John Frederick Murray
Authors: Geoff Watts
Journal: The Lancet (2020)

Leading US chest physician. He was born in Mineola, NY, USA, on June 8, 1927, and died of complications from coronavirus disease 2019 in Paris, France, on March 24, 2020, aged 92 years. In 1988, John Murray, Emeritus Professor of Medicine at the University of California, San Francisco (UCSF), CA, USA, led a group of colleagues in proposing an expanded definition of acute respiratory disease syndrome (ARDS) intended to take account of its various pathophysiological features. They also devised what became known as the Murray Lung Injury Score for charting its development. Some 32 years later, Murray was to die of ARDS, brought on by coronavirus disease 2019. The event marked the close of a life devoted to the study and treatment of lung disease and to advancing lung research generally. His achievements prompted a 2005 edition of one of the leading US journals in the field, Chest, to include Murray in its series Giants in Chest Medicine. Murray grew up in Los Angeles, CA, USA, and studied for his bachelor's degree at Stanford University, and then for his MD at its medical school, graduating in 1953. Intent on an academic career, he started work at the University of California, Los Angeles. In 1966 he moved to UCSF, rising to become Chief of the Pulmonary and Critical Care Division of what is now the Zuckerberg San Francisco General Hospital and Trauma Center. He also became a Professor of Medicine at UCSF, eventually retiring in 1994. One of the most visible manifestations of Murray's contributions to his discipline is the Textbook of Respiratory Medicine that he co-edited with his fellow UCSF physician Jay Nadel. “It's still considered one of the key books to follow in the respiratory field”, says Paula Fujiwara, Scientific Director of the International Union Against Tuberculosis and Lung Disease (The Union). The book continues to fulfil its authors' original promise to “integrate scientific principles with the practice of respiratory medicine”. Writing was only one of the ways Murray exercised his influence. “He led a group that assessed the need for pulmonologists in the United States over future years”, recalls Philip Hopewell, Professor of Medicine at UCSF. “Its report revealed there would be a quite substantial need for more pulmonologists given the ageing of the population and the increasing frequency of lung disease.” More pulmonologists were duly trained. “He shaped pulmonary medicine as a specialty, and defined the training that was necessary”, Hopewell adds. “He defined the curriculum.” Action of this kind was second nature to Murray. “He didn't hesitate to lead. When he'd seen a problem, he would step forward. He was able to organise the right response.” Much the same is true in two other instances. One is the respiratory illness often associated with HIV/AIDS. “He convened a meeting of people who'd been involved in taking care of patients with HIV”, says Hopewell. “They shared their experience and put together a differential diagnosis of lung disease in HIV.” Another of Murray's interventions helped to foster change at the highest level of the US medical research establishment. “He was instrumental in the advocacy that led to the inclusion of the lung in what was then the National Heart Institute”, Hopewell comments. “It became the National Heart and Lung Institute”, he says, before later becoming the National Heart, Lung, and Blood Institute. In addition to his 1981–82 Presidency of the American Thoracic Society, Murray instituted a series of structural reforms that boosted its independence. He saw the need for a similar evolution in one of respiratory medicine's most venerable international institutions, The Union. “He basically modified The Union into its current form”, says Fujiwara. “Before that it was an organisation that had a lot of professors…but there was little involvement of the general membership.” Murray devised a structure that made The Union more open and inclusive, and allowed younger physicians to join it. Even after his term as President of The Union had expired, he would often be found in its Paris headquarters. A Francophile who loved the city, he and his wife had an apartment there, and spent much of their time in Paris after Murray's retirement from UCSF. But he would still return to San Francisco in the summer for the annual intake of new trainees. “He would always take on the task of being with the very young and green interns in their first month of training in the intensive care unit”, says Fujiwara. “He was a great teacher.” Murray is survived by his second wife, Diane, and their children, Douglas and Elizabeth, and by four stepchildren, Kevin, Simon, Darcy, and Amanda, from a previous marriage.