In 2011, after catching up on each other's lives in a taxi, Emmet turned to us with his inimitable impish grin and said, “You know, we are blessed. Life is great!” After his unexpected death on August 8, 2011, following a catastrophic cerebral hemorrhage, those of us who were fortunate to know him well also recognized that the greatness of Emmet's life and work had had a profound impact on us all and on the field of gastroenterology and hepatology. Perhaps the most important attribute of Emmet was how much he excelled in each of life's dimensions—as a husband, father, friend, doctor, and academician. At the time of his death, Emmet and Melenie had been married for 45 years and were the proud parents of three successful children. In addition, they were dedicated grandparents to eight grandsons, the youngest born in August, 2011. Emmet and Melenie greatly enjoyed gathering the extended family at their Lake Tahoe vacation home for skiing in the winter and boating and fishing in the summer. Emmet was devoted to his family, as each of them was to him, and to his mission in life of serving others. The love and closeness of his family were inspirational to all of us who had the honor of attending his memorial service in San Francisco.
As a true friend, Emmet had no peer. He was a warm, sharing individual with whom everyone felt comfortable and able to be natural without pretense or formality. At his core, Emmet thoroughly loved people and thrived whenever he had the opportunity to build new or solidify old relationships. He respected all people and sought to understand them more than he sought to be understood. His professional life was a reflection of his love of humanity, dedication to the service of others, and devotion to the generation and communication of new knowledge.
Emmet was born in San Francisco on April 12, 1942. The foundation of Emmet's balance and success included a loving family that emphasized humanism, education, and athletics. The untimely death of his father thrust additional family responsibilities upon Emmet, who was a sophomore at St. Ignatius High School in San Francisco at the time. As the oldest child and only son, he was an admirable role model as a student in the Honors program and a varsity swimmer. He studied both Latin and Greek, which he credited with kindling an enduring love of language and writing. He obtained a BS degree in Biology as well as a degree in education from the University of San Francisco, a school that challenged his intellect and allowed him to remain close to his mother and three younger sisters. While tempted to pursue dentistry, as had many of his relatives, his uncle John Bryan, MD, Chief of Radiology at St. Luke's Hospital in San Francisco, redirected him to medicine. Emmet obtained his MD degree from Creighton University School of Medicine in Omaha, NE, thereby completing a trifecta of Jesuit education.
Emmet completed his residency in internal medicine and became chief medical resident and then a fellow in gastroenterology at Oregon Health & Science University (OHSU) in Portland. There he began a lifelong friendship and collaboration with David A. Lieberman, MD, who later became Chief of the Division of Gastroenterology at OHSU and President of the American Society for Gastrointestinal Endoscopy (ASGE). Emmet's primary mentor at OHSU was John Benson, Jr, MD, Chief of the Division of Gastroenterology, who went on to become President of both the American Board of Internal Medicine (ABIM) and American Gastroenterological Association (AGA). He helped Emmet craft a vision of a career as a clinician-investigator and impressed upon him the importance of explicit training in research, which he pursued as a fellow in gastroenterology at the University of California, San Francisco (UCSF), under the direction of Rudi Schmid, MD, immediately after completing service as a medical officer in the US Navy in Oakland, CA. Emmet thrived under the mentorship of Bruce Scharschmidt, MD (later editor of the Journal of Clinical Investigation, President of the American Society of Clinical Investigation, and Chief of the Division of Gastroenterology at UCSF) and Robert Ockner, MD (later Chief of the Division of Gastroenterology at UCSF and President of the American Association for the Study of Liver Diseases [AASLD]).
After he returned to OHSU as a junior faculty member, Emmet's subsequent investigative career gravitated to clinical research, and his love of hepatology, kindled at UCSF, became his lifelong passion. While ascending to the rank of professor of medicine at OHSU, it became clear that Emmet was a consummate “triple-threat” academician with strengths as a clinician, clinical researcher, and educator. In addition, he was also an excellent administrator. His patients revered him, and his research was impeccably conducted, critically analyzed, and lucidly reported. He flourished as an educator of students, house officers, fellows, and community physicians and was awarded several prestigious teaching awards. His research contributions spanned the breadth of gastroenterology and hepatology (from flexible sigmoidoscopy to liver transplantation) and brought enlightenment to numerous areas of study. He had a particular interest in the treatment and prevention of viral hepatitis. His book chapters and reviews set high standards for scholarship, and he had a particular ability to distill information with great clarity on diverse topics for the healthcare professional. Given his charismatic personality and love of people, his leadership style was marked by building consensus and solidifying commitment among all stakeholders. His expertise in hepatology and his ability to build consensus resulted in his co-founding of a highly successful liver transplantation program at OHSU.
All of these skills and achievements led Emmet to be the top choice of Martin Brotman, MD (later President of the AGA) to lead a new initiative in hepatology and liver transplantation at California Pacific Medical Center (CPMC) in San Francisco, in collaboration with a premier transplant surgeon, Carlos Esquivel, MD. The decision to join CPMC was a difficult one for Emmet because it meant leaving an academic setting for a private hospital and potentially compromising the development of liver transplantation at OHSU. He reached out to many of us to discuss this opportunity and accepted the CPMC offer only after he was convinced that the OHSU liver transplantation program would prosper after his departure. In our discussions, Emmet always placed the needs of OHSU above his own, displaying an unselfish loyalty to both the institution and to his principles. Together, Emmet and Carlos created a successful liver transplantation program, established an internationally recognized presence in hepatology, and helped reinvigorate gastroenterology at CPMC. Emmet and his colleagues also pioneered the practice of sending hepatologists to underserved communities to provide a tertiary level of care in outreach clinics throughout Northern California, Oregon, and Washington State. Despite the intensity required to execute the clinical mission, Emmet also developed a robust clinical trials unit within CPMC with the help of Robert Gish, MD. The productivity and success of that unit provided patients with the options of investigative care as well as state-of-the art conventional care.
In the mid-1990s, Stanford University School of Medicine and the Stanford Medical Center dedicated resources to establish a preeminent liver transplantation program. To achieve this goal, they recruited nearly the entire CPMC team, with Emmet and Carlos Esquivel as Co-Directors of the Liver Transplantation Program. Emmet was also appointed Chief of Hepatology and Director of the Fellowship Program in the Division of Gastroenterology and Hepatology. Thus, Emmet and colleagues took on the responsibility for “all things liver” at Stanford. As anticipated, Emmet excelled once again in patient care, clinical research, the training of students, house staff, and fellows, and administration. While at Stanford, his contributions to the medical literature soared, and he continued to produce lucid reviews and chapters about often controversial topics. With Lawrence S. Friedman, MD, Emmet also co-edited a highly acclaimed Handbook of Liver Disease, the third edition of which was published on the day of his death. The final tally of publications by Emmet was well over 700.
Between 2008 and 2011, Emmet became an emeritus Professor at Stanford and began working part-time as Vice President and Chief Medical Officer at Romark Laboratories, LC, to develop a new therapeutic agent for hepatitis C. Subsequently, until his passing, he served as Principal Medical Fellow at Vertex Pharmaceuticals, Inc, to advance the use of new antiviral therapies. His affiliation with industry allowed him to pursue his passion for improving the care of patients with viral hepatitis and educating physicians about new therapeutic agents.
Emmet provided invaluable service in wide-ranging leadership and editorial positions in gastroenterology and hepatology. He was the 1995–1996 President of the ASGE and the 2004–2005 President of the AGA. He was a member of the Board of Directors of the American Liver Foundation (1991–1995) and the American Digestive Health Foundation (1994–2001), for which he served as Vice Chair of Public Health Programs and Chair of the Digestive Health Initiative. He was a member of the Board of Directors of the AGA Foundation for Digestive Health and Nutrition, a member of the Board of Directors of the Northern California and Nevada Division of the American Liver Foundation, and Chair of Digestive Disease Week Council (2000–2002). He was a member of the Subspecialty Board on Gastroenterology of the ABIM (2001–2007) and Chair of the Gastroenterology Board and a member of the ABIM Board of Directors in 2007. Emmet's peers regularly selected him for listing in The Best Doctors in America, and he was inducted into several honorary societies, including Alpha Omega Alpha Honorary Medical Society, the North Pacific Society of Internal Medicine, and the Pacific Interurban Clinical Club. He was honored with Mastership in the American College of Physicians, Honorary Fellowship in the Royal College of Physicians of Ireland, and Honorary Fellowship in the Royal College of Physicians of United Kingdom. He was also a Fellow of the AGA, the ASGE, and the American College of Gastroenterology. In 2004, Emmet joined the American Clinical and Climatological Association. He and Melenie loved the meetings and appreciated the traditions of the organization and camaraderie of the members.
Emmet, the consummate communicator, was heavily involved in medical publication. He was an associate editor of Liver Transplantation and Surgery (1995–1999), Digestive Health & Nutrition (1999–2004), and Reviews in Gastroenterological Disorders (2006–2007) and was section editor of liver transplantation for Current Opinion in Organ Transplantation (2000–2007). He was editor-in-chief of Current Hepatitis B Reports. At the time of his passing, he was editor-in-chief of Digestive Diseases and Sciences, into which he put tremendous energy to improve the quality and stature of the journal. He was also honorary editor-in-chief of the World Journal of Gastroenterology and executive editor of GastroHep.com. He served on the editorial boards of Gastroenterology, Revista de Gastroenterologia de México, Minerva Gastroenterologica e Dietologica, Gastroenterology & Hepatology, Therapy, The Open Hepatology Journal, and World Journal of Hepatology. He was a member of the editorial boards of Hepatology (1993–2006), the official journal of AASLD, and the Journal of Hepatology (2000–2007), the official journal of the European Association for the Study of the Liver.
Emmet was a magnificent mentor, and his numerous disciples have provided moving tributes to his warmth, compassion, empathy, work ethic, integrity, grace, and wisdom. He led by example and consensus-building, was generous in his praise of others, and was always humble about his own accomplishments, which were prodigious. He was an international ambassador of gastroenterology and hepatology, yet wholly devoted to his family, friends, and closest colleagues. Emmet was truly beloved, and he truly loved life and was always thankful for the opportunities he had been given. He deeply loved his wife Melenie and his family, whose grief we share. Medicine has lost a giant, and we have lost a great and precious friend.