TRANSACTIONS OF THE AMERICAN CLINICAL AND CLIMATOLOGICAL ASSOCIATION, VOL. 127, 2016
Memorial RICHARD STARR ROSS, MD 1924 − 2015
Richard S. Ross, MD, who as the seventh Dean led the Johns Hopkins University School of Medicine through a time of tremendous growth in basic research and clinical medicine, succumbed to complications of advanced Parkinson’s disease at his home in Baltimore, Maryland, on August 11, 2015, at the age of 91. An enthusiastic member of the American Clinical and Climatological Association since 1963 and President in 1979, he has his wife Elizabeth (Boo) were significant proponents of the scientific and social gatherings making many friends over the years. Dick was a native Hoosier, raised an only child of Louis Francisco and Margaret Ross in Richmond, Indiana. No doubt these circumstances were partly responsible for his down-to-earth nature and no-nonsense attitudes. He lived with his parents on the grounds of the Eastern Indiana Hospital for the Insane where his physician father was superintendent. ci
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This provided an early exposure to the workings of a complex medical institution as well as grist for one of his favorite quips: “I was born and raised in an insane asylum, which many people hear with great interest” (1). Dick nodded to his father as his main source of scientific instruction as the local schools were abysmal in this respect. Excelling overall academically, he was accepted into Harvard College with scholarship in 1942. Due to the war time need for physicians, Harvard Medical School had an accelerated program that Dick entered the following year. He graduated with a medical degree cum laude sans baccalaureate in 1947. Prior to graduation, Dr J. Howard Means, who was Chairman of Medicine at the Massachusetts General Hospital (MGH), extended an offer of an internship. During that first year, Hopkins-trained MGH attending Myles Baker suggested that Dick seek out how things are done outside of Boston. He spent several rotations at Johns Hopkins Hospital that he greatly enjoyed, especially the central responsibility given to interns providing patient care. Half-way through his second Assistant Resident year, Dick made the fateful decision to stay at Johns Hopkins Hospital to complete his training which would forever benefit Maryland to Massachusetts’ loss. Key to this decision was the opportunity to work with A. M. (Mac) Harvey, MD, who had just recently accepted the position as Chairman of the new Department of Medicine at Johns Hopkins School of Medicine. Harvey was heavily recruiting young, energetic people and he became Dick’s mentor and close friend for many years. During this first year at Hopkins, Dick met his future wife, Elizabeth McCracken. She was working as a research associate after graduating from Vassar College. Married in 1950, Dick had 2 years of pay back to the Army for his schooling. Due to the conflict on the Korean Peninsula, he served as Captain in the 141st General Hospital that was based on the island of Kausho in southern Japan. Finishing the tour, he returned to Baltimore as an Assistant Resident under the direction of Resident Victor McKusick. Prior to his year as Chief Resident Physician in 1953, Dick returned to Boston. Under A. Clifford Barger at the Harvard Medical School, Dick studied heart failure in the canine model, which stimulated his life-long interest in cardiac physiology. Joining the faculty of the Johns Hopkins School of Medicine in 1954, his early scholarly interests included work with Dr W. Gordon Walker investigating the exchange of proteins between plasma and extracellular spaces with the then novel but primitive electrophoretic gel apparatus. At the direction of Dr Harvey, Dick assisted in the care of adults referred to the pediatric cardiologist Dr Helen Taussig due to her worldwide reputation in congenital heart disease. Although this
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situation was not immediately welcomed by Dr Taussig, Dick diplomatically made the best of it, quickly becoming expert in this arena. The advent of cardiac cineangiography naturally lent itself to care of patients with congenital abnormalities. Expert in its use, Dick became director of the Wellcome Trust Research Laboratory in 1960 with additional investigations including phonocardiographic and hemodynamic studies with one of his key collaborators, J. Michael Criley. Dr Criley described his friend and colleague as approaching challenges with calm and clear-eyed logic and leading by example (2). Studies of coronary blood flow and hypertrophic cardiomyopathy followed as well as development of a novel approach using xenon gas to measure blood flow in coronary arteries (3−6). He helped organize one of the earliest multicenter, randomized trials to evaluate the use of bypass surgery in the emergency management of angina pectoris (7). These experimental efforts, all focused by his desire to improve the diagnosis and the management of patients with heart disease, are witnessed by over 150 publications. Named Director of the Cardiovascular Division in 1961, he was promoted to Professor in 1965 with an endowed chair following in 1969 as the Susan and William Clayton Professor of Medicine. These were busy times including, to name just a few responsibilities: Chair of the National Institutes of Health (NIH) Cardiovascular Study Section, Editor of the Principles and Practice of Medicine, President of the American Heart Association (AHA; 1973−1974) with many appearances in the media as well as testimony before Congress often centering on preventive aspects of coronary artery disease. Dick recalled these times as the most exciting and enjoyable period of his life. In 1974, Dick was one of three physicians called upon by Judge John Sirica as chief judge of the US District Court in Washington, DC, to evaluate whether former President Richard Nixon was medically fit to travel from his home in San Clemente, California, to the Watergate hearings. This story is recounted with entertaining detail in the Transactions of the American Clinical and Climatological Association, entitled “A California House Call” (8).There was unanimous conclusion by these three consultants that Nixon was too ill to travel at the time. Years later, Dick recounted the tremendous emotion and press coverage that he viewed as frequently unfair but anticipated. For historians, it may be this encounter that he will be longer remembered (9). With desirable research and administrative skills, Dick became Dean of the School of Medicine and Vice President for Johns Hopkins Medicine in 1975. Dick viewed himself as moving from a specialist back to a generalist, taking pride now not in his own work but in the
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accomplishments of his entire faculty (10). During an interview in 1980, he said that “any discussion of Hopkins’ greatness begins with Osler, Halsted, Welch and Kelly, the four physicians in the early years…the line between these men and the present is direct (11).” This reinforced his view that educating and hiring the right people are the most important aspects of maintaining quality. He took deep interest in personally recruiting for leadership positions and insisted upon “selection of the best possible students, bright, well-rounded, motivated, imaginative people” (12). Concerned about the shrinking pool of young investigators, he sought to foster biomedical research by establishing a fund to encourage those early in their career with pilot grants that would lead to successful external sponsorship. Over his term of 15 years, Dick worked to improve the facilities and activities available on the East Baltimore campus for students and faculty in an effort to maintain the heritage of excellence. Former chair of Medicine, Myron “Mike” Weisfeldt called Dick a “true Hopkins legend…His great characteristics were integrity and commitment. There being enough of both to infect all around him” (2). His leadership resulted in such successful metrics as increasing the amount of NIH funding from $20 million to more than $100 million when he stepped down in 1990, leaving Hopkins in first position nationally in received monies. Philanthropic efforts led to 29 endowed professorships and numerous buildings doubling available research space that included a 10-story laboratory, named in his honor, the Richard Starr Ross Research Building. His wise guidance and mentorship benefited many students and faculty during his tenure. Among the many honors and awards he received, notables include membership in Alpha Omega Alpha, member of the Institute of Medicine of the National Academy of Sciences (1975), Gold Heart Award (1976), Conner Lecture (AHA, 1979), Master of the American College of Physicians (1979) and the James B. Herrick Award (AHA, 1982), the Abraham Flexner Award for distinguished service to medical education (Association of American Medical Colleges, 1994), and the Johns Hopkins University President’s medal (2005). He was President of the Interurban Clinical Club (1978) and fellow in the Royal Society of Medicine. Dick was a long-time member of the Board of Overseers of Harvard College and a member of the Board of Directors for the Merck Corporation and the Noxell Corporation. Dick’s talents extended far beyond his professional home. With the nearby Chesapeake Bay beckoning, Dick took to sailing the waters with his family outside their summer house on the Severn River. He owned two boats. The first, a wooden hull Lightning class, he named Diastole.
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The other, a fiberglass Mobjack, christened Systole. Sailing adventures in the Caribbean and Eastern Seaboard were often shared with the family of his good friend Dick Johns, now a University Distinguished Service Professor Emeritus. After his busy years at Hopkins, he and Boo traveled extensively. They spent parts of every winter on Sanibel Island, Florida, where he golfed nearly daily. An inveterate learner, Dick learned to windsurf while in his sixties and he kept abreast of politics, history, science, and new technologies. He devoted many hours to researching the family ancestry with files filled now with over 900 records. Ever a teacher, Dick took many opportunities to share knowledge with his children and grandchildren. One of his favorite expressions was “see one, do one, teach one.” That applied to sailing, golfing, shucking oysters, identifying constellations, photography, and learning how to dissect a pig’s heart. This last skill was something all his children learned to perform in the family kitchen and then they went on to teach their classmates. One of his favorite organizations was the American Clinical and Climatological Association (ACCA). Dick viewed it differently from the usual scholarly societies because of the “secret sauce” that depended on members’ partners leading to memorable meetings and enduring friendships. His Presidential Address characteristically focused on the quality of clinical studies regarding coronary artery bypass surgery as well as the likely overuse of this operation. His wife Elizabeth, known affectionately as Boo, was critical to his success. In fact, they both started a standing tradition that continues to this day: seating assignments at one of the dinners is achieved by randomly selecting couples from slips of paper placed in a bowl. This idea was meant to encourage current members to meet those who they do not yet know as well as new members. As Boo’s health declined, Dick would still attend, later escorted by one of his two daughters. When he could no longer manage the travel, he lamented missing the meetings, the science, and his remaining friends. He was a member for nearly 52 years. Devoted to his family, Dick leaves behind his wife of 65 years, three children, and five grandchildren. This writer only came to know Dick well starting in 1998 when he was asked to become Dick’s personal physician. As a young faculty member, I was honored to serve in this capacity for someone who had contributed so greatly to our school, the Baltimore community, and academic medicine. Through my modest efforts, I helped a Dean emeritus who aimed to remain an intellectually engaged and a vigorous member of Johns Hopkins, which was true through his eighties. I came to slowly realize that I benefitted far more from this relationship than he in my care.
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I imagine this is what he did for so many others — he took more than an abiding interest in my career, offered sage advice, made introductions, and helped my personal growth in many other ways. Although nearly four decades divided us, it made little matter to the core of doing what is good in medicine. I among many others will miss his intelligence, spirit of generosity, good humor, and friendship. With appreciation to Meg Ross and Deb Chambliss for their helpful reviews and sharing of family memories.
Paul G. Auwaerter, MD REFERENCES 1. Ross RS. Autobiography. Unpublished, date unknown: 1-8. 2. Grauer N. Richard S. Ross, longtime Johns Hopkins medical school dean, dies at 91. The Hub: Johns Hopkins Magazine. 2015. Available at: http://hub.jhu.edu/2015/08/13/ richard-ross-som-dean-obit. 3. Criley JM, Ross RS. Cardiac cine-catheterization. Heart Bull 1963;12:44−9. 4. Ross RS, Criley JM. The cardiovascular laboratory. I. Mod Concepts Cardiovasc Dis 1965;34(11):49−54. 5. Friesinger GC, Schaefer J, Gaertner RA, Ross RS. Coronary sinus drainage and measurement of left coronary artery flow in the dog. Am J Physiol 1964;206:57−62. 6. Ross RS, Ueda K, Lichtlen PR, Rees JR. Measurement of myocardial blood flow in animals and man by selective injection of radioactive inert gas into the coronary arteries. Circ Res 1964;15:28−41. 7. Unstable angina pectoris: national cooperative study group to compare medical and surgical therapy. I. Report of protocol and patient population. Am J Cardiol 1976;37(6):896−902. 8. Ross RS. A California house call. Trans Am Clin Climatol Assoc 2003;114:255−70. 9. Roberts S. Richard S. Ross, Johns Hopkins Dean and Watergate Walk-on, Dies at 91. The New York Times. 8/17/15, 2015: B6. 10. Ross RS. Leaders in Medicine. Interviewed by Johns RJ, Alpha Omega Alpha; date unknown. 11. Taylor B. An exclusive profile/interview of Richard S. Ross, MD, dean of the Johns Hopkins Medical Faculty and Vice President for Medicine. Interview by Blaine Taylor. Md State Med J 1980;29(1):35−7. 12. Ross RS. On deaning and Hopkins: an interview with Richard S. Ross, M.D., dean emeritus of the Johns Hopkins University School of Medicine. Interview by Janet Farrar Worthington. Md Med J 1992;41(10):887−91.
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Memorial RICHARD STARR ROSS, MD 1924 − 2015
Richard S. Ross, MD, who as the seventh Dean led the Johns Hopkins University School of Medicine through a time of tremendous growth in basic research and clinical medicine, succumbed to complications of advanced Parkinson’s disease at his home in Baltimore, Maryland, on August 11, 2015, at the age of 91. An enthusiastic member of the American Clinical and Climatological Association since 1963 and President in 1979, he has his wife Elizabeth (Boo) were significant proponents of the scientific and social gatherings making many friends over the years. Dick was a native Hoosier, raised an only child of Louis Francisco and Margaret Ross in Richmond, Indiana. No doubt these circumstances were partly responsible for his down-to-earth nature and no-nonsense attitudes. He lived with his parents on the grounds of the Eastern Indiana Hospital for the Insane where his physician father was superintendent. ci
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This provided an early exposure to the workings of a complex medical institution as well as grist for one of his favorite quips: “I was born and raised in an insane asylum, which many people hear with great interest” (1). Dick nodded to his father as his main source of scientific instruction as the local schools were abysmal in this respect. Excelling overall academically, he was accepted into Harvard College with scholarship in 1942. Due to the war time need for physicians, Harvard Medical School had an accelerated program that Dick entered the following year. He graduated with a medical degree cum laude sans baccalaureate in 1947. Prior to graduation, Dr J. Howard Means, who was Chairman of Medicine at the Massachusetts General Hospital (MGH), extended an offer of an internship. During that first year, Hopkins-trained MGH attending Myles Baker suggested that Dick seek out how things are done outside of Boston. He spent several rotations at Johns Hopkins Hospital that he greatly enjoyed, especially the central responsibility given to interns providing patient care. Half-way through his second Assistant Resident year, Dick made the fateful decision to stay at Johns Hopkins Hospital to complete his training which would forever benefit Maryland to Massachusetts’ loss. Key to this decision was the opportunity to work with A. M. (Mac) Harvey, MD, who had just recently accepted the position as Chairman of the new Department of Medicine at Johns Hopkins School of Medicine. Harvey was heavily recruiting young, energetic people and he became Dick’s mentor and close friend for many years. During this first year at Hopkins, Dick met his future wife, Elizabeth McCracken. She was working as a research associate after graduating from Vassar College. Married in 1950, Dick had 2 years of pay back to the Army for his schooling. Due to the conflict on the Korean Peninsula, he served as Captain in the 141st General Hospital that was based on the island of Kausho in southern Japan. Finishing the tour, he returned to Baltimore as an Assistant Resident under the direction of Resident Victor McKusick. Prior to his year as Chief Resident Physician in 1953, Dick returned to Boston. Under A. Clifford Barger at the Harvard Medical School, Dick studied heart failure in the canine model, which stimulated his life-long interest in cardiac physiology. Joining the faculty of the Johns Hopkins School of Medicine in 1954, his early scholarly interests included work with Dr W. Gordon Walker investigating the exchange of proteins between plasma and extracellular spaces with the then novel but primitive electrophoretic gel apparatus. At the direction of Dr Harvey, Dick assisted in the care of adults referred to the pediatric cardiologist Dr Helen Taussig due to her worldwide reputation in congenital heart disease. Although this
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situation was not immediately welcomed by Dr Taussig, Dick diplomatically made the best of it, quickly becoming expert in this arena. The advent of cardiac cineangiography naturally lent itself to care of patients with congenital abnormalities. Expert in its use, Dick became director of the Wellcome Trust Research Laboratory in 1960 with additional investigations including phonocardiographic and hemodynamic studies with one of his key collaborators, J. Michael Criley. Dr Criley described his friend and colleague as approaching challenges with calm and clear-eyed logic and leading by example (2). Studies of coronary blood flow and hypertrophic cardiomyopathy followed as well as development of a novel approach using xenon gas to measure blood flow in coronary arteries (3−6). He helped organize one of the earliest multicenter, randomized trials to evaluate the use of bypass surgery in the emergency management of angina pectoris (7). These experimental efforts, all focused by his desire to improve the diagnosis and the management of patients with heart disease, are witnessed by over 150 publications. Named Director of the Cardiovascular Division in 1961, he was promoted to Professor in 1965 with an endowed chair following in 1969 as the Susan and William Clayton Professor of Medicine. These were busy times including, to name just a few responsibilities: Chair of the National Institutes of Health (NIH) Cardiovascular Study Section, Editor of the Principles and Practice of Medicine, President of the American Heart Association (AHA; 1973−1974) with many appearances in the media as well as testimony before Congress often centering on preventive aspects of coronary artery disease. Dick recalled these times as the most exciting and enjoyable period of his life. In 1974, Dick was one of three physicians called upon by Judge John Sirica as chief judge of the US District Court in Washington, DC, to evaluate whether former President Richard Nixon was medically fit to travel from his home in San Clemente, California, to the Watergate hearings. This story is recounted with entertaining detail in the Transactions of the American Clinical and Climatological Association, entitled “A California House Call” (8).There was unanimous conclusion by these three consultants that Nixon was too ill to travel at the time. Years later, Dick recounted the tremendous emotion and press coverage that he viewed as frequently unfair but anticipated. For historians, it may be this encounter that he will be longer remembered (9). With desirable research and administrative skills, Dick became Dean of the School of Medicine and Vice President for Johns Hopkins Medicine in 1975. Dick viewed himself as moving from a specialist back to a generalist, taking pride now not in his own work but in the
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accomplishments of his entire faculty (10). During an interview in 1980, he said that “any discussion of Hopkins’ greatness begins with Osler, Halsted, Welch and Kelly, the four physicians in the early years…the line between these men and the present is direct (11).” This reinforced his view that educating and hiring the right people are the most important aspects of maintaining quality. He took deep interest in personally recruiting for leadership positions and insisted upon “selection of the best possible students, bright, well-rounded, motivated, imaginative people” (12). Concerned about the shrinking pool of young investigators, he sought to foster biomedical research by establishing a fund to encourage those early in their career with pilot grants that would lead to successful external sponsorship. Over his term of 15 years, Dick worked to improve the facilities and activities available on the East Baltimore campus for students and faculty in an effort to maintain the heritage of excellence. Former chair of Medicine, Myron “Mike” Weisfeldt called Dick a “true Hopkins legend…His great characteristics were integrity and commitment. There being enough of both to infect all around him” (2). His leadership resulted in such successful metrics as increasing the amount of NIH funding from $20 million to more than $100 million when he stepped down in 1990, leaving Hopkins in first position nationally in received monies. Philanthropic efforts led to 29 endowed professorships and numerous buildings doubling available research space that included a 10-story laboratory, named in his honor, the Richard Starr Ross Research Building. His wise guidance and mentorship benefited many students and faculty during his tenure. Among the many honors and awards he received, notables include membership in Alpha Omega Alpha, member of the Institute of Medicine of the National Academy of Sciences (1975), Gold Heart Award (1976), Conner Lecture (AHA, 1979), Master of the American College of Physicians (1979) and the James B. Herrick Award (AHA, 1982), the Abraham Flexner Award for distinguished service to medical education (Association of American Medical Colleges, 1994), and the Johns Hopkins University President’s medal (2005). He was President of the Interurban Clinical Club (1978) and fellow in the Royal Society of Medicine. Dick was a long-time member of the Board of Overseers of Harvard College and a member of the Board of Directors for the Merck Corporation and the Noxell Corporation. Dick’s talents extended far beyond his professional home. With the nearby Chesapeake Bay beckoning, Dick took to sailing the waters with his family outside their summer house on the Severn River. He owned two boats. The first, a wooden hull Lightning class, he named Diastole.
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The other, a fiberglass Mobjack, christened Systole. Sailing adventures in the Caribbean and Eastern Seaboard were often shared with the family of his good friend Dick Johns, now a University Distinguished Service Professor Emeritus. After his busy years at Hopkins, he and Boo traveled extensively. They spent parts of every winter on Sanibel Island, Florida, where he golfed nearly daily. An inveterate learner, Dick learned to windsurf while in his sixties and he kept abreast of politics, history, science, and new technologies. He devoted many hours to researching the family ancestry with files filled now with over 900 records. Ever a teacher, Dick took many opportunities to share knowledge with his children and grandchildren. One of his favorite expressions was “see one, do one, teach one.” That applied to sailing, golfing, shucking oysters, identifying constellations, photography, and learning how to dissect a pig’s heart. This last skill was something all his children learned to perform in the family kitchen and then they went on to teach their classmates. One of his favorite organizations was the American Clinical and Climatological Association (ACCA). Dick viewed it differently from the usual scholarly societies because of the “secret sauce” that depended on members’ partners leading to memorable meetings and enduring friendships. His Presidential Address characteristically focused on the quality of clinical studies regarding coronary artery bypass surgery as well as the likely overuse of this operation. His wife Elizabeth, known affectionately as Boo, was critical to his success. In fact, they both started a standing tradition that continues to this day: seating assignments at one of the dinners is achieved by randomly selecting couples from slips of paper placed in a bowl. This idea was meant to encourage current members to meet those who they do not yet know as well as new members. As Boo’s health declined, Dick would still attend, later escorted by one of his two daughters. When he could no longer manage the travel, he lamented missing the meetings, the science, and his remaining friends. He was a member for nearly 52 years. Devoted to his family, Dick leaves behind his wife of 65 years, three children, and five grandchildren. This writer only came to know Dick well starting in 1998 when he was asked to become Dick’s personal physician. As a young faculty member, I was honored to serve in this capacity for someone who had contributed so greatly to our school, the Baltimore community, and academic medicine. Through my modest efforts, I helped a Dean emeritus who aimed to remain an intellectually engaged and a vigorous member of Johns Hopkins, which was true through his eighties. I came to slowly realize that I benefitted far more from this relationship than he in my care.
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I imagine this is what he did for so many others — he took more than an abiding interest in my career, offered sage advice, made introductions, and helped my personal growth in many other ways. Although nearly four decades divided us, it made little matter to the core of doing what is good in medicine. I among many others will miss his intelligence, spirit of generosity, good humor, and friendship. With appreciation to Meg Ross and Deb Chambliss for their helpful reviews and sharing of family memories.
Paul G. Auwaerter, MD REFERENCES 1. Ross RS. Autobiography. Unpublished, date unknown: 1-8. 2. Grauer N. Richard S. Ross, longtime Johns Hopkins medical school dean, dies at 91. The Hub: Johns Hopkins Magazine. 2015. Available at: http://hub.jhu.edu/2015/08/13/ richard-ross-som-dean-obit. 3. Criley JM, Ross RS. Cardiac cine-catheterization. Heart Bull 1963;12:44−9. 4. Ross RS, Criley JM. The cardiovascular laboratory. I. Mod Concepts Cardiovasc Dis 1965;34(11):49−54. 5. Friesinger GC, Schaefer J, Gaertner RA, Ross RS. Coronary sinus drainage and measurement of left coronary artery flow in the dog. Am J Physiol 1964;206:57−62. 6. Ross RS, Ueda K, Lichtlen PR, Rees JR. Measurement of myocardial blood flow in animals and man by selective injection of radioactive inert gas into the coronary arteries. Circ Res 1964;15:28−41. 7. Unstable angina pectoris: national cooperative study group to compare medical and surgical therapy. I. Report of protocol and patient population. Am J Cardiol 1976;37(6):896−902. 8. Ross RS. A California house call. Trans Am Clin Climatol Assoc 2003;114:255−70. 9. Roberts S. Richard S. Ross, Johns Hopkins Dean and Watergate Walk-on, Dies at 91. The New York Times. 8/17/15, 2015: B6. 10. Ross RS. Leaders in Medicine. Interviewed by Johns RJ, Alpha Omega Alpha; date unknown. 11. Taylor B. An exclusive profile/interview of Richard S. Ross, MD, dean of the Johns Hopkins Medical Faculty and Vice President for Medicine. Interview by Blaine Taylor. Md State Med J 1980;29(1):35−7. 12. Ross RS. On deaning and Hopkins: an interview with Richard S. Ross, M.D., dean emeritus of the Johns Hopkins University School of Medicine. Interview by Janet Farrar Worthington. Md Med J 1992;41(10):887−91.
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