In Memoriam: Dr. Daniel L. Levin

Dr. Daniel L. Levin, pioneer in the field of pediatric critical care medicine, died secondary to complications associated with Parkinson’s Disease on June 19th, 2025, with family at the bedside. “Dan” was my mentor, my colleague, my number one cheerleader and also my step-father. Despite being in my life for almost 30 years, I never fully understood the depth of Dan’s contribution to the field of pediatric critical care until I cleaned out his desk after his death. As his naive child, I often thought to myself (or maybe sometimes not so much to myself), “Things have changed so much since he was practicing. What does he know about the nuances of the research world?” particularly when he critiqued what I thought was my “final” draft. Turns out, the answer to that question was – everything. I came across piles of manuscripts authored by my step-father dating back to the 1970s explaining pulmonary hypertension in fetal pigs, the use of empiric antibiotics or bronchodilators in respiratory failure secondary to respiratory syncytial virus (RSV) or the ethical considerations for brain death (1–8). Things I do every day without a second thought, like adding papaverine to a spasming arterial line – there it was, “Randomized controlled trial of papaverine continuous infusions to prevent failure of arterial catheters in pediatric patients,” Dr. D L Levin, senior author (9).Born in 1943 in Chicago, IL, Dr. Levin forged his own path to become a pediatric intensivist. He transferred from University of Michigan to complete a degree in English at University of Illinois in Champaign, explaining his deeply rooted insistence on correct grammar and intentional word choice (“you are not bagging the patient, you are providing bag-mask ventilation to the patient”). While attending medical school at the University of Illinois (where he also completed a Master’s Degree in Psychology), Dr. Levin noticed that very sick pediatric patients were grouped with less acute patients, which he felt did not allow for optimal care. In 1969, while in his pediatric residency at Rush-Presbyterian St. Lukes, Dr. Levin capitalized on the idea of organizing medical care based on acuity, and helped open the hospital’s first four-bed pediatric intensive care unit (PICU). Having no available defined training options for “pediatric critical care medicine,” Dr. Levin went on to complete a fellowship in pediatric cardiology at Children’s Memorial Hospital in Chicago and finally a fellowship in neonatology at University of California in San Francisco, intentionally obtaining expertise in both cardiac and respiratory pathophysiology. Even during fellowship, Dr. Levin noticed lack of coordination of care between team members in early PICUs – there did not seem to be anybody focused on the whole patient, but rather solely on their individual subspecialty organ system (10). Armed with a unique set of skills, Dr. Levin along with Dr. Frances Morriss (anesthesiology) were recruited to University of Texas Southwestern (UTSW) in Dallas to lead the new PICU. At the time, most PICUs were led by anesthesiology-trained individuals. From 1975-1996 at UTSW, Dr. Levin became one of the first pediatricians to serve as a PICU medical director, in addition to becoming Medical Director of Pediatric Trauma Intensive Care at Parkland Memorial Hospital from 1987-1995. Under his and Dr. Morriss’ leadership, the program grew to 38 beds between the two hospitals, and the two trained 55 fellows in pediatric critical care from across the globe. Many of these fellows have contacted me since Dan’s death, emphasizing the impact of his mentorship on their careers. Dan kept hard copies of every single abstract and paper his fellows went on to publish in a folder and took pride in all their successes. For an intensivist who carried the nickname “Jaws” due to his no-nonsense nature, he was a surprisingly sentimental softie whose kryponite was any type of baked good. Dr. Levin used his platform as a pediatric leader to pass legislation to help prevent drowning, an enormous public health problem in the South (11–13). From 1984-1995, Dr. Levin headed an organization called Seeking Positive Leadership Against Swimming Hazards (SPLASH), eventually getting an ordinance passed in Dallas for safety fencing. Dr. Levin also served on the Committee on Pool and Spa Drain Covers for the United States Product Safety Commission and was the Chairman of the Drowning Prevention Committee for the Pediatric Section of the Society of Critical Care Medicine (SCCM). He developed a strong interest in both ethics and brain death, becoming an expert in both areas, teaching university level ethics courses, lecturing around the world, and ultimately publishing 50 original manuscripts (including works in the early years of Pediatric Critical Care Medicine [5, 6, 17]), countless abstracts, 32 book chapters and serving as principal or senior investigator for 19 grant funded projects (14–20). Dr. Levin’s commitment to education and research helped push pediatric critical care medicine forward as a formally recognized field of its own. In the late 1970s, Dr. Levin was one of several individuals who petitioned SCCM to create a pediatric subsection, and ultimately helped to build what, in 1987, would become the board-recognized subspecialty, pediatric critical care. Dr. Levin and Dr. Morriss wrote one of the first pediatric intensive care-specific textbooks. This textbook underwent four editions, was translated into multiple languages and served as a guide for learners around the world (21,22). Dan used to tell me the story of meeting a senior pediatric intensivist who told him that as a resident, there was just one attending in the intensive care unit. “When the fellow had to be out of town, he would give [the residents] the textbook and say, ‘Just do what it says in here and you’ll be okay.’” Dr. Levin further contributed to the academic rigor of the field of pediatric critical care by serving as an early member of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), sitting on the executive board from 2008-2017 and the senior advisory committee from 2018 until his death. Looking for a change of pace, Dr. Levin moved to Hanover, NH in 1996, recruited to Dartmouth Hitchcock Medical Center to build a six-bed PICU at Children’s Hospital at Dartmouth (CHaD). Involving families of critically ill children in the care of the child was incredibly important to him (23), and he participated fully in the design and build of the unit that would eventually become 10 beds, ensuring there was space for families to sleep in each patient room. At Dartmouth, Dr. Levin taught as a Professor in Pediatrics and Anesthesia and served as medical director of the PICU at CHaD from 1995-2005, developing a mobile critical care unit program, and ultimately retiring from clinical work in 2013. In 2003, Dr. Levin received the “Distinguished Career Award” from the American Academy of Pediatrics, Section on Critical Care Medicine, in addition to a recognition for “Major long-term contribution to intensive care of critically ill children at local, national and international level” at the World federation of Pediatric Intensive and Critical Care Societies, in 2011. Despite his many accomplishments, Dan was a humble, kind and quiet man who loved sports, travel, wine, fishing and beating my mother at Scrabble, but above all, he adored his grandchildren. In the last few years of his life, Dan moved to the Chicago suburbs to fill his final role as “Danpa” to my two daughters – his only granddaughters in a sea of 10 grandsons. Wanting to pass on some of his academic legacy, Dan included me in his long-term research on the origins of pediatric critical care. We collaborated on multiple projects including a textbook chapter and, in his final days, he filled his hospital time by editing (and editing and editing) whatever drafts I brought him of our most recent manuscript (S. E. Gardner Yelton, D. L. Levin, unpublished observations, 2025). One of the last things I, very fittingly, said to him was, “We have gotten it under the word count,” to which he responded, eyes closed, with a thumbs up and a smile. In addition to his grandchildren, Dan is survived by his wife, Judi, three children (Micah, Brendan and Erin), and four step-children (Ryan, Abby, Tyler and Sarah). I hear Dan’s guidance every time I walk into a resuscitation telling me, “Always take your pulse before you take the patients’ pulse.” I pass these words of wisdom on to all my trainees and try to live my life by the same standard (for example when dealing with a toddler tantrum). Thank you, Dan, for your life’s commitment to the health of children, your insistence on excellence and your persistence in making the world a better place. I miss you every day.