I [HA] had heard from my father that a professor never retires, and Dr. Lightfoot epitomized that. With his last post-retirement teaching appointment, he was told to “just write your own contract this time.”
Dr. Lightfoot’s decisions highlighted the roles of humor and family, especially after his wife, whom he loved deeply, passed away. When fellows would point out he shouldn’t be eating so many sweets, he would quip he was on a mission to raise his HbA1c, but alas he wasn’t successful. He would also slyly point out he had outlived his various primary care physicians.
He was a huge fan of college football, particularly “because the National Football League players are professionals and don’t make mistakes whilst the college players make them, which makes the game far more interesting and entertaining.” Many under his tutelage thought maybe he liked teaching for the same reason he liked college football.
In 2007 the UK rheumatology fellowship was reborn under then-Chief Leslie Crofford, MD. She hired [author] Kristine M. Lohr, MD, MS, to be program director. That brought Dr. Lightfoot and Dr. Lohr back together after 26 years. He had recruited her out of her fellowship to work at Medical College of Wisconsin. She remembers his annual pool parties at the country club. He became her model of how to be a teacher and researcher.
In 2013 Dr. Crofford returned to Nashville as professor of medicine and chief of rheumatology and immunology. Dr. Lohr became chief, and Dr. Lightfoot became her teacher again.
He had substituted Diet Coke for TaB, but not his breakfast from McDonald’s.
Teaching Philosophy
Teaching was Dr. Lightfoot’s calling, his life’s work; he would never tire of it. The saturated brains of students were the rate-limiting step in learning. While he was in New York he came across Graham R.V. Hughes, MD, FRCP, and studiously followed literature on coagulopathies, perhaps in part motivated by his own Factor V Leiden and personal experience with pulmonary emboli. Lupus erythematosus, rheumatoid arthritis and vasculitis were his other disease foci.
Most of his teaching, however—motivated by a first love—was clinical reasoning. He evolved a bedrock philosophy for this, best summarized as “Think ahead, plan ahead.” His teaching scripts were short, pointed and repeated as often as needed to create the desired effect on the learner—but not more often.
One of his pet peeves was test ordering without considering the pre-test probability. One book he would reference more than others was Beyond Normality, which deals with the likelihood of false positive results with the ever-increasing number of tests ordered, among other things.1 “An abnormal serology is not a disease,” he would reiterate.
