First and last of my vivid memories of Fred Whitehouse are actually tied to Davida Kruger. Shortly after I moved to Detroit in 1986 to establish a comprehensive diabetes center at Wayne State University and the Detroit Medical Center I made an appointment to see Fred to pay him homage as the giant of diabetology. Upon my entrance he stopped my compliments and said, with his usual dry humor, “Oh, I don’t really do anything here. My job is just to hold the doors open so Davida does not run into closed ones….” More sadly, it was on 1 March 2019, while flying to Houston for a meeting, when Davida, who happened to sit next to me on the plane, received the call about Fred’s passing. She was clearly shaken by that awful news. Ironically, the night before, at the meeting of the Endocrine Club of the Michigan chapter of the American Association of Clinical Endocrinologists (AACE), the past officers of AACE took a picture together to deliver it to Fred upon learning that he was in a local hospice.
Another classic “Fred” recollection: We were caught in the epic snowstorm of 2003 at the Washington, DC, Mandarin Oriental Hotel (where we were preparing educational efforts for the anticipated approval of insulin glulisine) and the nation’s capital was shut down. All airports were closed, our flights canceled, and streets became impassable with the huge amount of snow. Fred approached me and said, “Let’s go and see if the Freer Art Gallery is open.” And so we went out into the blizzard, trudging the half mile through more than a foot of snow, the only crazy ones out in the street. I had a hard time keeping up with his long strides, but we made it and were the only people in the still-open gallery. Fred knew the collection by heart and became an amazing docent. For the next couple of hours he entertained me with descriptions of the fine points of Korean, Chinese, and Japanese art. That was vintage Dr. Whitehouse: ever curious, virtually “all-knowing,” whether it was history, art, architecture, or geography, but always courteous—a gentleman in the best sense of the word and the epitome of a true Renaissance man.
I had had other opportunities to savor Fred’s presence. We both belonged to the Detroit Academy of Medicine and the Detroit Medical Club (in 2005 they merged to become the Detroit Medical Academy); I was thus witness at the monthly meetings to the breadth of his knowledge, his incessant curiosity, and incisive questions or comments, whether the subject was a medical topic or a presentation about art history, architecture, wine making, or a legal issue. He was still at it at the last meeting he attended in January 2019, when the topic had to do with medical education and community involvement. And how can one forget our collective faux pas when the Michigan AACE Endo Club organized an evening to celebrate Fred’s achievements and legacy upon rumors of his retirement, only to be told by him that any such rumors were certainly premature! Indeed, he was actively taking care of his patients until the age of 89! However, probably the most precious comments came to me from his former patients. When Fred’s clinical practice was slowing down, he had referred some of his patients to me for ongoing diabetes management. They all related their admiration of Dr. Whitehouse not only as a superb all-around physician but also as a caring, compassionate human being. They had been comfortable letting him in on their problems way beyond diabetes, and they had felt he was always there, listening, and with valuable advice.
But enough of these reminisces for now. So who was Dr. Fred Whitehouse?
His formal data, as printed in his obituary (1), read as follows: Fred Waite Whitehouse, MD, was born in Chicago, Illinois, on 6 May 1926 but was raised in Dallas, Texas. He completed his undergraduate degree at Northwestern University in 1945 and his MD degree at the University of Illinois in 1949. He enlisted in the U.S. Navy during World War II, and after medical school, he was promoted to lieutenant and served as a flight surgeon during the Korean War based in Pensacola, Florida, and Lincoln, Nebraska. He completed his residency in Internal Medicine at Henry Ford Hospital in 1954 and a fellowship in diabetes at Boston’s Joslin Diabetes Clinic under Dr. Elliott Joslin. He joined the staff of Henry Ford Hospital in 1955 and served from 1962 to 1995 as Division Head of Metabolic Diseases and then the combined Endocrinology and Metabolism Division. He remained active on staff until his retirement in 2015. His wife of 64 years, Iris Jean, whom he met at Henry Ford Hospital when she was a floor nurse and he was a medical resident, died in 2017. He is survived by his daughters Dr. Martha Gray, Amy Kliman, and Sarah Whitehouse, eight grandchildren (Kendra, Julia, Evan, Brian, Andrew, Alexander, Benjamin, and Alexandra), and 13 great-grandchildren.
However, there was far more to him than is contained in this brief summary.
To start with, Dr. Whitehouse was involved in numerous clinical research trials, including the Diabetes Control and Complications Trial (DCCT) that confirmed the importance of blood glucose control to prevent diabetes complications. He served as President for both the national American Diabetes Association (ADA) (1978–1979) and the Michigan affiliate of ADA and was the recipient of many awards for his work, including the ADA Banting Medal (1979), the ADA Outstanding Physician-Clinician Award (1989), and the ADA Outstanding Physician Educator Award (1994). He also served on many national, state, and local medical organizations and committees and was a Master of the American College of Physicians. He contributed nearly 180 publications to the peer-reviewed literature, the most recent being in 2017 at the age of 91, and was also a reviewer and editor for several diabetes publications (1).
As one of those who listened to Fred’s life journey with diabetes on several occasions, I was always moved by his description of how it all started (2). His first experience with type 1 diabetes occurred at the age of 12 in the summer of 1938, when his younger brother Johnny was diagnosed after experiencing symptoms during a family car trip through Arizona and California. Their mother recognized signs of diabetes because one of her cousins had been diagnosed with it and then died in 1919 while on the way to see a “famous doctor” in Boston (3). Fred was quoted as saying, “I was the resident chemist in our family because I had an amateur chemistry set and would boil the urine, trying to get the color blue because that meant no more sugar in the urine. That was my initiation into diabetes” (3).
Thus, young Fred became the family doctor and took charge of his brother’s diabetes care, giving him insulin injections, sterilizing needles and syringes, and testing urine for glucose with his chemistry set. He even carried snacks in his pockets, in case his brother’s glucose went low. At that time, Benedict’s solution and urine were the only means of assessing glucose control outside of the hospital. Beef-pork insulin was administered in glass syringes with long steel needles, which needed to be sharpened and sterilized prior to each use. His experience led to his lifelong interest in helping those afflicted by diabetes.
Fred graduated from Highland Park High School in Dallas, Texas, at age 16. He liked to read the dictionary as a boy, and the family suspected he had a photographic memory as he learned so much about every subject and remembered everything. That characteristic proved useful in his ensuing endeavors. His journey to the world of diabetes, however, was not straightforward. After graduating from the University of Illinois College of Medicine in Chicago he decided to leave Chicago and wanted to do a rotating internship. He did not want to go east because there were only straight internships there and he was unsure what he wanted to specialize in. He actually wanted to go into obstetrics. “There's nothing more delightful than delivering babies,” he said (3). However, he did not want to be a gynecologist. He decided to look for an internship in the Midwest and came to Detroit to check out Henry Ford Hospital in November of 1948. He left very impressed by the physicians who interviewed him. As he reminisced, “…if half of the people at Henry Ford on the staff were half as good as Jim Baltz [Dr. James I. Baltz, a gastroenterologist], it’s going to be a great internship” (4). As a medical student Fred had trained at Presbyterian Hospital in Chicago, where Dr. Rollin Woodyatt was the leading physician for patients with diabetes, and he came to admire the man and his style. That contact and, of course, his early experience handling his brother’s diabetes came in handy and turned into a lifelong career.
After a 2-year (1950–1952) stint as a Navy flight surgeon during the Korean War following his internship, Whitehouse returned to Henry Ford to finish his residency and then took the big step into the world of diabetes: a fellowship in Boston, Massachusetts, at the New England Deaconess Hospital, which shared space with the Joslin Clinic at the time. Fred spent 15 months there working with several trailblazers from diabetes history, including Dr. Elliott P. Joslin himself. At the time, Dr. Joslin was in his mid-80s and spent most of his time in his office, but Fred and others would accompany him on rounds when Joslin did see patients. “The old gentleman was still hale and hearty, and worked every day at the hospital doing his rounds every Saturday morning starting at 8 a.m. He really was a remarkable man,” he said of Dr. Joslin (3). Fred left the Joslin Clinic in September 1955 and returned to Henry Ford Hospital in Detroit as a senior staff physician. There he served as chief of the division now known as Endocrinology, Diabetes, and Bone and Mineral Disorders for more than 30 years, becoming regarded as one of the nation’s leaders in the field of diabetes. As the division website said about him before his retirement: “Over the course of 60 years, Dr. Whitehouse has helped change the face of diabetes management and treatment” (3). At Henry Ford Hospital, the Fred W. Whitehouse Distinguished Career Award and the Fred W. Whitehouse Endowed Chair in Endocrinology have been named in his honor.
On a more personal side, Fred met his wife Iris, who was a nurse at Henry Ford Hospital, on the 4th of July 1950. “We all knew that we were going to the service because the war had just started. But I happened to see her in the cafeteria, and I remembered that that night the Detroit Symphony was playing at the state fairgrounds, open-air concert. So I thought, ‘Well, I might take her out there.’ So I called her up and said, ‘You got anything else to do? Come on and we’ll take the street car out to the fairgrounds, and go to the concert.’ And she did” (4). They got married in June 1953. They both realized that people needed to learn more about diabetes than what they were given to read on a piece of paper. Iris became the first diabetes teaching nurse at Henry Ford Hospital. She finished her degree at Wayne State University with a Bachelor of Science in Nursing and then worked at Ford from 1969 to 1997 as a diabetes teaching nurse. “We had a formal program where people came and spent 5 days with us to learn how to do things. And this was a big thing within the American Diabetes Association at that time. They are now called CDEs (certified diabetes educators)” (4).
From his early experiences at the illustrious Joslin Center to his involvement in pivotal clinical trials of the 1980s, which led to today’s understanding of diabetes management to prevent complications, Dr. Whitehouse was in the thick of it. But let his own words tell the story: “The combination, by early 1980s, of insulin pumps, hemoglobin A1c, and newer insulins promoted probably the very best clinical study that was carried off in the United States, called the DCCT, which proved (results were presented at the ADA scientific meeting in 1993) that controlling diabetes made a difference in the health of people with diabetes. Not only immediate health, but postponement of eye trouble, kidney trouble, things of that nature. You might say ‘Well, we’ve known that.’ But we didn’t know that. This was a great argument, ever since insulin was discovered, as to how diabetes complications came up. They knew about kidneys in 1935. Eye problems occurred in the late 30s, early 40s. People with diabetes, as a result of taking insulin, started to live instead of dying off in the first year or two. They lived on, but they didn’t live safely. They got these problems. And some people thought, ‘It’s part of the disease.’ And others said ‘No, it isn’t. It’s part of the control of the disease.’” (4). He also served as an investigator on many other pivotal diabetes trials such as Action to Control Cardiovascular Risk in Diabetes (ACCORD).
Notably, Fred was involved in testing human insulin in the late 1970s and, along with one of his colleagues in Detroit, treated the patient who was the second-ever person to inject human insulin. He also treated some of the earliest patients on insulin ever to utilize new tools such as blood meters and insulin pumps, as well as those who had transplants of various natures. One of his patients was Elizabeth Hughes Gossett, who was diagnosed at age 11 in 1919 and was one of the first to ever receive insulin from Dr. Fredrick Banting in 1922. Before her death from pneumonia in 1981 at the age of 73 (after an estimated 42,000 insulin injections), she saw Dr. Whitehouse but actually kept her diabetes a secret from the world. She was a “closet diabetic,” Whitehouse said. “There are far less closet diabetics than there used to be, and people are more open. That’s a good thing because you can learn from others who are going through similar experiences” (3).
In a 2012 interview Dr. Whitehouse stated his belief that the next leap forward would be just as amazing—preventing type 1 diabetes and helping those with type 2 diabetes avoid complications with better management. Regarding the possibility of a cure, he said, “I think prevention of type 1 diabetes will come first. Then, better control of daily swings in blood glucose and better control over low blood sugar spells. Perhaps third will be better control of overweight and obesity. Last in my view will come the ‘cure of the insulin-dependent diabetic person.’ This will require stem cells from the diabetic’s own tissues developing into beta cells, then preventing these ‘personal’ beta cells from being killed off as they initially were. This will be the crowning achievement. That’s all coming, but I think diabetes will be around for a spell” (3).
A special symposium at the ADA 75th Scientific Sessions in 2015 focused on the changes in diabetes care over the last five decades, and Fred was the one chosen to present on that topic. Not only was he instrumental in advancements in diabetes care, but his service and volunteerism were instrumental in efforts to educate others about diabetes care and prevention. “There are things that have happened over the past 50 years that clearly make life a lot better for people,” he remarked. “There’s been a lot of change, most of it for the better, but what people want is a cure and we don’t have that yet” (5).
The following is from his daughter Sarah’s recollections: “He loved baseball, Chicago Cubs being his favorite team. He was progressive for the times: In the 1960s he encouraged my Mom to go back to college for a BSN and to work when she became bored at home with school-age kids. He encouraged all of his daughters to find work we love. He encouraged Davida, his lifelong clinic partner, to move beyond her early role in diabetes. He was a special man. I think so many people liked him because he had a special way of immediately connecting to a person in conversation, finding that common thread between them. One of his patients recently wrote to me that the Joslin Clinic told her, as she was getting her 50-year medal, that Dad had the most 50-year medal patients as of that time. That’s a testament to how he loved to help others.”
When Fred was asked “What do you want your patients to remember about you?” he answered: “I hadn’t really thought about that. I guess I would hope that they would think that I was trying my best to help them. But that I also was not doing it for them, but they knew what they should do themselves. William Osler used to say, ‘The way to live a long life is to get a chronic illness and to take good care of it.’ But I would hope that people, when it comes to diabetes, would say to themselves ‘Well I can, I can do better because he helped me do better’” (4).
Dr. Fred W. Whitehouse was a gentleman who made an incredible impact on treating diabetes for more than seven decades.
Acknowledgments. I am deeply and forever grateful to Sarah Whitehouse, Fred’s daughter, for sharing personal recollections and giving me access to her recollections, unpublished materials, and family pictures and to Davida Kruger (Henry Ford Health System, Division of Endocrinology, Diabetes, and Bone Disorders) for pictures and lifelong friendship.