Keith A. Reimer, MD, PhD: 1945–2002
Keith Arnold Reimer, MD, PhD, a well-known experimental cardiologist and cardiac pathologist and a Professor of Pathology at Duke University died on March 15, 2002, at the age of 56. The cause of death was metastatic carcinoma of the kidney. His disease was advanced when it was diagnosed in September of 2001, and it essentially incapacitated him for the remainder of his life.
Keith was born in Beatrice, a small town in Nebraska, on April 10, 1945. He graduated from high school in a class of 7 students. Typical of Keith is the fact that by the time he had graduated, he had taken every course offered by the school except Home Economics. After graduating from high school, he attended Bethel College in North Newton, Kansas, from which he graduated in 1967. While at Bethel, he met and married Susan Stuckey. Although this educational history seems an unlikely prelude to a career in science, he became a very successful scientist.⇓
I first met Keith on a spring day 34 years ago, when a young medical student with a red beard turned up in my laboratory at Northwestern University Medical School. At this time, he was finishing his second year in medical school and was searching for a laboratory in which to pursue graduate work. His aim was to enter the MD, PhD program at Northwestern. The goal of this program was to produce physicians trained as scientists. In Keith’s case, the science was experimental pathology.
I questioned him carefully about why he wanted to follow a course of study that would lead him to become an expert in the field of cell injury, simply because research in cell injury was unpopular in 1968. Few physicians and even fewer scientists cared why cardiac muscle cells died when you reduced their blood supply. He convinced me that this general question was of interest to him and began his graduate work in the summer of that year.
His thesis project involved the genesis of lethal ischemic cell injury in the rat kidney. Because he was a very skillful, efficient worker, and was lucky in the sense that his experiments proceeded without difficulty, he finished his research project in 1971, wrote an excellent thesis, and defended it with skill. During this time, it became obvious that he had significant talent. He was very bright, reasoned quickly and with great precision, and, moreover, was an excellent writer. He left the laboratory as a complete scientist who was able to recognize an important problem, design an experiment or a series of experiments to solve it, and then summarize his findings in a publishable form.
He returned to medical school and received his MD degree in 1972. Having been exposed to pathology during his graduate work, he decided to take residency training in this discipline. He performed well in his clinical work but, after two years as a resident, he decided to return to research as a post-doctoral fellow in my laboratory. Although his work on renal injury was accepted in renal circles, he decided to join the mainstream of the laboratory’s work and began studies on cardioprotection by β-blockade. When I decided to accept the chair in pathology at Duke in 1975, Keith joined me in Durham. During the next 26 years, he did an enormous amount of work and wrote a series of papers that have had a significant impact on the practice of medicine, especially cardiology and pathology.
His best-known work is in the field of cardioprotection. The advent of thrombolysis as a treatment of acute myocardial infarction in man showed the beneficial effect of reperfusion with arterial blood on the threatened heart muscle in patients with evolving acute myocardial infarction. Over a period of a few years, work on reperfusion went from unpopular and academic to popular and relevant. Keith was invited to give lectures in much of the western world. In addition, he attracted a large number of very talented post-doctoral students to join the laboratory.
There are three important concepts that he was heavily involved in developing. The first was the creation of a way to accurately estimate whether a therapy designed to protect the ischemic heart actually did protect it, the so-called AMPIM (Animal Models for Protecting Ischemic Myocardium) study. There were numerous such therapies being proposed but few of them actually worked. He led the way in making it possible to distinguish objectively whether or not a therapy was beneficial. Earlier, he had shown where the salvageable myocardium was located in an area of ischemia in the experimental animal as a function of the duration of ischemia. This led to the concept of a “wavefront of ischemic cell death” beginning in the subendocardium and extending to the outer wall of the heart. It was the middle and outer layers of the heart that survived longer and were therefore most salvageable by reperfusion. Finally, in 1986, an excellent MD, PhD student working in our laboratory named Chuck Murry found preconditioning, the strongest form of cardioprotection so far identified. In this form of protection, a brief dose of ischemia and reperfusion is used to protect the heart against a sustained episode of ischemia. A little bit of injury followed by reperfusion turned out to delay ischemic cell death for an extended period of time. Preconditioning has proved to be a very popular field of study. There have been about 200 papers published on this topic every year since 1997.
Keith was very proud of Murry’s accomplishments. Chuck presently is an Associate Professor of Pathology at the University of Washington in Seattle. He managed to visit Keith twice during his illness. In fact, the esteem that Keith was held in by his post-docs and collaborators was confirmed by the numerous visits of members of this group during his terminal illness.
Keith was an excellent and dedicated teacher. Medical students responded well to his honesty, forthrightness, and his fine but dry sense of humor. He attracted at least 10 medical students to do experimental research in his laboratory. Each was successful and learned much about how research is done. Post-doctoral fellows from the United States and from around the world worked in his laboratory, including Richard Vander Heide, Lisa Schwartz, Masaru Tanaka, Vincent Richard, and Laurent Sebbag. Through much of his career, the laboratory had a unique international flavor.
Although he did not publish many papers on human cardiovascular disease, Keith was an excellent cardiovascular pathologist and did an enormous amount of work on human cardiovascular disease. Donald Hackel was his mentor in this area, and after Don’s death, Keith replaced him as Chief of Cardiovascular Pathology at Duke.
What about Keith the man? He was a fine husband and had a happy life with his loving wife Susan and their child Kerwin. Keith and Susan had a very active avocation breeding cockatiels and had over 900 birds in their aviary at the time of his death. This activity led him to become an excellent bird geneticist. Gardening was his other avocation, and he had a splendid collection of irises.
He was a good friend and colleague to me from the start. The intellectual strength of the man is what I miss the most. His capacity to size up a problem or a concept and to assess its value in an instant was his greatest talent. In a humorous, good-natured way, he could destroy a hypothesis or add substance to it. He was fun to be around. This aspect of his personality is unforgettable and irreplaceable. As a member of the editorial board of Circulation and Circulation Research, I know that many scientists encountered this side of his personality, although they probably did not recognize Keith as the reviewer.
Keith joined the International Society of Heart Research (ISHR) in 1976 and was elected a Councilor of the American Section in 1979. He served as Secretary of the American Section from 1985 to 1994, and from 1989 to 1995 was a member of the Council of the International Society. In 1997, he became President-Elect of the American Section and was the sitting President of the American Section when he died. He served the ISHR well, and I am certain that this organization will miss his quiet, precise, and often pointed observations and leadership.
Keith is survived by his wife Susan, their son Kerwin, his father Arnold Reimer of Beatrice, Nebraska, his brother Dr Gregory Reimer of Magnolia, Texas, and two sisters, Lynne Haecker of Omaha and Nancy Reimer of Lincoln, Nebraska.
In March of 2002, the ISHR honored Keith by establishing the Reimer Lectureship. This lecture will be given annually by an invited scientist at the world congress or at a selected section meeting in non-congress years. This Reimer lecture will serve as a lasting memorial to Keith, who gave so much to cardiovascular science.