In the 17 years that I have managed the Diabetes Care Editorial Office, my staff and I have assisted thousands of authors, editors, and reviewers. We have become friends with more of them than we could begin to count. Sadly, we recently lost two especially dear friends, Richard R. Rubin, PhD, CDE, and Harry Keen, MD. Richard lost his battle with cancer on March 25; Harry died unexpectedly on April 5 while undergoing treatment for lymphoma.
We were honored that these great men not only wrote and reviewed articles for Diabetes Care but also served the journal in editorial roles: Richard as an Associate Editor (2002–2004) and Harry as a member of the Editorial Board (2001–2003). Over the years, as our friendships with them grew, they shared family stories and hobby interests with us. It was not unusual for either to e-mail our office, just to send a photo or a “Hope all is going well.”
Our friendship with Richard began during his time as an Associate Editor of Diabetes Care. He remained a frequent reviewer for the journal after his editorial duties ended—and even after his cancer diagnosis. Richard loved his family and photography and would often send us pictures of his photo projects, the grandkids, or himself and his wife, Karan. After learning that my avocation is writing, he never failed to ask how my book was going, or if I had even been able to do any writing lately. He never complained about the downward trend in his health. Instead, he spent his time living life. Richard was one of those people who inspires others to focus on the best in life, not the worst.
Our friendship with Harry dates from 12 years ago, when we began recognizing top reviewers for Diabetes Care. During the early years of this program, the Editorial Office sent each top reviewer a colored glass mug with gold lettering as a small token of thanks. Harry, then in his 70s, never failed to “win” a mug. He once commented that he was aiming to earn a whole set for his mantle and mentioned that they made great beer mugs! Harry loved working with clay and creating pottery. Once, he sent photos of a failed project and the look of surprise on his face when it collapsed. Harry taught us that, from time to time, we need to be able to laugh at ourselves.
Richard received his BA in history from the Johns Hopkins University in 1965 and his PhD in social psychology from Hopkins in 1971 (1). Harry graduated from London’s St. Mary’s Hospital Medical School in 1948. Each man had his own story on why his career turned toward diabetes.
Richard’s reason was personal
When a person is diagnosed with diabetes, there is a ripple effect, like that produced by a pebble tossed into a still pond. The disease affects not only the patient, but also those who share the patient’s life, especially family, friends, teachers, and work colleagues. The psychological aspect can be overwhelming for all. Richard knew this firsthand, not only from his younger sister’s diabetes diagnosis in 1959 (when a glass syringe had to be boiled before each use), but also from his 7-year-old son’s diagnosis in 1979. In his President’s Address to the 67th Scientific Sessions, Richard recalled, with both humor and emotion, how the family pediatrician asked him to stick himself with the syringe to demonstrate for his son that it did not hurt too much (2).
Richard started seeing diabetic patients in his counseling practice soon after his son was diagnosed, and in 1984 he began working at the Johns Hopkins Comprehensive Diabetes Center. Not long thereafter, he and Chris Saudek, MD, and Mark Peyrot, PhD, began research on the Center’s 5-day diabetes education program. The three men reported on the program’s powerful benefits for patients’ emotional well-being, self-care behavior, and glycemic control in a series of articles published in Diabetes Care in the late 1980s and early 1990s. Richard attended his first Scientific Sessions of the American Diabetes Association (ADA) in 1985 and continued attending right through last year. In 1986 he was one of the first people to take the certified diabetes educator (CDE) exam. He joined the National Certification Board for Diabetes Educators in 1989, becoming its chair in 1991 (2). His work in diabetes education earned him ADA’s Outstanding Educator in Diabetes Award in 1997. In 1994, he became a coinvestigator in the Diabetes Prevention Program (DPP), a landmark study that proved it is possible to prevent or delay the onset of type 2 diabetes in people at high risk for the disease (2). His first book, Psyching Out Diabetes (1992), was written with June Biermann and Barbara Toohey (2). International speaking engagements on diabetes took him to many countries, including Japan, Germany, Mexico, England, Denmark, Lithuania, and Finland. He also somehow found time to write more than 200 articles, reviews, book chapters, and books (3).
A tireless volunteer, Richard served the ADA for more than 30 years. He was elected ADA President, Health Care and Education, for 2006–2007, and chaired the association’s Committee on Professional Councils and the Council on Behavioral Medicine and Psychology. He was a member of the Association’s Program Publications Editorial Board, the Scientific and Medical Programs Oversight Committee, the Health Care Finance Administration Advisory Group, and the Health Care and Education Advisory Board for the Pinnacle Society. He also chaired the Task Force on the Delivery of Diabetes Education and Medical Nutrition Therapy. The ADA recognized his contributions as a volunteer with the Rachmiel Levine Medal for Service in 2007 and the Addison B. Scoville Award for Outstanding Volunteer Service in 2010 (4).
Harry’s story was quite different
Born in London in 1925, Harry had thought about medicine since early childhood. In a 2006 interview, he stated, “Even as a kid, I realized that [medicine] brought one into quite close contact with other people, and quite often people in distress, people in trouble, and that one could sometimes do something for them. Sounds awfully spiritual . . . but that’s the way it was.” However, when Harry finished school, he found he had a difficult choice to make—enlist in the army and fight for the things he believed in, or devote his attention to the field of medicine. (He did serve 2 years in the Royal Army Medical Corps in Egypt.) Others finally convinced him to dedicate his time to medicine (5). The field of diabetes is much better off for that decision.
Harry credits the pioneering hypertension expert George Pickering, then at St. Mary’s Hospital Medical School, for setting his course in diabetes research. After learning that people with diabetes had particularly high blood pressure, Pickering decided to examine this complication, but he needed someone to measure blood pressure in all the diabetic patients at St. Mary’s and in all their first-degree relatives. Enter young Dr. Keen (5).
During the 1950s, Harry continued at St. Mary’s Medical School and also joined the diabetes department at King’s College Hospital. After completing a research fellowship in 1961 at the National Institutes of Health in Bethesda, Maryland, he went to Guy’s Hospital Medical School (now part of King’s College London School of Medicine) as a physician, investigator, and teacher, becoming professor of human metabolism in 1971 (5,6). He was named professor emeritus at Guy’s Hospital Campus of King’s College London after his retirement in 1990 (7).
Among Harry’s many accomplishments are the first demonstration of microalbuminuria; the discovery and development, with John Pickup, BM, DPhil, of continuous subcutaneous insulin infusion; the establishment of one of the first diabetes centers in the U.K.; and leadership on the St. Vincent Declaration, which catalyzed the creation of many of Europe’s national diabetes programs. Harry held office in a number of prominent British, European, and international health organizations; he was, for example, honorary president of the International Diabetes Federation (IDF), vice president of Diabetes UK, and president of the NHS Support Federation (7,8). Throughout his career, Harry remained active in health care policy, and he was a vocal advocate for the NHS (9).
The ADA recognized Harry’s contributions in the field of diabetes with the Kelly West Award for Outstanding Achievement in Epidemiology in 1989 and the Harold Rifkin Award for Distinguished International Service in the Cause of Diabetes in 1992.
In one of his last e-mails to me, Harry continued to express his pride in the NHS, saying, “I qualified in 1948, just before the NHS started (and was out on the streets for the 2 years before, campaigning for it). I’m proud to have worked in it and for it (i.e., for the public).”
Both men shared a commitment to serve
Despite the many demands on their time, rarely did either man decline to do a review for Diabetes Care. They realized the importance of providing constructive criticism and guidance to new and seasoned authors alike. Neither complained about how often we asked them to serve, and both always thanked us for any help they received in submitting or reviewing a paper. These two men were tireless in their fight to stop diabetes, always putting others’ needs before their own. Their lives were about giving.
In the weeks since their passing, you have heard and read numerous tributes to them. You knew about their place in the history of diabetes before you ever picked up your copy of the journal. On behalf of the Editorial Office and the editors of Diabetes Care, I can only echo that the field of diabetes has lost two giants . . . and mourn that we in the Editorial Office have lost two cherished friends.