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TRANSACTIONS OF THE AMERICAN CLINICAL AND CLIMATOLOGICAL ASSOCIATION, VOL. 107, 1995

MEMORIAL

DAVID ELLIOTT ROGERS 1926-1994

When David Rogers died on December 5th, 1994 a sense of aston- ishment seemed to pervade the enormous number of individuals whose lives had intersected with his, or who had been touched by him in one

way or another, despite the fact that his illness had been widely known

for some months. People were surprised because it hadn't occurred to anyone who knew him that he wasn't indestructible, and the reason for that was that he was such an enormous presence in his world.

His world, of course, changed over the course of his professional career. Valedictorian of his medical school class at Cornell in 1948, he took two years of house staff training on Mac Harvey's Osler Medical Service at Hopkins before returning to The New York Hospital as a fellow in Walsh McDermott's Division of Infectious Disease. A year later he was Chief Resident in Medicine on David Barr's service at The

New York Hospital. David was a highly effective house officer; he loved the problem-solving, relished the interactions with his peers, and was moved deeply by the opportunity to support and to intervene on behalf of his patients. His house staff years were followed by two years as a medical officer in the Navy, including a year at NAMRU 1 in California. When he left the Navy he came back to New York, and spent a year in the laboratory of Rene Dubos at the Rockefeller Insti- tute for Medical Research, and then two additional years at the

Institute and at Cornell University Medical College. Back at Cornell,

three years following his chief residency, he was made Chief of the Division of Infectious Diseases. His experiences with Dubos and Mc- Dermott had a powerful effect. With both men David spent happy

hours talking about science, about research, and about the relation of

medicine and science to human welfare. The imprint of those conver- sations had a great deal to do with the directions his career took. McDermott became a true mentor for him and was influential in

helping to shape David's early career trajectory. Many years later, at

the Robert Wood Johnson Foundation, McDermott accepted appoint- ment as Senior Advisor to the Foundation and helped to formulate a number of the programs that took shape during David's tenure as President. Among the early influences that came to him through McDermott was his work with the Navaho Nation during the 1950's, an experience that affected him profoundly, as he saw how the absence of basic health care services could erode the quality of life.

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MEMORIAL

David was the son of Carl Rogers, an eminent academic, and a

distinguished clinical psychologist who taught at the University of

Rochester during David's boyhood, and later at Ohio State University and elsewhere. The father was a powerful influence on the son's life; David recalled him as "very humanistic, very supportive, very prizing of people," characteristics that were replicated in his own life. Drawn to an academic career, David early knew that he wanted to be a departmental chairman, an ambition he achieved at the age of 33 when he was appointed to the chair of medicine at Vanderbilt. He had made himself a national authority on staphylococcal infections and on host

defenses. He published early and important studies on bacteriemia, on

the blood stream clearance of staphylococci and E. coli, and on noso- comial infections. During the influenza epidemic of the late 1950's he and his group published a classic series of papers on the pulmonary

complications of influenza. He wrote widely on the changing patterns of serious microbial diseases and on the indiscriminate use of antimi- crobial agents. A series of papers on botulism appeared early in his Vanderbilt years, and he wrote also on histoplasmosis, which he en- countered there for the first time. In addition, occasional papers began to appear at about this time on teaching and on the responsibilities of

academic medical centers for the design of new health care delivery systems. At Vanderbilt he worked hard to polish his clinical skills. He quickly took on virtually all the CPCs, and gradually, he later told me, became quite adept at that particular form of intellectual nudity. He built a strong and devoted house staff and recruited a superb group of faculty

colleagues. During the mid-1960's he made care of the poor and of

minorities an increasingly important part of his mission at Vanderbilt. During that time he was one of only three chairmen of medicine in the country who vigorously supported the development of Medicare and Medicaid, at a time when organized medicine was intensely opposed. In addition, he was keenly sensitive to the fact that, when he came to

Vanderbilt, he was a liberal New Yorker moving into an area with strong southern traditions. The house staff and faculty were largely southerners, and it early became important to sort through the issues in a collegial manner. David later recalled his clear sense of the "agony and schizophrenia of the south of that time. It was a community trying

to deal practically and sensitively with something deeply imbedded within it. And, when I recognized that, it allowed me to be much more effective in civil rights, because I wasn't so righteous: instead of berat- ing people, I tried to help them work through this problem that I knew they were going to resolve. And ultimately they did. When I go south

MEMORIAL

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now, my sense is that they've done much better than we have in race relationships." In 1968 he moved to Johns Hopkins as Dean of the Medical School and Medical Director of the Johns Hopkins Hospital. His tenure there was marked by a strong and successful push to recruit minority med- ical students into the Hopkins classes, to help the Johns Hopkins Medical Institutions to invest more of themselves in their poor East Baltimore neighbors, and to promote an effort to develop a health care

system for the new

community of Columbia, Maryland.

After three years at Hopkins he moved to the Robert Wood Johnson Foundation as its founding president. Together with an extraordinary

group of hand-picked colleagues, and with a tightly engaged Board of Trustees, he invented a new kind of foundation, strongly activist, willing to be visible in controversy, and operating in a mode that included outside consultants, committee members and advisors to a very substan- tial and unusual degree. The Foundation derived its agenda to a signif- icant extent from the health care concerns of the American population

and from internally developed programs that sought to broaden the

horizons of promising young medical academics. Under his leadership the Foundation embarked on a carefully designed program to improve access to basic medical care services for the underserved. During his fourteen years there more than $500 million went to improving the health care of Americans with special access problems. These included regionalized emergency care networks, a large program designed to improve the outcomes of high risk pregnancies, programs demonstrating thatschoolhealthservices couldimprove healthcareforpooryoungsters, a series of primary care outreach programs in community hospitals, and numerous others. In addition, he worked throughout that time, and in fact for the rest of his life, for improvement in minority representation in medical school faculties and classes, and he strove to enhance the sup- port of predominantly black schools. When he left the Foundation in 1986, he returned to Cornell as the first Walsh McDermott University Professor of Medicine, a chair named for his beloved mentor. From this perch he threw himself into

the fight against AIDS and became a powerful force on the national

scene in behalf of these patients and of a rational and compassionate approach to their welfare. He saw in the problem of AIDS not only the clinical and human issues of individual patients, but the broad and

compelling public health implications of the disease. He saw also a call

on the conscience of his profession and on that of the wider society, and

pressed the need for us to examine in ourselves our own values, our

own views of degrees of human worth.

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MEMORIAL

Over a career that touched, with extraordinary success, most of the opportunities to make a difference offered by the medical career, David

had developed a powerful social conscience, and he became extremely

effective at wielding it. He was effective because he believed passionately in the social responsibilities of his profession, and because he believed with equal passion in academic medicine as the repository and in fact the steward ofthose responsibilities and the traditions on which they rested; and he was effective because he had a remarkable ability to yoke pow- erful institutions to his personal visions, and to his indignation.

David was a remarkably creative person. He was creative in re-

search, in the application ofphilanthropy to health, and in the arena of

governmental responsibilities to the sick, especially the HIV-infected. That array of expressions of creativity was impressive enough, but there was more: David became, over the course of years, a talented and

accomplished sculptor. He worked almost entirely in wood. By the time

he got to Vanderbilt his work was of sufficient quality to justify a one-man show in Nashville. He continued to sculpt through the rest of his life. Once, when he was asked how, in addition to all his profes- sional commitments, he could find the time, the energy and the inten- sity to sculpt, he said, "because I'm really very serious about it." The

deeper fact was that it brought him joy.

Honors came in profusion, of course. Among those of which he was most proud was his designation by the United States Junior Chamber of Commerce as one of the ten outstanding young men of the year, in 1961. He was proud also of his election to the Johns Hopkins Society of

Scholars, the Abraham Flexner Award of the Association of American Medical Colleges, and the Gustave Leinhard Award of the Institute of

Medicine of the National Academy of Sciences. Although he hadn't gone to Vanderbilt, he was named a Distinguished Alumnus of the School of Medicine in 1990. David was elected to the Climatological in 1961. He loved the Asso- ciation, and in fact his last paper was presented at the Ponte Vedra meeting in 1994. It was an extraordinarily graceful description of the joys and opportunities that had been brought to his life by his remark- able talent for wood sculpture. The paper, which appeared in the Transactions for that year, was his last published contribution. David is survived by his beloved and devoted wife of many years, Bobbie; by a daughter, Anne; a son, Greg; and a sister Natalie. He was survived also by a daughter Julia, who died in late 1995.

Jeremiah A. Barondess