As it turned out, I had lied to my best friend.
When Ken Kirsh was first diagnosed with Stage IV colon cancer I was only recently removed from my many years in oncology clinics working specifically with people suffering with his very disease. Resection of contained metastatic liver disease along with oxaliplatin, bevacizumab and irinotecan represented major steps forward in the treatment of the disease and had cured those who could undergo liver resection and extended the median survival to 22 months in those who couldn’t. Ken was not a candidate for liver resection.
And so I told him, “hey bro, things are moving quickly in the science of this disease and if you stay alive 2 years, something else will come along by then.” I wasn’t lying at the time. I really believed it. Ken – I am not sure – ever did. I wrote about our complementary and opposite cognitive styles in a blog here There IS Crying in Baseball when he was first diagnosed, but did not mention our sometimes complimentary and opposite emotional styles. Whereas, I am dispositionally optimistic, Ken was a dyed-in-the-wool pessimist. He was the kind of pessimist that thought of himself as a realist and guys like me as self-deluded. Many times in our work together, his judgment saved us and helped us avoid disasters. Pessimists are good at anticipating problems.
And really good at preparation. Ken died nearly 22 months exactly from his diagnosis. And when it came to the things that mattered to him and he wanted to complete, he was prepared.
All along, his main concern was the well-being of his loving wife Kristy and taking care of her after he was gone. He worked right up to very near the end to make sure she would receive maximal support and together they paid off their mortgage in record time. Throughout his life and in the 25 years I’d known him, I had always marveled about his clarity of purpose and consistency in his approach, always in the face of huge odds. Ken came by his pessimism honestly as one might if they wrestled with a neurological problem since birth. The last place in the world you want your baby pictures to appear are in neurology textbooks. And yet while that left Ken with the view that things don’t always work out for the better and that the world is indeed unfair, for people with pain he fought for fairness. When it came to devotion his was unmatched and to those lucky enough to get close to him he was easily one of the most generous of people you will ever meet. He was generous to me with, among a million other things, imparting his manner and temperament to our work – it toned down and took the edge off some of our pieces and made them more effective. Ken was insistent and resolute in his advocacy and far less abrasive than I can be.
Ken received FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin and irinotecan)-Bevacizumab a strategy that had changed from the days when they gave the oxali and iri parts separately when I was still in the field. As our dearly departed colleague in pain management, Dan Brookoff used to joke – and he was, by training, an oncologist – his colleagues were only happy when the chemo regimen name, composed of initials for the various agents, spelled out their wives’ maiden names. It was extremely tough. Ken was tougher. He went through it, endured and showed up for work every day. Both of our fathers were blue collar workers – another thing that bonded us. Mine a railroad brakeman; his a steel worker. Ken, PhD and all, always approached work with an ethic and attitude of a steelworker. If he could have laced up work boots before crunching numbers, coming to clinic or giving a talk, he would have. Prior to his cancer, I don’t think I can ever recall him taking a sick day in 25 years. And he wasn’t, from the day he was born, a completely well guy.
After he progressed through this regimen he tried Erbitux. He initially responded and developed the telltale rash about which he joked about having teenage acne again. We joked about both of our turns as bass players in rock bands, playing in those earlier days of our lives. I was a bit of a hack (but as I told Ken, I could play fast), Ken was a serious musician and songwriter who played his whole life alone and with bands and along with the immensely talented Kristy on flute. Just another of his great talents and one of the things he shared during his younger years with his brother, Al, whom he idolized.
Later still Ken entered hospice. During this time his friends visited and he welcomed them all though it was hard for him to interact in his usual ways. He was surrounded by his loving family, his mom and Al along with Ken and Kristy’s collies. And of course, Kristy was devoted to caring for him till the very end.
I saw my best friend the last time just a short time before he died. The cancer had taken a lot out of him. His usually lightning fast mind was slowed and his verbalizations even slower. We sat together for 2 days, often silent while he dozed or woke briefly to pick up the threads of a small talk conversation. I had made him cry when I told him how much more meaningful and important knowing him had made my life. I thanked him for always having my back no matter the controversy. I told him I would miss him every day. He cried, but couldn’t formulate too much more of a response and I decided not to go further through the quicksand saying all the “important” and “emotional” things for my own benefit – things that truthfully, never required saying because our mutual respect and loyalty did not need explicit acknowledgement. I sat in a chair that was slightly behind where he was lying on a couch and it made me think of the million times I stood behind him when we were working, analyzing data or writing together and I would read what he was typing over his shoulder. On my way back to the airport I was thinking how Ken is so woven into all my memories and thoughts about Lexington. I love that town and always will go back for Keeneland. Ken didn’t like gambling and only reluctantly came with me to Keeneland a couple of times. But I always saw him in the morning for breakfast and to work and after the track for dinner. My favorite place on earth won’t feel the same to me ever again.
I learned that Ken, one night not too long before he died, had expressed his wish to have made it to 100 
refereed publications – he had 99. As if by magic the next day someone not privy to that conversation sent along a draft from a study we had all done asking for comments prior to submission. We all set about working feverishly to get it submitted while Ken could still appreciate it. Somewhere in heaven, I imagine Ken sitting around with our mutual dear friends, Si Budman, Howie Smith and Dan Brookoff and they are toasting him on his 100th publication. Ken was always extremely proud of the work we did together; not just the volume but the quality. But 100 is a nice round number and Ken was exacting and liked round numbers. (the fact that the damn disease took him just 3 days shy of his 45th birthday was thus all the more cruel – yet more evidence that Ken could be right about the basic unfairness of the universe). Fortunately, I am fairly certain that with all his good works, Ken didn’t have to show his CV to get through the turnstiles at the Pearly Gates.
In his advocacy, Ken spoke truth to power and always put people with pain first. He showed it in the clinic and showed it in his research and writings. He was steadfast and reliably brilliant. He was unflinchingly honest and devoid of self-deception. You couldn’t help but love him. I loved him and now I miss him. I only wish science had marched on, cured him or given us more time with him and not made a liar out of me.
This guest blog post is written by Steven D. Passik, PhD.
Please post comments and well-wishes here!
This blog is posted with permission from Dr. Kenneth L. Kirsh’s family and is compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Steve, the work you and Ken did had a big impact on my work with patients. The field has lost a great pain psychologist. You wrote a beautiful tribute to your best fiend.
I send my sympathy to Ken’s family and to you, Steve.
Diane Novy
I met Ken through Steve, and this introduction was simply the greatest gift one friend can give to another.
With limitless love, and to a life so-well lived, Perry
Dr. Passik, thank you for revealing who Ken was, thank you for your honest, loving, beautiful account of the life of your colleague. I am a Russian doctoral candidate at UK, living in Lexington, Kristy teaches my daughter. I resonate with the publication record account you mentioned (and with every word you wrote, to be honest myself) and Ken’s wish of a 100th publication. Numbers. He loved to crunch numbers to help people through pain. My understanding is that he directed his own treatment! Such a bright mind, such a strong spirit that Ken had, such a dedication, passion–if you will–and as you have said, such an unfairness! WHY GOOD PEOPLE SUFFER!!!???!!! I miss Ken also, although I’ve never met him. Thank you for your blog post. Thank you for letting Ken live in our hearts and minds. He will not be forgotten as long as he lives in our hearts.
Steve,
What a beautiful tribute to a very special colleague and wonderful person. Although I only had the pleasure of meeting him a couple of times, he made a lasting impression.
My thoughts and prayers are with the Kirsh family and also with you Steve.
Dear Friends and Colleagues
Thank you so much for your beautiful thoughts and sentiments. It has been so emotional for me to read about everyone’s love and admiration for Ken – and I was well aware of how people felt about him. I am so happy that his family has been able to see your words and recognize how many people were so fond of him. When I spoke to him during the course of his illness and relayed people’s well wishes he always seemed mildly surprised about how many people thought about him, asked about him and asked me to tell him that he was being thought of. He was too modest to “know” people felt this way about him. Ken’s family, like him, are so modest as to not probably fully know how much of an influence he had on our world. Your words were of comfort to me as I mourn this loss and I hope to the Kirsh family as well. Anyone reading the blog now, please don’t take my “thank you note” to mean your remembrances are no longer welcome – they are! Thank you all from my heart.
Steve
All, I am not surprised to see the outpouring of love and appreciation for Ken as a friend, colleague, scholar, and patient advocate. What does surprise me is that so many VERY busy people stopped in their tracks to pay homage to such a wonderful man. Many thanks to everyone that posted comments!
I don’t think there’s much more that I can add other than what has already been said. I do remember the first time I met Ken and shook his hand several years ago, at a PainWeek conference; it felt like we knew each other for twenty years. He was just so comfortable to be around.
And finally, I want to give Steve a big fat hug for the loss he continues to endure and acknowledge him for his time and energy to see that his friend (almost brother), colleague, and partner in crime received a sendoff second to none by creating this platform to honor Ken.
Cheers to our beloved Ken Kirsh! May you rest in peace.
Steve awesome post to your dear friend. We in the pain community are indebted to the work you guys have done. Now more than ever we need your help in this horrible pain epidemic. I watched my mother go through a similar treatment for her colon cancer. It is ravaging. In a day and age of making cars that can drive themselves we are far from curing these diseases. This society needs a wake up call. We need to start channelling brilliant minds back into medicine.
Steve, your passage was incredible. You are a great writer and a great friend; I am so sorry for your loss and my deepest condolences to Ken’s family. He was an inspiration and a pioneer in our field. Ken’s intellect and wit would always elevate the mood in any room, and I am glad that I had the chance to work with him on many projects along the way. He was kind and caring and will certainly be missed.
May he rest in peace.
Steve – I am so sorry to hear about Ken. Your tribute is beautiful, thank you for sharing. My thoughts are with you and Ken’s family.
Steve, your blog was beautiful and from your heart. You lost your academic and personal soulmate.
The family lost a wonderful and devoted husband. The medical profession lost an intelligent and wise professional. We all lost a friend and a resource for information..
With that being said. we all benefited from our contract we had with Ken. He will be missed but not forgotten!
Howard A Heit
Steve, this is such a poignant and compelling tribute to an amazing person. Ken paved the road for so many psychologists in pain. Ken was compassionare and provocative and legendary in his own time. I learned of his passing through this post and I cant think of a more beautiful way to hear such sad and tragic news. I am so sorry for your loss, for the loss to his family and community, and to his many followers and supporters. The field of pain research owes hom a great debt. Thank you, thank you for this tribute!
I’m so sorry to hear about Ken’s passing. We never met in person, but I know Steve well and have read, and re-read so much of Ken’s work. It’s clear how he impacted so many lives far beyond his circle of friends. It was Ken’s work that helped lay the groundwork for those of us following to find a way to integrate compassionate and effective pain care, while not only minimizing the risks for addiction, but also managing it as well. Ken helped us help others to decrease suffering in multiple dimensions.
It sucks losing people (and pets) we love deeply. It just sucks. Yet Steve’s tribute to Ken beautifully captures the reasons it sucks to lose those we love…. We LOVE them. We are richer and deeper people because of these connections, and that shines through in Steve’s goodbye. My condolences for Ken’s family and friends who knew and loved him dearly. Know that he did great things for our world, and his passion and knowledge left much more love in this world than before. -Michael
I’m so sadden to hear of the passing of Ken. He was such a pleasure to work with and I am truly blessed to have been educated by him. I will never forget our first meeting-
Steve, Ken and I in Tampa picking you both up from a baseball game in a taxi prior to dinner! What a loss. My thoughts and prayers go out to you Steve, his wife Kristy and his entire family and friends.
With Sympathy
Paige
I was so saddened to hear of Ken’s passing. He was as unique as he was amazing. I had the good fortune to play music with Ken for about a year in a couple of different bands. He was an outstanding musician and one of the best bass players I’ve ever heard. He was one of those guys that made everyone around him better. Ken was also incredibly generous. Whether giving a very memorable presentation at a conference, playing music at benefit for individuals with disabilities or helping a family complete their adoption, Ken was always quick to help. I learned a lot from him through conversations during our rides to and from rehearsals. I’m going to miss his quick wit and brilliant mind. Although I only knew him briefly, my life was made better by knowing him.
My heart goes out to Kristy and his family. I will keep you in my thoughts.
So sad to hear about the loss of Dr. Kirsh. I had the privilege of knowing him through work and meeting his delightful wife outside work. He always had a kind word and generous nature. He will be greatly missed. Prayers for his family. Rest in heaven dear friend.
I’m deeply saddened by the passing of Dr. Ken Kirsh. It was an Honor to know him and work with him. His passion for his work and the love he had for his wife was truly inspiring. I was fortunate enough to have spent time with Ken and Kristy at dinners when our mutual friend, Dr. Passik was in town. I would leave the evening thinking wow this man is Brilliant! He was also one of the kindest men I’ve ever known who cared so deeply for his patients and the people he worked with. You will never have met a finer man than Dr. Kirsh. The world doesn’t seem right that he’s gone. Steve, thank you for sharing such a Wonderful tribute to your dear friend. Dr. Kirsh, thank you for your passion, your contribution to life and your kindness. Rest In Peace. My thoughts and prayers go out to Kristy and his family.
Ken had made so many positive contributions to the pain community. Easy to get along with, never an ego, and his dog stories were always legendary. Rest In Peace.
Steve P,
Thanks so much for this amazing tribute to Ken. I remember first reading and thinking about prescription opioid abuse and coming across the dynamic duo of Kirsh and Passik. When I finally met you guys, I was struck by Ken’s quiet and humble intelligence, and how kindly you both greeted me as a new colleague. I know how it is to lose a close friend and co-conspirator. His was a major contribution to the field, and he will be missed.
Steve B
Steve, what a beautiful and amazing tribute to a wonderful person. My sincere condolences to his family. Now more than ever, we need to continue and enrich his legacy by stepping up our own collective clinical and academic work to enhance our ability to help people who suffer from acute and chronic pain. We will not disappoint you Ken.
Many years ago I had the honor of getting to know Dr. Kirsh and Kristy as well as Dr. Passik while they lived and worked in Lexington. Dr. Kirsh certainly had a keen sense of humor, love for his wife Kristy, their dogs, music, the 2nd Amendment and if I remember correctly “The Cleveland Indians!”
I too remember the many times we were coaxed into meeting Dr. Passik at Keeneland, although both admittedly not into the horse racing industry as Dr. Passik, we still went for the experience of friendship and to make fun of Steve’s losses and celebrate the joy of his wins. Ken was/is genuine. At the very least I am truly grateful to have known him.
I pray the good Lord above embraces him, comforts and INSPIRES those who he left behind to….Never Ever Give Up! Lead through your pain and when the bell tolls you’ve left your mark in helping to heal others.
Thank you Dr. Kirsh…
It was with a very heavy tearful heart that I heard of Ken’s passing. So much has been written about Ken in the above Blogs .. I would agree with them all. I met Ken in 2007, at the time he was teaching at UK. Soon after meeting he joined the large pain clinic in Lexington where I was also working. We became friends, easily and quickly, he was that kind of man. Ken and I spent many hours discussing the treatment of pain, the plight of pain patients, bourbon and whatever topics came to mind. We published articles together, did research and shared patients. My time with he, Kristy and their puppies were all precious moments. I look back with sadness that I didn’t make more of an effort to return to Lexington to spend some time with him after his diagnosis.
Ken just about always had a smile. It was either the impish smile as he holds up a plate of vegetables in the picture above, or the warm genuine smile of a friend. Laughter was common for him. He was the peace maker … the arbiter. When I would go off about something, Ken frequently brought me back to earth. His example (and my age) have mellowed me over the years, but Ken’s influence was certainly powerful. He took pride in the publications and projects he was involved with, but never one to boast or insist on credit .. the work was satisfying for him. He was always willing to help, students, fellows, or anyone who asked and was never one to complain. With his chronic medical issues, he had a few scrapes while in Lexington, prior to his cancer diagnosis. But was quickly back to work with no comment, and those who didn’t know him well, rarely even knew.
A true gentleman, true friend, intellect, and genuine human being was Ken Kirsh. I agree … the world will be less bright with his passing. Althought I believe that where he is now will be brightened by his presence. May God Bless Ken, Kristy and their families, they will continue to be in my prayers.
He gave so much to us all and I am honored and blessed, though undeserving, that such a man called me friend …Thank you Ken.
Truly an amazing man. Loved his talks and his educational presentations
Steve Marcum PT
An amazing tribute to Ken, Steve. The world is definitely a lesser place without him. It was a privilege to work with him and get to know him. My thoughts and prayers go out to his wife and family. He will be missed.
-Matt
I am honored to have known and worked with Ken . What a wonderful person. This is a great tribute to all who ever met him. Still in shock. May he rest in peace. Hugs and prayers for family and friends.
I was shocked to read of Ken’s death. I had no idea he was ill. What a loss! in 2010, Ken & I published a paper in the Journal of Opioid Management called “Defining clinical issues around tolerance, hyperalgesia, and addiction: A quantitative and qualitative outcome study of opioid dosing in a chronic pain practice.” It was based on my long-term patients, is even now one of the very few long-term outcome studies in existence, and I still cite it frequently in my teaching. Ken’s contributions were invaluable — his thoughts, his statistics, his kindness, his dedication to the project. I loved working with him. I am so sorry for what Ken and his wife went through in the past 2 years!! . It brings me back to my daughter, Jessica, a composer, who was diagnosed at age 29 with colon cancer in 2001. I anticipated she would survive for 2 years, and indeed she died 23 months later. Treatment options seem to not have changed much since then. I learned a lot from your heartfelt tribute, Steve. So so sorry!!!!
Steve – thanks for writing and sharing this heartfelt and touching tribute to Ken. I am certain he appreciated the gift of your time, visits and supportive words & deeds in the last 22 months of his too-short life. He will be missed, strike that, already is missed. My thoughts and prayers go out to his family.
Steve, I am so sorry to hear of Ken’s passing. We have lost too many good people too soon. I remember fondly all the publication collaborations we all did together with Howie. You are in my thoughts. Pya
I worked with Ken years back on pain medicine educational modules on QuantiaMD. He was a brilliant, compassionate doctor and a great man. He will be missed. In 44 years with us he made a tremendous positive impact on countless lives. Rest in peace, Ken.
My heart goes out to Ken’s family.
Steve, thank you for your wonderful tribute to a colleague I wish I was able to know better than I did.
A beautiful and richly deserved Tribute to a wonderful man. He was an inspiration to everyone who he touched. Ken, we will all miss you dearly. My condolences and hugs to your family.
Thank you Steve. Wonderful. Ken’s consistent kindness and humility is what I’ll always remember. Ken’s accomplishments were rivaled by few but he always simply introduced himself as just Ken, “here to help”. I feel so blessed to have known and learned from him.
When I heard the news about Ken, the first thought that entered my mind was the word Titan. I think that Mike Brennan said something not long ago along the lines of worrying about who is going to carry the baton in upcoming years in the battle of managing chronic pain. I share that same feeling. When it comes to losing someone like Ken, it would take a Titan. They don’t come around often, but you know one when you see one.
Thanks Steve for sharing this wonderful tribute to a wonderful man. May Ken Rest in Peace, and his family should know that we always remember the Titans.
Thank you Steve for helping us to share the breadth of our loss of your most esteemed colleague and great friend. Ken’s kind words to me and validation were a source of empowerment and inspiration during the brief time we spent together and can only be an echo to his family for his approval of my far less elegant manner but somehow still recognizable common ground with his virtuous accomplisments.
Although many are those paths we cross,” Like the stars in the night , some of them are different , some of them sparkle ! ”
You will be missed , but not forgotten.
A great tribute for a great man. It was a pleasure to know Ken and work with him as a colleague. His passion for pain management, for patient care and for advancing our knowledge in this area was tremendous. It was pleasure to know him and to work with him. He will be dearly missed by all who were fortunate enough to know him. My prayers and thoughts are with Ken’s family during this difficult time.
You two were like brothers. Wonderful tribute to a wonderful person. Hugs to you and condolences to Ken’s family.
Steve,
Thank you for penning this tribute to Ken. The news of his passing was deeply felt and grieved. My condolences and greatest empathy goes out to you and Ken’s family. It was truly an honor to know Ken and work with you both. I hope that when you are on the West Coast again, you find your way to San Diego so we can catch up, and share a toast to a great man, good friend, and trusted colleague.
Greg
To Ken’s family I am so very sorry for your loss.
Though only a brief time with us, his work will prove long lasting. And with it so shall our respect, esteem, land wonder at what he achieved in so short a time.
I will miss him, and the community in which we dwelt shall as well. He made us better and he made the lives of countless souls more bearable.
Well said Steve…. when you introduced me to Ken and referred him to us to assist on several projects..you said he wouldn’t disappoint. He didn’t. He was smart, kind, humble, and became a friend and colleague…and I will cherish the friendship. To his family…please know that Ken has a very large extended family throughout the Country that will miss his smile and friendship. Thoughts and prayers to you.
Thank you for this tribute to our friend and esteemed colleague. Ken ‘s presence in our lives was truly a blessing. His work will continue to guide clinicians to provide optimal care. Ken was such a caring and loving friend and professional. Our hearts are with Kristy and his family. Rest In Peace my friend.
Rest In Peace “Ken from Kentucy” which is how you introduced yourself when we first met. Thank you for teaching our students about prescription drug abuse. Your legacy will live on with all that you taught me and other.
Beautiful tribute, Steve. And one that Ken so deserved. My condolences and blessings to his family.
Dr. Passik,
Thank you for sharing. Humanity never ceases to amaze, the capacity for love is ever-growing. I always enjoyed the times when I was able to hear Ken speak. His professionalism, his brilliance, and his kindness we’re always apparent for all to see. His passion for helping people on anyway he could, and reducing the suffering of patients was an inspiration. Thank you again Steve, my thoughts and prayers are with the Kirsh family.
Jake
What a great picture and testimony by Steve. I really
miss the few great years we worked together in Indy
Warmest thoughts and prayers,
Dr Bill Dugan
sofiapassik@gmail.com I’m so touched by this. My sincerest condolences to his family. Sending much love and keeping them in my thoughts.
A wonderful man who impacted so many lives at Millennium Health, including our customers. Gone too soon.
This is a beautiful tribute to him.
Steve,
Thank you for sharing this deeply touching tribute to Ken. Your affection shines through in your words. The world is a little darker without Ken. He will be missed.
Warmest regards,
Scott
I am honored to say Ken was a friend and a colleague. I can not say anything more beautiful about Ken than what Steve has written. All of us who were fortunate enough to know Ken are richer. because of it. Ken, your gentleness will be missed. Lynn
What a fantastic tribute to a friend and colleague and what a terrible loss of a wonderful person. May he rest in peace.