In Remembrance of Robert D. Orr MD, CM: Physician, Mentor, Teacher, and Friend

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I first met Bob Orr when I was a medical student and he was teaching a class on bioethics. He had recently started the clinical ethics consult service at Loma Linda University Medical Center (LLUMC), and I had had an interest in ethics since my undergrad days. I did an elective with him my senior year and wrote a paper on the ethics of liver transplantation, which I knew nothing about, but he encouraged me nonetheless.

Dr. Orr had reluctantly left his home in beautiful Vermont to come to the desert of Southern California and start an official ethics program at LLUMC. He was a Family Medicine physician by training; thus, he joined the Family Medicine department and served as one of the attendings who would chief in the residency clinic.

Bob was a master teacher. His lectures were engaging and thought-provoking, and he knew that telling stories was the best way to help people understand what ethics was all about. For Bob, he believed that ethics meant treating people kindly and fairly. Ethics was not just an academic endeavor for Bob. He saw it as a way to make the world a kinder, gentler place for those who were often overlooked and disadvantaged. This was demonstrated by how Bob would treat the socioeconomically challenged patients and their families who we saw in the residency clinic with kindness and compassion.

I matched into LLU’s Family Medicine residency after medical school, and Bob soon became one of my most trusted mentors. As I became more familiar with how the healthcare system worked, I became more disillusioned with it. Our hospital was located across the street from a skilled nursing facility, so we would routinely have nonagenarians with end-stage dementia who were admitted for the usual illnesses such as urosepsis and pneumonia. They would come in unaware of their surroundings, often contracted and unable to swallow, and we would intubate them and place multiple lines so we could treat their infections and do everything possible to prevent them from dying.

This was not the image of medicine I had in mind when I decided to go to medical school, and I soon started to doubt if this was the career for me. I began to despair over the potential “mistake” I had made when I started talking to Bob about my concerns. He listened thoughtfully and patiently and empathized with me and my questioning. I seriously considered leaving medicine as I could not reconcile what I thought medicine should be and what I found it to actually be. I will never forget Bob’s unwavering kindness and support. Bob convinced me that because of my love for ethics I might enjoy the field of palliative medicine. I went to one of the early national meetings and fell in love with the people and the philosophy. I believed this was a field that would help me use my medical training in ways what would also align with my philosophy that there can be tremendous healing even at the end of life.

Bob had faith in me to become a competent, kind physician even when I had no faith in myself. Because of his support, I successfully finished residency and started to plan about how we might start a palliative care program at LLUMC. Bob had helped me see there was a better way to care for those who were the most vulnerable, especially those near the end of their lives.

Bob decided to return to his beloved Vermont with his wife soon after I finished residency. Because of the excellent teaching and coaching he had provided me, I was able to start the Palliative Care program at Loma Linda. This would not have been possible without Bob’s encouragement and support.

Several years later, I was fortunate to cross paths with Bob again. Jerry Winslow had been good friends with Bob and served as the Vice President for Mission and Culture at LLUMC and decided that Loma Linda needed to train more ethicists if it was to have a robust program. Bob was convinced to come out of retirement and moved back to Southern California to provide a two-year fellowship in clinical ethics consultation. He trained me and four other physicians during that time. We would meet weekly to discuss the readings for each session. Bob chose the most applicable, relevant articles so we would have an outstanding foundation in clinical ethics consultation. Even though we were busy with our “day jobs” in various medical specialties, I was sure to read the articles ahead of time so as not to disappoint Bob. He would guide and direct us in a thoughtful discussion of the article and looked forward to hearing others’ point of view. Bob made these sessions come alive by sharing stories of consults he had done previously and the lessons he had learned from them. Under Bob’s expert tutelage, I eventually became chair of the ethics committee in 2009 and continue to serve in this role.

I knew Bob’s health had been declining when my husband and I were planning a trip to Vermont in 2019 to visit my niece, who was attending college in the southern part of the state. We had made arrangements to visit the Orrs at the end of our weeklong journey through Vermont. But who was there to meet us as we arrived at the Burlington airport late at night? Bob wanted to share a map that he had marked with his favorite drives and spots to visit. He wanted to make sure I did not miss any of the places he loved and wanted me to enjoy them as well. I carefully preserved that map so when I return to Vermont I can retrace some of those steps. That was the last time I saw Bob, and I will always treasure that visit.

Always one to plan ahead, I received an email from Bob in March of 2021 inviting me to say a few words at his memorial. I was both devastated by the request and deeply humbled. I certainly did not want to think about the possibility of a world without my teacher, mentor, and friend. I was so glad when we could gather in Vermont to celebrate Bob’s incredible life.

Bob was an amazing teacher, outstanding physician, and steadfast friend. He showed God’s love in the life he lived, treating everyone he met with respect and kindness. I can’t believe how lucky I was to have the honor and privilege of learning from and working with him. He always set the bar high and pushed us to achieve our very best. If you were one of Bob’s patients, students, colleagues, or friends, you know what a special honor and blessing that was.

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