Juan Rosai, MD

Juan Rosai, MD, was a friend, former colleague, and contemporary: our respective birthdates separated us by less than 2 months in our birth year of 1940. His accomplishments were multifold not just in surgical pathology: he was also an essayist, philosopher, lecturer, and humanist in the Renaissance sense. All of this is appropriate for a child of the Tuscany region who was born in August 1940 in the small town of Poppi, Italy. Given the desperate situation in postwar Europe, including Italy, he and his family immigrated to Argentina after his father, Enzio, returned from the WWII. His father quite literally walked across Europe after the war to reach his home because it was thought that he was lost forever as a victim of that war. Juan had memories of his return and the enormous joy of finally seeing a father whom he knew in name only. Those memories of long ago filled his marvelous memory bank, which stored images of the unique and mundane with vivid recall and accompanying captions. It was Juan's ability to see beyond what others saw in order to establish connections that allowed him to first describe aggressive angiomyxoma, histiocytoid/epithelioid hemangioma, spindle epithelial cell tumor with thymoma-like differentiation, and sinus histiocytosis with massive lymphadenopathy—the eponymous Rosai-Dorfman disease—as just a small roster of his many firsts.Part of his Italian genome and heritage was his love of opera, and, not surprisingly, the 2 giants of the 19th and 20th century, Giuseppe Verdi and Giacomo Puccini, respectively, were his favorites. Juan introduced me to opera while we were together at the University of Minnesota from 1974 to 1985, our “golden” years during the chairmanship of Dr Ellis Benson, who recruited us to the Twin Cities of Minneapolis and Saint Paul, Minnesota. After all, what did a boy from East St Louis, Illinois know about opera—not much? We went together to the Metropolitan Opera touring company performance of Puccini's La Bohème at the Coffman Auditorium to experience my first opera. That revelation with my unexpected reaction allowed us to attend many more operas after that. This is but one example of Juan's ability to influence, even in small ways, the lives of others.Another passion of Juan's life was soccer, which was a near-total void in my life. Was it necessary to know anything about sports other than the St Louis Cardinals? Soccer created a conflict for Juan with the dilemma of Italy or Argentina or Argentina or Italy. Then there was something called the World Cup. Why all that excitement for something that only came around every 4 years (unlike the annual World Series)?How is it possible to arrive at this point with only a passing acknowledgment of Juan's many accomplishments and honors: tumors first reported, multiple editions of Ackerman and Rosai, and Rosai and Ackerman's Surgical Pathology, Armed Forces Institute of Pathology–American Registry of Pathology fascicles on tumors of the thymus and thyroid, hundreds of peer-reviewed papers, editor of the International Journal of Surgical Pathology, editorial board membership of our best journals, editor of the American Registry of Pathology tumor fascicle series, trustee of the American Board of Pathology, United States–Canadian Academy of Pathology Maude Abbot Lecturer, and Distinguished Pathologist Award? The reason is that Juan was much more than those prodigious feats of scholarship and recognition. Juan followed in the footsteps of his mentors, Eduardo Lascano, MD, and Lauren V. Ackerman, MD, as a mentor and educator of the first rank. The many residents and fellows who have had the privilege of sitting across the microscope from him were the beneficiaries of his superb observational skills and perceptive insights with the flow of images as the slides moved across the stage. Juan also had an incredible collection of slides, in part passed on to him by Dr Ackerman, from which he could put his fingers on one in a matter of moments to demonstrate a similar case that he had seen 10 or more years ago. His path to the diagnosis was enlightened by the gift of extraordinary recall; over the years, this allowed him to report the previously unreported.When Juan could no longer carry the burden of the next edition of Rosai and Ackerman's Surgical Pathology, he left behind one of the truly great accomplishments of multiple editions that were a tour de force of single authorship whose tradition began with its first edition in 1953. These editions have reflected a comprehensive understanding of anatomic pathology as applied to the patient during life. Juan brought his scholarship and clear, succinct writing skills to elevate and establish Rosai and Ackerman as the essential standard for this particular genre of references. Dr Ackerman was the first to acknowledge that Juan took the subsequent editions well beyond just the next level of excellence. Others can only follow in those footsteps.Juan was the master surgical pathologist in his ability to interpret the image into a diagnostic context whose ultimate end point was to be translated into the care of the patient, which is, after all, what we all seek as physician-pathologists. There have been few peers to the likes of a Juan Rosai.Dr Ackerman used to say that “books and papers” fade into the obscure past and yellow on the way, but one's enduring legacy is the lives of those whom we have taught and who in their turn teach others. Those of us such as Juan regarded Dr Ackerman as our mentor, but now several subsequent generations of pathologists hold Juan Rosai in that same august position.As a final note, I knew that this time would come around for one of us, when either Juan or I would be asked to memorialize the other. Rather than lament Juan's passing, let all of us who knew and respected him rejoice in his life with its many accomplishments. We can wish for those who loved him our shared sense of loss as well. What greater legacy can one person leave behind than a better and richer world for those who will follow?

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