More Prescribing Rules
One more prescribing rule [See “Rheuminations,” September 2009, p. 6], honored mainly in the breach, in our overspending climate: don’t prescribe an expensive brand when generics are as good or better, especially Nexium (which I have never prescribed) versus omeprazole, Lipitor versus simvastatin (which now costs the VA three cents a pill), and—for rheumatologists who are writing 80% Uloric—allopurinol except for the 10% who might need Uloric.
Lonnie Hanauer, MD
Millburn, N.J.
In Memoriam: Hildegard Maricq, MD
With sadness we note the passing on October 25, 2009, of Hildegard Maricq, MD, professor emeritus at the Medical University of South Carolina in Charleston. Born in Rakvere, Estonia, Hildegard was later displaced and spent several years of her youth as a refugee. At the conclusion of World War II, Hildegard settled in Belgium where she met her husband, John, and where she earned a medical degree from the Free University of Brussels, graduating at the top of her class. With her family, she immigrated to the United States, where she trained in psychiatry and began her lifelong studies of the microcirculation. Her research attracted the attention of E. Carwile LeRoy, MD, who recruited her first to Columbia University’s College of Physicians and Surgeons, and then in 1975 to the Medical University of South Carolina.
Over the next 20 years, Dr. Maricq devoted her professional career to the study of Raynaud phenomenon and to the microcirculation in connective tissue disease. Her work led to a better understanding of the epidemiology and pathophysiology of Raynaud phenomenon. One of her most significant contributions was the refinement of the technique of nailfold capillary microscopy and the demonstration of its value in distinguishing primary from secondary causes of Raynaud phenomenon, especially scleroderma spectrum disorders.
During her long and productive career, Dr. Maricq published more than 100 articles and trained many fellows from the U.S. and elsewhere around the world. Her work remains widely quoted in current medical literature and will be a lasting legacy of her devotion to the study of the microcirculation in health and disease. As one of the founding faculty members in the Division of Rheumatology and Immunology at MUSC, she left a lasting impression and will be sorely missed by the faculty and staff.
Hildegard will also be remembered for her profound love and devotion for her family and for her native land of Estonia. Hildegard was a remarkable woman who overcame much adversity. She never forgot the experiences of her youth, which led her always to argue forcefully for justice for all peoples. We send our condolences to her three sons, Matti, Andre, and Peter.
Richard M. Silver, MD
Distinguished University Professor
Medical University of South Carolina
In Memoriam: Robert F. Willkens, MD
Robert Frederick Willkens, emeritus clinical professor of medicine in the division of rheumatology, died on November 11 at Harborview Medical Center, where he had served for more than 50 years. Dr. Willkens was a gifted clinician, teacher, and scholar, a leader in the arthritis community, and an active participant in community affairs. He first came to Harborview as an intern in 1954, completed his residency, and eventually became a clinical professor. Apart from a year as a research fellow in arthritis at Columbia Presbyterian Medical Center in New York, he spent his entire career at the University of Washington in Seattle. His roles at Harborview included chief medical resident, president of the medical staff, and rheumatology section head for 40 years.
Through Dr. Willken’s work at the University of Washington, he gained worldwide recognition for his contributions to the effective treatment of arthritis in its many forms. In particular, his leadership in establishing the efficacy and defining the limits of methotrexate therapy led to his designation as “the father” of this agent, a drug now recognized as the most effective single treatment for rheumatoid arthritis. Early in his career he recognized and defined a remarkably high prevalence of rheumatoid disease among the Yakama people of Central Washington; he then helped to establish the genetic basis of this association. He visited their reservation regularly over the last 30 years to provide expert consultative care. He also held numerous positions at the ACR (formerly ARA): member of the Education Council, member of the Committee on Rheumatologic Care, liaison and member of the Marketing and Communications Committee, and chair of the Local Arrangements Committee. These, among the other contributions mentioned, led to his recognition by the ACR as a Master and then as its Distinguished Rheumatologist in 1999.
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National and international recognition has come through his service on four different editorial boards, including that of Arthritis & Rheumatism and the Journal of Rheumatology. Locally, he also edited the Bulletin of the King County Medical Society, chaired the Washington State Board of Medical Examiners, served as president and then chaired the Board of Directors for the Western Washington Chapter of the Arthritis Foundation, was president of the Northwest Rheumatism Association, and received the R.H. Williams Superior Leadership Award from the Seattle Academy of Internal Medicine. In recognition of his achievements, the University of Washington established the Robert F. Willkens Professorship.
Dr. Willkens applied the same energy that he used for rheumatology to building up his community, believing arts and culture made life richer. He was the first board president of ACT Theatre. He provided free medical care to actors in need and is believed never to have missed a production. “Seattle was a bit of a rough-and-ready place in the 1960s,” said ACT Artistic Director Kurt Beattie. “He was a very cultural man who had a passion for the art form, and he gave you the feeling when you were around him that you were talking to an enormously well-rounded, exceptionally intelligent man who had a real heart.”
Bob Willkens will be sorely missed by the rheumatology community, not only in Seattle, but many parts of the U.S. and around the world.
Keith Elkon, MD
Head of the Division of Rheumatology
University of Washington, Seattle
