A true giant in the field of neuro-ophthalmology, B. Todd Troost, MD, died on November 13, 2017. Todd was an innovator, a step ahead of this time in many aspects of his career, particularly with the role of computers in life and medicine. He was a remarkable clinician, researcher, and teacher, who inspired, encouraged, and supported many medical students (including one of the authors) and residents.
Todd completed his Bachelor of Science degree in Biophysics with honors from Yale University in 1959, and his MD degree from Harvard University School of Medicine in 1963. After an intern year in Denver, Colorado, he served as captain in the United States Army Medical Corps from 1964 to 1966, and the last year as a flight surgeon at the 121 Evacuation Hospital in Ascom, Korea. After service in Korea, he returned to Colorado General Hospital for neurology residency from 1966 to 1969.
After residency, Todd was the NIH Fellow in Neuro-ophthalmology at the University of California School of Medicine, San Francisco, under the direction of Dr. William Hoyt. The other fellows at that time were Joel Glaser and Enrique Piovanetti, and the 3 of them became close friends. After his year in San Francisco, Todd followed Joel to the University of Miami where he was a Research Fellow and Associate from 1970 to 1973. He then was appointed to the faculty, where he remained until 1977. From 1977 to 1980, he was Chief of the Neurology Service at the VA hospital in Pittsburgh, Pennsylvania, concurrently serving as a Senior Lecturer in the Biomedical Engineering Program at Carnegie-Mellon University. He then became Professor and Vice Chairman of Neurology at Case Western Reserve University School of Medicine, at the same time completing a Master's Program on Computers in Medicine from 1980 to 1983 at Case Western University.
In 1983, Todd was appointed as Professor and Chair of the Department of Ophthalmology of Bowman Gray School of Medicine (as it was then named) and also held an appointment in the Department of Anesthesia. During his time as Chair, he was known as an exceptional leader, teacher, and innovator, and his inspiration of others continued long after his retirement in 2004.
During his career, Todd had many academic accomplishments (see below). However, his greatest pleasure was teaching and mentoring. Long before it was required or even fashionable, Todd recognized and welcomed medical students on their clinical rotations and gave them unparalleled attention and teaching on rounds. The best demonstration of his impact on the lives of the medical students can be seen in their own words, as the graduating class of 2000 dedicated the 2000 Gray Matter yearbook to him with the following dedication (in part):
“In addition to being a well-trained physician and an astute clinician, Dr. Troost is incredibly generous with his time to medical education. He serves regularly as neurology attending physician, actively participates in second and third year neurology lectures, and maintains a website filled with information for students. He takes personal time with each third-year rotation group, freely offers career planning advice and reads more curricula vitarum and personal statements than any one person should.”
Todd's residents also benefitted from his experience and knowledge, including masterful didactic lectures and teaching during clinical rounds and at the bedside. Indeed, Todd was so devoted to resident training that, in 2002, he and his wife Gail used their own money to establish the B. Todd and Gail Troost Residency Education Fund, a continuing legacy of their personal investment in every neurology resident Todd mentored.
Todd's contributions to the fields of neurology, neuro-ophthalmology, and many allied disciplines are many. A look through his curriculum vitae reveals over 90 scholarly articles and 85 book chapters, many of which were seminal in the field, particularly in the area of eye movements, migraine, benign positional paroxysmal vertigo, and the neurological complications of cardiac surgery. In addition, Todd was a major force in making the Journal of Neuro-Ophthalmology (previously the Journal of Clinical Neuro-Ophthalmology) the official journal of NANOS and getting it cited in PubMed.
News of Todd's passing prompted many accolades, some of which are shared below (with permission of the writers):
Lou Dell'Osso, PhD: Todd did a fellowship in our laboratory from 1970 to 1972, after which he stayed on as a VA-funded investigator before moving on to Bowman Gray in 1983. During that time, we collaborated on many studies and learned about computers using Unix. For many years, we used a program Todd wrote called “RUNREF” that automatically formatted the references in our manuscripts for each particular Journal we were submitting to; that was long before commercial programs such as Endnote or Bookends were available. We will all miss Todd's “all-in” approach to whatever he was involved with.
Tom Carlow, MD: Todd had an early impact on my life and neuro-ophthalmic career. I was a neurology resident and fascinated by how the eyes functioned when a friend suggested that I call Todd Troost and consider a fellowship in neuro-ophthalmology. At the time, he was on staff at the Bascom Palmer Eye Institute and extremely kind and helpful. That conversation led to my fellowship at the BPEI. Todd was an early strong supporter of NANOS. He served on the NANOS Board of Directors for 4 years, developed our first website and managed, in collaboration with Ron Burde, the transfer of J. Lawton Smith's Journal of Clinical Neuro-ophthalmology to NANOS along with a journal name change to the Journal of Neuro-Ophthalmology. Todd will truly be missed by Susan and me.
Robert Daroff, MD: Todd was an extremely valuable member of the Eye Movement Trio in Miami and Cleveland, along with Lou Dell'Osso and me. I lost track of Todd when he left Cleveland, but will always cherish our previous productive relationship and friendship.
Preston C. Calvert, MD: Todd and I worked together for several years on the original NANOS website. He was passionate about neuro-ophthalmology, and about the use of the then-new medium of the Internet to further the goals of our subspecialty. Todd was a good friend to me, and a loyal servant to NANOS for many years.
Louise Mawn, MD: Dr. Troost was kind and generous with his time. While I was a medical student, he encouraged me to train in ophthalmology, wrote a recommendation, read my essay, proofed my application, and let me use the typewriter in the neurology office with the ability to white out and fix typos! He was an exceptional educator and professor.
Todd is survived by Gail, his wife of 43 years. Gail describes a full and exciting life with Todd, enjoying travel and cruises, gardening, and even quilting together. Todd will be greatly missed by his family, friends, and the medical community.