Noble J. David, MD, best known as “Nobby” to the readers of these pages, was my closest friend. He was also always a very welcome friend to literally thousands of colleagues, students, and patients who will greatly miss him.
He passed away on November 30, 2011, at the age of 83, at the Erasmus Hospital in Rotterdam, Holland, where he had valiantly traveled to receive a transcutaneous aortic valve replacement. The procedure went well but he subsequently succumbed to hospital-acquired pneumonia.
I first met Nobby in 1962, when as a senior medical student at the University of Miami, I would attend Neurology Grand Rounds. He and J. Lawton Smith would put on memorable performances facilitating learning of what at that time appeared to be impossibly complex neuro-opthalmic issues. Our relationship grew closer on my return to Miami for training in Neurology in the 1960s. He eventually became influential in my joining the faculty of the Department of Neurology and subsequently became my Wednesday evening dinner companion for more than 40 years. That meant that I was able to laugh at new jokes, gain insight into the human condition, and keep learning medicine from this profound intellect for more than 1600 Wednesday nights!
The annual resident's day dinners at his home were legendary. There would be music, Middle Eastern food, and Nobby playing his cello accompanied by other talented colleagues. He was a real “feeder.” He fed us food, he fed us music, and he fed us knowledge.
Nobby's contributions to medicine, neurology and neuro-ophthalmology were at times ground-breaking and at other times importantly expansive of known facts. In the 1950s, he was able to prove that retinal arterial embolic debris associated with amaurosis fugax was the same material being embolized from the carotid artery bifurcation. This is currently taken for granted in linking carotid atheromatous disease with transient ischemic attacks. Also ground-breaking was his contributions to the development of techniques to better understand retinal circulation, physiology, and disease. I can remember the hours and hours he would toil over fundus photographs of retinal fluorescein angiography.
Nobby further contributed to the literature of several clinical entities that were just becoming understood at the time. Among these were delineation of the distinctions between PSP and simple Parkinson disease; emphasis on saving blindness by early recognition of pituitary apoplexy; the wide clinical spectrum of basilar arterial disease; the clinical course of giant cerebral aneurysms, pituitary adenomas, bilateral anterior cerebral artery infarctions, and subtle visual field defects in occipital lobe strokes. He even alluded to the potential infectious origin of Creutzfeldt–Jakob disease as it developed in a pathologist who may have been exposed through his occupation.
In spite of all his responsibilities as Chief of Neurology at the Miami VA Hospital, Nobby served on the National Advisory Eye Council at the National Institutes of Health, giving of his time to review and evaluate lengthy grant proposals.
At the University of Miami, he was the bridge between the Department of Ophthalmology and the Department of Neurology. He taught and performed investigational work with both Departments, and he facilitated blending of the programs. In 1989, he led the Department of Neurology during a period of transition.
Nobby always characterized himself as a “Dukester” demonstrating a very idealized gratefulness to his undergraduate years, medical school, and graduate training at Duke University.
This past year has been an exceptionally difficult one for the neuro-ophthalmology family in Miami. First the passing of J. Lawton Smith and Joel Glaser and now the passing of Noble J. David.
He leaves behind a loving family and thousands of grateful patients, students, and colleagues. Most certainly, a Memorial fund will be established jointly within the Department of Ophthalmology and Neurology.
I find myself exceptionally fortunate to have enriched my life by having known him. He was, after all, my closest friend.
“Now cracks a noble heart. Good-night, sweet prince. And flights of angels sing thee to rest.”