In 1975, UMass Chan Medical School was still very much a fledgling institution and University Hospital would not be open for another year. Jim Dalen, MD, a cardiologist, who had been a faculty member at Harvard Medical School and the Peter Bent Brigham Hospital, was one of several of the first department chairs of UMass Chan who came from Boston to be a part of this exciting new “Worcester Medical School.”¹

Dalen builds a service from the ground up

As a founding faculty member and chair of the Department of Cardiovascular Medicine, Dalen faced the immediate challenges of building a clinical department, getting patients to come to the newly built hospital, and jump-starting revenue for the clinical service.¹ He initially recruited faculty who had been on his Cardiology service at the Brigham. Ira Ockene, MD, professor emeritus of medicine, and John Howe, MD, were among his first recruits. “I thought Jim was an extraordinary person,” said Ockene, who ran the cardiac catheterization lab and worked with him closely for many years. Howe added, “At that time, there was no hospital—it was still under construction, but Jim was set on building a nationally recognized program in cardiology…and it would become the cornerstone of what would be a major academic medical center.” Howe further reflected on the grassroots efforts Dalen led in the early days: “At that time, doctors from central and western Massachusetts would have to take a day off from work to travel to Harvard in Boston to get CPR certified. Jim decided that he and his cardiologists from the medical school would go out to the community hospitals and train the doctors on site.” These relationship-building efforts of Dalen and his small, but highly dedicated, faculty were essential to creating pathways for patient referrals, thus driving patients and future revenue streams to the newly established University Hospital.  

Visionary leadership shapes a department and shines a light on innovative work

A few years later, in 1978, Dalen would become the chair of the Department of Medicine and the Department of Cardiology would subsequently merge with Medicine. As chair of Medicine, Dalen was a visionary leader in all three of the fundamental mission areas: education, research, and clinical care. Joel Gore, MD, professor emeritus of medicine, remembered Dalen’s commitment to interns and residents. “[Dalen] was insightful,” said Gore. “He knew more general medicine than any person I ever knew. He was always out on the wards talking to the interns and residents and making us feel wanted and needed and cared for.” Dalen’s office door was always open and he was willing to talk through questions and issues at any time. Gore further recalled a funny but “classic Jim” story about a study that he and Robert Goldberg, PhD, professor emeritus of population and quantitative health sciences, later conducted. He explained that at some point earlier in Dalen’s life, he had been told that he was going to be at higher risk for heart disease because he had a crease in his earlobe. Dalen was not convinced about this possible association, however, and at his direction, Gore and Goldberg studied several hundred patients who came into the hospital with and without earlobe creases. “We were able to disprove that people with earlobe creases had an increased risk of heart disease and wrote a paper about it,” said Gore. “[Dalen] ended up on all the talk shows about it. Everybody was just enamored with this whole thing about earlobe creases. That paper probably got more attention than any other study I published throughout my career.”    

Dalen establishes foundation for preventive and integrative medicine at UMass Chan

Dalen was a pioneer and champion for preventive and integrative medicine at the UMass Chan and the medical center, and believed strongly in the benefits of preventive assessment and care in medicine. He had been the principal investigator for the Harvard site of the Multiple Risk Factor Intervention Trial (MRFIT), which was one of the earliest seminal clinical trials on heart attack prevention.¹ In 1983, in collaboration with Judith Ockene, Robert Goldberg, and Jon Kabat-Zinn, Dalen would go on to establish the Division of Preventive and Behavioral Medicine. Judith Ockene, PhD, professor emeritus of population and quantitative health sciences and medicine, who served as chief from the division’s inception until 2018, commented, “Jim always had a vision of where things should be or could be. He said, ‘Medicine should have an epidemiologist and a focus on prevention’—and he was right, but that was far ahead of its time. No other medical schools at the time had preventive and behavioral medicine as part of a department of medicine.” She continued, “And then, of course, there was Jon Kabat-Zinn and the stress reduction program.”  

Indeed, Dalen had hired an epidemiologist for Medicine, Robert Goldberg, PhD, who started in Cardiology, but eventually joined the Division of  Preventive and Behavioral Medicine. “[Dalen’s] innovativeness, creativity, and willingness to try something new, were part of what was so great about him,” said Goldberg. “When I came for my initial interview at UMass Chan in 1981, Jim was sitting across from me at his desk smoking a pipe. After about 20 minutes of talking, he said, ‘I think we've got enough, let's go on rounds…let's meet some people.’ So, I am sitting there thinking, ‘You know I'm not a physician…did you even look at my C.V.?’,” Goldberg remembered with a laugh. He continued, “But after we went on rounds, we went back to his office and right then and there, he asked what I wanted to do for my research and I told him I wanted to extend my doctoral dissertation into doing community surveillance for heart disease and maybe other types of cardiovascular diseases.” That was the beginning of Goldberg’s career at UMass Chan and the foundational discussion that led to the Worcester Heart Attack Study which was initiated and supported by Dalen, Gore, Goldberg, and Joseph Alpert, MD, another prominent cardiologist that Dalen had recruited when he came to UMass, who served as chief of the Division of Cardiovascular Medicine, before leaving for the University of Arizona. Goldberg and Judith Ockene also went on to secure a multi-million dollar grant to develop smoking prevention programs and other innovative prevention programs, always with Dalen’s blessings and enthusiastic support. Dalen, as Ockene astutely remarked, “had a wonderful way of getting different kinds of people together—he just had an unbelievable way of seeing things and how they could be.”

The sky was the limit

Dalen’s vision for Medicine seemingly had no limits. Case in point: The Stress Reduction and Relaxation Program. Jon Kabat-Zinn, PhD, professor emeritus of medicine and founder of the Mindfulness-Based Stress Reduction Program (MSBR), was a PhD-trained molecular biologist from MIT, who was a postdoctoral fellow in Rob Singer’s lab in the Anatomy Department at UMass. In the fall of 1979, he started a stress reduction and relaxation program originally housed as part of the physical therapy department. “During the first cycle of the program, I was sitting in my basement office when in walks Jim Dalen in his white coat and a stethoscope around his neck. He plunked himself down in a chair while introducing himself as the chair of Medicine,” recalled Kabat-Zinn. Dalen asked what he was up to, and Kabat-Zinn explained that he was teaching people meditation and yoga to help them reduce their stress and hopefully stay out of the hospital as a complement to whatever traditional medical care they were receiving. “And [Dalen] said to me, ‘OK, this sounds really great. I get you're trying to teach people to be healthier and to use this meditation and yoga,’ which at that time were wildly foreign concepts,” said Kabat-Zinn. He continued, “he was very accepting because nobody knew what it was about. And he said, ‘OK, so you're going to do this and I want you to keep good records,’ which of course I knew. Being trained as a scientist, there was no question I had to do outcome studies and publish any interesting results.” Since 1979, more than 25,000 people have completed the evidence-based MBSR training at UMass,² and it is now taught and incorporated in hospital and clinical settings all over the world. 

Pioneering spirit leaves a rich legacy 

Dalen continued as chair for the Department of Medicine and later served as interim chancellor before he left UMass Chan in 1988 to go to the University of Arizona. There he would serve as dean of the College of Medicine for thirteen years and as vice president for Health Sciences for seven years before he retired in 2001. Of his impact at UMass Chan and the medical center, T.J. FitzGerald, MD, chair and professor of Radiation Oncology at UMass Chan/UMass Memorial Health remarked, “No one during that era was more influential in developing the academic and clinical reputation of our medical school than Dr. Dalen. He was an icon and beacon that defined excellence and fostered excellence in all who knew him.” FitzGerald, who earned his medical degree at UMass Chan, continued, “He recruited outstanding faculty and ensured that our education was far greater than the sum of the parts of our clinical and academic work. He wanted UMass to be the best institution it could become and succeeded in aligning all who knew and worked with him to focus on that singular mission. He made all of us better physicians and I personally enjoyed each moment with him.”

Dalen passed away on January 16, 2024, in Oro Valley, Arizona, but leaves behind a legacy of a pioneering spirit, unwavering advocacy for his faculty and trainees, and a vision for how medicine could and should be practiced. These enduring core values continue to inspire us in the Department of Medicine today as we envision new ways to practice medicine, conduct impactful research, and teach the next generation of clinicians and researchers. 

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Author’s Note

I would like to extend my sincere appreciation to many of Dr. Dalen’s former colleagues who generously shared their time and memories with me. In particular, I would like to thank Drs. T.J. FitzGerald, Rob Goldberg, Joel Gore, John Howe, Jon Kabat-Zinn, and Ira and Judy Ockene. Some of their stories have been shared in this tribute and some will have to remain part of the lore of the 1970s and 1980s at UMass Chan and the medical center—but all are dearly treasured. 

Of note, when I spoke with Dr. Howe, he shared that when he thinks of Jim, a famous speech that President Theodore Roosevelt gave at the Sorbonne comes to mind. Here, I leave you with this excerpt from President Roosevelt’s speech:

"The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows the great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly…”³

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References 

1. More, E.S. The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research. Lamar Soutter Library, University of Massachusetts Medical School, 2019.

2.  Center for Mindfulness, UMMH MBSR 8 Week Online Live. [cited 2024 April 1] Available from: https://www.ummhealth.org/umass-memorial-medical-center/services-treatments/center-for-mindfulness/mindfulness-programs/mbsr-8-week-online-live.

3. Roosevelt, T. Address at the Sorbonne in Paris, France: "Citizenship in a Republic". 1910 [cited 2024 April 1] Available from: https://www.presidency.ucsb.edu/documents/address-the-sorbonne-paris-france-citizenship-republic