Medical dean bids farewell
By Beverly Creamer
Advertiser Education Writer
The first hint that something was wrong came about two years ago, when Dr. Edwin Cadman rose to speak at a medical school conference at Ko Olina.
Rebecca Breyer • The Honolulu Advertiser
He couldn't find the words.
With the UH medical school in Kaka'ako as a major accomplishment, Dr. Edwin Cadman looks to a future of reading and running.
"I just couldn't think of the right words to say," he remembered. "I was giving a talk and I couldn't find the words."
That moment was the beginning of a journey that brought the dean of the John A. Burns School of Medicine to this point in time.
The soft-spoken man with the enigmatic smile had just a few moments earlier told the leaders of his university that he suffers from a neurological degenerative disease called primary progressive aphasia, a form of dementia that robs people of their speech — and slowly of their minds.
His voice shook. He was telling them about the end of the life he knows now — and about the hope he has given the University of Hawai'i as architect of the new medical school in Kaka'ako.
As he finished, members of the UH Board of Regents and others rose in spontaneous applause.
The regents and university president acknowledged the medical school dean with accolades as Cadman stood there, resigning the position he had held since 1999. He told them he would try to serve for an unspecified time as a tenured faculty member.
His medical condition will be monitored constantly, he told them, and he will be evaluated every six months, if not more often.
"I don't want to embarrass the university, my medical school, nor myself," he told the regents, almost breaking down.
When it is time to leave, "I will know," he said during an interview after his announcement.
Cadman stared straight ahead, his face expressionless as he spoke of his future.
No, he is not angry, he said, answering with one word.
No, he is not afraid, answering again in a single word.
And, yes, he will go on running, maybe even do another marathon, and read with an intensity he's never had before. He will read aloud and to himself, keeping a journal as he does so. His doctors say it might help, though there is no known treatment for the disease.
Some early signs
Cadman talked slowly about the progression of small problems he noticed, long before he knew anything was seriously wrong.
Rebecca Breyer • The Honolulu Advertiser
That first struggle to find the right words would continue, though at first he thought it was because he was tired and had gotten up early.
As UH medical dean, Dr. Edwin Cadman was instrumental in building a new medical school in Kaka'ako. Cadman resigned yesterday, citing health reasons.
But it happened a few months later. Then again and again.
"It was just a word-finding problem," he said, and he didn't seek medical consultation.
But when he visited former colleagues at Yale in November, the discrepancies in his speech were clearly noticeable. It was a trip that occurred in the aftermath of the October flood that heavily damaged parts of the UH-Manoa campus, including the medical school. Labs were flooded and power throughout his building was knocked out.
"I'd been up for 36 hours," he said, "and some people hadn't seen me for five years and they noticed — 'What the heck was going on?' "
That's when, he said, "I thought I had a brain tumor."
Cadman, who turned 60 in May, told The Advertiser that he kept his medical condition confidential until he had a definitive diagnosis — which came in March — and so he could think through his future.
His condition and prognosis have been a carefully guarded secret — and the subject of rampant speculation.
"I needed to think about my condition and not hurry with my life decisions — going back to the medical school as dean or not," he said.
In the end, he decided he had to step down.
"I'm a very public person and I get asked media questions ... and asked to present my thoughts on a daily basis and I don't want to embarrass myself or the medical school," he said.
Diagnostic process
In December, Cadman received a preliminary diagnosis at the Memorial Sloan-Kettering Cancer Center in New York. It was later confirmed in March by more tests at Northwestern University Medical Center in Chicago, which 20 years ago was the first to identify the disease and is considered at the forefront of research on it.
The progressive disease causes gradual decline in thinking ability, but impairment may remain confined to language difficulties for as long as 10 to 14 years. In other cases, far sooner there may be impaired reasoning, judgment and memory. However, the disease generally does not impair daily living and, in fact, patients generally maintain core memory and are able to continue with hobbies and recreational activities.
While medical literature notes that there is little to stop the progression of Cadman's condition, including cognitive and even behavioral and personality changes, some sufferers learn sign language as a way to communicate. Cadman said he has not started doing that, although he said the disease can leave a patient mute.
Cadman has always been known as a masterful athlete and distance runner, a familiar figure loping along Hawai'i roadways training for marathons, triathlons or other endurance races. He ran his first marathon at age 36 and has done a dozen since then and says he thinks he'll be able to do another — either Boston or Honolulu — in the next couple of years. Currently he has a hamstring injury and is biking four or five days a week while it heals.
During his short tenure in Hawai'i, Cadman has been widely credited with rejuvenating a foundering medical school, assembling a cadre of prestigious researchers and helping set the university — and the state —Êon a course toward biotechnology and cutting-edge medical research that could pay dividends for years to come.
He was the highly regarded chief of staff at Yale-New Haven (Conn.) Hospital in 1999 when he was lured here. He set out to make the UH medical school one of the nation's best, and now, ensconced in a $150 million Kaka'ako campus and riding a wave of new federal grants and contracts, the school may be poised to achieve that distinction.
"There are few leaders in this university's history that have made the difference that Ed has made to the medical school and our community," said interim UH President David McClain.
Sam Shomaker has been acting dean of the medical school since Cadman went on medical leave in February, and McClain said he intends to appoint Shomaker as interim dean for at least a year until a search can be conducted for a new dean. Cadman said he has great trust in Shomaker, who he said is doing an "outstanding job."
Shomaker said it is Cadman who "has moved the medical school forward in very significant ways and is the one who had the vision of a research institution and launched us on that path."
Cadman's salary as dean was $330,000 a year, with a $100,000 annual bonus if he stayed for five years. His new salary will be set by the regents, and he said he will leave his $500,000 bonus in a fund managed by the UH Foundation until the time comes when he leaves the university.
Still part of UH-Manoa
There had been much discussion about making the new medical school the 11th campus in the UH system, but McClain recommended that the board maintain the new school as part of the Manoa campus for the next few years.
At times during his announcement, Cadman was too overcome to continue.
"When I came to Hawai'i in November 1999, the state had (as) one of its goals to diversify the economy with the biotechnology industry," he told regents. "I articulated the state's vision for this industry. It is your vision, not mine: Embrace it, surround it and build it. The renaissance is happening in Kaka'ako."
But the regents and McClain said it was Cadman who took the vision of a viable and healthy medical school and made it a reality. Patricia Lee, outgoing chairwoman of the Board of Regents, who ends her term on the board this month, was visibly shaken at Cadman's disclosure.
"I'm having a hard time," she said, her words failing before she regained her composure.
"The medical school is a testament to your leadership and it will remain. ... You really galvanized our community and we thank you. You will never be forgotten."
Reach Beverly Creamer at bcreamer@honoluluadvertiser.com or 525-8013.
