In Memoriam

The Quintessential Educator

It seems so ironic that in this issue of the American Journal of Electroneurodiagnostic Technology, as we celebrate fifty years of ASET achievements, we must also mourn the loss of Lewis Kull, who was such an integral part of those achievements.

I met Lew in July of 1990, when I interviewed with him, as I applied for the job as assistant chief technologist at Children’s Hospital in Boston. I had the pleasure of working with him, and sharing office space and daily challenges with him for the next nine years.

Lew began training in EEG technology at the age of seventeen, immediately following high school, and he devoted his life to this field for the next forty-four years! His talent and brilliant mind were readily recognized and he flew up the career ladder, taking on supervisory jobs in innovative labs from Montreal to Los Angeles.

His contributions to ASET are legendary. He has given nearly I 00 lectures for ASET, and countless presentations for regional societies, as well as the international Organisation of Societies for Electrophysiological Technology (OSET). He presented the first Kathleen Mears Memorial Lecture and received the Theda Sannit Outstanding Educator award both in 1996, and was given ASET’s first “Distinguished Service Award” in 2008, after his tragic accident.

Lew’s enthusiasm for all facets of END technology was infectious! When a student finally grasped a difficult concept, such as polarity, he would jump up and down for joy, and declare his confidence in that student’s ability to learn. He had a unique way of fostering independence in students and newly hired technologists. He had a sense for when someone was “ready to fly” and despite protests, he would push the fledging out of the nest, and insist that the novice run a test solo. The children that came in as patients always loved seeing him. He always had time to joke with them, address their fears, and ask how they were doing, and really listen to their answers.

Lew loved to travel, and also loved the peaceful solitude of his little “Tea House” on a river in Vermont and the exciting cultural opportunities that come with living in the city. He shared his life with his beloved Wheaton Terrier, Fritz, and later, offered his loving protection to adopted greyhounds, rescued from the racetrack.

We will all carry fond memories of Lew enjoying the good times, dressed in costume for an ASET social, regaling his students at the most off-the-wall graduation celebrations ever, and just relaxing with friends over dinner after a day of ABRET exams.

Lew was always very reticent to bring up his achievements, but if we could each share a special fact about Lew, we would have quite a list! Did you know that he played the drums, very well, in high school? And that he was quite a risk-taker, and enjoyed flying glider planes?

I can tell you that Lew is now sending us a message; follow his example, find a reason to smile every day, do the best that you can, teach others what you know, and strive for new challenges whenever you can. He has taught us what he can, and now we must “go solo” and build upon his lifelong achievement.

 – Faye McNall, R. EEG T., MEd
ASET Director of Education

North American clinical neurophysiology has been dealt a distressing blow with the passing of Lewis L. Kull. We have lost an outstanding teacher, investigator, scholar, mentor, and colleague.

Our professional relationship with Lew began at Children’s Hospital, Boston, where Lew was Chief Technologist of the EEG, Long-Term Monitoring, and Intraoperative Monitoring programs from 1988 to 1999. Both locally and nationally, Lew had a major influence on the politics of elevating EEG technology from a purely technical field to a profession with considerable stature in the medical field. Lew guided this modern transformation from the “EEG tech,” which consisted of technicians placing electrodes and turning on the machine to the “Electroneurodiagnostic (END) technologist” who is now indispensable to the modern neurophysiology laboratory. Lew lead this transformation from “pasting and recording” to an era in which END technologists are appropriately considered colleagues and peers.

He accomplished this in both his laboratories in Boston and New York, as well as through his work with the American Society of Electroneurodiagnostic Technologists and the American Board of Registration of Electroencephalographic and Evoked Potential Technologists. Even in his absence at the last ASET meeting in New Orleans in August, his presence was felt: a life-sized picture of Lew was there, greeting the attendees, and several of the speakers dedicated their lectures to Lew. The home webpages of both of these organizations carry tributes to him.

Lew was the innovator behind the transition from paper recordings to digital recordings at Children’s Hospital. Gone were the huge piles of EEG recordings that lined the reading room and hallways of the EEG laboratory. Lew and his fellow technologists spent hours every week boxing piles of paper recordings to be sent to Iron Mountain, New Hampshire for storage. However, digital recordings were not without problems. The early programs had many problems such as inexplicably erasing data, inaccurate synching of EEG and video, and mysterious shutdowns. Lew always rose to the occasion during those early days and we are not aware of any problem that he could not troubleshoot. Although Lew was technically the laboratory manager, he attended every special test that we did: the epilepsy surgeries, the cortical stimulations, and the Wada tests. He was so talented that his mere presence in the operating room or monitoring suite brought certainty that all would go well. We are now spoiled because he “set the bar” and we expect everyone to be like him and function at his outstanding level.

Lew was responsible for many other changes that occurred at Children’s Hospital. While EEG remained the core activity of the laboratory, upon which all innovations were added, the technologists soon were required to do evoked potentials, long-term EEG and video monitoring, intraoperative studies, ambulatory EEG recordings, and dipole localization techniques. Change is always difficult, both for the leader and those led, but somehow, Lew managed to navigate this entire modern transformation seamlessly, while still maintaining the admiration of those that he led forward.

Physicians who look at squiggly lines all day can sometimes, actually frequently, be a rather strange lot with whom to work. Lew dealt with all sorts of different and often bizarre personalities. He was able to adapt readily to any curve ball thrown to him, and there were many. A key to his success was his warm and engaging personality and his willingness to listen. He treated everyone with respect, whether it be the legendary Pierre Gloor or Cesare Lombroso or the new EEG fellow during their first week in the laboratory. Lew had an outstanding knowledge base in electrophysiology and could read EEGs very well. We remember asking Lew on many occasions what he thought about a record. A typical Lew response was to tum to a certain page of the recording and then ask the physician whether they thought the waveform could possibly be a frontopolar spike, knowing dam well that an obvious frontopolar spike had been missed. By asking rather than telling he showed humility, trying very hard not to embarrass the physician reader.

Lew was extremely adept at managing the laboratory. This is now an even more difficult position as medicine has moved to benchmarking, RVUs, and increasing volume. However, he was interested in far more than just managing the EEG laboratory. He loved to teach and he did it very effectively. Despite his superior knowledge, he was humble in his approach to teaching. He enjoyed getting feedback from his students and used this information to improve his teaching. He was a great mentor, often counseling students and fellow technologists about career advancement. He was the leader of our END technology training program and Lew trained a generation of END technologists. A major part of his legacy is to leave us with some of the finest END technologists that we have ever worked with, and through them, he shall live on.

Even after he left Boston, he continued to help us and gave us all the time we needed as we developed other programs. His ability to interface neurophysiology with emerging computer technology is without comparison, and he was a major contributor to the application of neurophysiology to neurocritical care, especially the development of digital trending analysis. That the neurocritical care program at Columbia is the leading program in the clinical and research applications of neurophysiology to neurocritical care is a testimony to Lew.

Another love of Lew was research. He relished working with faculty and residents on clinical research projects. When given a problem Lew never said he could not do it, rather, he spent his time solving the problem. His intelligence, common sense, and work ethic served him very well. Lew also wrote very well and has contributed numerous articles and books to the medical literature.

Probably the most endearing feature of Lew was his friendship. He cared deeply about others and when he asked you how you were doing he really wanted to know. He supported his colleagues during both tough and good times, always willing to offer any help that he could give. To know Lew was to like Lew. One only has to read the comments from his trainees and colleagues on the Caring Bridge Journal Update and realize that he was an exceptional person.

While Lew will be greatly missed, his many good deeds will not be forgotten. He has had a major influence on a generation of EEG technologists and physicians. Skills learned from Lew will be passed on to the next generation. A person’s legacy is measured not only by their own actions, but by who they surround themselves with and how they mentor the careers of others. While we lost a great man, his impact on clinical neurophysiology will live on.

– Gregory L. Holmes, MD
Dartmouth Medical School
James J. Riviello, Jr, MD
Baylor College of Medicine

In many ways, Lew Kull was the personification of ABRET. As a leader in the field of electroneurodiagnostic technology, he was an invaluable resource as a board member, examiner, colleague, and friend. To our recollection, he is the only person to have served on the ABRET Board of Directors for three separate terms. Further distinguishing him was the informed and historical perspective that he brought to each of those terms.

Upon rejoining the Board after ten years, one might have expected him immediately to jump in and offer his unique point of view on each and every topic presented. Rather, he was initially a quiet observer – taking in the discussions around him and observing his fellow board members. Whenever there was a need for clarification of an issue, he could quietly command the attention of all in the room as he presented a well thought out solution.

Lew was also a tireless advocate of projects and innovations that would enhance the level of professionalism in electroneurodiagnostics and improve patient care. This was particularly evident in his most recent passion, the new CLTM examination. Lew played an integral role in the examination’s planning and development. As a patient advocate, he served as the ABRET liaison to the Professional Advisory Board of the Epilepsy Foundation.

Lew was very personable. He preferred the human interaction of a telephone call over the more impersonal email interaction. He was always very aware of those with whom he worked and would inquire by name about the children of his fellow board members. In addition to his professional responsibilities, he was working toward a master’s degree in statistics – his second master’s degree. He was a perfectionist, and when he undertook an assignment, it was completed in a thorough and insightful fashion. Even when not actively serving on the Board, he was always a wonderful sounding board, a source of advice, and a consultant.

With the passing of Lew Kull, there is an empty seat at the ABRET Board table. We can only hope to approximate the level of excellence that he brought to his profession and to his service on the ABRET Board of Directors.

– Janice Walbert, R. EEGIEP T., BA
David Burdette, MD
For the ABRET Board of Directors

Here at Columbia University, we are struggling to come to terms with the tragic loss of our dear colleague, mentor and friend, Lew Kull. Lew joined us in 2001 and served as the Director of Clinical Neurophysiology Operations at the Columbia campus of New York Presbyterian Hospital, until his tragic traumatic brain injury in April 2008. He was the founder and director of our School of Clinical Neurophysiology Technology, which was a central part of Lew’s personal commitment to addressing the shortage of trained EEG technologists. He was instrumental in all aspects of our program, supervising more than 20 EEG technologists, managing adult and pediatric epilepsy monitoring units, inpatient and outpatient EEG services, and our rapidly expanding intensive care unit brain monitoring service.

Lew’s commitment to educating others and to advancing clinical care was striking. In addition to regular long work weeks, he also taught his students on weekends. He worked overnight shifts for a week at a time to help provide new technologists with on the job training. He spoke regularly at national meetings, authored review articles and chapters, and participated in important research projects. When Lew spoke, people clamored to listen. He was the “go-to” man for virtually any question about EEG technology, not only for us here at Columbia, but for many across North America. At national meetings and during other travel, it became clear that Lew had trained or helped to train the head EEG technologists at many, if not most, epilepsy centers throughout the U.S. and Canada. For many of his trainees, Lew was a close friend and instrumental force in their lives.

Lew loved to teach. He was never too busy or tired to answer questions or seize a “teaching moment” – in person, in written manuscripts, in presentations, and through long, detailed, referenced emails. He taught without being judgmental, without pointing out weakness, but rather by selflessly empowering others, encouraging them, and pointing out their strengths.

Despite his prominence and stature, Lew was remarkably humble. He was always eager to learn new things and to branch out into new areas. In his final years, he was intrigued by the EEG patterns of the critically ill and helped to further their study. He named his dog “Sirpid”, after one of the new EEG patterns discovered in this population, and is co-author of an article, currently in press, on intracranial EEG in patients with acute brain injury in the Neurological ICU. At the time of his accident, Lew has just finalized arrangements to devote substantially increased time to research in this area.

Lew was a friend. He was genuinely caring and saw good in everyone. He was a role model for so many and will remain a positive influence on the lives of thousands. Lew became the victim of a traumatic brain injury early on a Saturday morning as he was on his way to teach at the school he founded. His students, trainees, and colleagues will carry on his work and his mission. We, at Columbia, miss him daily.

We hope to soon re-open his school, now to be named in his honor. It will be small token of our love and respect.

– Barbara Irvine, Ed Gallo, Edgar Toro, Tommy B. Thompson, Ronald G.
Emerson, Timothy A. Pedley, and Lawrence J. Hirsch on behalf of the
entire Columbia University Comprehensive Epilepsy Center and the Clinical
Neurophysiology Laboratories at the Neurological Institute of New York

After Hours Lew

Being a loyal friend and former NYC roommate of Lew Kull I perhaps knew him in different ways from his medical, professional colleagues, and family. Once I learned of his April5, 2008, TBI accident on June 12th, I took on the unofficial role of becoming his “patient advocate” and NYC “information point person” since his family lives in Ohio and Texas.

Lew rented a room from me when he first moved to NYC in 2001 and we soon not only became roommates but also trusted friends. We included each other in social outings where Lew invited me to the Broadway show “Mama Mia” and to join him in the VIP seats at the Macy’s Thanksgiving Day Parade. I invited him to movie screenings, art openings, dinner parties, etc., and we always enjoyed each other’s company and shared some great heart to heart talks. Every Sunday night we would gather in the den and watch “Six Feet Under” which became our tradition just like eating at Gabriella’s which was Lew’s favorite Upper West Side neighborhood Mexican restaurant. Even after Lew moved into his own apartment in 2003, so he could have his dog with him, we stayed in touch as well as with other mutual friends sometimes celebrating various holidays together.

Two weeks prior to Lew’s accident he and I had dinner at Gabriella’s, at his customary last minute invitation, and we had a great time as usual. Then I did not hear from Lew for several weeks, which was not unusual for him, as was his pattern.

Since Lew compartmentalized both his professional and private lives and because he was extremely understated about his accomplishments, it was not until this past year, via meeting some of his medical colleagues, that I fully understood how accomplished and respected Lew was in the field of neurodiagnostic technology. I already knew Lew was brilliant with a good and generous heart. I also had a pretty good idea he had an important job but I had no idea of the number of lives he has positively impacted by his work and research. He has changed for the better the lives of many children, political figures, celebrities, and thus has changed the world for the better. He has given vast numbers of people over the years – around the country and world- their lives back!

Lew extended so many times his helping, generous, healing hands to so many deserving individuals around the world. How ironic that Lew’s traumatic brain injury accident happened while in route to do a friend a favor before Lew was to teach a Saturday morning class.

I hope and pray Lew’s life’s journey will now bring even more attention to the shortage of traumatic brain injury research, treatments, and long-term care facilities and to the dire reality of much needed policy reforms in our American healthcare, legal, and Medicaid systems.

Let’s make that fight and mission part of Lew’s true and lasting legacy!

– Jon Mikel Zeigler
Event Marketing Director/Producer

My Friend Lew

Like most friendships, ours grew over time. I first met Lew across the table at an ABRET exam; he was the candidate and I was the examiner. In the 25+ years that followed, he became a mentor, a colleague, a confidant, an ally. Most importantly we became friends, a relationship that involved mutual knowledge, esteem, and deep affection and respect.

To most who knew him professionally, Lew embodied the best to which we aspire; he was no different in his personal life. He was generous to a fault. He gave tirelessly to those in need, in all aspects of his life. He was a genuinely engaging spirit, a keen observer, and an expert listener. Lew had strong opinions on many subjects, but he was always willing to view things from many angles. He was a man who was a teacher at heart and simultaneously a student, educating all he came in contact with and learning from every encounter.

Lew was an example of selflessness and dedication to his family and friends, and his passion and enthusiasm in the labors of life continue to be an example to all who knew him to live life and love family and friends to the fullest.

Thank you my dear friend, for all you have given, and will continue to inspire.

– Judy Ahn-Ewing, R. EEG/EP T., CNIM, CLTM, BA
Royal Oak, Michigan

Originally published in:

The Neurodiagnostic Journal, 49: 130–137, 2009
DOI: https://doi.org/10.1080/1086508X.2009.11079712