Richard D. Rowe, MD (1923-1988)

Richard Desmond Rowe died quietly at his home on January 18, 1988, after just a brief illness, surrounded by his family and closest friends. Not quite 65 years old, Dick Rowe left a professional and personal legacy that most will never attain.

A private, modest and unassuming man, he was born in Christchurch, New Zealand. Although he lived on the other side of the globe for almost 4 decades, he always relished his ''Kiwi'' background. Dick Rowe attended primary school and King's College in New Zealand, and he took his undergraduate and medical training at the University of Otago, receiving his MB, ChB in 1946. Completing his internship at the Waikato General Hospital, he spent the following year in Japan as a member of the Second New Zealand Expeditionary Force, and there he cultivated his taste for Japanese cuisine. After his tour of duty in Japan, he made the pilgrimage to the Northern hemisphere, spending a year as a house physician at the Leicester Royal Infirmary in England. From England he made the short journey to Scotland and pediatrics as a house officer at the Royal Hospital for Sick Children in Edinburgh. Crossing yet another ocean, he moved to Vancouver for a year's residency in pediatrics, thus beginning his long association with Canada and Canadian medicine.

During his sojourn in Edinburgh and Vancouver, Dick's interest in children's cardiac disorders matured, and it seemed inevitable that he would seek further training in this young field. The transition to Toronto, Dr. John Keith and the Hospital for Sick Children was part of this evolution, and from 1951 to 1954, Dick was a fellow in cardiology at the Hospital for Sick Children. He joined the staff of the Hospital for Sick Children in 1955, remaining in Toronto until 1960. He returned briefly to New Zealand in 1960, assuming a post at the Green Lane Hospital in Auckland as a senior pediatric cardiologist, only to return to North America in 1963. With the retirement of Dr. Helen Taussig in 1963, he was asked to become codirector of the Johns Hopkins Division of Pediatric Cardiology. Obtaining the Harriet Lane Professorship in Pediatrics at Johns Hopkins in 1965, he assumed the directorship of the division until 1973. With the retirement of John Keith, he was asked and accepted the "call of the wild," returning to Toronto and the Hospital for Sick Children as professor of pediatrics and director of the division of cardiology. He relinquished the director's position in 1986, both to enable a sabbatical and to allow the pursuit of professional interests in selected aspects of acquired heart disease in children. He remained active in the division until his death in January 1988.

Dick Rowe was an eloquent spokesman for the patient with congenital heart disease. Through his more than 250 papers, nearly 40 book chapters and 3 textbooks - including the classic Heart Disease in Infancy and Childhood that he coauthored with John Keith and Peter Vlad and the Neonate with Congenital Heart Disease that he initially wrote with Ali Mehrizi - Dick contributed substantially to the body of knowledge of his specialty. The 1950s bore testimony to his prodigious academic output. He, Peter Vlad and John Keith in a series of publications emanating from this institution described a wide spectrum of congenital heart malformations, providing correlations with clinical examination, noninvasive assessment and cardiac catheterization and angiography. Dick Rowe and the Toronto "establishment" pioneered the application of left heart and retrograde arterial cardiac catheterizations in the fragile neonate and young infant. Throughout much of his long and productive career, Dick had a particular interest in the neonate with structural or nonstructural heart disease and with the transitional circulation. An Essay in Medicine written in 1957 under the aegis of the Royal College of Physicians and Surgeons of Canada addressed changes in the pulmonary hemodynamics of newborn infants. Dick was awarded in 1968 his MD from the University of Otago on the basis of his thesis on the influence of oxygen environment and metabolic status on closure of the ductus arteriosus in the neonate.

He was a keen and precise observor of clinical findings and his "ear" was a legend in both Baltimore and Toronto. He was frequently the final arbiter of differences in opinion of the auscultatory exam. Perhaps his small stature was perfectly suited to the small baby, and he particularly enjoyed examining the newborn and conducting teaching rounds. His interest in the normal and the disturbed transitional circulation and the neonate with a distressed neonatal course matured into the benchmark clinical observation of transient myocardial ischemia in the distressed newborn. While at Johns Hopkins in the 1960s he addressed in a series of clinical papers the mechanisms of closure of the ventricular septal defect, describing as well those auscultatory phenomena associated with the so-called "aneurysm" of the membranous ventricular septum. As one of the founding fathers of the Joint Study on the Natural History of Congenital Heart Defects, he saw this important collaborative study mature to publication and global recognition. As the years passed he retained his interest in the mainstream of pediatric cardiology, but he began focusing on selected aspects of acquired heart disease in children, particularly on the mucocutaneous lymph node syndrome of Kawasaki and on endomyocardial disorders in children. From early 1987 through the early fall, he was on sabbatical in England working with his son Peter, also a pediatrician, on a monograph critically examining certain aspects of these disorders. Tragically dying just 6 weeks before his intended retirement, he did not live to see the completion of this monograph or to enjoy with his family the retirement he had so anticipated.

But the legacy of Dick Rowe is far more than just the written word. His trainees populate the globe and they bring to their units more than the dogma of pediatric cardiology. Those individuals fortunate enough to have been trained by Dick Rowe could not help but be touched by the humanism and compassion of the man. Quiet, but strong, dedicated to the principles of patient care, scholarly productivity and the training of pediatric cardiologists, Dick guided not by remonstration, but by example. He enjoyed teaching and it was intensely personal and satisfying when at Johns Hopkins he was presented by the pediatric housestaff the Alexander J. Schaffer award for excellence in clinical teaching. Always one to eschew self-agrandizement, he was honored during the last year of his life when the Society for Pediatric Research named a Richard D. Rowe award in perinatal cardiology. He was to have presented the first award in May 1988. He was meticulous in his science, cautious in making too hasty a personal judgment and most of all he was fair in every aspect of his personal and professional life. That his judgment was so respected and his opinions so highly sought can be seen by the number of committees, hospital, national and international, on which he sat. Never one to make statements rashly or in anger, the measure of the man was in his attention to detail and the doctrine of fairness. A superb organizer and administrator, Dick was a tremendous advocate for his staff. His vision for the collective good was not just an ideal: he made it a reality.

For one who gave so much to medicine, Dick enjoyed his family and was in his own understated way intensely proud of his children. Married to Bobbie for almost 38 years at the time of his death, their 4 children were born in Toronto; their 2 sons are physicians; 1 daughter is an attorney and one a linguist. One of the great joys in Dick’s life was his collaboration begun in early 1987 with his son Peter on selected aspects of acquired heart disease in children. Dick and Peter were working on their contributions to within 3 days of Dick’s death. Both in Glyndon, Maryland, and in Toronto, Dick and Bobbie’s home was always open to relatives, friends and former and present trainees. Classical music emanated from their living room, and Dick’s preference for the classical guitar was often apparent. One was always made to feel welcome in the Rowe’s home. The spirit of giving was one of Dick’s greatest attributes. While his voice is now quiet, the contributions to pediatric cardiology of this gentle giant from Christchurch and the gentleness of his love and friendship will provide solace to those who have not yet made their own final journey.