, is the true Renaissance Man," says Verbie Prevost, professor emeritus of American literature at UTC. "While medicine has always been first with him, it is always connected to all the other things in life that he also values -- literature, art and music chief among them."

The formative years

The son of a Metropolitan Life Insurance Co. salesman, Cleaveland was born in LaGrange, Georgia, a textile town about 30 miles north of Columbus. Later, he attended high school in South Carolina after his father took a job there.

Cleaveland said he was headed to the University of South Carolina when a representative from Duke University telephoned to ask why he had turned down a scholarship to attend the North Carolina school. Due to a clerical error, Duke had failed to mail him a notification, it turns out, and he quickly raised $500 for room, board and books and headed to Durham.

After his senior year at Duke, he spent a summer as an intern at Yellowstone National Park where he met his wife of 59 years, Ruzha, which is the Croatian word for rose. ("She told someone the other day that the first 58 years of marriage are the rough ones," Cleaveland chuckles.)

After Duke, he began his medical studies at the University of Oxford in England. Cleaveland said English doctors are trained in the humanities, noting that one of his mentors there once gave him tickets to the opera. He was counseled by tutors at Oxford to develop interests outside of his clinical studies.

He later finished his medical degree at the prestigious Johns Hopkins University School of Medicine in Baltimore. After finishing his medical training, Cleaveland spent two years in military service at Fort Knox, Kentucky, tending to sick and wounded service people flown in from the war theater in Vietnam.

"The two years I spent in Fort Knox were amazing," Cleaveland says. "Every night an airplane would land and we would get wounded, snake bites, malaria. It was a fellowship in things I wouldn't have otherwise seen."

After his military service was done, Cleveland was recruited to Chattanooga by some of his medical school friends who had already set up practice here. The health care system in Chattanooga in 1971 was primitive compared to today, Cleaveland says.

"When I started in Chattanooga we didn't have a infectious disease specialist," he says. "We didn't have a medical oncologist in the city. We had three cardiologists. We had no (kidney) dialysis going on in town."

Over time, Cleaveland said he saw amazing advances in medical science and an influx of specialists. While treatment improved, specialization has been dispiriting to some internal medicine docs, he says.

"Adult medicine has been so carved up it's almost unrecognizable," he says.

Family physicians are unsettled, he said. "I had one tell me recently, 'I'm just a garbage man. I gather up the patients after the sub-specialist can't do anything."

For all the advances in medicine, Cleaveland says the United States still hasn't solved the cost side of health care. As an example, he noted a local cancer patient whose pills are $478 per tablet, a mark-up of about 100 times what patients in other countries pay for the same drug.

"Some of the co-pays on people with Medicare are mind-blowing," he says.

He said medicine in the United States as been politicized to the point that he sometimes gets "really violent e-mails" from people who take issue with his newspaper columns about health care policy.

Throughout his medical career, Cleaveland said he tried to treat those entrusted into his care as people first and patients second.

"It's the difference in saying 'let's go see the diabetic in (room) 409,' vs. saying, 'let's go see the man in 409 who happens to have diabetes."

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