Brian Patrick Kavanagh (1962–2019): An Appreciation

Dr. Brian Kavanagh of the Department of Critical Care Medicine at the Hospital for Sick Children in Toronto sadly died in June 2019. His colleagues around the world will remember him as a critical care physician who excelled in everything he did, an illustrious medical career that was cut short all too soon. He was an outstanding clinician, teacher, and researcher, as well known in the world of adult critical care medicine as he was in pediatric critical care. It is a cruel irony that in the month that he died, it was announced that he had been awarded one of the highly coveted tier 1 Canadian Institutes of Health Research career investigator awards, positions funded by the Canadian government for outstanding researchers acknowledged by their peers as world leaders in their fields. What was remarkable was that he managed to achieve this during his terminal illness. Brian graduated in medicine from the University College of Dublin in 1985 and, following his internship, did 3 years training in internal medicine in Ireland. He moved to Canada in 1989, having been accepted into the University of Toronto anesthesia training program. Following completion of this, he moved to Stanford to take up a fellowship in critical care medicine, returning to Toronto General Hospital in 1995 as a staff anesthetist and intensivist. He began what was to be a distinguished academic career by setting up his laboratory there and attracting the first of many research fellows from different parts of the world to do basic science research. It was our great good fortune at SickKids that Geoff Barker managed to persuade him to cross the street in 1999 and join the Department of Critical Care Medicine and the Research Institute at the hospital. It was to prove to be an inspired decision as he went on to develop a stellar research career in the investigation of the mechanisms of acute lung injury, while at the same time he was able to retain his skills as an insightful and knowledgeable clinician and teacher. To be present at rounds in the ICU while he took the fellows through a teaching point in physiology was a privilege for all present. He was always in great demand as a faculty member at various national and international symposia and many will attest to the brilliance and clarity he brought to his presentations at these conferences. Given his Irish background, he loved a good argument, especially when it came to “guidelines” or “protocols” in critical care medicine. He also proved to be a very able administrator and from 2006 to 2017, served as Chair of the Department of Anesthesia at the University of Toronto, during which he introduced significant changes resulting in a considerable rise in its academic profile. Although he was a man of many talents, one of the lesser known outside his family and close friends was his skill as an exponent of traditional Irish music. He was a very accomplished performer on that uniquely Irish instrument, the “uilleann” pipes, which are somewhat akin to the Scottish bagpipes. I have a very clear recollection of him playing the pipes in front of an audience of several thousand at the opening ceremony at the World Congress of Intensive Care Medicine in Sydney in 2000. He played a haunting Irish melody while beautiful pictures of Ireland were projected onto a screen behind him. A truly memorable occasion. Brian’s music was enormously important to him as was his Irish family and cultural heritage. He was a regular performer at Dora Keogh’s pub on the Danforth in Toronto and went regularly to perform in New York, where there is a very vibrant traditional Irish music scene. He was also deeply steeped in his country’s language and literature, particularly the poetry of William Butler Yeats. Shortly after Brian’s passing, a celebration of his life was held in Toronto. At a standing room only affair and amid laughter and tears, many people spoke of his many qualities as a father, spouse, partner, brother, work colleague, and caring physician. What shone through most of all was the man’s kindness and humanity, as well as the courage with which he faced his final illness. Despite his many pursuits and career accomplishments, one constant and the greatest pride and joy in his life were his two daughters Afric and Dáire. A life well lived. His passing is a loss to both SickKids and the wider critical care community. Ar dheis Dé go raibh a anam (May he rest in peace).

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