In Memoriam: Vijay H. Aswani, MD, PhD (1962–2021)

We all come to earth as humans but few leave as angels, and Vijay Aswani was one such soul. Dr. Vijay H. Aswani, MD, PhD, FACP, FAAP, a former Associate Editor of Clinical Medicine & Research and a former Internal Medicine/Pediatric physician at the Marshfield Clinic Health System (Figure 1) passed away, unexpectedly, on June 27, 2021, in Amherst, New York. He was only 59 years old.

• Download figure
• Open in new tab
• Download PowerPoint

Figure 1.

Vijay H. Aswani, MD, PhD. Professional portrait courtesy of Marshfield Clinic Health System.

Dr. Aswani was an outstanding physician, a humanitarian, and a dedicated researcher. He was also a friend. He left an indelible mark on anyone who ever met him, especially his patients, many of them with special needs, and their parents. Describing him just as an outstanding physician would be an understatement. He was far above that. Indeed, recurring feedback from his numerous patients was that “he was the best doctor I had seen ever” or “he was the best doctor ever to walk on earth.”¹ On his professional webpage at the University of Buffalo in New York², where he worked last, he shared his patient-seeing philosophy with a quote from a famous 20^th century physician, Francis W. Peabody, “The secret of the care of the patient is in caring of the patient.” To his patients and their caring family, he was more than a doctor, he was a doctor-friend with empathy who not only provided healthcare but also moral support during the most vulnerable time in their lives. It was very common for him to make rounds in the hospital to see his cystic fibrosis patients on weekends and on holidays even when he was not on-call or wheeling away his patient, if needed, to another appointment. He had genuine empathy for the suffering of his patients which had its genesis, perhaps, in his atypical, complex childhood.

Born in Lagos, Nigeria, to Indian, Sindhi parents, Vijay spent his childhood in Monrovia, Liberia, until the age of 10 when he was sent thousands of miles away to a boarding school in Panchagani, India, for his primary and secondary schooling to get him a good education.³ He told me that it was one of the most difficult phases of his life, and in his words, “How could someone leave a 10-year-old far away from his parents” (personal communication). His homesickness, unreachable distance from loved ones, dependence on 1970s postal communication system which would take weeks to reach its destination, coincidental friendship with the son of a pastor, and availability of a church nearby, catalyzed him to seek strength through faith, and by the age of 16, this born-Hindu boy told his parents that he had adopted Christianity. He devoutly practiced his faith unencumbered from influences from his medical education and basic research training until he took his last breath.

Vijay received his undergraduate and masters degrees, and in 1992, a Doctorate of Philosophy in biochemistry from the University of Bombay. After a stint of jobs, he joined the Medical University of the Americas in Nevis, West Indies, as an Associate Professor of Biochemistry. While still teaching, he convinced the administration to let him join the medical program and graduated with a medical degree in 2005. As they say, each person comes to the earth with a calling and only if he or she could find it. That medical degree at the age of 43, thirteen years after his PhD, was Vijay’s calling and gave him the mission of life he was born to follow. In his words, he provided “emphatic and expert patient care and forging long-term caring relationships with his patients and their families.” He lived and breathed his mission.

His humanitarian efforts in global public health were as exemplary as his clinical practice. While working for Marshfield Clinic, he volunteered for City on a Hill, an inner-city clinic in Milwaukee for the uninsured; Summer Camp Hozhoni in northern Wisconsin for children with cancer; and medical missions in El Salvador and to the Ngobe Indians living on the coast of Isla Bastimentos, San Blas, Panama. As if these efforts were not keeping him busy enough, in January and February of 2015, he joined Partners in Health to visit Sierra Leone to take care of pediatric patients with Ebola (Figure 2). I remember asking him, “Vijay, are you sure you want to do this knowing the immense personal risks involved?” He replied, “Sanjay, I am a doctor. It is my job. Plus, I was born in that region and I have a feeling for the place” (personal communication). Later, in a personal essays, he wrote, “I was moved to go for several reasons: I grew up in West Africa—I was born in Nigeria and lived in Monrovia, Liberia until age 10—and I was appalled by the death and fear of Ebola, unexpectedly, even by people in health care. When a building is on fire, most people run out—but firefighters, trained and prepared, go in. I felt that as a physician, I should be going to rather than running away from a disease.”^3,4 My conversation with Vijay that morning showed me there are Super Heroes among Heroes when it comes to practicing medicine. In order to volunteer to treat patients with Ebola, Dr. Aswani had to resign from his job with Marshfield Clinic, undergo six weeks of training and seeing patients followed by three weeks of quarantine, and then rejoin Marshfield Clinic to continue his medical career in the United States. Not surprisingly, he also volunteered to see patients with COVID-19 in New York in 2020, and he was preparing to visit a newly built hospital in Sudan, with one of his Sudanese patients, to help the ‘Lost Boys.’⁵ Truly, a doctor’s doctor.

• Download figure
• Open in new tab
• Download PowerPoint

Figure 2.

Vijay Aswani, MD, PhD, dons Personal Protective Equipment (PPE)—except the boots—during World Health Organization (WHO) training in Freetown, Sierra Leone. Photo and caption reprinted with permission. Copyright 2015 Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.

In addition to his extraordinary medical career, Vijay was an accomplished researcher. Seeds for his interest in bacteriophage therapy research were sown in 2006 after spending a week with hands-on time in Dr. Elizabeth Kutter’s Phage Biology Laboratory at the Evergreen State College in Olympia, Washington. He returned very excited and asked if he could do a Resident Research Project in my laboratory that focused on diseases caused by MRSA (methicillin-resistant Staphylococcus aureus) and try to identify the bacteriophages that could combat these bacteria. He set out to isolate bacteriophages from local sewage waste that could kill MRSA. While he was not able to isolate bacteriophages against MRSA, he did isolate and characterize two novel phages from the podoviridae and siphoviridae families that could lyse Staphylococcus epidermidis.^6-8 Vijay and I continued to collaborate until his untimely death. Ironically, his last publication, “An Early History of Phage Therapy in the United States: Is it Time to Reconsider?”⁹ came out a day before his passing. His excellence in research and teaching earned him several awards including, but not limited to, the Nikolai Award for Outstanding Resident Research (2009), the Joseph J. Mazza Teaching Award for Excellence in Combined Internal Medicine-Pediatrics Education (2012), and the Louis A. Ruth Siegel Award for Excellence in Teaching (2019).

While working at Marshfield Clinic, Tuesdays were Vijay’s research days and invariably he would call me from the Cattails Café to ask whether he should get a coffee for me, as well, before walking over to my office. We would discuss our projects, work on rescuing manuscripts after review, or grant applications. We mostly conversed in English, neither of ours’ mother tongue, with occasionally Vijay switching to Hindi to share some self-deprecating Sindhi humor; he had a regular persona, too. Despite not being on call, his pager would constantly be buzzing. After a couple of hours, he would leave by saying, “we are short staffed today; they need me in the clinic.” And then he will be gone for a week, sometimes weeks and even months — who knew this time it would be forever?

The profession of medicine lost one of its most ardent servants on 27 June 2021. This world was a lot better place with Dr. Vijay Aswani in it as a physician caring for special needs patients, comforting families, and volunteering to treat patients with deadly diseases like Ebola and COVID-19. Rest in peace, Vijay.

• Received July 9, 2021.
• Accepted July 26, 2021.