Clinical Professor of Medicine Robert D. Libke, MD, could be called the grandfather of infectious disease prevention and control in the San Joaquin Valley.
When he came to Fresno five decades ago, he was the only infectious diseases specialist in the region, consulting at hospitals in and around Fresno, including Valley Children’s Hospital.
Forty-nine years ago, he became a faculty member at UCSF Fresno, just two years after the then graduate medical education campus was established in 1975. As the sole infectious disease (ID) expert, he was frequently sought out by physicians in the community, academic colleagues, and trainees. Over the years, in times of uncertainty and fear, such as during the AIDS epidemic in the late 1980s and early 1990s, and most recently, the COVID-19 pandemic, his guidance and leadership were invaluable.
Libke retires this year as one of the longest-serving members of the faculty at UCSF Fresno, having joined the academic ranks in 1977. His list of awards is too many to name fully, but among them: Kaiser Teaching Award, Best Physician in Fresno, Fresno’s Best Doctors, Fresno-Madera Medical Society Lifetime Achievement Award.
He is praised by physicians in the Valley, and for good reasons, says Alex Sherriffs, MD, co-medical director of the UCSF Fresno Alzheimer and Memory Center. Sherriffs was a UCSF Fresno Family and Community Medicine resident from 1978 to 1981 and had rotations with Libke.
“Bob trained a generation of doctors who practiced in this community in the ‘80s and ‘90s. We learned about infectious diseases from him. We are so grateful to him. The community is so grateful to him for sharing his skills and knowledge about infectious diseases,” Sherriffs says.
“And it wasn’t just infectious diseases; he was the inpatient attending for countless trainees, sharing knowledge and attitudes that guided our development and practice of medicine through our careers, regardless of specialty.”
Libke has served as director of the UCSF Fresno Division of Infectious Diseases and as chair of the Community Regional Medical Center Infection Control Committee, among other posts over the years. Quiet by nature, Libke helped shape the Division of Infectious Diseases without fanfare and played an instrumental role in building the fellowship program.
Besides his habit of wearing a new tie every day, his unwavering calm is a trademark that colleagues, fellows, residents, medical students, staff, and patients have appreciated.
Michele Maison-Fomotar, MD, MSc, is an assistant clinical professor of Medicine in the Division of Infectious Diseases who trained at UCSF Fresno as an internal medicine resident (2016-2019) and then as an ID fellow (2019-2021). She admires Libke for his steadfastness, clinical skills, and thoughtfulness as an educator and clinician.
“His depth of knowledge across such a variety of infections amazed me. What stayed with me, though, is his calm. There could be a stack of referral papers waiting for him, patients to see, and questions coming from every direction, yet he never made you feel that he was too busy for you. He would listen, staff a patient, answer a question, and take whatever came next in stride.”
From a reassuring presence during the COVID-19 pandemic to his habit of leaving M&Ms and pretzels as snacks for busy residents and fellows, Maison-Fomotar says Libke put first those he taught, worked alongside, and cared for.
Libke has conducted research projects and written groundbreaking chapters on coccidioidomycosis (Valley fever), including a chapter in a 1987 pediatric infectious diseases textbook. Among numerous clinical roles, he has served as chair of Community Regional Medical Center’s Institutional Review Board (IRB), which oversees research, as well as chair of the Infection Control and Antibiotic Stewardship.
"Dr. Libke embodies the mission of UCSF Fresno to train exceptional physicians to respond to the need for more doctors and to improve health in the San Joaquin Valley," says UCSF Fresno Vice Dean Jose M. Barral Sanchez, MD, PhD. "He is a pioneering clinician-researcher in the field of infectious diseases in this vast region, especially in coccidioidomycosis. We are lucky to have had him as the leader of the IRB and other programs. I am grateful for his many contributions to UCSF Fresno, to his trainees, patients, and to the communities he has served.”
Libke’s legacies to the community include longstanding HIV care.
Roger Mortimer, MD, assistant dean of academic affairs at UCSF Fresno and a family medicine physician specializing in HIV, was one of several physicians who spoke at a recent UCSF Fresno event honoring Libke’s legacy and career. Mortimer says he profited from Libke’s mentorship during residency training in Family and Community Medicine at UCSF Fresno from 1991 to 1994. “I got to work with him side-by-side. It was a very growing experience for me.”
The comprehensive care patients receive today is largely due to Dr. Libke's initiative to open HIV programs when no one else was willing to step up and help. Libke led the drive to open two HIV programs more than 35 years ago – one at the old Community Medical Center, and one at Saint Agnes Medical Center – in Fresno, Mortimer says. “He saw a need, and so he picked up that baton.”
The Community Special Services clinic (now associated with Community Regional Medical Center) continues to operate today and serves about 3,000 patients.
A program that fits
Libke earned a bachelor’s degree from the University of Washington and his medical degree from Marquette University School of Medicine. He spent an internship at Memorial Hospital of Long Beach, then returned to Seattle to complete residency and a fellowship in infectious diseases at the University of Washington.
Fresno had not been on Libke’s radar in 1974, when he completed the fellowship. “I don’t know if I had ever been here, unless it was driving through,” he says.
He had no idea at that time how his arrival filled a medical need in the Valley.
“It turned out, I was the only infectious diseases specialist between Los Angeles and San Francisco, and the Sacramento area.” He adds with a laugh, “That was a nice place to be when you were brand new in your field, everybody thought you were great, because you were the only one.”
He particularly found the calls from Valley Children’s Hospital rewarding and missed going to the hospital after it had its own pediatric ID specialist. “It’s a little different world, and it was kind of fun.”
Along with his teaching and consulting roles, Libke balanced private practice with his academic duties for years and is among the founding physicians of Inspire Health Medical Group (formerly Central California Faculty Medical Group), established in 1979.
Libke discovered the combination of teaching, patient care, and consulting work suited him.
“I fit the program or the program fit me, I’m not sure which,” he says. “The thing that kind of glued it all together for me was the training programs. And so even though I was doing consultative work in the other hospitals, my place of value was with the training program at the county hospital.”
Teaching is a challenge but ultimately rewarding, Libke says. “I like to see people learning, and I appreciate it when they learn from me. There’s a certain joy you can get from that.”
To teach effectively requires constant learning, and Libke says, “whenever I meet a new disease or challenge, or new outbreak, I have to learn a lot in order to be able to figure out how to deal with it, so it’s always a learning process, and I enjoy that.”
His learning curve at UCSF Fresno began in 1977, when he saw his first case of Valley fever. “Personally, when I arrived in Fresno, I had no experience in coccidiomycosis. I trained in Seattle. We rarely, if ever, saw it,” he says. “My main challenge at that time was learning about that particular disease, which was obviously prominent, as it is now in Fresno.”
Libke credits Roger Larson, MD, among other physicians in Fresno at the time, for sharing their knowledge about Valley fever. (Larson, who died in 2013, was the first full-time director of the training program in internal medicine at Fresno General Hospital, (renamed Valley Medical Center, then University Medical Center.) “He was instrumental in my acquisition of knowledge about that disease,” Libke says.
Libke’s passion for learning, his curiosity, and his involvement in new developments in infectious diseases have not waned, says Geetha Sivasubramanian, MD, chief of the Division of Infectious Diseases at UCSF Fresno.
She shared her admiration for Libke at the event honoring him, and among her remarks, “I just get goosebumps that I get to be on the same floor as him when I come in every day,” drew soft chuckles and nods of agreement from members of the audience.
Almira Opardija, MD, an associate professor in the ID division at UCSF Fresno, also expressed her appreciation. “As you begin your next chapter, I hope you know how deeply I appreciate you. And not just because of your contribution to my ID knowledge, confidence, and skills, but for the kindness and gentle guidance that you always showed.”
As for his future, Libke says he will remain a presence at UCSF Fresno in the ID offices and will continue to offer this advice to fellows, residents, and medical students: “Keep an open mind. There’s never a time when you can’t learn something.”
