His career has bridged "town and gown" — seeing patients at Menlo Medical Clinic, teaching Stanford medical students, helping to lead a clinic for low-income patients in San Jose and delving into hard cases as a member of the Stanford Hospital & Clinics Ethics Committee.
The lifelong musician — he plays the bass — has played in school and local symphony orchestras and various bands, including a three-man jazz trio that's been together 30 years.
Fiene and his wife, Nancy, a pianist and music teacher, felt like they'd come home when they arrived in Palo Alto from the Midwest in 1961 for Fiene's internal-medicine training at Stanford.
"We just felt that we were at home in all ways," he recalled in a recent interview. The kind of people who were here, the philosophy of life — they were compatible with our feelings and we just felt we belonged here."
The couple raised their four children in Palo Alto before moving eventually to Portola Valley.
Fiene brought a primary-care doctor's perspective to his work with Stanford medical students, where he taught on the wards of Stanford Hospital.
"I'd see them in their fourth and fifth years on the ward and they'd still love the aspects of training in which they really connected with the patient — talked and, more importantly, listened to them. And that's what we'd try to teach them.
"Technology is very seductive and very powerful, so it's important that they also learn to have the personal connection with the patient."
Though retired from daily practice, Fiene continues teaching medical students at the Pacific Free Clinic in San Jose, which operates on Saturdays.
The Stanford student-run clinic serves families and singles, newly arrived immigrants or people who have lost their jobs and have no insurance but need medical care.
"The main purpose is to provide care for a group of the population that's under-served or not served at all, and to give the Stanford students an exposure to this group and make them aware that there's a large group out there in dire need of help," Fiene said.
Retirement also has given Fiene time to return, in a way, to his agricultural roots as manager of a small winery in his Portola Valley Ranch housing community.
"We grow the grapes and go through the whole process of crushing, pressing and fermenting," he said of the winery, which was started by other residents of Portola Valley Ranch before the Fienes moved there.
"The dirt is under my fingernails," he said, recalling his childhood summers helping on a family farm in central Wisconsin.
Though his family lived in town, he would help with the dairy farm during the summer, milking cows and taking the milk to the creamery.
"When I first started working on the farm there was no electricity — we had kerosene lamps — no indoor plumbing, and we plowed with horses," he said.
Fiene also continues his 15-year membership on the Stanford Hospital & Clinics Ethics Committee, which provides guidance on difficult cases, including transplants, end-of-life issues, or ascertaining the best interests of a homeless patient who has no family or surrogates.
"It's very challenging and with increasing technology the issues become more complex," he said. "We have the ability to do so much more in terms of keeping people alive that our ethics have to race to keep up with our medical technology."
The 34-member panel includes 13 physicians as well as nurses, community members, a chaplain, a social worker and others.
"Decisions like that are too difficult to just leave to one group of people so it's a widespread group of people who give their input," he said of the committee, which was founded by former hospital chaplain Ernle Young, who recently retired.
The cases handled by the committee reflected the gamut of issues and the connection with humanity that Fiene has relished in his career as a caregiver.
"It's a real cross-section of society and of humanity and that's just what makes it so fascinating," he said.
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