Donald A. B. Lindberg (1933–2019)

Donald A. B. Lindberg, influential director of the United States National Library of Medicine (NLM) and unsung hero of medical research and science, died on 17 August. He was 85. Thanks to his vision and leadership, more than a million people a day can use PubMed to look up biomedical information and nearly 150,000 people a day can look up trials on [ClinicalTrials.gov][1]. Researchers in artificial intelligence, computational biology, and health care policy routinely use the mapping between hundreds of different biomedical vocabularies and ontologies provided by the NLM's Unified Medical Language System. Many of the current leaders in biomedical computing have been trained by programs funded by the NLM, which Don directed from 1984 to 2015, starting well before big data, precision and genomic medicine, or deep learning for medicine were even recognizable terms, let alone vibrant disciplines of their own. Don grew up in Brooklyn, New York. He became passionately interested in human biology at Amherst College in Massachusetts. After graduating in 1954 with a bachelor's degree in biology, he considered going to graduate school. Persuaded that medical training would provide more opportunities, he enrolled instead at Columbia University's College of Physicians and Surgeons in New York. It was a very good school, Don acknowledged, but “very far from the study of human biology” and “a high-class trade school at best.” Although the medical school experience was “thrilling,” the large amount of required memorization was “almost antithetical to experimental science.” After graduation in 1958 and a residency in pathology, Don served on the faculty of the University of Missouri for 24 years. In 1984, he left to direct the NLM. Early on, Don recognized that medicine needed to be more data driven. During his residency training, his data-driven approach to medicine landed him in hot water with the surgery department when he showed that silicon used for cardiac bypass was causing extensive embolization and death. Only upon showing the surgeons the imaging data was he able to change their practice. This pattern was to be repeated throughout his career. At NLM, he used data to convince members of the U.S. Congress and influential commercial stakeholders to better serve the public interest by, for example, requiring prior registration of expected outcomes for clinical trials. Don was a pioneer in medical computing. In the 1960s, he developed some of the earliest laboratory information systems, consisting of a punch card–fed clinical reporting program running on a Datatron-205 computer with 20 KB of memory. Twenty years later, he led the development of Artificial Intelligence Rheumatology Consultant System Ontology, an AI program that could diagnose complex cases of rheumatological disease. ![][2] PHOTO: JESSICA MARCOTTE One key to Don's success was his ability to attract top talent to lead NLM initiatives and implement his vision, including computational biologist David Lipman, biomedical informaticist Alexa McCray, medical librarian Betsy Humphreys, and health informaticist Milton Corn. Don helped lead initiatives that spanned the mission of the National Institutes of Health. He delegated many program responsibilities to his NLM colleagues and could seem detached. However, he was deeply knowledgeable about the programs he oversaw and preferred to lead by helping to set the agenda and then empowering his colleagues to work out the implementation details themselves, making himself available for guidance when needed. He had a dry sense of humor and used it to lighten what are often dry subjects, as when he named an early NLM resource Grateful Med. Don surrounded himself with expert advisers, such as Nobel laureates in Physiology or Medicine Richard Roberts and Joshua Lederberg, who understood the importance of computing to biomedical investigation and helped him develop long-term strategic plans for the NLM. Don's rare combination of strong scientific vision and leadership skills allowed him to work well both on Capitol Hill and across U.S. universities and academic health centers. Because he could bring parties with opposing perspectives together to develop a shared view of the public good in the applications of information technology, he was frequently in demand for leadership challenges that extended beyond the remit of the NLM. From 1992 to 1995, he served as founding director of the National Coordination Office for High Performance Computing and Communications in the Office of Science and Technology Policy, Executive Office of the President. In 1996, the Health and Human Services Secretary appointed him to serve as the U.S. coordinator for the G7 Global Health Applications Project. He was also a founding member of the American Medical Informatics Association and its first president. Those who run libraries are frequently underappreciated, as many take for granted the important and far-reaching services that they provide to their communities. Even with all of his accomplishments, this was true for Don in many circles outside the informatics community. Many forget how different the research world was before resources such as PubMed were commonplace. These advances have been driven by technological developments, most notably the internet, but Don's vision predated them. Much of the difficult foundational work and a corps of well-trained and engaged scientists and physicians were already in place when the technological capabilities came to be. Don found the recent (re)discovery of the importance of data science in science and medicine somewhat amusing. Don's wife of more than 60 years, Mary, became well known to those of us who worked with the NLM. Ever since their second date in 1957, when they started planning their life together, Don and Mary embodied joint decision-making. She survives him, along with his brother, two sons, and two grandchildren. Don's work lives on with millions of patients, doctors, and scientists who depend on access to and investigations of the exponentially growing corpus of biomedical knowledge. [1]: http://ClinicalTrials.gov [2]: /embed/graphic-1.gif