Nobel Prize
When I was a resident UpToDate was still incomplete and work in progress. I was an early convert and fan. l had become a disciple of Rose of the Yellow Book.
I remember talking with Sarah Faubel and she would convincingly argue that UpToDate is so important to medicine that Rose deserved the Nobel Prize. She explained that it was the best way to move information from the frontiers of science to the physicians providing care at the bedside. I think she was right.
I met my hero
I met Dr. Rose a few times, here is the e-mail I sent my (at the time) future wife about meeting him.
Bud and NephMadness
Burton Rose made two appearances in the inaugural NephMadness of 2013. That year the Thin Ascending limb was dedicated to educational resources (Matt and I have always been medical education nerds). Both UpToDate and Clinical Physiology made the Big Dance.
Here is how we described UpToDate
UpToDate is a juggernaut which rewrote the rules of medical publishing. It was the first successful electronic textbook. When textbooks were just thinking about gluing a CD-ROM to the back page as a multi-media extra, Rose had thrown out the whole book and just used the CD-ROM. This allowed him to ship the textbook before it was done. I remember ordering UpToDate in the mid-90s and internal medicine was not even complete. It was almost finished but some specialties were completely absent. However, every 3 months I would get a new CD with updates to the current files, newly written sections and cards and an update to the abstracts of Medline. In the days before PubMed, UpToDate shipped with a copy of index medicus.
The other freedom of the CD-ROM, was it allowed an 1all new editorial style. Instead of doling out strict word limits in order for the textbook to hit the length determined by the marketing department. Rose was able to go into as much detail as he wanted.
Completely disruptive. He outflanked all of the internal medicine textbooks and they still haven’t caught up.
And how we described Clinical Physiology of Acid-Base and Electrolyte and Disorders
I was finishing my first month of my first rotation as a third year med student when I asked my resident what I should read to help me understand fluids and electrolytes and he told me to get Burton Rose’s book. This may have been the worst advice ever: 893 pages (excluding the index) of electrolytes. I bought the book and it went on my shelf. The book remained unopened for 2 years. During my internship year I finally started reading it. His straightforward, mechanistic explanations of the physiology made everything logical. The yellow book (4th edition cover) taught me most of what I know about physiology. I don’t think my experience is unique. I have a feeling that lots of nephrologists out there and probably some endocrinologists and critical care doctors understand the body because of the clear, visual prose that is Rose’s gift.
Clinical Physiology went down to ASN Kidney Week in the first round but UpToDate beat Wikipedia. It then advanced to the Saturated 16 by vanquishing The Renal Fellow Network. UpToDate continued its run by destroying ASN Kidney Week 82% to 18% and advanced to the Effluent 8. The ride came to an end when Captopril defeated UpToDate, preventing a trip to the Filtered Four.
The following year NephMadness started using experts to help build the brackets. Edgar Lerma, who know everyone asked if Dr. Rose would help out. Here is his response. Classy. Totally classy.
We had an electrolyte bracket and invited Dr. Rose to be our selection committee member. We had a conference call, but legal entanglements prevented him from being part of the contest (at least that’s what he told us, it could have been that after talking to us he wanted nothing to do with NephMadness).
The first Second Generation Narins Award Winner
I won the Robert G Narins award from the ASN in 2017. When you get the award you give a short five minute acceptance speech during the big plenary session and a standard trope is to mention how you knew Robert Narins and how he inspired you in nephrology. But even though I’m from Detroit and work only a dozen miles away from where he was chief, our paths never crossed and I never met Robert Narins. My hero and inspiration in nephrology was 2009 winner, Bud Rose. So I think that makes me the first second generation Narins award winner.
I remember sometime in the early 90s when I was thinking about what my place in medicine would be. I knew I wanted to be involved in teaching but research wasn’t my bag and publishing in traditional academic journals wasn’t something I was interested in. I was explaining this conundrum to a senior resident and he suggested I look Rose up in PubMed. See how many publications he had. There is clearly at least one other Rose BD, but looking through the titles I can find nine articles by our Burton Rose. That moment crystalized what I wanted from my career, to be a medical educator without trying to excel at both medical education and research. I wanted to be Burton Rose.
The first thing I did after seeing that Rose passed was come to this blog and search for his name. Eight pages. There are 8 pages of posts that show up when you search for Rose. His presence looms large over my career.
He was a giant.
He will be missed.
He will never be forgotten.
Thank you for the teaching.
Thank you for the inspiration.
There is a lot of chatter on Twitter about his passing here are some of the tweets.