Dr. Felix Anthony Conte, the last of the famed troika, along with Melvin M. Grumbach and Selna L. Kaplan, who made UCSF the foremost Pediatric Endocrine group in North America, passed away on December 4, 2024, at age 89. Felix was born on June 18, 1935, in Pittsburgh PA, and was raised by his mother, in the Bronx, NY. He attended Stuyvesant High School in New York City and received his BA in 1957 from Columbia University, where he played (sparingly) as a backup center on the football team. After college, he attended New York University School of Medicine, received his MD in 1961, and then did his pediatric internship and residency at New York’s Bellevue Hospital (1961–64), where he met his lifelong love, Mary Cronemyer (1938–2017). According to Mary’s obituary, “Mary was a nurse at Bellevue in the early 1960s when Dr. Felix Conte worked up the courage after 3 years to ask her out. After their sixth date, Mary informed Felix that she had decided to become a nun. Felix proposed on the spot. Mary promptly went on a 3-month missionary trip to Mexico before responding. When she returned she accepted his proposal, much to the relief of her future children.” Mary and Felix married in 1963.
In 1964, Felix joined Mel Grumbach’s pediatric endocrinology fellowship program at Columbia’s College of Physicians & Surgeons, beginning their lifelong association (Fig. 1). Felix was “called up” to the US Army, serving in the Medical Corps at Ft. Meade, Maryland (1966–68), and then re-joined Mel, who had moved to UCSF as Chairman of Pediatrics, to complete his fellowship (1968–69). He returned to New York for 1 year as Assistant Professor of Pediatrics at Mount Sinai School of Medicine, but Mel, UCSF, and San Francisco were powerful magnets, drawing Felix back to UCSF in 1970, where Felix remained until he was “called up” by a Higher Power.
Felix (with the big smile) and Mel Grumbach at the Festschrift held for Mel and Selna Kaplan in conjunction with the VI Lawson Wilkins Pediatric Endocrine Society/European Society for Pediatric Endocrinology Combined Meeting in Montreal, 2001.
Felix (with the big smile) and Mel Grumbach at the Festschrift held for Mel and Selna Kaplan in conjunction with the VI Lawson Wilkins Pediatric Endocrine Society/European Society for Pediatric Endocrinology Combined Meeting in Montreal, 2001.
Felix was a brilliant clinician with encyclopedic knowledge and an astonishing ability to cite almost any article he had ever read. He rose through the academic ranks, reaching Professor in 1995. His contributions to the scientific literature were numerically modest; only 57 were original publications, but many were of high impact: 24 have received at least 100 citations on either the Web of Science or Google Scholar. He also co-authored 38 book chapters, most in major reference textbooks, including his magnum opus on “Disorders of sex differentiation” (with Mel Grumbach and Ieuan Hughes) in Williams Textbook of Endocrinology [1], which has been cited over 830 times (Google Scholar).
Felix’s principal interests were in human cytogenetics, sexual development, and puberty, fields to which he made several major scientific contributions. While still a fellow, he ran the UCSF cytogenetics laboratory where he co-authored the first report of feto-maternal lymphocyte transfer [2]. By karyotypic analysis of lymphocytes from 30 healthy pregnant women, he found that all who subsequently delivered a male child had some cells with small, acrocentric chromosomes indicating an XY karyotype. The article concluded, “the data suggest that the feto-maternal transfer of lymphocytes is common, happens at least as early as the 14th week of gestation, and may be a consequence of transplacental migration of circulating fetal lymphoid cells, as well as leakage of blood. The antenatal diagnosis of a male fetus can be made by karyotypic analysis of lymphocytes in maternal blood. Similarly, it should be possible to identify fetal chromosome abnormalities by this procedure.” This landmark observation underlies the now-routine diagnosis of fetal genetic disorders by examining cells (and now directly examining DNA) in the mother’s blood.
His interest in cytogenetics led to studies of disordered puberty in “the syndrome of gonadal dysgenesis” i.e., Turner Syndrome. Such patients produce little if any gonadal steroids, so that there is essentially no steroidal feedback on the hypothalamic-pituitary-gonadal axis. With Mel and Selna, he showed that, during human development from the newborn to the young adult, there was a pronounced biphasic pattern of plasma basal (unstimulated) FSH (and LH) concentrations [3]. This pattern was similar to, but exaggerated in comparison to that in eugonadal children, indicating that neither the timing of hypothalamic GnRH secretion nor pituitary responsiveness depended on gonadal steroid feedback. Thus, puberty was independent of the gonad – a truly unanticipated finding!
In the 1970s and 80s, before pediatric endocrinologists were available at many medical centers, UCSF’s large population of pediatric endocrine patients (undiluted by diabetes) permitted collection of fairly large series of rare diseases: the description of hypopituitarism caused by cranial irradiation [4]; 42 patients with craniopharyngioma [5]; transsphenoidal treatment of 15 children with Cushing syndrome [6]; long term follow-up in 42 such patients [7]; early diagnosis of germinoma by pituitary stalk thickening [8].
His clinical insight coupled with deep knowledge of human physiology permitted the diagnosis of a previously undescribed disease: aromatase deficiency [9, 10], and glucocorticoid-responsive hypotension in the extremely premature infant (a study done without Mel and Selna!) [11]. Felix was extraordinarily insightful about potential clinical implications of new basic research but would caution against glib extrapolations with his most famous saying: “Rats are not people, even though some people are rats.”
Felix loved to teach. He taught reproductive physiology and endocrinology to undergraduates at UC Berkeley and UC Santa Cruz, taught pre-clinical and clinical courses to UCSF medical students, supervised residents and directly supervised and taught 87 pediatric endocrine fellows (including the five authors of this obituary). Felix did not like to travel, but he attended meetings in Europe and North America and was a lifelong contributor to the Lawson Wilkins Pediatric Endocrine Society, serving on multiple committees from 1980 to 2000, including as a Director (1989–92).
But Felix’s true passion was for clinical pediatric endocrinology and his patients. Even Mel was dazzled by his clinical acumen, calling him “the endocrinologist’s endocrinologist.” In 2003, Felix was elected to UCSF’s Gold Headed Cane Society in recognition of his clinical expertise as a physician and long service as a teacher. Felix was known for his big laugh, boyish sense of humor, and corny jokes. His patients adored him and the fellows always went to him for an authoritative answer about anything; many of us continued to consult him even decades later. Felix was a devoted, deeply religious family man, who was immensely proud of his and Mary’s five children, and delighted in their lives and the lives of their eleven grandchildren. Felix Conte was both an iconoclast and an icon. He embodied intellect, compassion, kindness, and humility. He was beloved because he was always himself. He will be sorely missed.