Burton “Bud” D. Rose had already written a textbook that his colleagues referred to as the “nephrology bible.” Still, he wasn’t satisfied.
Rose knew his book could only stay accurate for so long before he’d have to update it — which, for most volumes, happened every five years.
But Rose wanted to keep his textbook up to date constantly. So he asked his publisher if they’d assist him in transferring the textbook to a computerized format, which could be regularly updated. They refused — so he decided to do it himself.
In 1992, aided by his wife, Gloria, Rose created a computerized database of medical information called UpToDate from their home. Today, the digital platform is used by over 1.5 million clinicians worldwide.
Aside from his online pursuits, Rose worked as a professor at Harvard Medical School and a nephrologist at Beth Israel Deaconess Medical Center. He died on April 24, from Alzheimer’s disease complicated by COVID-19, at the age of 77.
Theodore I. Steinman, a professor at Harvard Medical School and a senior physician at Beth Israel Deaconess Medical Center, called UpToDate the first “living textbook.”
“He was probably the most influential person ever in the world with regards to medical information and education,” Steinman said.
Mark L. Zeidel, a professor at Harvard Medical School and physician in chief and chair of the Department of Medicine at Beth Israel Deaconess Medical Center, often calls Rose the “Steve Jobs of Medicine.”
In part, that moniker stems from the fact that Rose created UpToDate with a piece of technology from Apple, the hypercard. But Zeidel also saw UpToDate as an example of “disruptive technology” like the computers and phones Jobs created.
Both Steinman and Zeidel said that Rose could have been in contention for a Nobel Prize in Medicine, which cannot be awarded posthumously.
“He really was deserving of the Nobel Prize in Medicine because of his worldwide impact on medical education and medical information technology,” Steinman said.
“I regret that it never occurred to me, but we could have actually put him up for the Nobel Prize in Medicine and he might have won it because of the significance of this contribution, because people around the world are using it constantly,” Zeidel said.
Zeidel said that most of the 170 interns and fellows at Beth Israel Deaconess regularly use UpToDate.
“When I come in and do rounds, they don't quote the textbook,” he said. “They quote UpToDate. Because at two in the morning, they can call it up on a computer right at the point of attack where they're working, and they can look up what they need to find, find it quickly, and get the authoritative information.”
Isaac Kohane, the chair of the Department of Biomedical Informatics at Harvard Medical School, said Rose’s creation “revolutionized” medicine.
Rose had a unique mix of “vision and pragmatism” that allowed him to create such an impactful technology, he added.
“That resource was so singular, and the editorial process that was put together was so rigorous and so strongly academic, yet because of his leadership, so determinately practical and focused, that it became the unquestioned standard,” Kohane said.
Despite the fact that UpToDate took more and more of his time, Rose remained active as a clinician and professor.
“He always took time to be an attending physician on the renal service at Beth Israel Deaconess Medical Center, and he was always a wonderful one on one teacher,” Steinman said.
Martin Pollak, a professor at Harvard Medical School and chief of the Division of Nephrology at Beth Israel Deaconess Medical Center, called Rose a “beloved teacher.”
“He just had a very clear, concise way of breaking down complicated concepts,” Pollak said, and he used his skills to teach medical students and patients alike.
He taught an annual course at the Medical School on kidney disease that people from all over the world flocked to, Pollak said. In 2009, the American Society of Nephrology granted him the Robert G. Narins Award, the highest award for education in nephrology.
Gloria Rose, his wife, said he approached pursuits outside the hospital with the same verve.
She recalled that, while at work, he was looking at the names of their immediate family members, and created the acronym “Badgers” — short for Bud, Ann, Daniel, Gloria, and Emily Rose.
“So then he started calling us the Badgers,” Gloria said with a laugh. “He was just always thinking outside the box, he was very funny in that way.”
Rose was also a romantic, Gloria said. One day, he surprised her with flowers and a cake, announcing that it was the 10,000th day since they had met.
“He was goofy in a good way,” she said. “He was very spontaneous.”
He loved basketball and tennis, and spent hours at a time bettering his technique.
“With everything that he did, it wasn't that he wanted to be the best. He wanted to improve his game. Always,” Gloria said. “He would go out on the driveway and keep shooting, until he just got it.”
With UpToDate, Rose refined medicine, too.
Denise Basow, the CEO of Clinical Effectiveness at Wolters Kluwer, the company that currently runs UpToDate, wrote in a statement that his work changed the medical field over the last three decades.
“Once he had the idea for UpToDate, he wouldn’t let anything get in the way of pursuing it,” Basow wrote. “That pursuit has impacted the practice of medicine and the lives of patients for almost 30 years.”