II. BIOGRAPHY

Earl Johnson Brewer, Jr., was born July 3, 1928, to Maurine (Bowman) and Earl Brewer and raised in Fort Worth, Texas. He graduated from high school in 1945, then attended the University of Texas at Austin for a year and a half after which he spent a year and a half in the United States Regular Army stationed at Letterman General Hospital in San Francisco, California. On February 26, 1948, Sergeant Brewer received an honorable discharge and proceeded to work his way through Texas Christian University in Fort Worth as a laboratory technician at All Saints Hospital. He earned a Bachelor of Arts degree in 1950 with a major in psychology and minors in chemistry and biology. With the help of a Jesse H. And Mary Gibbs Jones scholarship, he attended and graduated from Baylor College of Medicine (B CM) in Houston, and became a licensed physician in the State of Texas on August 14, 1954. A 1954-1955 BCM internship at Jefferson Davis Hospital, Houston, was followed by Dr. Brewer's three-year specialty training in pediatrics both at Baylor and at Harvard Medical School in Boston. Another Jones Fellowship made possible his 1956-1957 work as Senior Assistant Resident at Harvard and the Children's Hospital Medical Center. He then returned to Texas as Chief Resident at Texas Children's Hospital (TCH) 1957-1958, and was certified by the American Board of Pediatrics (ABP) July 1, 1959. He remained on the staff of TCH 1958-1991 and, as Clinical Professor, developed and directed the Pediatric Rheumatology Center and Service at both TCH and BCM 1958-1988. He also served on the staff at St. Luke's Episcopal Hospital, Methodist Hospital, Ben Taub Hospital, and on the consulting staff at Hermann Hospital and Shriners Hospital for Crippled Children for the same 30-year period. In 1962 this pioneer in pediatric rheumatology also founded KelseySeybold Clinic's Pediatric Department and chaired that department for 21 years.

Dr. Brewer's interest in the study of rheumatic diseases began early in his career. The first special treatment centers for children with arthritis appeared in 1960 as he worked with the March of Dimes, an organization then beginning to apply lessons learned from experience with polio victims to arthritis sufferers. In conjunction with that effort, in 1962 Dr. Brewer published "Home Treatment Program for Children with Rheumatoid Arthritis."

By 1964 it was apparent that classification criteria was necessary to coordinate scattered efforts to organize pediatric rheumatology, so the American Rheumatism Association (ARA) appointed the Juvenile Rheumatoid Arthritis (JRA) Subcommittee of the Classification Committee. Dr. Brewer chaired this criteria subcommittee from 1965-1978. This group prepared and published in 1972 what is known as the "JRA criteria." That lead to Dr. Brewer's 1973 founding of the Pediatric Rheumatology Collaborative Study Group which would conduct both national and international drug studies to determine effective drug treatment for JRA. Dr. Brewer worked with the National Institutes of Health (NIH), National Institute of Arthritis & Musculoskeletal & Skin Diseases (NIAMS), from 1975 as principal investigator for four JRA studies by 20 centers in the U.S. and 5 centers in the USSR. Numerous subsequent multi center studies resulted in FDA approval of several anti-arthritis medications.

In 1976 the Arthritis Foundation (AF), the ARA, and the Shriners of North America sponsored the first Conference on the Rheumatic Diseases of Childhood in Park City, Utah. This gathering of physicians interested in pediatric rheumatology, and the two subsequent meetings held there in 1986 and 1991, became known as the "Park City meetings." The following year medical professionals from around the world met at a pediatric rheumatology conference in Oslo, Norway, where Dr. Brewer participated in discussions regarding international JRA criteria.

Nationally, in addition to working with the NIH, Bureau of Maternal and Child Health (MCH) and NIAMS, Dr. Brewer successfully organized and chaired the Pediatric Council of the ARA and, in 1980, the Rheumatology Section of the American Academy of Pediatrics (AAP). He was a member of the committee that persuaded the ABP to establish a Board of Pediatric Rheumatology in 1990. Established in 1980, the American Juvenile Arthritis Organization (AJAO) held its first national meeting in 1984, and honored the JRA research pioneer by awarding the first Earl Brewer Health Professional Award in 1989.

From his earliest medical career, Dr. Brewer attended and testified at legislative hearings in Austin, organized and participated in workshops for professional care givers and parents of chronically ill children, worked with the Texas Department of Health (TDH), and generally supported case management initiatives. He was instrumental in the development of the State's first health management organization at Kelsey-Seybold's Special Care Center. Dr. Brewer advocated a team approach to providing the treatment and care of chronically ill children and the special needs of their families. He coordinated local family outreach efforts beginning in 1982, and his Pediatric Rheumatology Tertiary Center team at TCH pioneered the initial outreach teams that visited clinics throughout Texas. Dr. Brewer directed the Texas Crippled Children's Service Regional Pediatric Rheumatology Center 1982-1988.

MCH sponsored the productive 1984 "New Horizons in Pediatric Rheumatology" meeting in Houston. In the meeting's aftermath there was a rapid expansion of services for chronically ill children and their families. Dr. Brewer worked full time with MCH after he retired from practice in October 1986, and closed his medical office in April 1987. He co-chaired Houston's June 1987 U. S. Surgeon General's Conference that focused on the family-centered, community-based coordinated care that Dr. Brewer encouraged. In a December 1987 memo, Dr. Brewer initiated Houston's Family-to-Family Network to bring parents into the decision-making process involving their chronically ill children and to link those parents with representatives from the appropriate health care agencies. In May 1988 he traveled to Europe with the U. S. Surgeon General and MCH personnel to study case management and coordinated care in various countries. His plans for the comprehensive care he promoted were nurtured and supported by MCH Special Projects of Regional & National Significance (SPRANS) grants.

Dr. Brewer was awarded the 1988 U. S. Surgeon General's Exemplary Service Award in recognition of his untiring work, and he was considered for the position of U. S. Surgeon General in 1989. Other notable awards and honors include, but are not limited to, American College of Rheumatology Master of Rheumatology Award, 1996; Honorary Member of the USSR's AllUnion Scientific Society of Rheumatologists, 1991; Distinguished Lecturer at the 25th Anniversary meeting of Arthritis Health Professions Association (AHPA)/AF in 1990; Invited Lecturer at the 60th Anniversary meeting of All Union Congress of Rheumatology, USSR, December 1988; AF Award of Appreciation, 1986; and March of Dimes Service Award, 1965.

During his professional career Dr. Brewer authored over 190 published articles, booklets, and several films, and was a local, regional, state, national, and international lecturer. He also wrote three books on arthritis. His definitive book on juvenile rheumatoid arthritis was published in 1970 with a second edition in 1982 and translation into several languages.

By the end of 1990 Dr. Brewer completed his work with Kelsey-Seybold Foundation and MCH and was ready to begin another career as a writer. His exemplary medical career and outstanding contributions to pediatric rheumatology, case management and coordinated health care, and to improving the lives of chronically ill children and their families are probably greatly attributable to a philosophy he expressed in his speech "The Last Thirty and the Next Ten Years" at the March 1991 Park City III meeting:

"While it is true that nice things sometimes happen to nice people by chance,
people who plan ahead have a much better chance of success."