MEDICAL BULLETIN

Hundreds gather to remember Frederick C. Robbins, M.D.

2004 is 50th anniversary of his winning the Nobel Prize

Frederick C. Robbins, M.D., center, with, from left, Thomas H. Weller, M.D., Max Born, Ph.D., John F. Enders, Ph.D., and Linus C. Pauling, Ph.D., in 1954, on the occasion of Drs. Weller, Robbins and Enders receiving the Nobel Prize in Medicine or Physiology. Dr. Born shared the 1954 Nobel Prize in Physics, and Dr. Pauling received the 1954 Nobel Prize in Chemistry.

Dr. Robbins relaxes on the deck of his summer home in Maine.

Dr. Robbins poses with his wife, Alice, daughters Chris and Louise, and dogs Geoffrey and Gwinnie.

“I think it looks more like my brother,” Dr. Robbins joked after his portrait was unveiled in the lobby of the medical school building that now bears his name. In addition to Dr. Robbins, seated, among those attending the building-renaming ceremony in May 2003 were, from left, his sister-in-law, Nancy, and one of his brothers, Daniel, and Dr. Robbins’ wife, Alice.

Dr. Robbins and David Satcher, M.D., Ph.D., who was a student during Dr. Robbins’ tenure as medical school dean, chat before the east wing of the medical school is formally renamed the Robbins Building in a ceremony in May 2003. It was to be Dr. Robbins’ last appearance at the medical school.

The year 2004 marks the 50th anniversary of Frederick C. Robbins, M.D., sharing the Nobel Prize in Physiology or Medicine. He, John F. Enders, Ph.D., and Thomas H. Weller, M.D., were recognized for their role in isolating the virus responsible for poliomyelitis. Their discovery resulted in the development of effective vaccines for polio and paved the way for vaccines preventing other major scourges of childhood, including measles and rubella.

But on a rainy day in September, hundreds gathered in Northeast Ohio to remember Dr. Robbins not only as a Nobel Prize-winning researcher but also as a teacher, administrator, colleague, friend, brother, father, husband and humanitarian whose efforts reached around the world. The institution with which Dr. Robbins had been associated for almost 50 years held a memorial service for him Sept. 19 on campus at the Harkness Chapel, followed by a reception in Thwing Center. He had passed away Aug. 4 at the age of 86.

Dr. Robbins came to Cleveland in 1952 as a professor at the Case Western Reserve University School of Medicine and director of the Department of Pediatrics and Contagious Diseases at what is now MetroHealth Medical Center. He was dean of the medical school from 1966 to 1980.

From 1980 to 1985, he was president of the Institute of Medicine of the National Academy of Sciences in Washington, D.C. In the late 1980s, he was instrumental in establishing the School of Medicine’s collaboration with the government of the central African nation of Uganda and Makerere University there, for HIV/AIDS and tuberculosis research. The effort has been associated with a decrease in the incidence of AIDS infection in Uganda.

Dr. Robbins also helped launch Case’s Center for Adolescent Health in 1990 and served as its director from 1992 to 2000. He remained active at the medical school until his death, at which time he was dean emeritus and University Professor Emeritus. University Professor is the highest scholarly rank at Case, held by only three other faculty members in the history of the university. Additional honors related to Case included an honorary doctor of science degree (1992), the Special (Medical Alumni Association) Board of Trustees Award (1993), and the first Frank and Dorothy Humel Hovorka Prize (1994), given for exceptional achievement in teaching, research and service. Also, in 2002, the fifth floor of what then was known as the east wing of the medical school was renamed for him, and a professorship in child and adolescent health was endowed in his name. In May 2003, the east wing was renamed the Frederick C. Robbins Building. A new student advising society also was given his name in 2003.

Among those surviving Dr. Robbins are his wife, Alice; two daughters, A. Christine and Louise; and two brothers, Daniel and William. (For additional information about Dr. Robbins’ life and career, please see the Vol. 9, No. 2, 2003, issue of the Medical Bulletin.)

What follows are excerpts of the tributes made to Dr. Robbins at the campus memorial service.

Richard Hanson, Ph.D.

Leonard and Jean Skeggs Professor of Biochemistry, Case Western Reserve University School of Medicine

I can think of no one who better embodied the principles of true academic commitment.

Fred Robbins was admired and loved by those of us who knew him. For me, he was a friend, a mentor and a role model for all that is good in academic life.

In an age that often rewards hype, Fred Robbins stood out for his modesty, integrity and candor. For that reason, his views on many issues were greatly valued by his colleagues.

He cared deeply for the fate of those who were less fortunate and often neglected: those who were subjected to the terrible scourge of polio, the victims of AIDS, especially in Africa, and the adolescents in our own city. He was always on the side of the less advantaged; in a word, Fred cared deeply for many things, and that is what made him so special to all who knew him.

He had the great good fortune of having both a long life and being appreciated while he was alive. Honors fell gracefully on Fred; one never got the impression that he thought that he had them coming. On the contrary, he always seemed a bit embarrassed by them. Winning a Nobel Prize never made him act as if he had some special insight on all aspects of life, although this was often expected of him. This surely was part of his charm.

Fred understood that there were values that extend beyond personal gain and that honors and position mean nothing if they are not built on a foundation of charity of spirit and a commitment to the common good. This is why a man of his character is so rare at any institution.

I considered it an honor and privilege to have known him for 25 years and to have had the opportunity to share, in some small way, his vision for a more collegial life in our academic community, for the building of scientific excellence at the university and in our affiliated hospitals and a commitment to the education of our students. I know that Fred would be embarrassed by all this praise. He was always one to quietly prick the balloon of hyperbole. But it would not be hyperbole for me to say that we are unlikely to see another individual of his stature in our lifetime. There was only one Fred Robbins, and he has left us.

Long may the memory of Fred Robbins live in the hearts and minds of all that the life of this unique man has touched so significantly, and may his spirit live on in all of us.

Edward M. Hundert, M.D.

President, Case Western Reserve University

When you think about it, over 50 years of passion and service is really just awe-inspiring. I had the wonderful opportunity to interact with Fred Robbins several times over the year that we shared here together. For me he’s just an incredible role model, to have this incredible Nobel laureate scientist, also humanist, be there reaching out. I remember in our last conversation, him coming over and, obviously, what he was saying to me, he was saying because he cared about this institution and was caring about me as a person, and that was just what his life was all about.

Ralph I. Horwitz, M.D.

Dean, School of Medicine, and Vice President for Medical Affairs, Case Western Reserve University

Fred Chapman Robbins was a gift to the world, but he was a Western Reserve treasure. The Talmud says that when commenting on the life of one recently deceased, it’s okay to exaggerate his accomplishments, for the exaggeration, the hyperbole, brings comfort to family and friends. But for Dr. Robbins, exaggeration is not needed.

The Nobel Prize has a way of making otherwise ordinary men and women into sages. Dr. Robbins was no ordinary person, and he didn’t need a Nobel Prize to do that. He already was a wise man whose sage advice attracted around him faculty and students alike who were inspired by his quiet example and by his self-effacing style.

There are so many wonderful stories about Dr. Robbins it is not possible to relate them all. But one that I love that I initially thought was apocryphal: Dr. Robbins was caring for a young child with suspected Guillain-Barré syndrome. He flexed the child’s neck to test for meningismus and discovered a tick at the base of the skull. Dr. Robbins performed a key therapeutic intervention when he removed the tick and cured the paralysis. I would have thought the story was a bit of magical realism, but Dr. Robbins had the tick silver-plated and kept it in his office as a memento.

He was the first member of the faculty to visit me in the dean’s office when I assumed the position he once held, wishing me the best, offering his help. His very presence reminded me of the high standard he set as dean.

I remember his visit well. He shuffled into the office hesitatingly, radiating a calm and quiet certainty. I didn’t know Dr. Robbins when he was hale and hearty. I knew him only when he was frail and prone to illness. But I marveled at the contrast between the fragility of his body and the sturdiness of his spirit. Every visit we had, every chance meeting we had, was a reminder to me of his greatness and of the greatness of the Case medical school that he loved so much.

At the ceremony dedicating the Robbins Building, he remarked to me, “Ralph, I don’t deserve this honor.” He was right, of course. He deserved far more honor than we are capable of giving, and he honored us far more than we will ever be able to honor him.

Fred Chapman Robbins will always be a presence on our campus and a towering figure in the history both of the medical school and American medicine. And that is no exaggeration.

Thomas M. Daniel, M.D.

Professor Emeritus of Medicine, Case Western Reserve University School of Medicine

I would like to begin by commenting on Fred’s work with polio. My knowledge of these events comes chiefly from having worked with Fred to put together a book of essays on polio [Polio], one of which Fred wrote.

After the end of World War II, Fred returned to Boston to work as a research fellow in the laboratory of John Enders. There he joined Tom Weller, whom he knew well; the two men had roomed together in Vanderbilt Hall while students at Harvard Medical School. It is difficult for me to sort out who did what in that laboratory, for the work there appears to have been very much a team effort. However, I believe that it was Fred who first observed what came to be called the “cytopathic effect”— changes in the appearance of cultured cells and in the color of the culture medium that allowed recognition of viral growth. Certainly, Fred’s name was first on the paper that described this observation. This observation meant that it was no longer necessary to inoculate an animal to recognize growth in the viral cultures.

One thing of great importance that Fred did during his years in the Enders laboratory was to meet Alice, who was also working there, fall in love with her, and successfully court her.

The work of Enders, Robbins and Weller was recognized with the award of the Nobel Prize in Physiology or Medicine. These are Fred’s comments on this event from his essay in our book:

“In 1953, we heard a rumor that our group had been nominated for the Nobel Prize. We did not take it too seriously, and nothing happened. In October 1954, however, I received a call from Western Union, and they read me a telegram from Stockholm, Sweden, stating that Enders, Weller and Robbins had been selected as recipients of the Nobel Prize in Physiology or Medicine. Western Union said that they would send me the telegram, but it never arrived, and I have often wondered who, if anyone, has that piece of paper. Needless to say, the news was a shock, but a pleasant one.

“With the announcement of the award, our lives became very busy. There was the press to be dealt with, travel plans to make, arrangements to take our 3-year-old daughter to her grandparents in New York, and even clothes to be bought or, in one instance, borrowed. We were informed that white tie was mandatory at the awards ceremony. At other events, tuxedo was appropriate. I owned neither. It turned out that one of my colleagues on the faculty owned a suit of tails that fit me reasonably well, so that was settled. However, I had to purchase a tuxedo. When I informed the salesman that I needed a tuxedo promptly, he said, in a joking manner, ‘What’s the occasion? Did you win the Nobel Prize or something?’ When I replied in the affirmative he looked shocked but quickly recovered, and I received exceptionally fine service.

“I am often asked, ‘What difference did the prize make in your life?’ I don’t find it easy to answer that question, but it did elevate people’s (and I guess, to some extent, my own) expectations of me. About six months after I returned from Stockholm, a local newspaper reporter wanted to know what major breakthrough I had achieved in the interval! Another rather strange outcome was that from the day the prize was announced I never got another request to see a patient in consultation—a phenomenon that I never quite explained.”

Fred’s interest in polio continued throughout his life. He chaired the Pan American Health Organization commission overseeing and then certifying the eradication of polio from the Americas. This was no small task. Criteria had to be established for surveillance and monitoring. These criteria are now being applied to the campaign for global eradication. Again, from Fred’s essay:

“It has been a fascinating experience to watch and, in various ways, to participate in the evolving story of polio, from the first demonstration of success in growing the virus in tissue culture to its eradication from a major part of the world. I only hope that I will live to celebrate the completion of the job, i.e., global eradication. It has been shown in the Americas to be possible; it only remains for the rest of the world to follow suit.”

Fred did not live to see global eradication of polio, but the world is very close to that goal. At present, only isolated pockets remain in northern Pakistan and Afghanistan and a very few cases in central Africa. None of this would have been possible without the cultivation of the virus in which Fred participated and which led directly to the production of vaccines.

I came to know Fred best in connection with international activities. Fred first noticed the opportunity to obtain National Institutes of Health funds for the study of AIDS in Uganda, and he led many of us from Case into that country and into what has become a large and enormously productive collaboration between Case and Makerere University. Fred had exceptional leadership qualities, and he used them not only to bring along those of us from Case, but also to enlist Ugandans. He treated our Ugandan colleagues with great respect, and they, in turn, developed respect for him.

Later I became director of the Center for International Health of the School of Medicine. Fred was in my office frequently. I said to my wife, “Fred is my best friend and my worst enemy.” Best friend because he had so many and such good ideas for the nascent center. Worst enemy because it seemed my responsibility to get moving immediately on each of these ideas.

Trina Anglin, M.D., Ph.D.

Chief, Office of Adolescent Health, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Public Health Service, Department of Health and Human Services; inaugural Director, Case Center for Adolescent Health

As we share our thoughts about, and celebrate, Dr. Robbins’ life, my voice represents that of the “younger generation.”

I first met Dr. Robbins through Dr. Ted Mortimer. Together and separately, these two men guided my professional development and nurtured my soul. They had very different external styles but were kindred spirits in their scholarly passions and quest to improve public health.

Ted was helping me to sort out a particularly thorny problem. His eyes gleamed, which characteristically prefaced a particularly engaging idea. He announced, “Let’s hear Uncle Fred’s thoughts on this.” I asked, puzzled, “Who is Uncle Fred?” Ted replied, “If you don’t know, it is high time you met him!” I remember Dr. Robbins’ very careful listening to the problem statement and his asking just one question that penetrated to the center of the problem. A smile played around the corners of his mouth as the three of us considered each possible strategy and solution in detail. He was genuinely happy to be consulted and to assist a young person. What made the moment so special to me was the total understanding that Ted and Dr. Robbins shared and the joy they found in thinking together about a new issue, which included a joking but stimulating debate.

It was also Ted Mortimer who helped me appreciate the very special heritage of Metro—Cleveland City Hospital, which was renamed Cleveland Metropolitan General Hospital, and which today carries the modern name of MetroHealth Medical Center. I arrived at Metro in 1975 to start my School of Medicine Clinical Scholars Program fellowship. Ted referred to this time period as the final years of “Camelot”—the years before hard-boiled concerns about finances and managed care outpaced the ideals of the department led by Dr. Robbins during the 1950s and 1960s. His leadership supported the growth of Metro through encouragement of its pediatric faculty and staff. From basic science and clinical research laboratories, to development of innovative patient service programs, to establishment of the first child life program in the country, everyone contributed toward the health and well-being of the child and family. Metro was where clinical care met Cleveland’s public health and social health challenges. It was Dr. Robbins’ belief in his faculty’s potential and firm expectations that they would grow and achieve, the development of an environment that made learning fun, and his depthless reservoir of kindness that created the foundation for Metro spirit. It was this nurturing atmosphere that kindled both men and women to move forward in illustrious pediatric careers of their own. This legacy of Metro continues today.

Adolescent health represents the epitome of the interface between clinical and public health. Dr. Robbins’ interest in adolescent health was not new; it was a part of his early vision for pediatrics at Metro—and this was several decades before adolescent medicine was developed as a formal pediatric subspecialty. Adolescent health finally became a major focus of effort for Dr. Robbins during the past 15 years. His interest was re-stimulated by being appointed to the advisory committee of the Carnegie Corp. of New York’s 10-year Council on Adolescent Development. He brought his broad knowledge of public and social health to this enterprise. In turn, the scientist in Dr. Robbins needed to get to the “root causes” of adolescent health issues—problems synonymous in many adults’ minds with the very word adolescent. The Case Center for Adolescent Health was created out of this concern.

The creation of the center was a magical time for us. Dr. Robbins brought his probing questions, wisdom, and broad base of knowledge. Carlyn Yanda brought her experience with, and appreciation for, the Cleveland community—its many neighborhoods, its formal and informal structure, and its helping organizations. I brought my concrete knowledge about adolescents and practical experience in program development.

The original intent of the Center for Adolescent Health grew out of this combined thinking. Our goal was to create a union between community and university for addressing the needs of Cleveland’s youth and their families. The center encompassed the Adolescent Consortium, composed of more than 100 community-based organizations, which was our major and unique strength. We wanted to create a home for service, learning and research that would be developed in concert with the community for the community’s benefit, as it advanced knowledge and practical know-how. This concept has recently been embraced by the National Institutes of Health and the Centers for Disease Control and Prevention as participatory research. A decade ago, it was a new idea, but one that is congruent with the university’s current thinking. It remains a new idea for conducting research to enhance adolescent health and well-being.

After I left Cleveland and the Center for Adolescent Health became a living reality, Dr. Robbins assumed its directorship. His belief and trust in the center’s staff encouraged them to grow. His great kindness and wisdom allowed the center’s staff to weather some difficult moments. He treated errors as opportunities for learning.

Dr. Robbins became a long-distance mentoring figure for me. But always, his visualization of the big picture, his grasp of context, his respect for my thoughts and knowledge, his expectations for seeking the best, most helpful answer or solution, his determination and persistence, and his understated humor, guided me. His generosity of spirit and kindness, the easy sharing of his analytic rigor, and his beliefs in our potential, coupled with high expectations for our achievement, are gifts to all of us.

Dr. Robbins was always learning and wanted us to grow from learning. He created small Camelots in his many activities. Our highest tribute to Dr. Robbins is for us to continue to learn and to apply our learning to improve the health and well-being, not only of our nation’s children and adolescents, not only of our nation’s population, but of all the people of the world.

David Satcher, M.D., Ph.D.

1970 Double Alumnus; Director of the National Center for Primary Care, Morehouse School of Medicine, Atlanta

In additon to representing myself and my family, I also am here to represent President Harvey Fineberg and the Institute of Medicine (IOM), where I serve on the council. Dr. Fineberg regretted that he could not be here. He sends his affection and condolences to the family.

Fred Robbins will long be remembered for his leadership of the IOM during a very difficult, early period of the institution. Harvey Fineberg said that he was amazed that, when word came to the IOM of Fred’s death, those who worked with him there responded with tears. The IOM will always appreciate Fred and his leadership.

Clearly, Fred Robbins will be remembered in so many ways by his family and by many others for years to come.

As we approach the eradication of polio in the world, he will be remembered for his early work with the polio virus—work that won him and his colleagues the Nobel Prize in Medicine in 1954 and work that will help us to rid the world of that crippling disease some day soon.

For his leadership and academic work at Case, he will also be long remembered. Even those who will not have the opportunity to meet him will come to know those outstanding scholars who will occupy the Fred Robbins Professorship in Adolescent Health.

Others will work in or visit the Fred Robbins Building at Case. No, Fred Robbins will not be forgotten. His work will live long after him.

And I will certainly never forget Fred Robbins. For me, he was a special mentor and friend from the time that I met him at Case until his passing.

As a student, I led an effort to recruit more minority students to Case and to make the environment more sensitive for a diverse faculty and student body. While Fred and I did not always agree during those early years, he always listened to students, and he responded effectively.

Later, when as a resident in the mixed medicine/pediatrics program at the University of Rochester, I decided to leave and become part of an effort to develop a hospital and medical school in Watts, Fred understood. In fact, he agreed to become a part of the visiting committee and helped to develop that program.

Later still, when Meharry Medical College was threatened with closure after having graduated nearly half of all black physicians and dentists in the nation, I decided to go there in 1982 as president. While many questioned and criticized my move, Fred agreed to help. He became a member of the board of trustees at Meharry and served for more than 12 years. He contributed greatly to the academic and financial recovery of that institution—always a favorite trustee of students and faculty. I am certain that he took some comfort in seeing the students challenge me as I had, as a student, challenged him.

As director of the Centers for Disease Control and Prevention and later as surgeon general and assistant secretary for health, I could always rely on his advice and support when making the most difficult decisions, such as the decision in 1995 to change from oral polio vaccine to injectable polio vaccine in the United States.

Fred Robbins was one of the world’s most brilliant medical scientists. He will be long remembered as such. But I will never forget that he was one of the most caring human beings that I have met. He always wanted to know how he could help.

He cared about the underserved in the inner city and rural communities. He cared about AIDS in Africa and worked in Uganda to help fight infectious diseases there.

I hope that one day someone will be able to say about me what I can comfortably say about Fred Robbins today. He was my mentor and friend in good times and bad. He cared about me and my family.

He went with me back to those places from where I came—places that America often ignores, places that are high risk and sometimes unsafe. He cared about those places and those people and yes, this Nobel laureate will be long remembered there as one of the world’s great human beings.

Chris Robbins

Daughter

I always learn something about my dad when I listen to his colleagues. But I’m here to tell you what he was like when he was not at work.

Dad wasn’t home much when we were kids. He worked evenings and Saturday mornings and had an ambitious travel schedule. But Sunday afternoons and the month of August were our time with him. On Sunday afternoons in the summer, he would take us hiking, picnicking or butterfly collecting. In winter, we would go skating, skiing or visiting museums.

In August we went to Maine. Maine is where our hearts are, and where Dad’s ashes will be scattered. Mom and Dad were introduced to Sorrento, Me., in 1949, just a year after they were married, by two medical friends, Dr. Gamble and Dr. Neuhauser. They rented houses there until 1980, when they finally bought one. Dad managed the woods around the cabin in a naturalistic way that still maintained the view. He had a small fern garden where he collected ferns, rocks and mosses.

He and Mom enjoyed tennis both in Maine and in Cleveland, and many of their friends were tennis buddies. Mountain climbing was another of Dad’s favorite activities, and he climbed mountains in Maine well into his 70s.

Dad was a natural explorer. Every place that we lived or traveled, he wanted to check out all the parks and natural areas within a 50-mile radius. In Cleveland he knew the Metroparks well, and he amazed us by remembering trails and picnic areas when we wouldn’t have a clue how to find them again.

I remember when we were children in Maine. We would go to the beach and play in the sand. Dad would go off for a couple of hours to explore the rocky coast. He would come back with a lobster buoy or some other treasure he had found. As we got older, we skipped the sand castles entirely, and all of us explored together.

When we traveled with Dad, we found out he had a worldwide network of acquaintances far beyond those we knew in Cleveland. We could be walking through any airport in the world and suddenly Dad would spot someone he knew. We would groan because we knew we would be waiting around with our luggage. But it was fun, too, because we’d see him transformed into the charming, animated Fred whose great passion was to talk shop. But if there was no one around that Dad knew, he would chat up the waitresses or the cab driver. He took an interest in everyone no matter what their station. He was a true Democrat, small D and big D.

I mentioned that Dad took us on outings on Sunday afternoons. But what was he doing on Sunday mornings? While we were at church, he would be sitting on the couch

Daniel Robbins

Brother

Fred was my big brother, my teacher, my friend and my hero. He was also the best man at my wedding and provided medication for my nerves—a small glass of sherry.

Fred showed an early inclination toward health care. I was 4 and he was 11 when we crossed the English Channel. He taught me how to vomit: with the wind.

When I was 17, he taught me how to negotiate the rapids of the Allagash River in a canoe. I remember that each time I go fishing.

When our 3-year-old daughter was diagnosed with cancer, we turned to Fred for the opinion that mattered. We’re glad we followed his advice. She is with us today. She is now well and has a beautiful family with three grandsons. Her name is Nancy.

Our age and geographic differences kept us apart a lot, but I have wonderful memories of the times we spent together in Maine and will always treasure our last visit, when the Robbins Building was dedicated.

You remember him as a great scientist, a great educator and a great humanitarian. I remember him as a great brother.