Bringing CNS Members Together to Make Children’s Lives Better


Robert S. Rust, MD

Robert S. Rust, MD

Dr. Robert Rust’s undergraduate studies at four State Universities (UCLA, Alabama, Kent, Virginia) resulted in Honors at Graduation in History and English Literature. Graduate studies in several Departments at Virginia resulted in an M.A. in History and training in immunology. He spent several years as lecturer and Associate Director of Studies at the International College, Salzburg, Austria and earned a certificate in Greek language, history, and culture at the University of Thessaloniki/Institute of Balkan Studies. He then returned to Virginia where he completed most requirements for Ph.D. in history. A longstanding interest in medicine and science diverted him completing his dissertation. He spent two years as a surgical Research Associate investigating wound infection and lymphatic aspects of immune function, published in nine papers. During this time he also discovered the writings of Osler and Penfield and entered medical school intent on becoming a surgeon.

During his first year of studies encounters with three remarkable individuals resulted in another change of course: 1) Lennart Heimer, the famous neuroanatomist and captivating teacher, with his spirited discussion illustrated with chalkboard freehand drawings of what was known and not yet fully understood concerning higher cortical functions and behavior; 2) Fritz Dreifuss, delivering two extraordinarily eloquent and stimulating lectures on “The Nature of Epilepsy;” and 3) James Q. Miller, neurologist and neuropathologist who, as leader of a Practice of Medicine small-discussion group, taught Rust those aspects of medicine that go beyond diagnosis and treatment. All would remain influential through the rest of his career. To these a number of other remarkably influential teachers were added through the rest of medical school. Despite dalliances with cardiology or infectious disease, he settled on child neurology during his third year.

Dr. Rust’s pediatric training at Yale-New Haven brought him into contact with numerous excellent teachers, foremost among them Laura Ment and George Lister; both taught more than medicine with their similar emphasis on meticulousness and clear thinking. Upon the recommendation of Dreifuss and Ment, he obtained his neurological training at Washington University, St. Louis, where numerous individuals influenced his career development during a golden era of that famous program. From the adult side Stuart Weiss, Mark Raichle, Bill Powers, and John Trotter were especially important. At Children’s, Phil Dodge, Art Prensky, Ed Dodson, Joe Volpe, master pediatrician Jim Keating, and others expanded and transformed his horizons as did interactions with a splendid cadre of fellow trainees. Dodson and John Trotter fostered interest in immunological disease and the first publications of what would form a particularly important element of his career followed.

Upon completion of formal clinical training, Rust remained at Washington University as a Clinical and Research Fellow in neurochemistry and neonatal neurology under Joe Volpe, Joe Ackerman, and Oliver Lowry. Although he was clinically active, Rust spent much of the following three years acquiring training as a scientist interested in the metabolic aspects of brain development, work that was carried out in three laboratories. This included developmental lipid chemistry in the Volpe laboratory, resulting in three publications concerning the regulation of the dolichol synthase pathway, of importance due to its intricate relationship to the glycosylation of membrane bound proteins involved in the development of neurological functions. In the laboratory of Joe Ackerman, Rust participated in NMRS studies leading to three publications concerning potential error in deoxyglucose estimation of regional cerebral metabolism or the role of cellular hypoxia in sepsis. And, in what would become his primary venue – Oliver Lowry’s laboratory – he acquired the meticulous skills of the microhistochemical methods that Lowry had so famously developed. These experiences enabled Rust to employ a rich array of techniques as he initiated developmental and regional studies of intermediary metabolism in normal brain as well as brains of animals subjected to hypoxia, asphyxia, or oligemia.

Of particular importance was a unique and comprehensive comparative evaluation of developmental changes in eighteen enzymes in seven pathways of intermediary metabolism of developing neurons, astrocytes, oligodendroglia, and Schwann cells, published as an invited paper in a 1991 Festschrift issue of Neurochemical Research honoring Louis Sokoloff. Rust then meticulously detailed regional concentrations and utilization rates of eight key intermediates of energy metabolism in 12 discrete regions of rabbit brain and spinal cord. The scope of the resulting illustration of regional metabolic heterogeneity correlating with regional functional demand by both energy and synthetic paths of intermediary metabolism had not been approached by prior studies. Dr. Rust published four clinical papers and established what would become in ensuing years large collections of children for longterm followup in a very large longterm study of childhood cerebellar ataxia, ADEM, MS and related conditions, newborn stroke, and headache.

Dr. Rust moved to the University of Wisconsin in 1990, succeeding Ray Chun as Director of Child Neurology and Medical Director, Cerebral Palsy Clinic. He established with an NIH grant a Developmental Brain Chemistry laboratory. He moved to Boston Children’s to become Child Neurology Training Director, Director of Neurological Education, Director of Outpatient Clinics, Co-Director of the Weekly Neuropathology Conference. In 1999 he returned to Virginia as Director of Child Neurology and Worrell Professor of Epileptology and Neurology and Co-Director of the Dreifuss Epilepsy-Child Neurology Clinics.

Dr. Rust has published 93 full-length papers or chapters addressing a broad variety of topics. With some overlap their distribution is as follows: inflammatory/infectious (44), biochemical (13), epilepsy (10), renal (6), historical (6), headache (5), neurocutaneous (5), movement (2), developmental (1) degenerative (1). Dr. Rust

has served as Training Director for 23 child neurologists; he has also mentored clinical research for 14 individuals and basic science for five more. He has served on five Editorial Boards and as ad hoc reviewer for 18 journals. He served as ad hoc advisor to the Technical Advisor to the NIH/NINDS sponsored Disability in Speech/Language Disorders consortium.

Dr. Rust is a devoted teacher. Despite his skepticism concerning the value of formal lectures, he has delivered as many as 36 in a year. His devotion to bedside teaching has made him available on short notice for consideration of interesting cases “where two or three are gathered together” to learn something. His enthusiastic partaking in what David Clark called the “clinical feast” of bedside medicine is usually palpable. He is known to incorporate not only what he regards as the all-important fundamentals of anatomy, pathology, and physiology, but also historical, literary, musical, geographical, or other references. His chief objective is to arouse interest in a particular problem but more importantly to illustrate the importance of meticulous history, successful limited examination drawn from a large bag of potential tricks, and to entrain by example curiosity, equanimity, empathy, and understanding. Residents from pediatrics, psychiatry, developmental pediatrics and, occasionally, veterinary medicine rotate through his clinics. He is devoted to rural outreach clinics, regarding them as an important element of Resident/Fellow education and professional growth.

Dr. Rust’s honors include the Outstanding Physician Award of the Wisconsin Epilepsy Association, the Raven Award for Service to the University of Virginia, and a recent Testimonial Dinner by the Epilepsy Foundation of Virginia. He has received eight University or national teaching awards. He has enjoyed numerous visiting professorships in America and overseas. He was particularly touched by the opportunity to deliver the Naomi Amir Memorial Lecture in Jerusalem in 1999, honoring a child neurologist whose vision and devotion to the care of children he has found particularly inspiring. In 2005, Dr. Rust was awarded the Child Neurology Society’s Overseas Visiting Professorship, which was spent in Iran. He was elected to the ANA in 1999. Perhaps he is best known for his frequent participation in the marvelous Child-Neuro on-line discussion group originated by Drs. Steve Leber and Ken Mack (approximately 1400 communications in the past 13 years). He has authored more than 120 published book reviews for the Virginia Quarterly Review of Literature over the past 37 years.

Dr. Rust has served on the usual list of departmental and university committees and for a number of years as a Faculty Fellow of Virginia’s liberal arts residential college. He has been a frequent examiner for the ABPN, has twice chaired the Annual Meeting of the Upper Midwest Child Neurology Society and is a long-time member of the Central Society for Neurological Research. He is in his eighth term as Chair of the CNS Archives Committee and has prepared numerous displays considering the careers of annual award designees, as well as “CNS Presidents,” “Women in Child Neurology,” and “Canadian Child Neurologists.” With Howard Goodkin he prepared a similar display of AES Presidents for the AES. He moderates selected poster discussions each year at the CNS. AAN service includes: member/Chair of the Child Neurology Education Committee; member of the Scientific Program Subcommittee; reviewer and Topic Chair for Child Neurology/Developmental Neurobiology; Secretary-Treasurer, Councillor, and now Chair-Elect of the AAN Child Neurology Section; Member or Co-Chair of the AAN Child Neurology Course for eight years, participant/Director of other courses. He is Chair of the Child Neurology Section of the RITE exam subcommittee and is a member of the President’s Advisory Council of ICNA.

Nothing that he has done could have been done without the support that he has received from Betsy, his wife of 32 years. His life has been enriched by the presence of four sons who, among other accomplishments, are all musicians. Dr. Rust has been a musician for most of his life and has performed as a member of various orchestras and in church. He enjoys many sports and coached little league for six years. He has many hobbies, among which he finds building free-laid stone.