If the tragedy of a death can be measured by how much the deceased was needed and by how many, Jack Ream's death is a tragedy of copious proportions.

The physician's tumble down two flights of stairs Friday at St. Mark's Hospital cut short a powerful career in reimplant surgery. Ream's hands were full with a briefcase, a camera and a box of suckers when he apparently fell backwards down the steep stairs at the hospital shortly before 7:30 a.m. His pockets were full of marbles.He died Monday afternoon without regaining consciousness.

The suckers and marbles were for the small patients he cared for, said colleague John Provost. Provost and Ream have shared an office for the past four years.

Ream had a lot of small patients. His skill with the reattachment of limbs in children was unrivaled in the west, said colleague Dennis Gordon.

"When a limb is severed, you have to go in and repair the broken bones, tendons, nerves, arteries and veins," Gordon explained. "The difficulty is when you get down to smaller structures like fingers particularly fingers on children. The blood vessels are so tiny that keeping them open is a real art. Dr. Ream was superb at reimplanting those very tiny digits on children. He often took veins from other parts of the body to put in place of those tiny veins.

"He was a man of incredible patience. He was able to sit there at times for 16 to 20 hours on one case and continue to redo things until he was satisfied they were working well."

One of Ream's most famous cases was 12-year-old Louise Wiens. Ream saved the youngster's hand after it was pinned for seven hours under a 25-ton concrete and metal beam following the explosion of the Goldminer's Daughter Lodge in Alta on March 16, 1985.

Despite the original diagnosis of severely damaged nerves, Wiens has almost a complete range of movement in her hand now.

But it isn't just injured children who will miss the gentle, skilled surgeon. He leaves four young children of his own, ranging from 8 to 18 years of age. And he leaves his wife, Victoria Jane.

The couple met at Harvard while he was getting his medical training and she was doing medical research. Their 23-year marriage mingled adventure and devotion.

"We didn't have one argument in 23 years," Mrs. Ream told the Deseret News Tuesday. Despite Ream's habit of lavishing long hours on his patients, his family never felt neglected, she said.

"The minute he was in the door and it was usually late he always gave us that same attention. Our children didn't see him as much as some children see their fathers, but when he was with us, he was absolutely 100 percent with us."

He loved medicine, his wife said. He often told her there was nothing else he would rather do and he would have done whatever was necessary to get the training he needed. She shared that passion, traveling with him to several underdeveloped countries where the couple taught doctors, nurses and interns modern medical techniques.

The Reams traveled with Care Medical and Orthopedics Overseas, she said. They went to Tunisia in 1972, Afghanistan in 1974 and Liberia in 1987.

"We couldn't take the children. Living conditions were too primitive and we were working too hard. Although, the next trip, we were going to take the older ones," she said. "We planned to do a lot more."

Wife, friends, colleagues all return to the same refrain: there should have been so much more.

"This loss has been more devastating to me than the loss of my parents," Provost said. "My folks died when they were elderly. If there is such a thing as a time to die, their time had come. But there was no reason for Jack to go. He was in the prime of his life. He was honored and respected by his peers and loved by his patients. For a man of his capabilities to be taken is a priceless loss to society."

Judging from Ream's past, the future would have been breathtaking. Born in Dingle, Idaho, Ream's passion for medicine won him entrance to Harvard Medical School. He did his internship and residency at the University of Virginia Hospital. He spent three years in the Harvard orthopedic residency program, serving for a year as the chief resident of orthopedic surgery at Massachusetts General Hospital. While in Boston, he also completed a fellowship in hand surgery.

"We had a hard time deciding whether to live East or West, but we came here because his mother was alone," Mrs. Ream said.

That concern for his family was characteristic of Ream, said his closest friend and fellow surgeon, Gerald Vanderhooft.

The week before he fell, Ream flew to Phoenix to be with his sister while her son underwent brain surgery.

Seven years ago, Ream, Vanderhooft and several other doctors traveled to China as part of a medical delegation. Ream also brought along his widowed mother, widowed mother-in-law and widowed sister-in-law.

"If that doesn't say something about a man, I don't think anything would," Vanderhooft said.

Ream was generally described as quiet and unassuming.

"He would have been upset with this sort of attention. He was a very private, caring sort of person," Mrs. Ream said.

Ream was disinterested in possessions and status symbols. "At the time he died, he was driving a diesel Oldsmobile that was far, far from new," said Vanderhooft. "He used to drive a Mercedes that he paid $4,500 for when he bought it. He drove it for 20 years. By the time he finished using it, it was the least attractive vehicle in the doctors' parking lot."

Ream set up the reimplant team at the St. Mark's Hospital, ensuring that two reimplant physicians are on call every day of the week, Gordon said.

His passion for medicine spilled over into the rest of life. "We spent a lot of time climbing mountains all over the world, skiing and scuba diving," his wife said. "He was very adventurous. He did a lot of things most people wouldn't do dragging his timid wife behind him. There are a lot of things I've done I wouldn't have done without him."

The family will receive friends at the Cottonwood Mortuary from 6 to 8 p.m. April 13. The funeral is at noon April 14 in the Cottonwood 2nd Ward chapel, 2080 E. 5165 South. Friends may call at the church at 10:30 a.m.

Ream will be buried in Dingle, near the ranch where he grew up.

The good-byes are hard.

"He has been a hallmark for all of us. You can look at Jack Ream and say, `Here is a kind of guy who practiced absolutely honest, intellectual and wonderful medicine. He is the type all of us should emulate," Gordon said.

"I felt blessed to be his friend," Provost said.

As Vanderhooft drove away from the hospital Monday, moments after Ream died, he thought about Ream's life.

"I personally felt more like celebrating a life well-lived rather than feeling despair or sadness. It renewed what little faith I have."

For his widow and four children, the loss will weigh heavy for a long time to come.

"I have a lot of years ahead of me," Mrs. Ream concluded softly.