William Bicknell: “A Lion’s Heart and a Leopard’s Mind”

William J. Bicknell, an outspoken, inspirational international health practitioner and advocate, who sought to “make people hurt less,” has died after a long battle with cancer. He was 75.

Bicknell, who died Tuesday night at his home in Marshfield, Mass., was the founder and chair emeritus of the School of Public Health department of international health, and he helped grow the department into a globally recognized leader. He held a dual appointment at the School of Medicine as a professor and director of international health programs in the department of family medicine.

During a varied career that spanned five decades and merged disciplines of practice and policy, Bicknell held posts as the first medical director of the Job Corps, Massachusetts Commissioner of Public Health, acting director of the Neighborhood Health Center Program for the U.S. Office of Economic Opportunity, and medical director of health and retirement funds for the United Mine Workers of America.

SPH Dean Robert Meenan (MED’72, GSM’89) says Bicknell has been an essential part of the School of Public Health almost from its beginning, and a fundamental force in the expanded presence of international health at BU. “Global health is now a major focus of Boston University and none of that would have been true without Bill Bicknell,” Meenan says. “The mission of the school is to prioritize the disadvantaged, underserved, and vulnerable, and Bill has embodied that mission in his life’s work.”

In the months after his diagnosis, Bicknell detailed his fight with metastatic lung cancer with methodical precision in blog updates and in a poignant final lecture he gave last month at the BU Medical Campus. Titled Lessons Learned from a Life in Public Health, the lecture was a no-holds-barred personal recap of his efforts to advance public health in 62 countries.

In many ways, the lecture was a reflection of the man who gave it: blunt but caring, profane yet profound. Rapid-fire observations delivered with clinical detachment were followed by touching anecdotes about Bicknell’s main career goal: making health services work better for the poor and other difficult to serve populations.

Brian Jack, a MED associate professor of family medicine and vice chair for academic affairs, says Bicknell devoted the last years of his life to strengthening the work of the Lesotho-Boston Health Alliance, which he and Bicknell founded a decade ago. The goal of the alliance is to improve Lesotho’s medical capacity by strengthening hospitals and establishing a family medicine residency program to help the impoverished country retain physicians.

“Lesotho is arguably one of the most needy countries in the world, and in the last years of his life, Bill dedicated himself to strengthening its health systems,” Jack says. Even after Bicknell was diagnosed with cancer, he continued to travel to Lesotho, making a final trip in March to say good-bye to the many people he had befriended there over the years.

“He was my good friend and a trusted colleague and mentor,” Jack says, “and his heart was with the people of Lesotho, to make their lives better.”

He recalls Bicknell as a strong believer in empowering communities to solve their own health problems, rather than prescribing solutions. The Lesotho program grew out of a series of workshops that the two men had conducted in Lesotho, in which the recruiting and retaining of physicians emerged as a key problem for the country. Once the problem was identified, Jack says, “we got to work on a strategy to address it.”

Bicknell was known for telling students and colleagues that the first step in approaching public health—at home or abroad—was simply to listen.

Kate Mitchell (SPH’09) was one of Bicknell’s students in spring 2008 and later worked as one of his teaching assistants. She says that Bicknell began each semester with his unique definition of public health: “The art and science of deciding who dies, when, and with what degree of misery.” But, she recalls, he also said public health could easily be defined as “the art and science of deciding who lives a longer, less miserable, happier life.” And his warning to students: “If you approach your work with the second definition, you often forget the consequences of what happens when you fail. Always keep the first definition in mind.”

In the video above, William Bicknell shares his experiences as a Peace Corps doctor in Ethiopia from 1964-1966.

Born and raised in Woburn, Mass., Bicknell earned a bachelor’s degree in biology from Johns Hopkins University in 1958. After graduating from Duke University School of Medicine in 1963, he joined the U.S. Public Health Service Commissioned Corps and was named senior physician for Peace Corps volunteers in Ethiopia. While there, he also worked in local hospitals and was exposed to a level of illness and suffering that presaged his shift to public health.

“It was a social and intellectual and emotional change for me,” Bicknell recalled in an interview this past April. “It totally hooked me on making services work for people, on improving health care systems.”

Several years after returning from Ethiopia, Bicknell earned a master’s degree in public health from the University of California, Berkeley. During his last lecture, he estimated that he had spent about half of his career working to further public health in the United States and the other half overseas—a proportion that “felt just right.” After coming to BU in 1978, he focused on establishing the curriculum for the nascent department of international health and later established the Center for International Health, which was eventually expanded into the current Center for Global Health & Development.

In recent weeks, tributes to Bicknell from faculty and former students have flooded his CaringBridge website. Bicknell had posted frequent updates until this past Monday, when his wife, Jane Hale, a Brandeis University professor, wrote that Bill was no longer able to write himself.

In the days before Bicknell’s death, former student Pratibha Shah (SPH’11) wrote on the site, “It has been a privilege and honor to have known you, taken your class, and interacted with you. My journey in the U.S., especially my academic journey, has been filled with many unforgettable people and experiences. But you have definitely stamped my heart and mind forever with your indefatigable spirit and most unique personality. You have a lion’s heart and a leopard’s mind.”

From another former student, Jane Craycroft (SPH’95): “You were my advisor at BUSPH. I first laid eyes on you during fall 1992 orientation and witnessed you deep in thought (sleeping?) while loads of us newbies filled one of the auditoriums. Later the same day, during the refreshment part of the event, while speaking with a group of students and eating a sandwich, you needed to be hands free (perhaps you started gesticulating or a handshake took place), so you put your sandwich in the pocket of your blue blazer. My initial thoughts were…my advisor is a crazy nut, what have I gotten myself into?

“Shortly after that day, I realized that, yes, you were a crazy nut but crazy in a dedicated, trailblazing, passionate, and full-of-life sort of way. A way I wanted to be, a way I strive to be.”

Monita Baba Djara, an SPH clinical instructor in international health, wrote on the site that Bicknell’s “iconic presence” would be missed. “You have always been an inspiration to me in the fierceness of your commitment to making the world a less ‘stupid’ place. Your legacy of asking the tough questions from a caring heart will live on in all of us who have had the privilege of working with you and being influenced by your unique brand of PH [public health].”

Many of those influenced by Bicknell said good-bye at that last lecture in May and in small gatherings held in Boston and Lesotho. Bicknell spent his last days surrounded by family and friends at home in Marshfield, in a sunroom where he could look out across the salt-marsh landscape he loved.

Memorial service details are pending.

View William Bicknell’s final lecture, Lessons Learned from a Life in Public Health, in the video above.

Michael Saunders can be reached at msaunder@bu.edu; Lisa Chedekel can be reached at chedekel@bu.edu.