Write this Down: Remembering Sir A
A tribute I wrote for one of the greatest and most legendary physicians I've had the pleasure of knowing. Rest in peace, Dr. Raymond Alonso
The first time I met you, I was a lowly student nurse in the old central ICU, fumbling over my patient’s morning medications. I lingered quietly in the corner when I heard your booming voice from the nurses’ station. You were discussing a patient with your renal fellow. You instructed him to write your orders word for word in red, blue, and black. “That’s just how he is,” the nurses tell me. You were always famous, something of a PGH version of Dr. House, with an uncanny grasp of physiology (but without the cane or the gruff bedside manner). Even then, you were an unforgettable and charismatic character.
Fast forward to med school, I met you again in a small group discussion in Biochemistry. Your posture commanded respect and attention, and our group was stunned to silence as you entered the room, Coke Light in hand. The silence didn’t last long, though, as you soon amazed us with your knowledge and entertained us with your jokes. The discussion ended in thunderous applause. I would meet you again in your renal physiology lectures. These lectures were uniquely yours, always with a punchline, always crystal clear when you taught us. Your unparalleled intellect sparkled brightest in the classroom.
As residents, or “MRODs” as you called us, we knew you for your zombie rounds and electrolyte cocktails. You were always quick to reply, even in the middle of the night, ranging from “Ok, thanks” to, in all-caps, “DON’T TOUCH MY FLUIDS.” We knew better than to mess with your electrolytes. We were happy to relay potassium trends to you, which were rewarded with step-by-step instructions and concoctions like a Potions Master. Occasionally, you would ask us to call your landline number, and, after we endorsed the patient, you would say, “Alright, Ella, get a pen and paper. You have one? Okay, write this down.” Your chart entries were as informative as they were amusing—from the time you called my batchmate’s handwriting uremic and encephalopathic, to when you asked your renal fellow to write, after being particularly stumped by a patient’s illness, “To Gastro service: Could this be kulam?”
Even during the pandemic, you made your presence felt. You were one of our consultants in the ever-dynamic COVID ICU. We conducted Zoom endorsements twice a day—once in the morning and again in the evening—so you could test whether your morning interventions were effective. We didn’t need to remind you about each patient; you already knew them by heart. You inspired us to go above and beyond, because that’s exactly what you brought to the table. You were a team captain in the truest sense of the word.
When we learned you were sick, we imagined we’d see less and less of you, but in between your own admissions and blood extractions, you still managed to do rounds and see patients. One day, I would see you walking the halls with your physical therapist, and in a few days, you’d be in the halls again, but this time doing rounds with your renal fellow, not far from when I first saw you more than fifteen years ago. No one could keep you from doing what you loved, it seemed. Seeing patients and teaching your trainees energized you in ways that disease could not destroy.
The last time we spoke was six months ago. I was already an endocrinology fellow then, and we were co-managing a patient whose sodium went through the roof. I, ever terrified of sodium, was already panicking, but you remained calm and discussed the case with me. I was still nervous talking to you, but you spoke to me like a colleague, listening to my thoughts and considering my suggestions.
I didn’t choose nephrology for a subspecialty, but let it be known that I considered it briefly, largely because you made it sound so fascinating. By now, hundreds of trainees and mentees have posted their salutations and gratitude—a lifetime of lessons, stories, and jokes. I am but an onlooker, a student nurse who lingered in the corner, a med student who laughed at your jokes, an MROD who wrote down your fluid orders, a doctor who will forever be changed by being part of your audience. And I know I’m not alone. We spoke only a handful of times, and I’m not sure if you remember me, but I guess that’s the demographic I want to represent: the many, many people you’ve influenced without you even knowing. It doesn’t take much to be amazed by you. You captivated every room you entered. You entertained us with your sharp wit and a humor that only you could deliver. Always enigmatic, with a flair for the dramatic.
Whether we were med students, residents, fellows, colleagues, or even casual listeners at our weekly mortality audits, we always learned something from you. Not just how to correct electrolytes or how renal tubular acidosis works, but more importantly, how to talk to a patient, how to think critically, how to honor both life and death. I’ve always known you were a master of physiology, but I’ve come to learn that you’re a greater master of humanity, persistent in your care as you are in your curiosity. You often joked that cardiologists and nephrologists collide, but the joke’s on all of us, because you not only mastered the kidney, but it turns out you have the biggest heart of all.
You will always be remembered, for how could we forget a man like you? Brilliance only exceeded by humanity, humor only surpassed by heart. The greats always have nicknames, and you will always be Sir A to us. We will be telling your tales for years to come, honoring the legend that you are. May you have all the Coke Light the afterlife has to offer.
