John Sharp, MD, died on September 14, 2008, at the age of 84, just two months after being diagnosed with pancreatic cancer. He had a profound influence on world rheumatology. Dr. Sharp developed the methods to measure radiographic damage in rheumatoid arthritis (RA). His work made it possible to understand the course of RA and to measure the effectiveness of disease-modifying antirheumatic drugs, including methotrexate, and biologic therapy.
His friends and colleagues learned of Dr. Sharp’s impending death from an e-mail he sent in the last month of his life. He wrote: “Things are moving pretty fast so it is time to say goodbye while I still can.” Then to each he wrote a personal note, a thank you, and remembrance. As the poet William Butler Yeats wrote: “Think where man’s glory most begins and ends, and say my glory was I had such friends.” For all those who knew Dr. Sharp, our glory was that we had such a friend.
John Thomas Sharp, MD, was born in Dalhart, Texas. He attended West Texas State College in Canyon and Antioch College in Yellow Springs, Ohio. He obtained his MD from Columbia University in New York City, and his rheumatology training at the Massachusetts General Hospital in Boston. During his long career, he was a member or chief of rheumatology divisions at the Massachusetts General Hospital; Henry Ford Hospital in Detroit; Baylor College of Medicine in Houston; University of Illinois Medical School in Champaign/Urbana; Rose Medical Center in Denver; the VA Hospital in Danville, Ill.; Emory University in Atlanta; and the University of Washington in Seattle. He was recognized as a Master by the ACR.
After his first retirement from the Joe and Betty Alford Arthritis Center in Denver, Dr. Sharp established a non-academic rheumatology practice in the underserved area of rural Tifton, Ga. Following his second retirement 10 years later, he intensified his research in radiographic methods and imaging techniques in RA, psoriatic arthritis, and osteoporosis.
Dr. Sharp had an endlessly inquisitive mind. In his 80s, he learned computer programming and languages, and statistics. He developed tools and methods for computerized reading of radiographs. At a time of life when many do less, Dr. Sharp continued to score radiographs for clinical trials, travelled the world for research meetings, “Skyped” colleagues everywhere, and pursued new research methods.
In 1996, Dr. Strand asked Dr. Sharp to meet with the Anti-inflammatory, Analgesic, and Ophthalmological Division of U.S. Food and Drug Administration to explain and demonstrate formal radiographic scoring of erosions and joint space narrowing in RA. This was the first set of formally scored films which demonstrated the efficacy of methotrexate (and leflunomide) in inhibiting radiographic progression. Thus began another busy and productive career for Dr. Sharp—he often kidded that this had “taken” his retirement. Dr. Sharp never advocated the use of the term “Sharp Score” but rather “composite method” for scoring radiographs. He was always interested in critically ascertaining comparability and reproducibility among the different scoring systems, rather than carving out unique recognition for himself.
When The Rheumatologist profiled Dr. Sharp’s contribution to radiographic scoring in rheumatology in its first issue, he often joked that he appreciated an “obituary before I passed.”
Dr. Sharp was the most decent and kind of men. He was respectful of all of his colleagues, even when he disagreed with them. He treated all equally, regardless of their experience or status. He strove to see the good in people. But he was not without deeply felt opinions, particularly with respect to the environment and social justice.
Désirée van der Heijde, MD, PhD, professor of rheumatology at Leiden University Medical Center in The Netherlands, recalls how excited she was, as a young researcher, to meet Dr. Sharp for the first time at the ACR Annual Meeting. “Meeting him, as the great man in this field, was wonderful for me. He always wants to show his development of the score as just an ordinary thing which he had done,” she says. “And he’s also very willing to share everything. He never kept things for himself—he’s willing to share credits and new developments.”
Jane Angwin, MA, a research associate at GlaxoSmithKline, wrote, “At an early (for me) ACR conference, John asked me to join him for tea. I was very junior and full of trepidation but John set me at ease. To my surprise, he said he wanted to thank me for explaining a mistake in one of his papers. He was grateful to me and had invited me so that he could say thank you! (It was nothing compared to what he taught me!) No politics—but honor, integrity, and generosity!”
Jim O’Dell, MD, vice chair of internal medicine and chief of rheumatology at the University of Nebraska Medical Center in Omaha, was one of Dr. Sharp’s fellows and later one of his collaborators. Dr. O’Dell wrote, “He was a true gentleman and had a tremendous impact on the field of rheumatology and maybe more importantly on many careers including mine. … I will always remember how patient he was with all of us struggling would-be Sharp readers (many of us were not so sharp! … but, of course, John would never say that). … I called him [toward the end], and although he was not feeling well, he graciously took my call. We had a chance to tie up the loose ends for a study but, more importantly, I got a chance to thank him for all he had done for rheumatology and me. I will always treasure that last call. He was upbeat and inspirational to the end. He will long be remembered.”
Wayne Tsuji, MD, a clinical researcher at Amgen, who worked with Dr. Sharp closely in his last years, wrote, “John was very helpful in discussions over design for the denosumab RA trial and of the X-ray reading, a critical endpoint of the study. We met over multiple lunches in Seattle and on Bainbridge Island to discuss endpoints and exploratory analyses. John’s interest in measurement of combined cortical thickness and development of the measurement program resulted in an exploratory analysis which was presented at the ACR/ARHP Annual Scientific Meeting in San Francisco. In the six weeks prior to his death, we worked to complete a manuscript reporting this analysis.”
Dr. Sharp was very interested in measurement of joint space width and developed a computer program which automated this measurement in digital images of hand radiographs. He took a course at the local community college to learn Java which he used to develop the program and which we plan to apply to the ERA and denosumab RA image sets, projects which hopefully will continue in his absence. Two weeks before his death, Dr. Sharp sent validating measurements for a revision of the joint measurement program and arranged collaboration with the Department of Computer Science at the University of Washington to continue following his death.
On several occasions within the past year, Dr. Sharp spoke of cutting back on his projects in rheumatology. He tried to limit his commitments to short-term projects and warned several collaborators that he did not know how long he would be able to continue working. He also spoke about getting involved in projects dealing with global and local environmental issues.
Dr. Sharp had a wide network of friends and collaborators in the United States and internationally. He continued professional commitments long after retirement from academic life with regular attendance at the annual meetings of the ACR and EULAR and with longstanding participation in OMERACT imaging efforts, including leadership of the Joint Measurement Special Interest Group. His kindness, patience, persistence, organization, dedication, and critical thinking will be missed by many.
Dr. Sharp is survived by Marjorie, his wife of 59 years, three sons—John, Tom, and Jeff—and seven grandchildren. He was a devoted husband and amazing father. He was loved and will be missed greatly.
Dr. Wolfe is a rheumatologist in Wichita, Kan. Dr. Strand is adjunct clinical professor of immunology and rheumatology at Stanford University School of Medicine in Palo Alto, Calif.
