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Robert A Bruce
OBITUARY
University of Washington
Obituary
Robert A Bruce Pioneer of cardiac medicine; developed the Bruce Protocol, a treadmill test used to diagnose heart disease. Born in Boston, Massachusetts, USA on Nov 20, 1916; died aged 87 years at an assisted living centre in Seattle, Washington, USA, on Feb 12, 2004. Bruce had been battling leukaemia and spinal stenosis.
erner Samson was a student fellow and “lab rat” for Robert Bruce, the man widely acknowledged as the “Father of Exercise Cardiology”. During early research at the University of Washington, “We spent hours with treadmills. We categorised individuals by their ability to walk on those machines. We called it the physical fitness index, which became the Bruce Protocol”, Samson told The Lancet. Bruce began his research comparing the heart activity of patients at rest to that under exertion using a technique called Master’s Two Step. It involved climbing and descending two steps, but was too strenuous for many heart disease patients. In 1949, Bruce and his colleagues began testing patients with a treadmill. Eventually, Bruce found he could analyse minute-to-minute changes in the heart by following electrocardiogram (ECG) readings as he increased the speed and incline of the treadmill. This technique enabled researchers to discover cardiovascular problems that were exposed only when the heart muscle was stressed. After Bruce and colleagues published their test results (Pediatrics 1963; 32: 742) the treadmill began to be used in cardiovascular diagnosis. A key discovery was the ability to establish standards for normal heart functions by age group, and thus to differentiate between loss of function due to age and that due to disease. Bruce was delighted to discover that 63% of respondents claimed to modify risky behaviour as a result of taking the test. In the Pediatrics paper, Bruce wrote: “You would never buy a used car without taking it for a drive and seeing how the engine performed while it was running, and the same is true for evaluating the function of the heart”. Bruce did his bachelor’s degree at Boston University and MD at the University of Rochester in New York where he was also an intern. He went on to the University of Washington, and became its first director of cardiology in 1950, a post he held for more than 30 years.
W
Terrell Tannen e-mail: [email protected]
THE LANCET • Vol 363 • April 24, 2004 • www.thelancet.com
Richard Page holds the Robert A Bruce Endowed Chair in Cardiovascular Research at the University of Washington. “He defined the protocol we all use”, says Page. “When I first took the chair, he stopped by to deliver bound copies of his papers to leave his academic legacy to the division he founded. He was truly vigorous, a serious academic individual who commanded the respect of everyone around him. What’s special about the chair I hold is that it’s named after one of the forefathers of a procedure rather than someone who donated money.” Bruce and his first wife, Eleanor Hinckley, had four children and were together for more than 50 years until her death in 1994. Their daughter, Nancy, died in 1972. His second wife, Jean Laughlin, died in 2000. In 2002, he married Barbara Klemka Bruce, a fellow resident of Ida Culver House, an assisted living centre in Seattle. “Bob Bruce was kind to the core. A real New England gentleman”, says Samson. “He never blew his own horn but he had a lot of bad luck in his life. He lost his first and second wives, a daughter, and was long estranged from a son. But he was actively interested in his work until the end.” A reception in Bruce’s honour was hosted by Page on Feb 11, 2004, at Ida Culver House. Though he was weak from anaemia, Bruce attended in jacket and tie, listening to the stories his colleagues shared about him. Samson was close to his mentor through his last days. “He had spinal stenosis and was taking platelet transfusions for leukaemia. When the stenosis became so severe it immobilised him, he knew it was inoperable.” His wife observes “He had a very practical mind and could see things clearly. Though he never showed it, the loss of mobility and the pain he was suffering made him decide he had lived a full life. He stopped taking the blood treatments.” He died less than 12 hours after the reception. As well as his wife, he is survived by three sons, four grandchildren, and a great-granddaughter.
1403
For personal use. Only reproduce with permission from The Lancet publishing Group.
University of Washington
Obituary
Robert A Bruce Pioneer of cardiac medicine; developed the Bruce Protocol, a treadmill test used to diagnose heart disease. Born in Boston, Massachusetts, USA on Nov 20, 1916; died aged 87 years at an assisted living centre in Seattle, Washington, USA, on Feb 12, 2004. Bruce had been battling leukaemia and spinal stenosis.
erner Samson was a student fellow and “lab rat” for Robert Bruce, the man widely acknowledged as the “Father of Exercise Cardiology”. During early research at the University of Washington, “We spent hours with treadmills. We categorised individuals by their ability to walk on those machines. We called it the physical fitness index, which became the Bruce Protocol”, Samson told The Lancet. Bruce began his research comparing the heart activity of patients at rest to that under exertion using a technique called Master’s Two Step. It involved climbing and descending two steps, but was too strenuous for many heart disease patients. In 1949, Bruce and his colleagues began testing patients with a treadmill. Eventually, Bruce found he could analyse minute-to-minute changes in the heart by following electrocardiogram (ECG) readings as he increased the speed and incline of the treadmill. This technique enabled researchers to discover cardiovascular problems that were exposed only when the heart muscle was stressed. After Bruce and colleagues published their test results (Pediatrics 1963; 32: 742) the treadmill began to be used in cardiovascular diagnosis. A key discovery was the ability to establish standards for normal heart functions by age group, and thus to differentiate between loss of function due to age and that due to disease. Bruce was delighted to discover that 63% of respondents claimed to modify risky behaviour as a result of taking the test. In the Pediatrics paper, Bruce wrote: “You would never buy a used car without taking it for a drive and seeing how the engine performed while it was running, and the same is true for evaluating the function of the heart”. Bruce did his bachelor’s degree at Boston University and MD at the University of Rochester in New York where he was also an intern. He went on to the University of Washington, and became its first director of cardiology in 1950, a post he held for more than 30 years.
W
Terrell Tannen e-mail: [email protected]
THE LANCET • Vol 363 • April 24, 2004 • www.thelancet.com
Richard Page holds the Robert A Bruce Endowed Chair in Cardiovascular Research at the University of Washington. “He defined the protocol we all use”, says Page. “When I first took the chair, he stopped by to deliver bound copies of his papers to leave his academic legacy to the division he founded. He was truly vigorous, a serious academic individual who commanded the respect of everyone around him. What’s special about the chair I hold is that it’s named after one of the forefathers of a procedure rather than someone who donated money.” Bruce and his first wife, Eleanor Hinckley, had four children and were together for more than 50 years until her death in 1994. Their daughter, Nancy, died in 1972. His second wife, Jean Laughlin, died in 2000. In 2002, he married Barbara Klemka Bruce, a fellow resident of Ida Culver House, an assisted living centre in Seattle. “Bob Bruce was kind to the core. A real New England gentleman”, says Samson. “He never blew his own horn but he had a lot of bad luck in his life. He lost his first and second wives, a daughter, and was long estranged from a son. But he was actively interested in his work until the end.” A reception in Bruce’s honour was hosted by Page on Feb 11, 2004, at Ida Culver House. Though he was weak from anaemia, Bruce attended in jacket and tie, listening to the stories his colleagues shared about him. Samson was close to his mentor through his last days. “He had spinal stenosis and was taking platelet transfusions for leukaemia. When the stenosis became so severe it immobilised him, he knew it was inoperable.” His wife observes “He had a very practical mind and could see things clearly. Though he never showed it, the loss of mobility and the pain he was suffering made him decide he had lived a full life. He stopped taking the blood treatments.” He died less than 12 hours after the reception. As well as his wife, he is survived by three sons, four grandchildren, and a great-granddaughter.
1403
For personal use. Only reproduce with permission from The Lancet publishing Group.