Tar Heel of the Week

Curiosity drives doctor-detective

Staff WriterApril 23, 2006 

Dr. Richard Frothingham, a Duke physician-researcher, savors mental challenges.

STAFF PHOTO BY JOHN ROTTET

  • BORN: Dec. 20, 1956, New York City

    RESIDENCE: Durham

    FAMILY: Married to Margaret Howell Frothingham. Children are Richard Nathaniel Frothingham, 20, a sophomore at Duke University; Cameron Elizabeth Frothingham, 18, a freshman at Wake Forest University; and Sarah "Sunny" Gilchrist Frothingham, 13. They also have an 18-month-old foster son. Parents, Dick and Mary Frothingham, live in Little Rock, Ark. Brother, Tom Frothingham, lives in Little Rock; and brother, Eddie Frothingham, lives in Corvallis, Ore.

    EDUCATION: Central High School, Little Rock, Ark., 1974; Massachusetts Institute of Technology, B.S. in biology, 1978; Duke University School of Medicine, M.D., 1981. Combined residency in internal medicine and pediatrics, University of Rochester, Rochester, N.Y., 1982-86.

    CAREER: Medical missionary, Hospital Lumiere, Bonne Fin, Haiti, 1987-1990; fellowship in infectious disease, Duke University Medical Center, 1990-93; staff physician, Veterans Affairs Medical Center, Durham, 1993 to present; various roles at Duke, 1993 to present. Currently, he is associate director of the Duke Human Vaccine Institute and director of the Duke Regional Biocontainment Laboratory, one of four facilities nationally researching emerging infectious diseases.

    RELIGIOUS AFFILIATION: Elder, Blacknall Memorial Presbyterian Church. Sunday school teacher, 1996 to present.

    MOST ADMIRED HISTORICAL FIGURE: Jimmy Carter. Says Frothingham: "He was not popular as president of the U.S., but he remains admired around the world, especially by poor people. He is a model of sincerity and compassion. He walked the walk, and still does."

    FAVORITE AUTHORS: Alexander McCall Smith, C.S. Lewis, Sir Arthur Conan Doyle.

    CURRENTLY ON HIS BEDSIDE TABLE: 303 Perplexing Chess Puzzles.

— Haiti broke Rich Frothingham.

Frothingham, then a young doctor, went to the impoverished island in 1987 to serve in a small hospital about 100 miles south of Port-au-Prince, the capital. He and his wife Margaret, a registered nurse and health educator, intended to stay as long as church and community donations from Durham would support them.

But before long, the vast scope of the work they had chosen began to wear on Frothingham. He saw many patients who were chronically ill. The idea of following a daily treatment regimen was foreign to many Haitians. Those who accepted the notion often could not afford medicine.

Frothingham, a lifelong achiever unaccustomed to admitting defeat, had to confront an unwelcome truth: He couldn't fix this.

"It was the first time I really wanted to do something and found that I could not," he says of his three-year sojourn in Haiti.

Today Frothingham, 49, an infectious disease doctor and research scientist at Duke University Medical Center, looks on his "failure" in Haiti as a turning point that forced him to find new ways to serve God and humankind.

Had he remained in Haiti, for example, he likely would never have stumbled into his latest role: drug safety advocate.

Frothingham's research in documenting the side effects of the antibiotic Tequin contributed to the Food and Drug Administration's decision in February to order stronger safety warnings on the drug's packaging. About the same time, FDA asked Frothingham to advise the agency on Tequin, which is linked to dangerous fluctuations in blood sugar levels, and other drugs in the same class -- a group known as the quinolones that includes such powerful drugs as Cipro.

Not a bad result for a project that Frothingham, best known for his work with vaccines and research into tuberculosis and plague, started mainly to satisfy his own curiosity.

"Most of it he did on his own time," says Dr. Chris Woods, who serves with Frothingham on a committee that decides which antibiotics should routinely be prescribed to patients at the Durham Veterans Affairs Medical Center. It was through that committee Frothingham first became interested in drugs such as Tequin, introduced in the U.S. in 1999.

Sifting reams of data

Frothingham filed Freedom of Information Act requests with the FDA for data about side effects of four different quinolones, including Tequin. Then he sifted through it for years to produce an analysis of health risks associated with the drugs.

The results were published last year in a major infectious disease journal.

"It was above and beyond what he would have been expected to do," Woods said.

Friends and colleagues say it's a typical pursuit for Frothingham, whose favorite pastimes include unraveling complex chess problems. They say he has a knack for latching on to almost any clinical subject and quickly becoming an expert.

"He's very interested in getting to the bottom of things," says Dr. Ken Wilson, a Duke infectious disease physician who was Frothingham's first research mentor. Wilson is also director of the HIV clinic at the Durham VA, where Frothingham sees patients weekly.

"He has a very precise and logical mind that just won't quit until it reaches the end point," Wilson says. "That's what happened with the quinolones. It's part of his personality to just keep penetrating and penetrating until he has the answer."

Frothingham says his constant questioning comes from his upbringing. His father was a philosophy professor who encouraged his children to question assumptions and seek information to form their own opinions.

Margaret Frothingham says her relatives, most of whom live in Alabama, initially didn't know what to make of her Yankee husband -- Frothingham was born in New York City. He seemed to never field a question he couldn't answer and excelled at any test of skill or intellect.

Master of windsurfing

Once, for example, Margaret Frothingham's brother broke out a new windsurfer during a family visit to Dauphin Island, Ala. The rest of the family members hopped right on the thing, with mixed results. But Rich Frothingham read the instructions and successfully maneuvered the windsurfer across the bay and back, without once going into the drink.

"He figured out the physics of it," Margaret Frothingham says.

Truth be known, her own first impression of her husband wasn't exactly favorable.

They met at a costume party thrown by friends from church. The guests had been instructed to "Come as You Were." Rich Frothingham, then a medical student at Duke, showed up as a nerd from MIT, where he earned his undergraduate degree. Margaret Frothingham, then a nurse at Duke Hospital, remembers his costume featuring supershort shorts, a pocket protector and a slide rule.

"If you had told me I was going to marry that person, I would have hit you," she says.

Friendship blossomed into something more when Frothingham traveled to Africa, where he volunteered in a Rwandan hospital for four months after finishing medical school. The two wrote letters back and forth, and by the time Rich Frothingham stepped off the plane at Raleigh-Durham International Airport, they were in love.

A mutual zeal to serve helped bring the couple together. When Rich Frothingham proposed, Margaret was in the process of arranging to work in a refugee camp close to the Thailand border. She chose to marry him instead.

"It was an interesting choice," Frothingham says jokingly.

Margaret Frothingham says she knew if she married him, they'd eventually do missionary work together somewhere.

She was thrilled when, after four years of marriage, they left for Haiti, where they lived in a house on a hill within walking distance of the hospital. Margaret Frothingham, who loved Haiti more with each day, was devastated when her husband confided after three years that he was too burned out to continue.

Since then, both Frothinghams have found other ways to serve.

Margaret Frothingham earned a master's degree from the Duke Divinity School and now works for Blacknall Memorial Presbyterian Church in a role she describes as a modernized version of parish nurse. And the couple recently became foster parents to an 18-month-old boy.

"I think Rich used to think he had to go somewhere to serve God," his wife says. "Today, I think he would say it's our duty to develop the gifts God gave us."

Staff writer Jean P. Fisher can be reached at 829-4753 or jfisher@newsobserver.com.

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