A tribute to Dave Sackett

David Sackett, the most important mentor of my professional career, died last month.

I am writing this article partly to acknowledge and thank him for his incredible contributions to medicine, critical thinking and evidence-based medicine. However, others such as Andre Picard  have already done so beautifully.

I am writing this partly because I fear that I didn’t tell Dave often enough how much he meant to me.

I am writing this partly because those of us who write for this website try to use evidence as much and as accurately as possible. Dave’s contributions to the evidence-based medicine movement have extended way beyond medicine, to evidence-based health care and policy, and we use them every day at Healthy Debate, as do others around the world.

However, I write this mostly because Dave was one of the most genuinely enthusiastic, generous, fun people I have known, and I want to celebrate that. I often tell those I mentor that an under-appreciated part of career planning is to make sure that we choose to work with colleagues who are brilliant, but who are also the kind of people we would want to have a beer with. Dave was one of those.

So, here are five more or less unconnected reminiscences about my most important mentor.

I have rarely met anyone as enthusiastic about the work of others, as Dave Sackett.  When I was a student in clinical epidemiology at McMaster in 1985, Dave was my clinical supervisor. I honestly felt that he cared as much about me and my ideas as he did about the President of the Medical Research Council of Canada. Now, Dave was a practical guy, and in hind sight I am sure that he would have answered a phone call from Henry Friesen before one from me, but the point is…. I didn’t think so at the time.

Dave was remarkably innovative, but at the same time exceptionally organized and always followed through. It’s admittedly a stereotype, but innovators are often not known for their organizational skills and vice-versa. One afternoon while Dave and I were driving from Hamilton to Toronto we talked about how the results of clinical trials could be presented so they would resonate with clinicians. We stumbled onto the number needed to treat.  The next morning Dave handed me a one pager with a bullet form summary of what we had talked about and an outline of the paper that we eventually published with Robin Roberts in the New England Journal of Medicine.  I am sure Dave had millions of other things to do, but when there was something innovative and worth doing, he got on and completed it. This is one of the reasons he was so incredibly productive.

Dave was the most gifted small group teacher I ever met (isn’t it great that a brilliant researcher was also passionate about teaching!). He often said to me, “Andreas, the best way to teach clinical epidemiology to medical students is not to teach them clinical epidemiology.” He recognized that most medical students went into medicine to care for patients, and not to become researchers or experts in reading the literature. So, he’d always start his small group teaching sessions by focusing on a patient who had been recently seen by the students, and would talk about how they had managed that patient, how they had made their decisions, and how confident they were that they did the right thing. At the end Dave would summarize what had been discussed, and almost magically it would become obvious that the group had discussed key epidemiological principles, and that those principles were highly relevant to the care of their patient.

Dave was a passionate guy, and he was passionate about more than medicine. It was great fun to watch him throw himself into his and Barbara’s new life in Markdale. For an evidence-base guy, he was a surprisingly early adopter of gadgets and his office at Irish Lake was full of them, including incredibly ugly electronic feet warmers that he and Barbara used in the cold winters. My wife and I have a small farm in the Ottawa valley, and Dave was always keen to point out that he could out-gadget me any time– his chain saw was bigger than mine, his gator newer than mine, and his truck better (I didn’t have a truck!).

Dave loved the simple things in life. Many years ago we were at a meeting in Washington, and we skipped the fancy dinner to watch a baseball game in his hotel room. I will always remember him propped up in his bed, T-shirt and boxer shorts on, contentedly watching the ball game while drinking pop and eating Doritos. Dave never understood why Doritos weren’t one of the essential foods on Canada’s food guide.

I am sure the hundreds of people who Dave has mentored in addition to myself will have similar stories. Probably his greatest legacy is the cadre of people he has trained and mentored – Brian Haynes, Deborah Cook, Gordon Guyatt, Sharon Straus, Finlay McAister and so many more. The great thing is that they not only learned so much from Dave and are carrying on his legacy, but they learned it from such a wonderful human being.