Stephen Hennigan, M.D.: Whole patient matters to infectious disease specialist

A thoughtful, funny and emotional hour-and-a-half phone interview with infectious disease specialist Dr. Steve Hennigan is followed up by an email from him a day or two later. In it, Hennigan elaborates on some of the topics touched upon in the earlier conversation.

"Any story should have a wholeness to it," Hennigan writes. "I think what I told you isn't quite complete. I would hope whatever you have to say about me will be a story that can move people to be their very best authentic selves."

We often stereotype doctors as cool-as-cucumber, if not downright cold, professionals who operate in a didactic world of scientific order. Medical training sometimes includes classes on bedside manner, serving to emphasize the perception that warmth and empathy, or, at least, the ability to easily display it, is not something that always comes naturally to those that choose the profession. The conversation with Hennigan hints that he does not fall into that category, and follow-ups with those who know him best confirm it as fact.

"He would get down on his knees with a patient, eye to eye, cry with a patient -- things that I had never seen before," says Lisa Rojeski, a physician assistant, of the 15 years she has worked with Hennigan. "He is just a different level of compassionate."

"Doing the work that I do, you see folks with all different levels of attunement to the people and living creatures around them," says licensed professional counselor Bill Symes, a close friend of Hennigan's. "Steve has this great emotional radar for when people are doing well and when they're not doing well. He's not only reading them in terms of, 'Are we getting along? Do we trust each other?' I think he's also reading them in terms of, 'Are they responding to the treatment? Are they feeling more energetic? Are they feeling more balanced?' For some doctors, and I respect this, to pay attention to your patient's emotional and physical health is just painful, because you're picking up on their suffering, and Steve just seems to basically tune into that and use that as a feedback loop on what he needs to address in his patient."

"Although he's a specialized infectious disease doctor, he's always connected to the whole person, their physical, emotional, psychological, spiritual and social makeup -- he's sensitive to that," says Dr. Mark Thomas, a staff physician at Washington Regional Medical Center and vice president and medical director of Population Health. "He doesn't look like a monk, and he doesn't live like a monk -- he has a regular family life, he's had his ups and downs just like all of us have had -- but he has this vocation to caring for people in the best way he knows how, and it comes out in every patient he takes care of. "

Renowned artist Hank Kaminsky met Hennigan decades ago, when Hennigan struck up a conversation with Kaminsky at the Fayetteville Farmers Market. The two became close friends.

"When it came to medical problems later on, he had another view from conventional medicine," says Kaminsky. "It took into account other factors: emotional, mental and sociological factors. He wasn't just a doctor. The whole idea of a doctor entering into a specialty, putting blindfolds on and only seeing their patients in terms of those specialties is a real limitation on the field of medicine. I think that Steve looks at the whole person. He just has an open heart, and he looks at everything through that lens of humanity."

Another word that repeatedly comes up in conversations about Hennigan? "Creativity."

"Doctors' kids are creative, but doctors usually aren't," says Thomas. "It's a special trait. When I say 'creative,' I don't mean that he's making up new treatments. He's very up to date on the medical literature, 'What are the latest treatments?' 'What are the best treatments?' 'How do you apply real time evidence to treating patients?' All of that. But creativity also comes with a state of mind in which you can say, 'What's really going on here? Did I miss something?' and, also, 'What are the actual resources that are available to treat this, that we haven't been thinking of, that might be applied to this particular patient?'"

Thomas has the perfect story to illustrate Hennigan's medical creativity.

"One patient, I remember, had a terrible cancer that had manifested itself in a wound in the groin that just wasn't healing, and it was eroding the deep tissue. Nothing we did worked -- antibiotics, wound care, special beds that would remove all the weight from the different parts of the body. Then Dr. Hennigan got this idea -- he had read this article, and he said what we needed to use was medical leeches. I looked at him and said, 'What are you talking about, Stephen? This isn't the Middle Ages!' But they are perfectly acceptable treatment, if not widely used right now."

The leeches helped, and, soon, the patient was discharged to continue his recovery at home. Hennigan, ever dedicated to his patients, was making home visits to check on his progress -- and he asked Thomas to accompany him. There was one part of the process of using leeches he had trouble with: applying and removing them.

"He thought he could maybe use a little more help from me on the more squeamish part of it," Thomas says.

"'Why is this person sick?' Maybe we've tried the basic stuff. Let's try something a little different; there may not be a guideline for it,'" Rojeski says of Hennigan's thought process. "It's still safe medicine, and he's seen it work for other people -- it's an art. 'Let's see if it works for you.'"

Symes says Hennigan's post on the Board of the Holos Foundation, an organization "dedicated to integrating psychedelic medicines into the heartland region of the country as they become legally available," is another example of Hennigan's curiosity in the name of healing.

"His interest in the healing practices -- he goes right to the fringe, 'What can we include that would be effective in reducing suffering? If this is something that's valuable, I'm going to pursue it, understand it, and apply it.' It's a part of his cutting edge mentality of general health: 'How do we reduce suffering in the world?' And I would say that's an actual commitment he has."

"I thought I was giving up creativity [when I chose the medical field], but, God, so much of taking care of patients is creative problem solving," says Hennigan. "Sometimes I say I sort of muddled into where I am -- and yet I can't imagine being anywhere else, because I feel so privileged to get to do this. And, gosh, sometimes it feels kind of like magic -- it truly does, because the things that people need are so much more than a prescription for an antibiotic. Sometimes people need to know that there's hope. They think they're going to die. They just need to know, 'You shouldn't die from this.' Sometimes people need to know that their being has value and that hurting themselves through destructive behavior only takes their misery to a darker place. So it's that ongoing fight to bring the best out of people on all levels."

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This singularity has been with Hennigan since he was a child, though it wouldn't be until he was an adult that he found the terms that defined that difference.

"I rebelled against my father in the years that followed, up until about age 15," he writes of the time right after his parents' divorce, when his mother moved away and he lived with his father. The nation was embroiled in the Vietnam War, and the chaos in Hennigan's own life seemed to echo the chaos of the era. "I acted out, ran away from home, hitchhiked across the country, somehow surviving all of that unscathed. But while I saw my own suffering in terms of the external issues of my day, the greater burden was really the terrifying knowledge that I wasn't like the other kids around me. I was different. It was years later that I came to understand that I was on the autism spectrum, or, more accurately said, neurodiverse.

"My own personal journey has led me to a place of appreciation, of knowing that my differentness gives me particular strengths. I think as humans, our goal must be to be no one other than who we are. In honoring our differentness, we are better able to give of ourselves to those around us, indeed to the universe itself. Because there is absolutely no one else in this entire universe exactly like each one of us. That is our gift."

Hennigan was born in rural Louisiana, to parents who had met in college: His mother, from Baton Rouge, came from a background of relative wealth, while his father, the son of a Pentecostal preacher, came from poverty. The only reason Hennigan's father was able to go to college, in fact, was his athletic skill: His prowess in both track and field and football earned him a scholarship. Charles Hennigan Sr., as it turned out, was talented enough at football to turn pro. He was recruited to play for the Houston Oilers, and the young family moved to that big city when Hennigan was a child.

"He was actually, in his day, kind of famous -- he made the first touchdown the Houston Oilers ever made," says Hennigan. "I don't think it was really optimal for me, because I could tell people who my dad was and get a crowd around me, wanting autographs."

Hennigan was only 7 when his father's career ended, and the family moved back to the farm in rural Louisiana. Both of his parents were involved in careers -- or missions -- that helped others: Charles Hennigan founded a learning center in Houston called the Hennigan Institute that offered education and counseling for students; he also tutored Louisiana prisoners who were attempting to earn GEDs. Hennigan's mother was a staunch civil rights advocate.

"She received anonymous hate letters from the racists in our town," says Hennigan. "I remember her weeping over the martyrs of the day."

The couple divorced when Hennigan was 12, and, after his mother moved away from their small Louisiana town, he lived with his father. Hennigan survived the aforementioned rebellion and, by the age of 15, had settled down somewhat. When he graduated from his tiny high school, he was at a loss as to where to go from there. He loved playing the trumpet in his school band and briefly considered a career in music. Medicine wasn't yet a blip on his radar.

"I went to college because that's what you're supposed to do," he says. "Everybody talked about me being bright, but I got a C in high school chemistry because my lab notebook was sloppy. So when I went to college, I thought, 'I don't know what I'm going to do, but I'm not taking any science classes.' So I would go to school, then I would quit and work. It took me seven years to get my undergraduate degree, and it was in liberal arts."

He got married early -- he was barely 20 -- and his wife was going to medical school while he was contemplated his next steps. Her studies interested him.

"The idea of helping people was very appealing to me, and yet I understood that in medicine there were things that were hard, things as simple as wounds and all the things associated with being human, all the things that we think we wouldn't want to do because, 'Gee, that's yucky,'" he says. "I was working in this produce company warehouse. I was sitting there all day long separating out rotten oranges from good oranges so we could sell the good oranges, and I kind of had this insight: 'You can get used to anything.'"

It meant catching up on his prerequisites -- since he had eschewed all science classes in his undergraduate years -- but once he had, he was accepted to the medical program at Louisiana State University Medical Center in Shreveport. He felt intimidated at first, as he was surrounded by people who had been gunning for the medical field for their entire academic lives. That insecurity fueled his motivation, and his hard work paid off -- he finished second in his class and went to Dartmouth to do his internal medicine residency.

"That was during the time of the AIDS epidemic," he remembers. This next part is difficult for him to talk through. "It was so tragic. People were sick, and they were dying, and we didn't have much to offer them. I'm always slow to decide what direction my life is going to take, but I had to be in infectious diseases, because that's where history was. It just felt right to me."

A year of internal medicine in rural West Virginia and a fellowship at Vanderbilt in Nashville in infectious diseases followed this revelation. He thought research and teaching was where he was headed -- "the opportunity to creatively ask and answer questions was so appealing to me" -- but, in 1994, when he came to Northwest Arkansas to visit a friend who was contemplating a job in the area, he fell in love.

"The area is just so amazing," he says. "The country is so beautiful. The people in this area are so progressive and thoughtful. There's the university, there are all these dynamic people in Rogers and Bentonville doing all of these interesting things, and there was nobody doing infectious diseases. I thought, 'This is what I should do.'"

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For the past year and a half, covid-19 has been one of the largest focuses of his practice. Though he is quick to say that those medical professionals on the front lines are the true heroes of the pandemic fight, he's been helping to establish best practices in fighting the virus, and his careful, considered social media posts on the subject have been widely shared.

"The only way you can know an illness is to care for it," he says of the virus' first days. "So I was getting on the phone and calling friends in other places. 'What does this look like? What does it feel like? How does it feel, standing at the bedside?' I remember the first patient that I saw who was so sick -- there's such a brutal lethality about these people who get really sick. We've gotten better at taking care of it. But that dark brutality is still a part of what we see in healthcare. And I think that part of the problem with this is that the public doesn't see that much. You hear people who have no respect for this infection because they've known 10 people or 50 people or however many who have had it, and it's like a bad cold or flu. We're saying, 'No! You can't imagine this! You don't want this.' The people we're seeing now are almost all people who have chosen not to be immunized."

"He is this man, flying through space: [that] is the image I get when I think of Steve and the pandemic," says Kaminsky. "He was always busy, but now -- sometimes the only time we get a chance to visit is texting at 12 o'clock at night. He would send me notes on something he had observed, and that was the way we had to talk, because he was just so busy. 'Man with wings' is the way I describe him during that period."

The anti-vaccine and anti-mask movements have been frustrating and heartbreaking for Hennigan.

"Everything has become politicized; it's become an ideology thing, which is heartbreaking, because these people that are all bowed up about masks and such, they're just humans like everybody else -- they're going to suffer like everybody else," Hennigan says. "What I try to do is be their advocate. I don't want to ridicule some other human. I've been ignorant, personally, in ways I won't even tell you about. None of us think perfectly, so why should I insult someone? And yet they just don't understand. I'm going Monday to a school board meeting to talk about mask mandates. There are these people who stoutly oppose mask mandates because of 'freedom.' Three children have died in Arkansas. That's not very many. But I've lost a son. I know what it feels like to lose a child."

Hennigan's son, Lucas Aaron Hennigan, died unexpectedly just four years ago. The result, says Hennigan, was a shift in his fundamental world view.

"Do you have children?" he asks, then, "I just pray you never have to go through that. It was the most painful thing I've ever been through in my life. But, sometimes, things are required of people, for whatever reason -- things happen that we have no control over. When that happened, I felt really strongly that I had to treat that loss with reverence, to honor my son, to hold that pain and carry it in a way that was reverent. And it changed me -- it still, to this day, hurts, but I'm more connected to the fabric of what life is, somehow. I think being a part of the reality of humanity, which includes suffering, is kind of a privilege.

"I've gotten to where I can look back on him with joy. Early on, you just want to draw back from it, because it hurts. But he was special. And I was privileged to get to be his dad. I think he led a complete life. He died when he was 30. But I have a lot to be joyful in him, and he's still with me."

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Hennigan has been practicing in Northwest Arkansas for nearly 30 years, and his habits of intense research and careful experimentation mean he's just about seen it all. But he lacks the hubris to actually think that way.

"I'm very aware of my own limitations," he says. "I'll tell patients I take care of, 'This is what I think. I could be wrong.' I'm quite transparent. I'm just as human as everybody else. I try to problem solve collaboratively with a patient, and I think there's a value in that transparency, because the worst thing in the world is to pretend like you know everything."

Those that practice alongside him, however, see things a little differently. Thomas says the duo often see patients who have been through doctor after doctor with no respite from their symptoms and are frustrated and out of hope by the time they reach Thomas and Hennigan.

"I would say [to them], 'I have to tell you this -- I can't remember when he was wrong," says Thomas. "'I can't remember when he made a diagnosis or made a treatment plan and was wrong. I think you'll be very happy.' And that seemed to cheer patients up a little bit."

"I would say there's a good possibility that he's a true genius," agrees Symes. "Sometimes arrogance goes with that, and that's not Steve -- he's humble. He has a great respect for people in his field."

The closest thing Hennigan is willing to admit?

"I am different," he muses. "It hasn't always been easy to be different. I had to come to a place where, you can only be who you are, right? If you're anything else, if you're inauthentic, you're just a pretender. And that's really bad, right? I think we have to accept each other's differences. We just have to be the best person we can be, and then, all together, make this work."