In Memoriam: Robert L. Kane, MD

Joseph E. Gaugler, PhD

A personal note from Professor Gaugler: The text below includes the notes I used when reflecting on Dr. Kane and his legacy at the 1st annual Robert L. Kane Memorial Lecture, held at the University of Minnesota on April 11th, 2019. A large segment of these comments are summarized from or taken directly from the wonderful obituary written by Jim Pacala, Joe Ouslander, and Deb Saliba published in the Journal of the American Geriatrics Society (Pacala JT, Ouslander JG, Saliba D. Robert L. Kane, MD (1940-2017). J Am Geriatr Soc. 2017;65(8):1656-1658), as I could not have said it any better. Those sections are in bold:

Robert L. Kane, MD, or “Bob” as so many of us knew him, was a pioneering visionary of geriatrics. He was educated at Columbia and Harvard and completed his medical residency at the University of Kentucky. After residency, Bob worked with the Indian Health Service on the Navaho Reservation. His academic career began at the University of Utah before he moved to Los Angeles, where he spent 8 years as a senior researcher at the RAND Corporation and as a faculty member at the University of California, Los Angeles (UCLA). While at UCLA, he worked with colleagues to articulate the need and the direction for the field of geriatrics in the United States. He recognized that a text succinctly summarizing the key aspects of clinical care for older adults would be a critical step in defining the field and in improving the care of older adults. Essentials of Clinical Geriatrics, first published in 1984, has become a landmark resource for learning geriatric medicine for countless young geriatricians. The eight edition, which was published in 2018, was typeset at the time of his passing.

His scholarly output was prodigious and stunning in both breadth and depth. He was the principal investigator for 120 grants and contracts. He authored 488 journal articles, 59 reports, and 61 editorials. He published 35 books and 90 book chapters. Note that this was at the time of his passing; since then he has had several other authored publications disseminated. He was recognized around the world for his influence on the care of older adults. Among his many professional honors were the British Geriatric Society medal for the Relief of Suffering Amongst the Aged and the Enrico Greppi Prize from the Italian Society of Gerontology and Geriatrics. He was a member of the University of Minnesota Academic Health Center’s Academy for Excellence in Health Research, the highest research honor bestowed at his institution. He was a recipient of the Polisher Award (now known as the M. Powell Lawton Award) from the Gerontological Society of America and the Edward B. Henderson Memorial Lecture Award from the American Geriatrics Society.

His academic statistics only tell part of the story. Whereas Bob’s academic work could be thought of as the building blocks of his life, his unique interpersonal style and character traits were the mortar surrounding and binding those blocks together. One’s initial encounter with Bob often produced a first impression of exactitude, criticism, and intellectual intimidation, but with repeated and lasting interaction, another more personal side of Bob emerged, one of compassion, respect, and tenderness. He certainly did not suffer fools gladly. Hundreds of colleagues and students can relate stories of getting grilled and dressed down when presenting a paper or research proposal. However, his superlative intellectual ability to “connect the dots” drove Bob’s critiques. More importantly, he had a passion that did not stop there—he went on to color and frame the picture those dots made.

I submitted the following to Rosalie (Bob’s erstwhile academic and personal partner) at the time of Bob’s passing that I wanted to share with you. This passage continues to reflect my thoughts and feelings about Bob, and in many ways parallels the sentiments of the Journal of the American Geriatrics Society obituary. “Perhaps my fondest recollection of Bob is how, in many ways, our intellectual work aligned much more closely in the past several years than when we first met. I have said this many times, but respect from Bob was earned, often with much effort on the part of those working with/for him. Bob and I collaborated for 18 years up until his untimely death. I first met Bob as a National Institute on Aging post-doctoral fellowship, and his mentorship was invaluable. During the 1st decade of our collaboration, it was always a struggle to demonstrate the significance of my research ideas on dementia and family caregiving.

However, with his experience of caring for his mother (which was so powerfully crystallized in several of his later books), our scholarly collaborations became similarly more attuned. For someone who spent much of his career in the data-driven realm of health services research, what struck me the most about Bob was how well he connected with family members themselves who were struggling through the day-to-day challenges of caring for relatives with memory loss or other serious, progressive conditions (much as he did). He frequently spoke to and engaged with community organizations, support groups, and many other local entities to share his caregiving story and to bring to bear his formidable intellect on possible solutions. In this vein, he kindly accepted an offer of mine to speak at our 2014 Caring for a Person with Memory Loss conference at the University of Minnesota. This is an annual, free conference of around 300 families, professionals, and people with memory loss themselves to learn about tools and resources that can help them navigate the many challenges of dementia. Bob’s presentation on advocating for family members in an often unforgiving healthcare system was not only well received, but received a standing ovation.

We always take our time with cherished colleagues for granted. In 2015, Bob and I co-edited a book called Family Caregiving in the New Normal that in many ways fully realized what our collaboration had become. The book intertwined personal narratives of the caregiving experience with state-of-the-art chapters on challenges to the sustainability of family caregiving, as well as possible solutions. I know both Bob and I were proud of the book, and I thought it would be the first of other important volumes. Now, it stands more as a culmination of my scholarly work with Bob over the past two decades, and for that reason will always hold a special place in my own career as I continue with the work that, in the end, both Bob and I valued so much.”

It is difficult to express how much it means to me to now hold the Robert L. Kane Endowed Chair in Long-Term Care and Aging, at an institution and in a state that I care for so deeply. When I first sat down behind Bob’s desk, in an office where I had spent countless hours debating with and listening to Bob on its other side, the personal and professional meaning of the Long-Term Care Chair became clear. The passage of time often means learning how to manage the loss of those close to us, and the daunting challenge of living up to Bob’s immense legacy is humbling and ever present (as no one person can likely do so). But perhaps Bob’s work is a testament to how we do both: by working together, in partnership and collaboration, to continue to understand, shape, and advocate for the best possible care for older persons, their families, and their communities. Bob would have certainly wanted it that way.

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