From the Chair
In the ABBA song “I Have a Dream,” there is a line, “I believe in angels / Something good in everything I see.” I, too, believe in angels who do good for everyone. Nicolaos Madias, MD, was a nephrology angel who died recently. I knew Nick and admired him as a wonderful human being—looking up to him in awe because of the massive difference he made to nephrology, especially in our understanding of acid base and electrolyte physiology, and because he was a gentleman to the core.
I first met Nick in 1987. Nick was chief of the Division of Nephrology at Tufts Medical Center (Tufts MC). He supported me through my early career until I was recruited to the Brigham and Women’s Hospital. He nurtured colleagues in the renal division at Tufts MC like no one I have worked with either prior or since. Special memories include the Christmas parties that he and his beloved wife, Ourania, had each year. We kept in touch over the years, and he would be there whenever I visited St. Elizabeth’s Medical Center, where he was chair of medicine.
Nick published extensively on acid base. In the early years, these studies, focusing on the effect of hypocapnia and hypercapnia on serum bicarbonate in dogs, were with William Schwartz, MD, and Jordan Cohen, MD. In later years, Nick worked on the molecular characteristics of the sodium-hydrogen exchanger (NHE-1) gene. He published studies on renovascular hypertension and even gave time to publishing a case report with me on predominant tubulointerstitial nephritis.
In more recent years, Nick published highly impactful and practical review articles with Horacio Adrogue, MD, and Jeff Kraut, MD, in the New England Journal of Medicine and many leading nephrology journals, deepening our understanding of how to manage disorders of sodium and water metabolism and of acid base dysregulation.
Many have said great things about Nick; here are a few notable tributes.
From Mark Sarnak, MD, current chief of nephrology at Tufts MC: “Nick was an outstanding teacher who had the unique ability to explain extremely complex subjects in easily understandable terms. He nurtured a culture of respect for everyone, hard work, and devotion to every patient. He was a friend and colleague who had a profound positive influence on many of our lives.”
From Andrew Levey, MD, Nick’s immediate successor as chief of nephrology at Tufts MC: “I worked with him during my entire career, and never did I hear him raise his voice or criticize a colleague or employee. Instead, he was endlessly patient and supportive. As his successor as chief of the Division of Nephrology at Tufts Medical Center, I learned from him that a leader respects each person for his or her contributions and does not expect anyone to do more than they are able to.”
From Ron Perrone, MD, scientific director of the Clinical and Translational Research Center and director of the Polycystic Kidney Disease Center at Tufts MC: “Nick taught me ethics and a kind and supportive leadership style by setting a remarkable example, which, to this day, has set the tone for how the division operates.”
From Dr. Horacio Adrogue, emeritus professor of medicine at Baylor University: “I had the enormous privilege of working with Nicolaos E. Madias for almost half a century, starting in Boston in 1975, when both of us were research fellows, performing experimental acid base studies in conscious dogs in the large environmental chamber of the renal division at Tufts MC. We became close colleagues, research collaborators, and best friends, co-authoring multiple studies published in high-impact medical journals. Such interaction allowed me to discover his multiple virtues, immense passion for medical research, unbeatable moral values, remarkable humbleness, tenacity, hard work to the extreme, devotion to excellence, superb writing skills, warm heart, loyalty, dedication to his duties, and commitment to always keep his promises. The Academy of Athens recognized his immense talent and contributions to medical research and elected Nick as a contributing member in 2019. I will miss him profoundly, and science has lost a giant and luminary.”
Bertrand Jaber, MD, who succeeded Nick Madias as chair of medicine at St. Elizabeth’s Medical Center in Boston: “The St. Elizabeth’s Medical Center community has lost a gentle giant. Dr. Madias was a tireless leader of academic and clinical excellence. He was an enabler of the faculty of his department, a perpetual optimist, and a champion of civil and respectful engagement. For those who knew him well, he will be remembered as a great physician and colleague, a demanding mentor, and a selfless friend and confidant.”
I always thought of Nick first as a clinician, then as a scientist, who used his enormous acumen to explain complex clinical concepts using basic physiological principles.
Rest in peace, Nick!
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