Richard Locksley, UCSF

When Dr. Root recruited Richard Locksley to UCSF in 1986, he was not filling a vacancy; he was asserting control over the intellectual direction of the department at a moment of crisis. San Francisco had become the epicenter of the AIDS epidemic, and its hospitals were treating the largest concentration of patients with profound immune collapse in the nation. UCSF, long distinguished for its strength in molecular and metabolic science under Lloyd “Holly” Smith Jr., now faced a different challenge: the city’s defining medical emergency was infectious and immunologic. As the new Chair of Medicine, Dr. Root understood that the department’s future would be determined not by incremental adjustments but by a decisive pivot. Hiring Locksley was the instrument of that pivot.

Dr. Root’s confidence in Locksley was grounded in shared formation. Most likely, it was an inherent understanding between outgoing chair Holly Smith and incoming Richard Root that Holly's former Chief Resident would be just the right man to act as Root's bridge between bench and bedside. Between 1980 and 1983, at the University of Washington, Locksley trained within a tightly bound infectious disease cohort that included Paul Beeson, Robert Petersdorf, Seymour Klebanoff, King Holmes, and Dr. Root himself. This was not a loose association but a disciplined network in which bedside diagnosis, laboratory investigation, and public health were treated as inseparable parts of a single craft. Dr. Root, collaborating with Klebanoff on the biology of how white blood cells kill bacteria, modeled the movement from mechanism to medicine; Holmes extended that rigor into clinical epidemiology. Locksley, the newest of the group, absorbed what might be called the Seattle grammar: that serious infectious disease work demands constant passage from the patient’s bedside to the laboratory bench and back again. Dr. Root knew precisely what that training produced because he had helped produce it. He had helped produce a doctor who knew, from the biology of how white blood cells kill bacteria, that the story of infection begins with the body itself.

By 1986, that training aligned perfectly with institutional necessity. The early AIDS epidemic exposed the limits of a purely antibiotic mindset, because the central mystery was not simply which pathogen was present but why the immune system had failed. Locksley’s work on immune signaling and cellular communication addressed that deeper question. Dr. Root recognized that appointing a conventional senior clinician would stabilize the division but not reorient it. By recruiting Locksley as Chief of Infectious Diseases and securing the research space necessary for his program, Dr. Root used the authority of the chair to consolidate leadership, laboratory infrastructure, and recruitment pipelines around a new premise: that UCSF would lead in understanding the immune response itself.

The decision inevitably shifted power. Locksley was young, and his rise signaled that infectious disease would no longer function as a peripheral consulting service but as a central scientific enterprise. In academic medicine, authority resides in who is hired, who is given space, and which questions are elevated to institutional priority. Dr. Root exercised all three levers deliberately. Over the ensuing decades, as the science of immune signaling reshaped HIV research and modern immunology, the logic of the 1986 recruitment became unmistakable. Dr. Root’s hiring of Richard Locksley was not an act of sentiment or favoritism; it was a strategic act of leadership that aligned doctrine, talent, and historical necessity at a decisive moment in American medicine.