In memoriam: Steven R. Mostow, MD, 1938-2002

April 2002

On Sunday, March 24, 2002, Steve Mostow, MD, was killed in an aircraft crash while attempting to land at Centennial Airport, a commuter airport just south of Denver.

Steve was a member of the infectious disease community in Colorado, a personal friend and colleague for well over 30 years, and an active member of the Infectious Disease News editorial advisory board. As recently as two months ago, Steve prepared some comments on influenza vaccine and vaccine shortages for this column.

What happened

He was flying three friends home to Denver from a vacation in Aspen. Steve was a well-qualified pilot, with more than 35 years of flying experience. The aircraft involved was a Cessna 340, a twin-engine aircraft capable of cruising at 20,000-24,000 feet, and was well equipped for flying in the Rocky Mountains, even in adverse weather conditions. A spring snowstorm was in progress, and weather conditions were poor though not terrible, with snow, ice and fog. On approach to Centennial Airport, he reported an engine failure and the aircraft lost altitude and crashed shortly thereafter. All on board were killed.

Although a fellow of the Infectious Diseases Society of America (IDSA), Steve only infrequently attended the annual meetings, and was not well-known within the broader infectious diseases community outside of Colorado. For that reason, I would like to tell you more about this remarkable guy, and why his death will leave such a huge void in this state.

His career

Steve was a graduate of Case Western Reserve University School of Medicine, completed internal medicine residency training and some infectious disease training at Cleveland Metropolitan General Hospital. Additional infectious disease training was provided at the CDC in Atlanta and Northwick Park Research Centre in London. After completion of his formal training, Steve returned to Cleveland Metropolitan General Hospital as a member of the infectious disease division.

In 1976, I recruited Steve to the University of Colorado. Actually, that’s not exactly true – Steve recruited himself to Denver; my role was simply to say “yes.”

For the first several years, Steve worked at the Denver Veterans Administration Hospital, and during the late 1970s and early ‘80s at Denver General Hospital. After that, he became chief of medicine at Rose Medical Center, an affiliated community hospital integrated into the university postgraduate training programs. During the last four years, he had been the associate dean for outreach at the Health Sciences Center.

His research interests were in influenza and influenza vaccines. He published a number of important papers on purification of influenza vaccines, and the development of a ferret tracheal ring organ culture system that could be used to assess the virulence of influenza viruses and the effects of antiviral drugs. Laboratory research was not his strong suit, however, and it ended when he became a chief of medicine. He then devoted his full attention to teaching residents and medical students, and developing a rural outreach program.

There were three passions in Steve’s career: medicine, teaching and flying.

He approached all three of these with enthusiasm and commitment. As a teacher, he was a master of the Socratic method and set a high level of expectation, always rewarding those who met his expectations with commendation, a “high five” or some other enthusiastic endorsement. Those who did not meet his expectations were admonished.

He brought the same passion and enthusiasm to his rural outreach efforts. He flew his own airplane to all corners of Colorado, and to small communities in neighboring states, especially Wyoming, the Nebraska panhandle and western Kansas. There he would meet and teach the local physicians, go over difficult patients with them, referring them to specialists in Denver as necessary, and helping the nurses and physician assistants as well, especially with infection control problems.

Steve seemingly found the perfect job in the last position he held as associate dean for outreach at the university. Here was a job that paid him for doing what he most loved to do – flying all over the state and region to rural communities, teaching wherever possible, helping the rural practitioners with their problems, arranging for specialist site visits and calling on the resources of the university whenever appropriate.

The bean counters will eventually tell us whether this program was cost-effective, as measured in terms of patient referrals and the income thereby generated. In terms of good will, appreciation, and personal help to the medical community in rural Colorado, however, the program was clearly an enormous success. These folks will miss Steve greatly.

Professionally, with his strong interest in influenza and its prevention, Steve found his own interests lay more in the American Thoracic Society than in the IDSA. Owing to his remarkable ability to use the media to accomplish his prevention goals, he was elected several years ago to the board of directors of the National Foundation for Infectious Diseases (NFID), where he was particularly interested in furthering his immunization and prevention goals. He most recently served as vice-president of NFID.

Personally, Steve had a style all his own; up-front, in-your-face, often brash. This served him well with the media, especially the television media, who seemed to worship him! It was no accident that Colorado had for a number of years the highest rate of influenza and pneumococcal vaccine use among Medicare recipients; Steve had scared the —— out of everyone with his annual predictions of the most dire influenza season ever!

On the interpersonal level, however, this same style served him less well; he often seemed brash and overly aggressive. When the establishment moved too slowly to suit him, he growled at it in various ways, offending even his friends from time to time. We learned to simply shrug it off, for it was simply the essence of Steve Mostow. We will miss him, and his passions, and his message of influenza and pneumonia prevention by immunization.