In his life-time, Robert Loeb epitomised for men in many countries the best in several aspects of medicine. He had contributed significantly to the advancement of knowledge. He was a wise and understanding physician. He was an outstanding teacher. He was a man whose counsel was sought, not only on the national but also on the international level. And withal he retained his modest and attractive personality.
Robert Loeb was born in Chicago, the son of Jacques Loeb, who was one of the pioneers in bringing the discipline of science into biology. He was educated at the Universities of Chicago and Harvard, from the latter of which he graduated MD in 1919 with the highest honours. After holding junior appointments at the Massachusetts General Hospital and Johns Hopkins, he went to the Presbyterian Hospital, Columbia University, New York. There he remained for the rest of his career, rising successively through the ranks of resident, assistant and attending physician until in 1947 he became Bard Professor of Medicine and Director of Medical Services.
His move to the Presbyterian was the decisive event in his life. Under the leadership of Walter Palmer, the department of medicine there was establishing its claim to a place in the forefront of medical thought. As such, it was attracting a galaxy of young men intent upon combining the exactitude of the natural sciences with the realities of medical experience in the clinical field. And, for Loeb, the times were propitious.
Exposed from his earliest years to the influence of his father (who served as the model for Gottlieb, the idealised investigator, in Sinclair Lewis’ novel Martin Arrowsmith), he was naturally orientated to think in terms of homeostasis and the milieu intérieur. It is not surprising, therefore, that his first work was concerned with derangements of electrolyte metabolism in disease. This led to a succession of revealing papers, culminating in the classical publication with Atchley, Richards and Benedict, in 1931, on the changes in electrolyte balance following diabetic acidosis induced in human subjects. With this, his flair for analysing clinical problems in terms of disordered biological function became widely recognised; and, with his further extensive work on Addison’s disease, he became universally accepted as one of the leaders of the new medical research that was sweeping the world in the period between the two world wars.
To regard Loeb as a scientist, to whom medicine provided merely the opportunity to apply his skills, would, however, be entirely mistaken. First and foremost he was a physician. It was from clinical problems that he derived his inspiration. His knowledge of medicine proper, although carried lightly, was encyclopaedic. With Cecil, he produced the outstanding medical text-book of his time. And in the care of his patients he showed that percipient understanding of their needs as human beings which is the hallmark of the born physician. When, therefore, Walter Palmer came to retire, it was a foregone conclusion that Loeb should succeed him.
This he did, but not without characteristic qualms. During the war that had just ended, he had been projected into the higher echelons of medical research policy. There he had shown his ability to handle men and programmes on the national scale. But his desire was to get back to the front line of clinical research and he had no illusions that, if he became head of the department of medicine at the Presbyterian, he would be consigning himself to increasing involvement at the policy level.
After much heart searching he accepted; and subsequent events fully justified his doing so. Now, however, he had to act vicariously, but his concern with medical progress remained as fresh as ever. He immersed himself in his assistants’ interests so that men from far and wide competed to work in his department. As a result he built up a most distinguished school.
Outside his own organization, his services were similarly in demand. Increasingly he became involved with bodies concerned with the development of medical knowledge, both at the national and the international level. He became, for example, a Trustee of the Rockefeller Foundation and the medical member of the President’s Science Advisory Committee. He played a major role in setting up the structure for medical research in the World Health Organisation. To many it remained a mystery why a man who appeared so hesitant about pressing his views, should be so sought after. But, despite his seeming diffidence, he never prevaricated. When difficult decisions had to be taken, and others were hesitating, it was he who came out and said unmistakably, albeit apologetically, what needed to be said. It was this, even more than his wide knowledge and generous appreciation of human achievement, that made him such an influence in the lives of his students, patients and colleagues and in the world of medical affairs. It was this also that accounted for the trepidation he inspired in those who did not measure up to his standards.
After his retirement in 1960, he continued for several years as Vice-Chairman of the Trustees of the Rockefeller University. In 1961, he was Acting Regius Professor of Medicine at Oxford. He carried out a series of missions on the promotion of medical education and research in developing countries. And throughout, he had a constant stream of visitors from home and abroad seeking his opinion on their problems or the refreshment of his counsel. Thus, when he came to die, the sense of loss was universal; for medicine is the most international of professions and, in this context, he had proved himself a worthy member.
Sir Harold Himsworth
[Times, 31 Oct 1973; New York Times, 23 Oct, 1973; Bulletin of Amer. Coll. Of Physicians, April, 1974; Brit.med.J., 1973, 4, 303; Lancet, 1973, 2, 1038, 1102]