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Farewell to our Good Friend and Outstanding Colleague David Flockhart (1952–2015)

2016; Wiley; Volume: 99; Issue: 2 Linguagem: Inglês

10.1002/cpt.327

1532-6535

Carl C. Peck, Raymond L. Woosley,

During the last hours of Thanksgiving Day 2015, sadly, we clinical pharmacologists lost a dear Friend and greatly admired colleague, David Flockhart. Although David had calmly explained his diagnosis and treatment in a series of podcast and radio interviews on Sound Medicine by National Public Radio1, the news of his passing forced an unwelcome new meaning of Black Friday for those of us who cared deeply for him. Within hours of the news of his passing, a flurry of heart-felt expressions of condolence and praise were electronically exchanged among David's closest ASCPT “family” and beyond. That David was one of the most influential clinical pharmacologists of our time, is a fact well documented by his numerous scholarly papers on Personalized Medicine and Pharmacogenomics and his website www.drug-interactions.com. But David was much more – he was a devoted father, world citizen (medical leader in Amnesty International), caring physician, medical visionary, and activist for science-based healthcare. Details of David's career from his student years in Scotland, and training and faculty period at Vanderbilt (Physiology), Miami, Georgetown, and Indiana Universities (Medicine, Clinical Pharmacology) have been well described in the tributes to David that followed within days of his untimely passing23,4. That this charismatic thought-leader may continue to inspire all fellow clinical pharmacologists, especially those in the early stages of their careers, we chose here to Celebrate David's life with a few anecdotes and facts from a few of his closest colleagues. Figure Illustration by Dave Klemm, Georgetown Univ. School of Medicine, by permission Sally Jo Yasuda: “Dave understood that information is absorbed best in “bite-size digestible pieces”. That is the beauty of his P450 card (www.drug-interactions.com) that is of great assistance in teaching medical students and in clinical practice and that has become an essential tool in drug development. Dave's research success was in part due to his focus on looking at the individual rather than just the mean of the population. That allowed for characterizing findings that were previously not understood and importantly, helping to better identify patients most at risk for an adverse reaction or patients who are most likely to respond to treatment. Dave's concern for the individual extended far beyond his brilliant research to his circle of friends to whom he showed great care and interest. I am so proud that I can apply Dave's clinical pharmacology contributions to my work every day. I am grateful for our 25 years of friendship.” Craig Brater: “An endearing and enduring characteristic of Dave's was his unbridled enthusiasm. I wager it is the rare person who had a conversation with Dave who did not hear an exuberant “FANTASTIC”!! In fact they may have heard several of those in a single sentence. When Dave's tumor recurred it quickly got to the point where it caused him to have an expressive aphasia. As you can imagine this was enormously frustrating to Dave. We still had conversations in which he was fully engaged. His verbal responses were limited to a yes or no, if that. But he was still a full participant of the conversation through body language, eye contact and the other word he could still get out as he would throw up his arms in glee and say “FANTASTIC”. Fantastic was clearly hard-wired in Dave just as his memory is hard-wired in us–FANTASTIC!!” Darrell Abernethy: “I am a better person for having the opportunity and privilege to be a friend and colleague of Dave Flockhart. We first met when I was interviewing for the Clinical Pharmacology position at Georgetown University in 1993. Dave had joined the faculty following his medicine residency and clinical pharmacology fellowship. I recall his efforts to begin a Center for Victims of Torture. I learned of Dave's deep involvement in Amnesty International and commitment to alleviate such suffering. I recall our dinner together after co-directing the 2015 annual Clinical Pharmacology Curriculum Review course. He was open about his diagnosis of glioblastoma and we both knew this was likely to be the last of these courses we would do together. During our wide ranging conversation, Dave reminisced of his involvement in the end apartheid movement at an earlier time, and his visit to Nelson Mandela while he was in prison. While so much can be said about Dave's many contributions to Clinical Pharmacology, his service to humanity towers above it all. Dave achieved the ideal, i.e. leaving the world a better place than he found it.” Arthur Atkinson: “Although I had known David through his membership in ASCPT and his work at Georgetown. I first worked with him when he came to NIH to lecture in the newly founded clinical pharmacology evening course. His lecture on pharmacogenetics was a tremendous success and he continued to contribute to the course for the ensuing 18 years. David also generously contributed his expertise and time to preparing an outstanding chapter on clinical pharmacogenetics that appeared with appropriate updating in all three editions of the Principles of Clinical Pharmacology text that was a companion to the course. All this was in addition to the many important contributions to the developing field of pharmacogenetics/pharmacogenomics that he made during his very productive professional career. David was truly one of the irreplaceable pioneers of our discipline who was also a good friend to many of us.” Shiew-Mei Huang and Issam Zineh: “We remember Dave for his humor, friendship, life in service to patients, and tremendous contribution to drug regulation. He served on the US FDA Advisory Committee for Pharmaceutical Science and Clinical Pharmacology3 from 1998 (Chair in 2014). His balanced insights always resulted in robust deliberation on how to evaluate and translate knowledge of patient variability into patient-focused dosing and labeling recommendations. He was a trustworthy advisor whose scientific strength and wisdom undoubtedly impacted public heath decision-making. Dave was generous with his time and was an exceptional teacher. He would visit the FDA Office of Clinical Pharmacology (OCP) to provide seminars and freely share his expertise on various critical clinical pharmacology issues. His legacy remains apparent at the FDA, and his former trainees, now OCP staffers, carry on Dave's important life-work in personalized medicine and therapeutic individualization. He will be missed.” Todd Skaar: “One of the many inspiring aspects of Dr. Flockhart's career was his interest in developing the careers of young investigator's. I recall him saying that he works to develop people, and he uses science to do it. Even more than his own accomplishments, he valued the success of the people that he trained. His ability to train scientists ranging from basic scientists to physician scientists truly exemplified the translational nature of clinical pharmacology. The excellence of his mentoring is clearly demonstrated by the success of the many clinical pharmacologists that he trained. He was a great role model of a mentor and his legacy will live on and continue to make contributions to this field through his many trainees. When faced with difficult decisions, I will often ask myself, “What would Dr. Flockhart have done”. James Tisdale: ““Dave was welcoming, generous, and a great collaborator. My primary appointment is at Purdue University, and I have an adjunct appointment in Dave's division. Dave welcomed all interested Purdue faculty members to serve as adjunct faculty members in the IU Division of Clinical Pharmacology. Though we are adjunct faculty, he treated us as if we were full faculty members in his Division. We participate fully in journal clubs, seminars, the Clinical Pharmacology short course, and social events. Dave was a world-class scientist and a warm person. As a collaborator, when I presented an idea to Dave that he liked, his response would be “fantastic!” I am a better clinical scientist, and, more importantly, a better person for having had the privilege of working with Dave.”“ Syed Rizwanuddin Ahmad: “David and I trained together in clinical pharmacology at Georgetown in the early 1990s. David joined because of his interest in personalized medicine and trained under the mentorship of Ray Woosley. He used that training to the benefit of his future trainees and innumerable patients. If I were to be asked which work of David's benefitted me most, it is definitely the drug interaction table at www.drug-interactions.com. David was always willing to help in any way, shape or form and collaborated with scientists around the world. Being originally from Pakistan, I wanted to study the genotype-phenotype relationship of CYP 2D6 in the Pakistani population and David was generous to offer his lab's resources to conduct the investigation. I, like so many others, will miss his friendship.” Kathy Giacomini and Dan Roden: “Ahoy Dave, from all of us in the Pharmacogenomics Research Network (PGRN): On Alan Shuldiner's speedboat, Dave Flockhart, Ron Krauss, Mike Province, Alan and the two of us sped around Baltimore Harbor in the fall of 2007. After a day of great research presentations, all of us were enjoying ourselves on a typical overcast afternoon in Baltimore. But one thing stands apart in all of our memories of that trip: the pure and extreme joy that Dave conveyed on that brief excursion around the Harbor. At that moment we saw a Scotsman, and one who, in this life or another, had experienced the joy of the sea. And we all caught a brief glimpse of Dave's soul, with all his passion and joy for science, and indeed for all of life. Ahoy Dave, from all the people you left behind. We miss your colossal passion for life.” Carl Peck and Raymond Woosley: The photo above is a fitting farewell as it shows Dave enjoying life, looking into the distance as the visionary he truly was and obviously ready to explode with another “Fantastic!!!” Dave's family has requested that donations be made in his name to either the Indiana University School of Medicine Division of Clinical Pharmacology or Amnesty International. Also, we propose that henceforth, the P450 Table that Dave launched at Georgetown (www.drug-interactions.com) and which is now posted at Indiana University's website, be forever known as “Flockhart's Table.” As a tribute to our loved and lost friend, we encourage our colleagues to support Flockhart's Table as an up-to-date resource for all those who care for the safe and effective use of medications and to seek ways to maintain this treasured resource. We are extremely grateful to the many contributors listed above and only regret that we were limited by space and could not invite all of Dave's many friends to contribute their personal thoughts and words to this Memorial Tribute to our friend, David A. Flockhart. Carl C. Peck Raymond L. Woosley