Academic medicine lost one of its great leaders in infectious diseases and AIDS when Merle Sande died at his home in Seattle, WA November 14, 2007 of complications from multiple myeloma/plasma cell leukemia. He became a member of the American Clinical and Climatological Association in 1986, and gave the Jeremiah Metzger Lecture in 2003.
Merle was an extraordinary man. He was charming, gregarious, exuberant and passionate about what he believed in. Some called him a charming rogue, which probably is accurate. He was goal-oriented and achieved his goals. He was a loving husband, father and grandfather.
Merle was born in Washington the son of Sigvald and Clara Sande; his father was a ferry boat captain in Puget Sound. He attended Washington State University and obtained his MD from the University of Washington School of Medicine in 1965. He received postgraduate training in internal medicine and infectious diseases at New York Hospital/Cornell University Medical Center, and after military service at Lackland Air Force Base in San Antonio, TX, he joined the faculty at the University of Virginia, where he quickly achieved a national reputation in bacterial infections and antimicrobial therapy. He made seminal contributions on the pathogenesis and treatment of meningitis and bacterial endocarditis. He rose to become Professor of Medicine and Vice-Chairman of the Department of Medicine.
Merle left Virginia in 1980 to become Chief of the Medical Services at San Francisco General Hospital and Vice-Chairman of the Department of Medicine at the University of California San Francisco. His arrival in San Francisco coincided with the first cases of opportunistic infections in gay men, which were the first manifestations of the AIDS epidemic. Merle quickly grasped the gravity of the disease and put together a program of research and clinical excellence that made SFGH the leading hospital in the world for the diagnosis and treatment of AIDS. He was responsible for establishing the first hospital ward dedicated solely to the care of AIDS patients; this became a model widely utilized around the world. He was instrumental in developing resources from the State of California, the City and County of San Francisco, the University of California, and the J. David Gladstone Foundation to create the Gladstone Institute of Virology and Immunology at SFGH for the study of the biology of HIV and its effects on the immune system. He chaired the University of California Statewide AIDS Task Force, the Mayor of San Francisco's AIDS Task Force, and task forces addressing issues of education, protection and infection control around HIV transmission to health care workers. He edited two textbooks on AIDS complications and treatment; one, The Medical Management of AIDS, which he co-edited with Paul Volberding, went through six editions and was the leading book in this area.
In 1996 Merle left SFGH to become Chairman of Medicine and the first recipient of the Clarence M. and Ruth N. Biner Presidential Endowed Chair in Internal Medicine at the University of Utah School of Medicine. He stepped down from that post in 2002 and directed the Department's residency program until returning to the University of Washington in Seattle in 2005 as Professor of Medicine in the Division of Allergy and Infectious Diseases. These latter moves were driven by his growing involvement with AIDS in Africa. In the 1980's, he helped foster an exchange program with Makerere University in Kampala, Uganda and was the driving force leading to the development of the Infectious Diseases Institute (IDI) at that university. The IDI is dedicated to the training of African health care personnel in AIDS care and prevention and to the development of effective models of AIDS care in African communities. He was the founding president of the Academic Alliance Foundation (now Accordia Global Health Foundation), an organization developed to support the activities and goals of the IDI and to help fight infectious diseases in Africa. Accordia was awarded a $12.5 million grant from the Bill and Melinda Gates Foundation to identify the most effective ways to prepare health care workers to treat infectious diseases in sub-Saharan Africa. This award was announced just a year after Merle's death.
As profound as his impact on AIDS care and prevention was, it is possible that Merle had an even larger impact on generations of medical students and house officers. His enthusiasm for clinical medicine and case-based teaching was legendary, and he was able to transmit that enthusiasm, always tinged with ready good humor, to those with him at the bedside or the chalk board. His office door was usually open; he had the ability to make those around him feel especially important and valued. He encouraged each of his Chief Residents to undertake a research project or review article; many of these were published in The New England Journal of Medicine or other high profile journals.
Merle received numerous awards and honors, including the Distinguished Alumnus Award from both Washington State University and the University of Washington, the American Medical Writer's Award, the Presidential Distinguished Service Award for Contribution to Health Care in Uganda, and the Alexander Fleming Award from the Infectious Diseases Society of America, a society of which he was a past president. He was also a Regent of the American College of Physicians. He married Mary Ann Rygg in 1961; they had four children of whom he was extremely proud, Suzanne, Missy, Eric and Sarah. At last count there were nine grandchildren. His first marriage ended in divorce. He married Jenny Lo in 2005.
The Sande Family and the Mandell Family were close. We spent many wonderful days together, starting in New York during our house staff and fellowship training and continuing through our time in Virginia and beyond. We traveled the state watching our kids take part in swimming meets. We purchased adjoining lots by a nearby lake. Merle himself, was a very fine athlete to which one of us (GM) can attest by mentioning an unbroken string of loses to Merle in squash and tennis and the bruises to prove it (I could beat him in swimming).
When he became ill, Merle showed his courage and kept his sense of humor. His wife Jenny, stayed by his side and was devoted and caring and made his last days as comfortable as possible.
Merle, we miss you.