Wednesday, February 21, 2018
News Roundup

With ALS, mentor to USF medical residents is now a patient

TAMPA — Ten years ago, when Dr. Michael Flannery became director of the internal medicine residency program at the University of South Florida's medical school, he made a commitment. Each day, he would say a rosary.

Last summer, he added a new prayer: If there's anything I need to do or to know, tell me.

He had been having premonitions of his own death. His body was beginning to validate them.

Flannery had seen the muscle weakness and spasms in patients. He knew what the symptoms might mean. As he searched for a more hopeful diagnosis, he kept his fears to himself. Then, one day in August, he and his wife learned the worst:

Flannery, 51, who has devoted his life to healing and the making of healers, has a terminal disease for which there is no cure — ALS, or Lou Gehrig's disease.

He has three children, including a boy just 11. He knows he can't change the course of the disease, which could paralyze him and keep him from breathing on his own. He can only influence the memories that his family will make together until then.

And so, after the diagnosis but before others knew, he told his wife, "Let's go out and celebrate."

This is Michael Flannery. He goes to Biloxi to volunteer after Hurricane Katrina. He opens a free clinic in Pasco County. He gives educational scholarships, six a year ranging from $500 to $1,000, to future doctors, nurses and pharmacists. One is earmarked for hospital janitors who want to go back to school.

Over 21 years, he has trained hundreds of new doctors.

"He has been the father figure of our program," said Kim Kolkhorst, a second-year internal medicine resident.

Stephen Klasko, chief executive officer of USF Health and dean of the Morsani College of Medicine, holds up Flannery as a role model in a world where the narcissistic TV character Dr. Gregory House long ago replaced Marcus Welby. Flannery combines the knowledge of House with the bedside manner and the teaching skills of the beloved, old-time doctor.

"He's a hero," Klasko said. "I would say maybe 20 or 25 percent of the physicians in the Tampa Bay area have learned how to do things right because of Dr. Flannery."

He teaches them that medicine is more than technology. It's a relationship.

Introduce yourself, he tells them. Sit at the same level as the patients so you're not towering over them. Don't rush. Listen to people. It won't take as long as you expect. Put your hand on their foreheads like moms do.

Do these things, Flannery tells the residents, and one day when your supervising physician walks in the room to deliver the diagnosis and the plan, you'll notice something: The patient will be looking at you, for assurance.

• • •

He grew up in the Forest Hills neighborhood of north Tampa and met his future wife, Terri, in parochial school at Most Holy Redeemer. They started dating at Tampa Catholic, went to USF and were married in their early 20s. She taught school in Hillsborough County.

Flannery feels lucky and blessed to have been accepted into med school. He knows by the month of acceptance that he wasn't among the first students chosen. Afterward, he was persuaded to keep a foot in academia, mentoring residents as an associate program director.

"When you work with them, they energize you," he said. "They are altruistic. They are motivated. And it's hard to resist feeding off that energy. Teaching becomes a two-way street."

He had kids at school and more kids at home. The first son, Brendan, arrived 21 years ago, followed by Kara, now 19, then Kevin, the youngest.

The family lives in Wesley Chapel, but they have seemed, at times, to live at a hockey rink in Brandon.

Flannery, a huge Tampa Bay Lightning fan, played on two recreational teams, the Blades and Power Play. When Brendan turned 18, they played together, father and son, until Flannery couldn't do it any longer.

He had broken his back and suffered nerve damage years ago. It was easy, when symptoms appeared, to blame old injuries.

He spent last summer getting medical tests. ALS, short for amyotrophic lateral sclerosis, can only be diagnosed by excluding other diseases.

Painful muscle spasms are his worst symptom so far. He likens them to having a muscle cramp while carrying weight but being unable to release the weight.

As a doctor, he doesn't need to be told what's ahead.

"It's a blessing and a curse at the same time, like you would expect," he said. "You maybe know too much. I think the biggest fear of physicians is the same as any patient. It's the process of death. Usually it's respiratory and people cannot breathe. And they get what's called air hunger. You can see that with many conditions. It's not unique with ALS."

The day of diagnosis left him with a sense of direction.

He and Terri could begin the process of planning how to deal with the challenge as a family. They could consciously make good memories.

She called their pastor at St. Rita Catholic Church in Dade City. They told the two older children, but waited to tell Kevin. They knew they would have to tell him; they couldn't hide his father's pain or the special equipment, the oxygen.

Flannery had been invited to open the Tampa Bay area's Walk to Defeat ALS, which would put him into a public role. So, a few weeks ago, they sat down with Kevin and told him about his father's disease. He seemed to take it okay at first but harder in the days that followed. School was complicated. Some kids knew more about ALS than others.

If you are 11, and your father has ALS, and you hear about a walk to defeat ALS, you, of course, believe that the walk will cure him. "We didn't expect that one coming," Flannery said.

One day, Terri went and talked to the class, openly, about her husband's disease. She explained that, some days, Kevin might need a little support from them. But other days, everyone should just have fun.

At home, Kevin tries to be supportive, too. He asks his father if he's okay. He tells him he loves him. "He's very mature and sensitive," Flannery said.

Terri takes it day by day, and sometimes, 5 minutes by 5 minutes. She looks for reasons to laugh. "You want to remember the good times," she said.

They focus on the things they can still do. Thursday night, they were headed to a Lightning game. "That's a blessing," Flannery said. "You just got to take it."

Flannery does not want to leave anyone. He has been a boy without a father. His dad, an FBI agent, died of a heart attack at age 44, when Flannery was 2. Terri lost hers when she was 13.

But when death comes, Flannery knows that it will end his pain. Pain hinders him from being the person he wants to be.

He resigned this week as the residency program director. He's now working in the graduate medicine education office, helping to keep programs accredited. It's a role flexible enough to accommodate fatigue.

He misses the patients.

He's treated thousands, most recently at Tampa General Hospital, as part of USF's teaching program there. "You don't realize it until you don't do it," he said.

He misses the students and residents. They miss him, too. When they got his email, explaining, they hoped it was an incorrect diagnosis.

"It's really hard," said resident Kolkhorst. "It's really sad. You wish there was something you could do."

Friday was Match Day. Fourth-year medical students learned where they had been accepted for residency programs. Flannery knew ahead of time who would stay in the bay area.

On Match Day, students lined up to sign a lab coat that would be given to Flannery.

They wrote notes of gratitude.

"When I interviewed for med school here," wrote Tim Goede, "my interview with you sealed the deal."

• • •

Today, at USF, hundreds will join the 2-mile Walk to Defeat ALS.

Some will wear T-shirts that say "Miles for Michael." His hockey pals will show up in team jerseys. His wife and children will be at his side. Kids from Kevin's school. Friends from the neighborhood. USF medical students, residents, fellows and faculty, ready to walk.

Michael Flannery will cut a ribbon, and all around him, muscles will obey.

News researcher Natalie Watson contributed to this report. Staff writer Patty Ryan can be reached at (813) 226-3382 or [email protected]

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