Herbert L Fred
June 11, 1929 – December 30, 2018
Herbert L. Fred, MD 1929 – 2018 Herbert L. Fred, MD─Professor Emeritus of Medicine, McGovern Medical School, Houston, and Master in the American College of Physicians (MACP)─passed away on December 30,2018. As a full-time medical educator for almost 6 decades, he leaves a legacy of several thousand trainees who learned to be better doctors under his watchful eye. And he will be remembered as a self-motivated, deeply committed, highly disciplined, strongly competitive, achievement-driven, independent thinker for whom learning was a passion, hard work the norm, and excellence the standard. Herb was born in Waco, Texas, on June 11, 1929 to Helen and Isadore (“Isie”) Fred. His father, a jeweler by trade, taught him that it isn’t the color of your skin, the size of your pocketbook, the depth of your knowledge, or the religion of your choice that matters. It’s what you do with what you have that counts. His father’s immense concern for the welfare of others inspired Herb to choose medicine as his calling.
His mother taught him the importance of an education, the value of high standards, and the virtues of integrity, discipline, and punctuality.
Growing up in Waco, Herb became a gifted table tennis player and spent his Saturdays defeating all comers at the local YMCA. After graduating valedictorian among 400 students in his Waco High School class of 1946, he entered the Rice Institute. Four years later, he received his BA degree there. At Rice, he was runner-up at each of its yearly table tennis tournaments.
In 1948, during summer studies at the University of Colorado, he won the University’s table tennis competition. That same year, Herb took 3rd-place in a 5-state talent contest in Denver; he impersonated the Ink Spots, Frankie Lane, Vaughn Monroe, Peter Lorre, and Winston Churchhill.
He received his MD degree from the Johns Hopkins University School of Medicine in 1954. He then completed his internship and residency training at the University of Utah Affiliated Hospitals in Salt Lake City.
After 2 years in the U.S. Air Force, Herb joined the faculty of Baylor College of Medicine in 1962. During his 7 years at Baylor, he was named the Outstanding Full-time Clinical Faculty Member by the senior classes of 1964 and 1965. The senior class of 1967 dedicated its annual, the Aesculapian, to him. Herb became Director of Medical Education at St. Joseph Hospital, Houston, in 1969. There he created Houston Medicine, a bi-monthly medical journal that went to all physicians in Harris County for 8½ years. In 1971, he became professor of Internal Medicine at The University of Texas Medical School in Houston. Between 1974 and 1979, the interns and residents at St. Joseph Hospital and at the University of Texas Medical School gave Herb a yearly award for “Excellence in Teaching,” and from 1990 to 1999, he earned the “Dean’s Excellence Award.” In 1999, he received the Benjy F. Brooks, MD Outstanding Clinical Faculty Award from the Alumni Association of The University of Texas Medical School in Houston. Over the years, Herb continued to receive numerous awards and honors─most for teaching, others for writing. Houston City Magazine selected him as one of Houston’s “84 most interesting people in 1984,” and Houston mayor Kathy Whitmire honored him by designating October 7, 1988, as Dr. Herbert L. Fred Day. That same year, then-President Ronald Reagan issued Herb a Presidential Commendation in recognition of 27 years as a medical educator in Houston. In 1994, The American Medical Writers Association, Southwest Chapter, awarded Herb a Certificate of Appreciation for outstanding contributions as a medical writer and journal editor. In 2002, Herb’s former trainees honored him for 50 years of bedside teaching by founding The Herb Fred Medical Society, Inc. He was named The American College of Physicians-American Society of Internal Medicine Distinguished Teacher for 2004. That year, he was The Donald Church Balfour Visiting Professor in Medicine at the Mayo Clinic in Rochester, MN. And in 2005, he won the TIAA-CREF Distinguished Medical Educator Award. In 2006, Herb received the Distinguished Alumnus Award from the Waco, Texas, Independent School District Education Foundation. Additionally, students at the University of Texas Medical School in Houston created a film titled “A Special Tribute to Herbert L. Fred, MD.” In 2007, Herb received The Federation of State Medical Boards Award for Excellence in Editorial Writing. Herb was the inaugural speaker in 2012 at the annual Herbert L. Fred, MD, MACP, Visiting Professorship in Medical and Biomedical Education at the Institute for Excellence in Education, The Johns Hopkins University School of Medicine, Baltimore, Maryland. The Texas Chapter of The American College of Physicians gave him The Laureate Award that year for his abiding commitment to excellence in medical care, education, and community service. In 2013, the Quality of Life Research Center at Claremont Graduate University, Claremont, California, granted him a Certificate of Recognition as an exemplary mentor in the positive development of junior colleagues in the medical profession. His additional honors included a film on YouTube titled “In Honor of Herbert L. Fred, MD, MACP;” Honoree of a Gala benefiting the Texas Medical Center Library; The John P. McGovern Compleat Physician Award, presented annually to one physician in America whose career is founded on the Oslerian ideals of medical excellence; a Certificate of Congressional Recognition from the U.S. House of Representatives for dedication and commitment to the practice of medicine and the healing arts; and Honoree: “A Tribute to Herbert L. Fred, MD, MACP” Special Grand Rounds, McGovern Medical School. Herb lectured or was a visiting professor of medicine throughout the United States and in China, Canada, Italy, Switzerland, and Denmark.
He began his writing career at the age of 10 years, when the Waco-News Tribune published a poem of his. As an adult, he authored 20 medical reviews, chapters in 6 medical texts, 506 journal articles, and 6 medical books, one of which was nominated for the National Book Award. He also wrote health-related articles for USA Today, The Pittsburg Post Gazette, The Houston Post, The Houston Chronicle, and The Macon, Georgia Telegraph.
Many of Herb’s clinical accomplishments are noteworthy. He closely supervised the medical care of indigent patients in Houston for 55 years. He also served as consultant for physicians across America. In addition, he and his colleagues made numerous, important contributions to the diagnosis and management of pulmonary thromboembolic disease. He and his colleagues were the first in the world to perform cardiac catheterization on patients with acute pulmonary edema of altitude, proving for the first time that the illness does not result from heart failure or pneumonia.
At the age of 88 years, in his 488th publication, Herb described 5 patients (2 of his own) who had the tricuspid insufficiency─pulsating varicocele connection. That disorder is now officially called The Fred Syndrome.
He and a Baylor medical student were the first to report use of the ophthalmoscope to diagnose sickle-cell disease. He was the first in America and second in the world to report the cause, consequences, and cure of grossly bloody urine of runners. He was a member of the team that established the diurnial variations of plasma 17-hydroxycorticosteroids in humans.
During his professional career, Herb collected and catalogued for quick retrieval an estimated 3 million medical reprints, presumably the largest medical reprint file in the world. That file, along with Herb’s papers, documents, letters, awards, and family photographs are housed in the Texas Medical Center Library Archives.
Herb was a member of the Texas Medical Association and Harris County Medical Society for more than 60 years. His love for and appreciation of libraries culminated in construction of The Herbert L. Fred, MD, MACP Student Study Hall, which opened March 30, 2016, in the Texas Medical Center Library. Medical students and house officers from both Houston medical schools can gain access to the Hall 24-7-365. Herb served on the editorial boards of 5 national medical journals, the Board of Governors of the American Osler Society, the Board of Trustees of Houston’s HCA Medical Center Hospital, the Board of Directors of the Friends of the Texas Medical Center Library, and was President of the Houston Congregation for Reform Judaism for 2 years. Many of Herb’s students became leaders in American Medicine, including a head of the United States Food and Drug Administration, a medical school chancellor, a president of a health science center, a president of the American College of Physicians, a president of a state medical association, a president of the American College of Gastroenterology, a president of the Infectious Diseases Society of America, a president of the Southwestern Surgical Congress, 3 medical school deans, 13 department chairs, 17 division chiefs, 8 training program directors, an executive director of a state board of medical examiners, and 3 different presidents of the Harris County Medical Society, the largest county medical society in America. In 1966, well before the current emphasis on physical fitness, Herb decided to develop a strong body as well as a strong mind. Consequently, he began to run, quickly graduating to marathons and ultramarathons (100-kilometer, 100-mile, and 24-hour races). From 1980 to 1983, he set a number of national age and age-group records for ultradistances, including a 100-mile run in 17 hours, 2 minutes, 3 seconds at the age of 53. On April 20, 2016, Herb completed an entire year of running one mile or more every day─a world record for 86-year-olds. He ended his running career in 2016, having totaled 253,010 miles─more documented lifetime miles than anyone else in the world. His interest in sports medicine led to his appointment in 1980 as adjunct professor in the Department of Health and Physical Education at his alma mater, Rice University (formerly, the Rice Institute). Herb was a proud son, caring brother, devoted father, and a grateful and loving husband. Preceeding him in death were his parents; his sister, Shirley Strauss; and his ex-wife, Lucy. Surviving him are his sweetheart, soul-mate, and wife of 40 years, Judy; his children, Stuart, Michael, Nancy and their families; his step-children, Daniel, Lisa, Stefani and Gregory; 7 granddaughters, one grandson, 2 great-granddaughters and one-great grandson. A memorial service and celebration of Herb’s life will take place on Sunday, January 6, 2019 at 1:30 pm at the Houston Congregation for Reform Judaism, 801 Bering Drive, Houston, Texas. Herb will be laid to rest with his parents at a private family gathering in Waco, Texas. In lieu of customary rememberances, the family requests with gratitude that donations in Herb’s name be directed to a charity of one’s choice.
Sunday, January 6, 2019
Herbert L Fred
January 6, 2019
Most of us walk through life looking for opportunity. We don’t always recognize it. I got lucky! In 1993, as a third year medical student, saw opportunity in a kyphotic man, in a white coat, at the LBJ county hospital in Houston. At the time, I didn’t really know who he was, or what he stood for, but that quickly changed. I could tell there was something different about him. He was special. His conferences, “Dr. Fred Rounds,” were infectious. The amount of learning, stimulation, and motivation, were palpable. And I wanted more of it. Interns and residents either loved him, or avoided him. He could pick out the imposters from across the room, and they knew it. For better or worse, he had everyone’s attention. It was usually for better, but it did not always feel that way at the time. He was tough, driven, committed, brutally honest and if you were one of the lucky ones, you absorbed these characteristics.
More amazing to me, was that he backed it up. He did not only talk the talk, … he had been in the battle, and was willing to get in the trenches with you. He had written about or read the topic of discussion. He knew the pressures and rigors medicine, and understood what it takes to achieve excellence. He continued this quest long after he had anything to prove. I spent most of my internship at LBJ, so that I could work with and learn from him. It was a true privilege and honor that I cherish now more than ever. He gave me permission! I also was privileged to see the soft, empathetic and caring side of Dr. Fred. He helped and supported me throughout my career, with letters and phone calls, and unwavering encouragement. I will miss the birthday phone calls! I will miss Dr. Fred much more. His teaching will not be lost. His character will never be forgotten. The impact on my life, I can never repay. Thank you Dr. Fred.
January 5, 2019
I communicated with Dr. Herb Fred for the past three years about him contributing an introduction to the 14th edition of “Wintrobe’s Clinical Hematology.” He was enthusiastic and encyclopedic. He was meticulous as he put the finishing touches on what was likely his last publication, entitled “The Wintrobe Legacy.” Herb wrote about Wintrobe’s “monumental contributions to the fields of hematology, medical education, and patient care.”
I became aware of Herb’s similar reputation as a giant in medicine in the past year. Dr. Fred was a master clinician, educator, author, and world-class runner. I am fortunate to have known him and to be one of his many students. Herbert Leonard Fred’s legacy — his teaching and writing and his love for medical knowledge and physical diagnosis — will remain a perpetual ideal for all of those who follow him in the pursuit of medicine.
January 5, 2019
I first met Dr. Fred when I was a third year medical student. While everyone was so worried about dealing with this tough man, I was so eager and thrilled to meet him. As I got to know him well and became closer to him, I learned that his mother died of a particular Stroke, the locked-in-syndrome. I autographed a book to him that was composed miraculously by a French journalist who suffered the same consequences. That was in 2001. In 2017 when I invited Herb to my Clinics Christmas Party, he could not make it. However, he sent his greeting through a recording that we played during the presentation. Dr. Fred and after 16 years past, recognized my gesture and honored me for recognizing the resemblance between the French man book and the disease of his mother. He honored me by so many beautiful words for this simple gesture only. Words that I will cherish for the rest of my life. The future will never have a Man like Herb Fred. He was a mentor, a friend and a father to me. I will miss him endlessly.
January 4, 2019
The first time I ever saw Dr. Fred was in the mid-60s at Baylor when he gave my classmates and me a lecture about ascites. I remember him describing to us the physical finding called “shifting dullness”. He then paused and looked at us, and proceeded to add that “shifting dullness” was a nickname he had given to one of his medical school professors. Being around Herb was never dull!
Listen to him: "Possible? It’s possible I could become the king of Egypt!" "Common things occur commonly." "CVA? Your patient has the Connecticut Veterans Association?" "If (name of actress) were to walk in here wearing nothing, you'd call attention to her ears!"
Sutton's Law. Milton's Law. Mutton's Law: know what to do and when to do it.
I had the unique privilege of being his only resident at St. Joseph Hospital from late 1971 through 1973. I was with him almost daily, and even trained to run marathons with him. His portrait which he signed and gave to me when I finished my residency remains in my office where I see it every day. His death is a great personal loss to me.
One of his favorite stories was about the time during his training with Maxwell Wintrobe in Utah. He had presented a case to Dr. Wintrobe whose only response was "did you consider leprosy?" just before walking away, leaving Herb somewhat flabbergasted. Herb then spent hours in the library researching leprosy. When he then told Wintrobe he still couldn't see how the patient could have leprosy, the response was "Right. But now you know a lot more about leprosy, don't you?" Herb was that sort of teacher.
When I hear of a physician who takes the time to get to know the patient, who weighs thoughtfully the possibilities, who expresses her or himself clearly and unambiguously, and who acts decisively in the most efficacious manner possible, I think of Herb. He was a gift to all of us, a preciously rare gift intolerant of mediocrity and demanding of the best from within us.
January 2, 2019
Dr. Fred was an icon. I had the privilege of working with him as a medical resident at LBJ Hospital in Houston back in 1992-1994. I learned from Dr. Fred how a diagnostician was supposed to think. His morning reports with residents (and his scathing criticism when we languished in imprecise, non-committal diagnoses) were legendary! He gave all of us a roadmap for how to think about medical problems and years down the line I remember (more than once) when faced with a difficult patient, thinking "what would Herb Fred say". Years after residency, I remember talking to Dr. Fred and listening to him passionately lament on the state of modern medicine and how the focus had shifted from the patient to just about everything else. Dr. Fred was a true giant in medicine and a huge loss. Rest in peace. Fahim H. Jafary MD (Singapore)
Pamela Paradis Metoyer
January 2, 2019
I had the pleasure and privilege to serve under Dr. Fred as a manuscript editor when he was editor-in-chief of Houston Medicine in the early 1990s. It was early in my career as a biomedical editor, and I was honored to have the opportunity to work with him. I cannot overstate the importance of that experience in shaping my future success. Dr. Fred's unrivaled command of the English language and his fund of medical knowledge definitely deepened my own. In the years that followed my editorship with Houston Medicine, Dr. Fred remained in contact with me and I edited a number of clinicopathologic conference papers for him. It was my distinct pleasure and honor as President of the Southwest Chapter of the American Medical Writers Association in 1994 to present an achievement award to him for his accomplishments as editor-in-chief of Houston Medicine. Although our contacts were sporadic in recent years, I always delighted in hearing from him or running into him unexpectedly at my local pharmacy. As he himself wrote about Norman Cousins, "You were a real mensch, Dr. Fred." Thank you for gracing my life in so many ways.
January 2, 2019
Dr. Herb Fred conducted daily rounds with our junior med student group at Ben Taub Hospital. The first day Dr. Fred confronts us, saying, “There is no study I know of that indicates that medical students need sleep.” We are expected to do careful histories and physicals on all our assigned patients. We draw and personally perform our patients’ ordered blood lab tests. Each day we describe our patient, their progress, and must know their lab values by heart. We must have read at least two articles in the library about our patient’s condition. If Fred doesn’t like the articles we choose, he sends us back to the library to read “the correct ones.” At the bedside, Fred teaches precise skills of physical diagnosis and the corollaries to be made with the x-rays and lab data. “The chest x-ray is part of a good physical,” he says. We must see each x-ray personally. I learn an enormous amount from Herb Fred, MD, and the reading he demands.
Decades later in my work as a psychiatrist, I continue to listen carefully as a physician first, and then move into an exploration of psychological data.
January 2, 2019
As the Director of the Institute for Excellence in Education (IEE) at the Johns Hopkins University School of Medicine, I had the good fortune and enormous pleasure of learning from Herb. He was the consummate clinician and teacher, and I feel most fortunate to have been his colleague, advisee and friend. He was a tremendous role model. Herb was deeply invested in the Hopkins tradition and the growth of the IEE. I always looked forward to his annual visit to Baltimore, where we could dine and chat, then attend the annual Herbert L. Fred, MD, MACP Visiting Professor of Medical and Biomedical Education. I'll miss those visits and our frequent telephone conversations. He was a "giant" in medicine who will be deeply missed, but his work, reputation and personality will certainly remembered forever.
Henny van Dijk
January 2, 2019
On his 80st birthday celebration at Ziggy's on Post Oak a number of friends and former trainees had gathered and would toast Herb by recalling their first meeting, his insistence on punctuality at morning rounds, something I was very familiar with. When we were working on a program, he would call me and because i had an answering machine the conversation would go - "Henny... 2 sec, HENNY...2 sec and he would hang up" while I was racing to the phone. So when it came my turn to roast I told the audience that Herb was the only physician I knew without any patience" But he had guts - I remember how we did a re-enactment at his 70th birthday of his baby picture when he was 6 mos. old. We used it as the final image while the script read "I was cute then, and I am still cute now" flashing for an instance the same pose. He would try out his jokes on me and often couldn't finish the joke because he would get a laughing fit and his laugh was something to behold, however when it came time to deliver he was a master story teller and the punch line would blow his audiences away. He was a runner and he set some remarkable records, so that is my tribute to Herb, an unforgettable physician, teacher, friend, and runner!
January 1, 2019
I was aware that Dr Fred was a first class clinician and had published extensively on physical diagnosis and patient care.I enjoyed his recent book " On Medicine today". The Good,the Bad and the Ugly(2014.)He was kind enough to review a couple of my cardiology books ( 2008 and 2015).He was very thorough and provided some very useful comments. I hope I can be as sharp as he was when I get to be his age.
My condolences to his family, I am sure he will be badly missed.
Leo Gordon MD
January 1, 2019
A remarkable individual who typified the essentials of classical medical care. Dr. Fred realized that despite technology and other advances in medicine the glue that holds the entire profession together is the singular dedication of an individual - the physician. I will miss our e-mail and telephone exchanges. I loved his laugh and appreciated his insights. His writings will sustain the profession long after he is gone. My condolences to the family. In Herb's case his "family" will continue to care for thousands of patients as they benefit from his insights.
January 1, 2019
I was lucky enough have Herb as my attending during my core rotation at Ben Taub in 1965. I had never even heard of a faculty member who had his team back around 7:00 p.m. to continue "Morning Rounds" for 2-4 hours. This happened at least twice a week! I did not acquire that habit.
Our friendship continued for nearly 60 years despite the sometimes painful experience of writing a paper with him.
As an attending in later years I was reminded of that saying, "Oh God, I'm tuning into my father." However, I was saying I was turning into Herb! I never even came close. I still remember sleep v. reading advice.
He was always very kind to me. The last call I got from him was about a month ago. He knew that Susan and I had been very ill so he checked often. It also gave us a chance to compare medicine the way it is now and in the "old days". He sent us a pecan pie from Goode Company. What a guy!!!!!
January 1, 2019
Too many are the memories of moments that impacted my life, but the one that I believe worth recalling occurred during one of Dr. Fred’s famous morning reports.
The presenter was rambling about a complicated case. The “problem” was not evident. The search was chaotic and the mood started being heavy. The resident decided to give up, so he asked Herb: “and what do you think the patient has?”, to which Dr. Fred replied “I have no idea” without even blushing.
With his permission I stood up facing the learners and told them: “here you have a diagnostician and a bedside clinician who spent longer than 60 years caring for patients. He did not rush. He did not guess. Yet, he’s still fascinated by finding the answer and showing you how to get there”
His humility has always been inspiring to me and to all who had the privilege to know him.
January 1, 2019
Through a twist of fate that I will never understand and always treasure, I was honored (and humbled) by the opportunity to edit and publish Herb's IMAGES OF MEMORABLE CASES: 50 YEARS AT THE BEDSIDE in 2007. I never met a man who so inspired and so moved me...his immense genius, his heart, his dedication to his calling, his ethics, his boundless energy...a larger-than-life figure. He demanded excellence, pushed people like me to do far better and far more than we ever could goad ourselves into doing on our own. After working on this remarkable book, we spent a lot of time together over the next several years, in conversation, over dinners, and during times when I shadowed him at his work and in his amazing office/library. I've never known anyone nearly as inspiring--or as endearing. He changed my life, and the lives of countless others (including many whose lives he literally saved). A towering intellectual, medical and moral figure whom I will never forget, and never case to be amazed by. Rest in well-deserved peace, Herb.
December 31, 2018
The best, yet often the most intimidating, teacher for all of us. I had an advantage few shared. I worked w him as his only resident for an entire year, his first year at St Joseph Hospital. On our first day together, he said (in private), Don, when we are alone together you call me Herb, I call you Don. In public, you’re Dr Girard, I’m Dr Fred. He continued, I (he) will support in public whatever you do. If you give someone strictnine, I’ll support it. In private, we will talk. During that year, I saw his compassion, observed his personal sorrows and losses, and of course observed his many, many wins. I left our year together in tears as did he. His mantra? the tireless energy to teach and for us to learn... to put into place his lesions. No compromises, not ever. With great respect, Don Girard
December 31, 2018
Dr. Fred played one of the most important teaching roles in my life. His demands that students, interns and residents on the medical services at Ben Taub General Hospital spend their time either caring for patients or reading the medical literature about modern diagnosis and treatment as it pertained to each patient assigned to us were stringent. He knew that the transition from the classroom to the bedside was a key moment in our lives. He knew that there might be a tendency in some of us to consider the clinical experience as something that required less book learning than we had done in our first two years of training in the classroom. Instead, he made it clear that we would be reading more, not less, and that he expected us to be reading at 3AM in the hospital library if need be and if time permitted. Those interns who received their degrees from medical schools other than Baylor (and who didn't know in advance about Dr. Fred's strict expectations) sometimes made the mistake of stating, after a busy night of call, they "had no time" to read about one of their patient's conditions. His response was simply and always to ask, "Did you sleep?" He was precisely what many of us who were too full of ourselves needed. I was blessed to have had such a man influence my professional life in a way that set me on the right path. His "way" influenced me in a way that has had an impact on the patients I have cared for for 50 years. His soul is bound within all of his students. May God shelter him eternally.