One Sunday during the first surge of COVID-19 in Boston, Dr. David F.M. Brown, exhausted, scared, and lonely, sat down at his computer and started typing.
Brown was chair of the emergency department at Massachusetts General Hospital, where doctors and nurses were scrambling to care for 200 COVID patients. He knew it would get worse.
“The days and weeks ahead will be difficult,” he wrote to his staff on April 5, 2020. “We will be severely tested in many ways.”
In another message several weeks later, he tried to rally his weary workers. “We can take heart in the firm assurance that collectively we are meeting the greatest challenge of our time,” he wrote.
Those e-mails to the 650 people who work in MGH’s emergency department became a weekly ritual, designed to inform and sustain front-line workers through their fear and grief. And they offer a window into how Brown may tackle his latest professional challenge: leading the world-renowned medical center into a new era of collaboration with its sister hospital, Brigham and Women’s, and the system that they anchor, Mass General Brigham.
Brown became president of MGH last week, taking the helm with recent and vivid memories of treating suffering patients and toiling beside other doctors and nurses through the unrelenting pressure of the pandemic.
During his many years in the emergency department, Brown became known for communicating important information, even when the news was unpleasant or complicated, and for making time for friends and colleagues despite a packed schedule.
“He has this ability when you’re talking with him [to make you feel] that you are the most important person to him at that point in time,” said Jonny Kim, an astronaut who trained as an emergency doctor with Brown until he joined NASA in 2017. “He gives you his full attention, and he makes you feel very special about the work you do and the person you are.”
Brown succeeds Dr. Peter Slavin, who was president of MGH for 18 years and whom Brown considers a mentor. In addition to overseeing the hospital, Brown is an executive vice president who will work closely with Mass General Brigham’s CEO, Dr. Anne Klibanski, to combine clinical services and create a more integrated hospital system. This includes better aligning MGH and the Brigham, which have remained friendly rivals for decades despite belonging to the same system.
It is a delicate challenge. He must balance the proud legacy of MGH — which this month marked the 200th anniversary of its first patient — with the ambitions of the larger system.
Brown, 58, came to MGH as an intern in 1989 and never left. He has taken care of patients almost the entire time, learning to juggle shifts in the emergency department with growing leadership responsibilities.
Running the emergency department through the pandemic reinforced what was important to him, he said: to keep “the patient at the center of every discussion and as part of every decision, and focusing on the well-being of our staff, who are our greatest resource.”
Brown, who has a wife, two adult children, and a grandson born during the pandemic, admits to feeling isolated and fearful early in the COVID crisis. He lived alone for several months to protect his family in case he became infected.
He didn’t sleep well. When COVID dreams roused him, he checked how his colleagues were managing. “People started getting used to being texted by me at 2 o’clock in the morning,” he said. He cleared his head during long walks along the Esplanade almost every day.
As MGH filled with hundreds of seriously ill COVID patients in the spring of 2020, Brown used his weekly memos to share the latest data and to thank the staff for their work. He acknowledged their fear and fatigue and admitted that he, too, was struggling.
Dr. Susan Wilcox, vice chair for clinical affairs in the emergency department, said the messages provided comfort at an unnerving time.
“We never felt we were on our own,” she said. “We never were left questioning what the next steps would be. It was very reassuring to have a constant stream of information when everything else felt so completely uncertain.”
For the past six months, Brown has been interim president of Cooley Dickinson, a hospital in Northampton that’s affiliated with MGH. Instead of working remotely, he drives to Cooley every week so he can walk the halls and meet with staff. He has toured the roof, the basement, the kitchen, and the patient floors in between.
He’s running Cooley for another 10 days, when Dr. Lynnette M. Watkins will become president there.
Brown grew up a few miles from that hospital, in Amherst. His parents still live there and he joins them for dinner every week when he works at Cooley. He was the salutatorian of his high school class before receiving degrees at Princeton and Columbia. As far back as he can remember, he wanted to be a doctor, inspired by his father, a gastroenterologist.
He ultimately chose emergency medicine because he was drawn to the challenge of helping people on their worst days.
He’s a skilled clinician, a patient teacher, and a level-headed leader, friends and colleagues say. Brown said he’s committed to diversity, equity, and inclusion — noting that patients in the emergency department are the most diverse in the hospital, representing different races, languages, income levels, and immigration statuses.
He’s also championed women physicians and promoted many; when he became chair of the emergency department in 2013, only one woman was in a leadership position. Now there are half-a-dozen, with women representing about one-third of the department’s leadership roles.
A professor at Harvard Medical School, Brown has guided younger generations of doctors, including Kim, a Navy SEAL who began training with Brown in 2016. Kim had planned to leave Boston for residency, but he changed his plans so he could work with Brown.
When Kim told Brown that NASA had selected him to be an astronaut, Brown was supportive, even though Kim had to leave in the middle of his training.
Before he left, Kim gave Brown his trident, a gold pin worn by Navy SEALs, in appreciation for someone he looked up to like a father. Brown displays the gift in his office and becomes emotional telling its story.
“He’s always put people as a priority, and when leaders put people as a priority over profit or metrics or any other thing, they will succeed in the long run,” said Kim, who works for NASA in Houston and is awaiting a flight assignment to space.
“It makes people want to work for you,” he said of Brown’s style. “It makes people want to do their best for you.”
Now Brown is tasked with sharing what he calls “the special sauce” of MGH across the hospital system while addressing the weighty concerns of doctors and others who worry MGH could lose not just its autonomy, but its identity.
Dr. Richard Wolfe, chief of emergency medicine at Beth Israel Deaconess Medical Center, is confident that Brown can pull it off. In 1995, Brown helped launch a joint residency program at MGH and the Brigham, which at the time was a controversial move.
“David was able to negotiate that development because everybody trusted him, and he would always just get the job done,” said Wolfe, a close friend and former colleague. “He’s always somebody that you can rely on. I think he is going to help catalyze that growing union” between MGH and the Brigham.
Brown is a devoted fan of the New England Patriots and was a team doctor for 25 years until he was promoted to hospital president.
”One of his role models is Bill Belichick,” Wolfe said, noting that Brown is competitive and likes to excel. “The only thing that worries me about his new appointment is now I have a Bill Belichick at the level of the [Mass General Brigham] leadership, and we’re the other place.”
Brown is eager to dive into his new job but realizes it comes with a loss: he doesn’t know if he’ll be able to continue working shifts in the emergency department.
In his office overlooking Storrow Drive, he keeps a set of blue scrubs, loosely folded and sitting on a chair. He hasn’t worn them in months.
“That’s something that I have to come to grips with on a personal level, because I went to medical school to be a doctor,” he said. “To give up that personal patient interaction is something that, right at this moment, is hard for me.”