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Medical leader and surgeon R. Hewlett Lee dies at 89

Lee was a major voice in Palo Alto, Stanford and state medical affairs

R. Hewlett "Hewey" Lee, M.D., a leader for decades in medical affairs in Palo Alto, Stanford University and statewide, died Wednesday after several years of declining health. He was 89.

Dr. Lee was known for his skill as a surgeon, his warmth with patients and others, and his sense of humor. He had been recognized by numerous professional awards during his life.

"He was a surgeon's surgeon," said retired surgeon Tony Marzoni -- Dr. Lee's partner in general surgery for many years -- who remembers Dr. Lee as his "surgical mentor and teacher."

"Hewey taught generations of general surgical residents their art and craft," he said.

"He was universally kind to everyone: physicians, orderlies, medical students, nurses, interns and all his colleagues. His patients just adored him," Dr. Marzoni said.

As for Dr. Lee's sense of humor, Dr. Marzoni recalled, "He used to say all one needed to be a surgeon were three things: spectacles to look knowledgeable, grey hair to appear experienced and hemorrhoids for that look of concern."

"Hewey was just such a special guy. He was my role model," said Dr. Richard Slavin, who recently stepped down as CEO of the Palo Alto Medical Foundation.

Dr. Slavin said he met Dr. Lee during a 1967-72 surgical internship at Stanford, where Dr. Lee was teaching as a member of the voluntary clinical faculty.

"He was the example of an individual I wanted to imitate," Dr. Slavin said. "He was such a talented person, with a special manner toward his patients. He was always so positive and constructive, and wonderful to work with. He was a humorous, gentle and kind, a special guy, and just phenomenally talented."

Dr. Slavin initially practiced with the Sunnyvale Medical Clinic, which later became part of the El Camino medical group before it affiliated with the Palo Alto Medical Foundation in 2000. He cited Dr. Lee's broader leadership in both improving health care and making it more accessible.

"He was instrumental in founding the TakeCare Health Plan," which was designed to expand access to health insurance, Dr. Slavin noted.

In a memo sent Wednesday to physicians and staff, Dr. Benjamin Maser, current president of the Palo Alto Division of the Palo Alto Medical Foundation, called Dr. Lee's passing "a tremendous loss to the organization."

"Dr. Lee was a great physician, a member of our founding family and just a really nice man," Dr. Maser wrote. "He will be missed."

Dr. Lee was the son of the late Dr. Russel Van Arsdale Lee, who founded the Palo Alto Clinic (which later became the Palo Alto Medical Clinic) in 1930 after several years of practicing medicine in Palo Alto as a partner with Dr. Tom Williams. In 1981 the clinic combined with the nonprofit Palo Alto Medical Research Foundation to become the Palo Alto Medical Foundation.

He was the youngest of Dr. Lee's four sons -- following Richard, Pete and Phil -- and he had a younger sister, Margo; all of his siblings achieved M.D. degrees.

Hewlett Lee's interests were broad, ranging from surgery to teaching, medical trends and politics, in addition to diverse personal interests. He was a general surgeon who specialized in breast-cancer surgery, retiring from active surgery in 1989 at age 65 but remaining involved as a board member of both the Palo Alto Medical Foundation and Stanford Hospital.

At the time of his retirement from the Palo Alto Medical Foundation, Dr. Lee served as executive director of the physician partnership and as vice president for health care, heading up the Health Care Division.

But his leadership extended far beyond Palo Alto and Stanford. In an extensive interview at the time of his retirement, Dr. Lee said his interest in health plans dated from the early 1960s, when he was elected vice director of the clinic in 1963 and named chairman of its Pre-Paid Plans Committee.

"At that time we developed the Family Medical Plan for Stanford faculty and employees, and that spread to four clinics, which we called the United Medical Clinics (UMC): San Jose, Sunnyvale, Palo Alto and the Redwood Clinic," Dr. Lee said.

After "innumerable meetings," he recalled that UMC evolved into TakeCare, a nonprofit, freestanding entity tied in financially with Blue Cross.

He also was involved in the early stages of Lifeguard, an "open model" health plan that grew out of the Santa Clara County Medical Society and the Foundation for Medical Care.

He served for a decade on the board of Blue Shield, California's first "preferred provider organization," or PPO. Blue Shield was created by the California Medical Association initially as a way to provide discounted health care for teachers and other lower-income persons, and later became available to anyone.

In the late 1960s, Dr. Lee served for 18 months as president of the Santa Clara County Medical Society (which once banned his father from membership after he founded the group practice clinic). Under his presidency, he stirred controversy when the society became the first such group in the nation to come out against the Vietnam War because "all kinds of good things were stopping" due to siphoning off funds for medical research.

When Ronald Reagan became governor in 1967, Dr. Lee soon was invited to join the state's Health Care Commission and was named chairman of the commission's Pre-Paid Plans Committee. Faced with the chaos of health coverage across the state, he led a reform effort to establish regulations.

"At this time pre-paid plans were bubbling out of the sewer," he said. People "were being sent out in white coats to sign people up" for plans that would have just one or two doctors to care for up to 3,000 people, he explained. "It was just sham and disasters."

Dr. Lee also personally helped draft legislation that became the core of the state's MediCal program to fund health care for the poor.

He was a delegate to the California Medical Association for 15 years and to the American Medical Association for 10 years.

As a surgeon, he was considered a pioneer in how to diagnose and treat breast-cancer patients, developing in the early 1960s a personal and clinic-wide policy of what he called "fully informed involvement" by the woman in treatment decisions.

Seeking alternatives to the then-standard treatment of full mastectomies, including muscle, for breast cancer, Dr. Lee and other clinic physicians began exploring other treatments, including radiation therapy when appropriate -- an approach which met initial resistance in the profession but later became the norm.

He was a graduate of Stanford University School of Medicine, where he developed a love of teaching. It would have become his career had he not been voted in as a partner at the Palo Alto Medical Clinic in 1956 by other partners, during an absence of his father. Earlier his father had hired him to be the clinic's fourth general surgeon, after Drs. Blake Wilbur, Alex MacKenzie and Ralph Cressman. He continued teaching at Stanford even as his career as a surgeon blossomed.

In a statement shared in Dr. Maser's memo, Dr. Marzoni wrote that Dr. Lee was "an avid birder and photographer, knew more limericks than anyone living, loved boating (his sons are both champion water skiers -- tricks and slalom), fishing and storytelling." He also developed and printed his own color photographs.

Dr. Lee was a native of Palo Alto and attended Palo Alto High School, Stanford University and its medical school (then still in San Francisco), from which he graduated with honors. He completed his surgical residency at the Stanford service at the old Lane Hospital in San Francisco, followed by a year in Cambridge, England, in a vascular fellowship. He then served in the U.S. Navy for two years in Korea and was present at the Inchon landing.

Dr. Lee was predeceased by two siblings, Richard Lee and Margo Paulsen. He is survived by his wife, Elizabeth; his brothers, Pete and Phil Lee; four children, Virginia, Phyllis, Eric and Stan; and six grandchildren.

There are no plans at present for a memorial service.

Former Palo Alto Weekly Editor Jay Thorwaldson can be emailed at jaythor@well.com. He also writes regular columns for the Weekly's print edition.

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