Stanley L. Robbins, 1915–2003

Stanley L. Robbins, M.D., the master teacher of pathology, died on October 7, 2003 at the age of 88. Born in Portland, Maine in 1915, Dr. Robbins graduated at the top of his class from Brookline High School in Brookline, Massachusetts. He went on to the Massachusetts Institute of Technology and Tufts Medical School, delivering the valedictory address at both schools on graduation. After training at Boston City Hospital, Dr. Robbins joined Boston University School of Medicine. He became Director of Boston University’s Mallory Institute of Pathology and Chairman of its Department of Pathology in 1965, a position he held until 1980. On his retirement from those positions, he accepted a post as Senior Pathologist at the Brigham and Women’s Hospital in Boston. He continued to teach medical school students and pathologists-in-training for many years to follow. In 1957, the first edition of Robbins’ Textbook of Pathology was published and marked a turning point in pathology teaching. In a largely negative preview of the book, two distinguished pathologists of that time informed the publisher that the book did not present enough descriptive morphology and was too heavily clinical. Differing sharply from “professional pathologists,” a student from Temple University wrote to the publisher, “I have begun reading my new Robbins’ textbook. I know Someone up there loves me.” Indeed Robbins had chosen an entirely different approach by writing a text that did not merely describe the disease, but discussed its origins and impact on the patient. His favorite admonition used to be, “Lesions do not arise in cadavers!” The following excerpt from a prologue, “The Scope of Pathology,” in the first edition of the Textbook of Pathology, describes his philosophy best: “But the study of morphology is only one facet of pathology. Pathology contributes much to clinical medicine. The pathologist is interested not only in the recognition of structural alterations, but also in their significance, ie, the effects of these changes on cellular and tissue function and ultimately the effect of these changes on the patient. It is not a discipline isolated from the living patient, but rather a basic approach to a better understanding of disease and therefore a foundation of sound clinical medicine.” Over the next 12 years, Robbins’ Pathology went through three editions and then Dr. Robbins did something quite uncharacteristic of successful authors. He completely rewrote the book shifting the emphasis further on disease mechanisms and so in 1974, a new Robbins emerged under the title, Pathological Basis of Disease. The seventh edition of this book (making it the tenth edition since inception) will be published in 2004. In 1971, along with Marcia Angell, Robbins wrote a smaller textbook, Basic Pathology (the so-called Baby Robbins). Together, these two books have been translated into over a dozen languages and there is little doubt that, through his texts, Robbins became the most influential teacher of pathology over the past 50 years. It was not merely the content of the textbooks but also their style that made them popular. I learned this firsthand, having joined as co-author of Basic Pathology in 1981 and Pathologic Basis of Disease in 1984. I gave Dr. Robbins what I thought was the final draft of a chapter that I had written. After editing heavily, Robbins wrote at the bottom, “There is no good writing, it is only good rewriting.” A feature that endeared Robbins to the students was his conversational style of writing. He peppered his prose with bits of whimsy and jokes that made the reader smile. One of my favorites is from the section on pigments that reads, “The tattoo pigment has the distressing property of persisting in situ throughout life in dermal macrophages, creating difficulties if one wishes to marry ”Alice“ when the adornment is seductively titled ”Mary.“ During his long career, Dr. Robbins also made contributions in research, helping to develop the frog pregnancy test that preceded the advent of the rabbit pregnancy test. He also conducted early research into coronary artery disease. Dr. Robbins was the recipient of the United States and Canadian Academy of Pathology 1991 Distinguished Pathologist Award. In 1992, he was awarded the Gold Headed Cane Award by the American Society of Investigative Pathology. His memory will be treasured by generations of medical students and physicians-in-training.