Robert Rouse, professor emeritus of pathology, dies at 70

Robert “Bob” Rouse, MD, professor emeritus of pathology at the Stanford University School of Medicine and former chief of pathology and the laboratory medicine service at the Veterans Affairs Palo Alto Health Care System, died July 28 after a brief hospitalization for complications from Parkinson’s disease. He was 70.

Respected by his peers for his contributions to basic immunology and surgical pathology, Rouse was known for his wry sense of humor, unflappable demeanor, precise language and incisive mind. He baked bread on a daily basis and would wear a bowtie at special events — on selected occasions, one made of wood.

Rouse exuded a preternatural calmness, recalled Roger Warnke, MD, professor emeritus of pathology, who first met Rouse in 1974, when Warnke was a resident pathologist at Stanford and Rouse was applying for his residency there.

“You’d think maybe he was asleep during a presentation, but when the talk was over he’d ask incisive, pertinent questions,” Warnke said. “He’d been totally engaged all that time, although you wouldn’t have known it.”

Rouse displayed unerring decency as a mentor and a co-worker, said Kristin Jensen, MD, associate professor of pathology, who in 2015 succeeded Rouse as chief of the VA-Palo Alto’s pathology and laboratory medicine service, a diagnostic testing facility with about 80 employees. “He was always checking in on how you were doing, and he was very gracious — always willing to step aside and let someone else take credit,” Jensen said.

Many who sat across or around a microscope with him, Jensen said, will recall his ability to scrutinize slides with his naked eye. “He could tell you with high accuracy what kind of tissue it was and, often, what the biopsy was for,” said Jensen of this offbeat skill, which amused trainees and colleagues alike.

“Bob was tall, lanky, thoughtful and very serious-looking,” Jensen said. “It was only when you got to know him a little better that his wry sense of humor came out.”

Native of St. Louis

Born Dec. 13, 1947, in St. Louis, Missouri, Rouse graduated with a bachelor’s degree in engineering from Northwestern University in 1970. He earned a medical degree from Washington University in 1974. At Stanford, he completed an internship in anatomic pathology; a two-year postdoctoral fellowship in the lab of Irving Weissman, MD, now a professor of pathology and of developmental biology; and a medical fellowship in surgical pathology.

In 1980, he was named an acting assistant professor of pathology at Stanford. In 1983, he was appointed an assistant professor as well as co-director, with Warnke, of the medical center’s tissue immunodiagnosis laboratory — a position he held until 2006. He was promoted to associate professor in 1991 and to full professor in 2001. In 2006, he assumed the role of chief of the pathology and laboratory medicine service at the Stanford-affiliated VA Palo Alto Health Care System. Although he retired from Stanford in 2015, he remained active as a part-time staff pathologist at the VA until December 2017.

Early in his career, Rouse co-authored a number of scientific journal articles on immunology with Weissman and other Stanford faculty researchers. These focused particularly on phenomena related to the maturation of lymphocytes known as T cells in the thymus. He later turned his immunological training to uses in pathology, such as the development of practical diagnostic applications of immunohistochemistry.

A surgical pathologist, he was an early adopter in the application of antibodies to tissue sections in order to get more-precise diagnoses. From 1988 through 1998, he served on the World Health Organization’s committee for the histological typing of thymic tumors.

“Diagnostic pathology is more subjective than many of us would like to admit,” Jensen said. To render the procedure more concrete, in the mid-1990s Rouse initiated a website, surgpathcriteria.stanford.edu, that emphasized textual, as opposed to pictorial, histologic descriptions, as well as differential diagnostic and grading criteria, in the belief that text allowed for more precision, consistency and accessibility than did images, whose interpretations could be somewhat subjective.

“Anybody could access that website,” Jensen said. “It’s becoming widely used nationally and internationally by practitioners and, increasingly, by patients around the world.”

A masterful gardener who with his wife, Bichtien, hosted annual garden parties at his home on the Stanford campus, Rouse was also a gourmet baker. “He would bake bread on a daily basis and bring it in to share with his coworkers,” Warnke said.

Rouse was a member of the College of American Pathologists, the California Society of Pathologists and the South Bay Pathology Society. He co-authored more than 100 peer-reviewed journal articles and numerous reviews and book chapters, and served on the editorial boards of Advances in Anatomic Pathology and the Journal of Histochemistry and Cytochemistry, and on the editorial review panel of Human Pathology.

In addition to his wife, Rouse is survived by a daughter, Liensa Rouse Vidra of New York City, and a son, Nicholas Rouse of Atlanta.

A small memorial was held with close family and friends. In lieu of flowers or gifts, his family suggested considering a donation to the Michael J. Fox Foundation to honor his memory.