by Alex Martirossian, MD (PGY-3)
The UAB Department of Medicine is fortunate to have such incredible and accomplished faculty, and one of the legends within the Division of General Internal Medicine (GIM) is Dr. Gustavo Heudebert. Ever since joining the UAB faculty in 1995, he has touched the lives of countless medical students, residents, and faculty through his extraordinary gift as a clinician educator.
And as of fall 2019, the UAB GIM was lucky enough to claim not just one but TWO Heudeberts in its ranks. Dr. Gustavo Heudebert’s son Alonso Heudebert recently completed his internal medicine residency and chief year at Washington University in St. Louis. He now serves as a faculty member where he fulfills various roles as a clinician-educator including attending on the Tinsley and VA wards and teaching in the VA Red clinic. I had the privilege of interviewing this dynamic Peruvian duo to learn more about their approaches to clinical teaching as well as a few fun points of rivalry.
Q: What was the process that led you [Alonso] to join the UAB faculty?
A: As I was deciding where I wanted to work, being close to family was very important, so I had narrowed it down to either WashU where my wife’s family lives or UAB where my family lives. In the end, moving to Birmingham turned out to be the best thing for us, and this may have been helped along by my mom secretly campaigning since I was in med school to get me to UAB [laughs].
Q: Gustavo, did you have to use any insider influence to help bring Alonso to UAB, or was it a pretty easy decision for everyone?
G: For me, it was actually a very difficult decision, because I had to try very hard to stay on the sidelines and not meddle. Both WashU and UAB are equally wonderful institutions, so I really wanted him to make this big professional decision on his own.
Q: How does it feel to work together? Is it awkward? Fun? What are the vibes?
G: I don’t find it awkward at all, and actually it’s been more of a goal of mine to meddle as little as possible with his professional career. Fortunately Drs. Centor, Estrada, and Kraemer have carried that mantle and have been great mentors for him, and I think that those professional relationships have been some of the many benefits of coming to UAB.
A: From my end, I actually always felt a bit nervous because even though I ended up doing my med school and residency outside UAB, I always felt like I needed to do things under the shadow of Dr. Heudebert “The Elder.” As I got older, I really came to appreciate how important family is and how that supersedes other things, so the transition was actually pretty smooth. I’m pretty excited about working together, but in reality there’s a fair bit of separation since he spends so much time in Montgomery.
Q: Now that you’re both teachers, what are some ways that your teaching styles are similar? Different?
G: He used to shadow me on the wards when he was a “wee pup,” and I think that we both share the bedside teaching style, but honestly I haven’t really had that many opportunities to watch him teach since coming to UAB.
A: In terms of teaching, I think that there are some areas in which we are very different and others where we are similar. For differences, Dad prefers to conduct rounds at the bedside whereas I prefer table rounds and then go see the patients. Dad is also extremely gifted at the physical exam, which is a skill I am constantly striving to improve. He’s also very detail-oriented. The cool thing about Pops is that you’re going to do things on service his way, but he’s not going to make you do it, he’s going to “show you the way.” He accomplishes this in a Socratic way by asking questions to gauge your understanding about pathophysiology or other details so that you understand why you should do things his way. I, on the other hand, am more hands off and try to let the learner choose their own care path. I think the thing that unites us is our enthusiasm and excitement for teaching on the wards.
G: To paraphrase Dr. Centor, I’m the biggest micromanager, the house staff has no idea. [laughs]
A: I have a great story to illustrate how my dad is a micromanager and his great attention to detail. My dad has a wonderful alfredo pasta recipe and one day my younger brother JP wanted to learn how he made it. They were working in the kitchen having a great time and as JP was stirring the sauce, my dad walked by and then stopped and stared at JP. JP turned around and asked “What?” My dad asked, “Are you doing that on purpose?” “Doing what?,” JP asked. Dad: “Stirring in the wrong direction.” [laughs].
G: Now JP will stir counterclockwise just to irritate me. [laughs]
Q: Gustavo, even as the more seasoned physician, are there times where you learn things from Alonso?
G: Unfortunately I haven’t really had the opportunity to see him in action, but one thing I would like to do when the COVID pandemic passes is tail him around. I don’t think I will adopt the practice of tableside rounds, but I would like to see what he does at the bedside and hear his lectures. But absolutely, you can always teach an old dog new tricks.
A: That’s one of the joys of medicine is that we’re always trying to improve ourselves, and we can learn from anybody.
Q: Now for the important question: Diet Coke or Coke Zero?
A: Ask anyone with a palate that works that it’s Diet Coke. Coke Zero is for people who want to drink Coke without the calories, whereas Diet Coke has its own flavor profile.
G: Diet Coke is the drink for old people and Dr. Centor prefers Diet Coke, so I’m going to stop there.
A: But if you average mine and Centor’s age though…
G: Still, it’s Centor’s preferred drink. I’m all about change, new things, and evolving, but Alonso is stuck with Diet Coke, but that’s okay, I still love him. [laughs]
Q: Is there anything that you guys are looking forward to in working together as faculty?
G: One of my passions is clinical reasoning and Alonso also has a liking for it, and one of my long term goals is to develop projects that we can work on together. I’m back from Montgomery in July and I have a few ideas of things we can do. Dr. Centor and a few other faculty would be involved, and I think Alonso would enjoy working with that group of individuals.
A: It’s interesting that even though I trained outside UAB and away from my dad and Dr. Centor, I developed this interest in clinical reasoning. When I came back, I found that this was what they love to do. We’ve had a couple opportunities to team up over the years, but my favorite time was when I invited my dad to be the CPC discussant at WashU, the equivalent of Clinical Problems Solvers (CPS) at UAB, where he is presented a case without much advance information. I tried to challenge him with a case about a middle-aged man with early onset Parkinson’s who developed scurvy secondary to malnutrition. Dad figured it out before the labs which was kind of a blow to my confidence, but I’m certain that I’ll find something to trip him up down the line.
G: Oh I’ve been tripped several times, but as you get old you don’t get as embarrassed anymore. [laughs]
Q: Thank you both very much for your time, UAB is very lucky to have you.
A: You’re very welcome. And if you’re looking for the best way to address the two Dr. Heudeberts, I’ve been advocating that you address one, I won’t say who, “Heudebert The Elder” and the other Dr. Heudebert.
G: Or as his mother suggests, we should call him “Heudebert 2.0” [laughs]