A Tribute to Al Mann

by Kelly Close

My reflections on a visionary, scientist, role model, and friend.

I was lucky to meet Al Mann in 1998. My boss at the time, Vivian Wohl, and I got to recommend stocks to 22,000 brokers, and MiniMed was still a very “cheap” stock – it later “split” in 1999 as well as in 2000, testament to tremendous value built by Al Mann and his amazing team as well as to wonderful things happening like Dr. Nicole Johnson, then 22, being named Miss America and strutting all over a stage and runway making diabetes look oh-so-good.

Vivian, one of the best investors ever, had the idea that we should go visit MiniMed and that I should go on the insulin pump. And, this wasn’t really an idea. It was an assignment that I would take on.

I had (like so many others) not really understood the benefits of physiologic therapy. That’s a polite way of saying I did not at the time want an insulin pump – but I did want to do an amazing job with my work. This was the very beginning of me getting interested in diabetes for my work. Back in those days, I’d been on NPH and regular insulin for the most part. I didn’t like having diabetes and was not interested in thinking about it more than I already did. The pump had been offered to me several years before, when I was in my mid-20s, but it had never once appealed to me. I thought I knew what it was – and I’d had no idea.

So we flew into Burbank, made a beeline to Minimed in Sylmar, California, and there I met Al Mann, who told Vivian and me the amazing history of Minimed and answered all my questions. And, transfixed me. I remember seeing the annual reports and absolutely loving speaking with Al and the other leaders of the company (who would later themselves become giants in the field, particularly Terry Gregg and Kevin Sayer) , and feeling embarrassed that I must have this whole pump thing wrong.

We had dinner with Al’s whole management team at his house – I remember well a player piano and a giant tank of beautiful fish, and Al answering question after question and distilling so many answers so that a young me could understand what building this company had been like.

I was begging for a pump after I heard what it had done for patients (this was way before social media) and the legendary head of Professional Development at MiniMed, Freddie Frederickson, worked with UCSF to get me my first pump. Twelve hours after I had put my pump on, I woke up and felt like a completely different person. Completely). NPH was very unstable – while I didn’t know that at the time, my whole body felt different and so much better. It is one of the most vivid memories of my young adult life – I felt so alive the day after I tried the pump, like insulin was coursing through my veins. Mr. Mann had changed my world.

Up until then, I had been in the emergency room 24 times over 12 years – over the next two decades, I would not be back once for related to diabetes.

I couldn’t believe that this man had created this technology and changed my life – I got used to thinking that with this device, I may not be so scared about waking up in the ambulance, waking up in the ER, waking up to the sounds of “oh, she has diabetes.” Sounds that made me feel so small and guilty for not being better at making my diabetes work.

There are hundreds of thousands of stories just like this, how a man changed the lives of so many – with various medical devices. Some of these stories are about diabetes, some of them are about blindness, some are about deafness. Al worked as hard and as productively as any CEO I’ve ever seen. My work back in the 1990s was equity research, and we studied leaders along with revenue growth and research and development and net margins. Al Mann epitomized leadership, and he was known for developing leaders, like Terry Gregg and Kevin Sayer who were on his management team, Claudia Graham, Kelly Joy and Freddie Frederickson who worked on physician and patient education.

And – the stock. We didn’t pick it up officially before it was bought by Medtronic in 2000, but over the years, so many many investors have said to Vivian and me, thank you, for recommending MiniMed. For me, Al actually helped me realize that I should leave Wall Street and work on diabetes full time – he told me that I cared about it too much to only do it part-time (along with many other stocks). And I have to thank him for that as well. 

I was lucky to know Al and got to see him nearly every year after meeting him and more often than that of late as our family is in Las Vegas often. After I left Wall Street, he gave me such valuable advice on how to run our small company, Close Concerns, and I absolutely loved talking to him about science and about diabetes.

He also refused to slow down and though I haven’t seen him since the fall, I understand that he was working on diabetes ‘til his final moments. Last year, one of the letters he wrote me included these words: “We must somehow address the diabetes crisis.  What I am trying to do is to offer a means of addressing this conflagration while I am still functioning.  In a few months I will be 90 years old.  I certainly do not need more business challenges nor any personal gains.  But unless we find reasonable solutions human health will continue to deteriorate and the global economy will be bankrupted.  I would be proud to help solve this crisis.”

Al was ahead of his time on so much, and we believe the same is true for his landmark inhaled insulin – we hope for the day many more patients will have access since it’s clear from all the anecdotal pieces we hear that it works – and gosh are there so many people who aren’t succeeding as well as they could with the current tools.

Here were some words I shared about Al last summer on the occasion of one of one of his many honors … many leaders spoke at that lunch in honor of him (Dr. Steve Edelman, Terry Gregg, Dr. Fran Kaufman, Dr. Jay Skyler), and afterwards, my associate teams at Close Concerns and the diaTribe Foundation and the analysts at dQ&A got to meet Al. It’s one of my favorites memories, where nearly every single young leader got to go through a line and shake Al’s hand. It is an image that will be forever marked in my mind.

“As an entrepreneur, an innovator, and a visionary, Al has transformed healthcare around the world. His was a faith in modern technology – but more than that, a faith in the actual people for whom that technology was meant: when given the right tools, patients will do all they can to live longer, healthier lives – and they have.

Al’s life work, in biotechnology, healthcare innovation, and diabetes, is to be celebrated and admired. His persistence, his creativity, and his compassion – not to mention a brazen defiance of conventional thinking in business and science – have made his medical advances possible. They include the pacemaker, the insulin pump, and most recently, more advanced and faster insulin than the planet has ever seen.

We are moved by how many people have been touched by the work of Al, both personally and professionally. They describe an impact on the lives of people with diabetes and beyond – a man who has delivered not just units of insulin but gallons of hope.”

sincerely, kelly

Postscript: In lieu of flowers, Al’s family has asked that donations be made to the Alfred Mann Foundation in Al’s honor.

Memories from Friends, February 26, 2016

“Thanks, Al.  Where would we be without you?

I think I'll eat a PBJ sandwich. Just because I want to.  My type 1 won't get in my way.  Thanks, Al.

If my time allows today, I may go for a long hike. I won't have to prepare all day for it. Thanks, Al.

Today, I am working on a reimbursement strategy for artificial pancreas and diabetes technologies. Thanks for bringing these to us.  

Al, you have been a liberator, a friend and a mentor.

Your inventions have freed so many of us to live more active and productive lives.

As your friend, I'll always treasure the bear hugs and belly laughs.

As a mentor, you taught me the rewards of hard work infused with purpose.

I know I speak for many, many people when I say ‘Thanks, Al.’ I wish I could give YOU the big hug right now.”

– Dr. Claudia Graham, VP, Marketing, Dexcom

“Al Mann was a true Renaissance man. He committed his life to creative ways to improve the lives of human beings. He made insulin delivery more effective for people with diabetes.  He helped the deaf to hear, the blind to see, the lame to walk. He never saw a problem that he didn't think that he could solve.  We shall miss him.” 

– Dr. Jay Skyler, University of Miami Medical School

“Many tributes will come forth regarding Al’s accomplishments over his lifetime.  I considered Al a colleague, a mentor and most importantly, a friend.  Al taught me many lessons during our time together, but the one that became my personal guiding compass is “take care of the patients and everything else will take care of itself”.  At MiniMed and Dexcom, that overriding goal has led us to great success, no matter how one measures success.  I am very sad today, but Al’s legacy lives on in the millions of patients he has enabled to lead more normal lives as a result of his genius and dogged determination.”

– Terry Gregg, Executive Chairman, Dexcom, Inc.

"We mourn the loss of a visionary, passionate pioneer who used his creative genius and business acumen to harness the best from technology to improve the lives of persons with diabetes another chronic diseases. While we mourn his death, we joyously celebrate his wonderful life."

– Dr. James Gavin, CEO and Chief Medical Officer of Healing Our Village, Inc., Clinical Professor of Medicine at Emory University School of Medicine, and Clinical Professor of Medicine at Indiana University School of Medicine

“I worked very closely with Al for a very long time.  He took a chance on me when I was very young and inexperienced and that opportunity has forever changed my life.  Al’s determination and commitment to what he did was like no one I have ever met.  Today we celebrate and remember the life of a great friend, leader and mentor.”

– Kevin Sayer, CEO, Dexcom

“The world has lost a visionary who put those with diabetes front and center at all times.  The world is less without him. Those of us who continue his work will remember his strength and determination and his dream of the artificial pancreas.”

– Dr. Francine Kaufman, Chief Medical Officer, Medtronic, Distinguished Professor Emerita of Pediatrics at USC

“Type 1 diabetes therapy as we know it, especially in the US, would not be the same without Al Mann. Do I believe that over 30% of type 1s in the US and 60% in the T1D Exchange would be on pump therapy if not for Al Mann? No way. His vision for insulin pump therapy as the best way for insulin delivery was ahead of everyone's time. He was also the first that I recall to appreciate the potential of continuous glucose monitoring. I have so many memories, but the one I will remember the most was many years after he sold MiniMed to Medtronic, he was honored at one of the "Friends for Life" conferences for CWD by Jeff Hitchcock in Orlando. It was a dinner, and Jeff asked for all kids wearing pumps to come up to greet Al and give him thanks. A swarm of kids, hundreds of them(!), went up to the stage to greet and hug Al in thanks. It was one of the most emotional moments I can recall.”

– Dr. Irl Hirsch, University of Washington

“Today is an incredibly sad day in the diabetes community.  Al Mann was a visionary, a true pioneer.  With his passing, we have lost an industry icon, mentor and friend.  Rarely does one individual make such an enormous personal contribution to an entire industry, yet, in our field, every company today can be linked in some way back to Al. Certainly, none of us at Medtronic MiniMed would be here without him, and we owe a debt of gratitude to him for his passion and tireless work in improving the lives of millions of patients with diabetes.  We will miss you, Al, but you will always inspire us. We are committed to working every day to fulfill your vision, and honor your legacy.  On behalf of the entire global MiniMed team, I would like to extend our deepest sympathies and support to the Mann family.”

– Hooman Hakami, CEO, Medtronic Diabetes

“The diabetes community lost a legend and those of us who were lucky enough to work for Al Mann are remembering so fondly how relentlessly he pushed for progress! His vision, drive, enthusiasm and bellowing laughter inspired us all to work harder and reach farther on behalf of people with diabetes. He founded MiniMed with the dream of an artificial pancreas, and he will continue to inspire me every day as we march toward closing the loop.”

– Kelly Joy, Senior Director, Education & Professional Relations, Medtronic Diabetes

“Al Mann has inspired several generations of the diabetes community to keep pursuing their dreams to improve the lives of people diabetes – even if we are not rocket scientists!”

– Dr. Rich Bergenstal, Executive Director, International Diabetes Center

 “As we look around the type 1 community and see so many kids and adults wearing insulin pumps, it's worth remembering, even if just for a moment, that the insulin pumps we use today trace their heritage to the vision of Al Mann. His vision of improving the health of people living with type 1 diabetes led to improvements in usability and miniaturization of insulin pumps, making them a viable tool for everyone and laying the foundation for the remarkable artificial pancreas systems currently in clinical trials. It's often said that today's successes rest on the shoulders of giants. Al Mann truly was a giant.”

– Jeff Hitchcock, CEO, Children with Diabetes

“Al had an effervescence that was unmatched. A brilliance beyond compare. A drive that was enviable. His laugh was infectious and his personality a gift. Al is the one and only person who will ever have a piece of my Miss America crown.  On his 75th birthday I gave him the largest stone from the crown because of my deep appreciation for his life altering work. His work in bringing Minimed to life helped me gain the courage and confidence to stand on the Miss America stage with diabetes. For his Innovation and his imagination I will forever be grateful. I suppose the best way to describe him is life saver. A saver of lives physically, mentally and emotionally in so many ways. What a blessing to know and be influenced by this giant.”

– Nicole Johnson, Miss America 1999 (w/ Al Mann)

“Al Mann began a journey to lift the burden of diabetes through technology. He and his work have been a guiding light for many others in this industry around the world. We now carry forward on the journey to create an artificial pancreas that Al described, for the millions of people around the world that he knew could benefit. Al took risks on ideas, believed in people, and we will miss him.”

            – Dr. Rebecca Gottlieb, Senior Director of Advanced Research, Medtronic (w/ Al Mann)

“We at NIDDK will always be grateful to Al Mann for his support of the DCCT. Under his leadership, MiniMed donated pumps and supplies-- assistance which contributed importantly to the success of the trial. He was a wonderful partner in T1D research.”

– Dr. Judith Fradkin, NIH/NIDDK

"With the passing of Al Mann a legend, a leader and a visionary giant has left us. I was fortunate to benefit from Al's leadership and generosity over many years. He will be sorely missed."

– Hakan Edstrom, President, MannKind

“He was a genius and a visionary, and his work touched many areas in such a substantial fashion … in particular the development of novel technologies to improve the life of people with diabetes around the world. I had the privilege to meet him on several occasions and have conversations by phone with him. It was also a privilege for me to be present when he presented the Keynote at the 2014 Diabetes Technology Meeting. I will treasure that moment – his words will always inspire me.”

 – Dr. Guillermo Arreaza, Director, Diabetes Technology Program, DDEM/NIDDK/NIH

“Al does not have diabetes and Al is not deaf. He selflessly uses that rugged determinism to take an innovative idea that will help people live a better life to the finish line …and NOTHING gets in his way! People who do not know Al might be surprised to find out that he is a sweet and generous man with a great sense of humor AND LASTLY ... There has never been more truth to this statement when it comes to Al Mann: BEHIND EVERY GREAT MAN IS A GREAT WOMAN … Thank you Claude for all that you have done to support Al all of these years

Al ... You will be missed but your legacy remains forever.”

            – Dr. Steven Edelman, University of San Diego, CA

“Al had such a compassion and drive to fix medical problems that were devastating lives through technology made is his own lab under his own watchful eye. It was a pleasure to work with him and witness the changes in people’s lives benefitting from these technologies. I was very fortunate early on to personally be one of those people who benefitted. Hugs for you Al! My prayers go out to Claude and all of Al’s family who will dearly miss him.”

            – Freddi Fredrickson, former Vice President of Professional Relations, MiniMed

“I worked within Al Mann companies for two decades, and my tenure at MiniMed altered the course of my life. When Al recruited me from St. Jude Medical, formerly his Pacesetter Systems Inc., Al began the lunch with his vision for the development of tools for patients to manage diabetes. Al articulated the management of diabetes from the patients’ perspectives and through the optics of parents of children with T1 Diabetes. I was already confident in Al’s ability to laser-focus on a therapy and to rally strong management teams. My background was then complex implantables utilizing technologies that could readily be applied to the world of small infusion pumps. Relating with Al was analogous to the characterizations of people relating with Steve Jobs. Al emphasized his visions with a deep voice that left no doubt regarding his passion. If the discussion was about size or performance of a medical device, Al demanded it be smaller and better performing than the known competition. Al sought technology superiority and did not fear such developments stressing the minds of the engineers and scientists. Years later I learned his pacemaker company, Pacesetter Systems Inc. had at least two interpretations: one as a device to drive the timing of the human heart and two, the “pacesetting” drive of Al, its visionary and spiritual drive.

The Paradigm 511 pump development was initiated circa 1999 on an office table covered with a white tablecloth and a bucket of Kentucky Fried Chicken. Over the course of an hour Al refined what was being proposed to him and raised the bar to the point of being nearly unachievable. Al insisted the Paradigm should implement a “bolus calculator” feature that was then circulating among the MiniMed staffers. Al demanded the pump be small to be comfortable for children and women, be easy to program and operate and it had to be reliable. MiniMed’s president, Terry, assured unlimited support for the new development and he kept his commitment. Al’s customer-centric attitude was pervasive among the MiniMed staff and Al took every opportunity to immerse himself in the evolving technology. At each breakthrough, Al’s praise fueled the next advance. When we shared a particularly attractive advancement, Al’s smiles and his sincere laughter were and remain unforgettable.”

– James Causey, former VP R&D at MiniMed; 91 issued patents, most assigned to MiniMed

“Al was an incredible human being who has helped over a million people thru the development of his programmable pacemaker, the insulin pump, the glucose sensor, the cochlear implant, the artificial eye, Technosphere insulin and many other technologies. His whole life was about helping people thru new technology. He never took a day off and right up to his death, he was still working on new devices to improve peoples lives. I had the privilege to visit him this past month in Las Vegas and he did not complain once about his failing health; instead, he wanted to demonstrate his new miniature programmable disposable patch pump that he had developed and how this would change the world of diabetes. Claude was at his bedside with me and stated he is happiest when he is working on new devices and technology to help patients. We will miss him greatly but fortunately he has helped millions of people and will be known as one of the greatest inventors and entrepreneurs in medicine.”

            – Dr. Bruce Bode, Atlanta Diabetes Associates, GA