Professor Dr. Leon Eisenberg
Dr. Leon Eisenberg
RIP 9/15/09
"The university is the last remaining platform for national dissent." ~ Dr. Leon Eisenberg
Physician - 2003 Lifetime Achievement Award for Psychiatric Research
Maude and Lillian Presley Professor Department of Social Medicine and Professor of Psychiatry, Emeritus Harvard Medical School Dept. of Social Medicine, Ruane Prize for Child and Adolescent Psychiatry Research
A leader for over 40 years, spanning pharmacological trials, neurological and psychological theories of autism and social medicine - from research to teaching and social policy. BOOKS
NYT obit Dr. Leon Eisenberg, Pioneer in Autism Studies, Dies at 87 "24 Sep 2009 ... Dr. Eisenberg conducted some of the first rigorous studies of autism, attention deficit disorder and learning delays."
Official HMS (Harvard Medical School)
obituary for Dr. Eisenberg 9/25/09
The flag will be lowered to half-staff today and tomorrow in honor of Leon Eisenberg, the Maude and Lillian Presley professor emeritus of social medicine at HMS, who died on Sept. 15. He was 87 years old. A child psychiatrist, Eisenberg is known around the world for innovative research in autism, groundbreaking advances in pediatric clinical trials and psychopharmacology, and integration of social experience into the study of disease. He also was a leader of the Medical School's affirmative action program, established in the wake of Martin Luther King Jr.'s assassination in 1968. Recently, Eisenberg had advocated for a rigorous code of ethics to avoid conflicts of interest in medicine and for depression screening in the primary care setting. In June, he was recognized by Children's Hospital Boston with an endowment in his name.**
Born in Philadelphia in 1922, the son of Russian Jewish immigrants, Eisenberg grew up to be bookish and inquiring. He recalled in a recent interview the experience of listening to English translations of Hitler's speeches on the radio. "Because of that extreme threat," he said, "I remember talking to my father and both of us agreeing that the only thing they couldn't take away from you was what you knew inside your head." His father dreamed that his son would go to medical school, and Eisenberg could not remember wanting anything else.
In 1942, when his turn came to apply, medical schools had stingy quotas for Jews, he said. Eisenberg was turned down by all the schools he had chosen, despite his nearly straight A's in college. In despair, his father intervened with a Pennsylvania state legislator. Days later, a letter came saying that Eisenberg had been accepted to one of those institutions, the University of Pennsylvania School of Medicine.
Eisenberg graduated as valedictorian of his medical school class. Yet he was denied, along with the seven other Jews who applied, an internship at the University of Pennsylvania hospital. He went to Mt. Sinai Hospital in New York, where he discovered psychiatry. He was drawn to the field's promise to "get in and understand things-myself and other people."
He was also intrigued by his first reading of Freud's The Interpretation of Dreams-"It seemed such exciting and out-of-the-way stuff." But he soon found psychoanalysis "politically unacceptable. How could you use a treatment that would take so long per person when the burden of mental illness was so high?"
In 1952, after a two-year stint in the Army teaching physiology to military doctors, he began a residency in child psychiatry at Johns Hopkins University, where his doubts about psychoanalysis were encouraged by the great psychiatrist, Leo Kanner.
Just 10 years earlier, Kanner had identified 11 boys with an unusual constellation of traits-extreme social isolation, an inability to look people in the eye, a preoccupation with objects and ritual, and hand-flicking and other repetitive movements. Eisenberg would join him in his exploration of the newly identified psychiatric disorder, autism, paying special attention to the social and family setting of the children in which it appeared.
"What is original and powerful about Leon's conceptualization is the understanding that the biological and social are part of one thing," said Felton Earls, professor of social medicine at HMS and professor of human behavior and development at the Harvard School of Public Health. "Biology is not compartmentalized from social reality. Very few people think like that."
Though Eisenberg suspected a genetic basis to the then rarely diagnosed disease, it would be years before the tools existed to look at it. In subsequent years, he turned his attention to more common childhood problems, such as school phobia, looking once again at the social setting in which they occurred.
In 1962, Eisenberg launched the first randomized placebo-controlled clinical trial of psychiatric medicine with children. "As simple as it seems, as straightforward, child psychiatry had gone on for 40 years before somebody did a randomized clinical trial," said Earls.
Only months after arriving to head the Psychiatry Department at Massachusetts General Hospital in 1967, Eisenberg was asked to join a small committee, including HMS professors Jon Beckwith, Ed Kravitz, David Potter, and Ed Furshpan, that was working to raise the number of African-American students at the School. Because of his experience with anti-Semitism, Eisenberg maintained a deep awareness of what it feels like to be excluded. His identification with those who face prejudice was at the heart of what he later considered his greatest achievement, the administrative restructuring that opened doors at the Medical School to a fuller, more diverse range of students. This push for affirmative action was galvanized by the 1968 assassination of Martin Luther King.
Eisenberg was asked to chair the HMS commission on black community relations and to chair the HMS admissions committee for seven years of the early affirmative action program. "It was a wonderful place to see to it that the plan was implemented," he said.
Alvin Poussaint, now faculty associate dean for student affairs at HMS and an HMS professor of psychiatry at Judge Baker Children's Center, joined the School in 1969, just in time to welcome the first class to include black students recruited through the affirmative action efforts. Eisenberg had helped lead the search for Poussaint, a medical doctor who could serve as liaison between the new minority students and the faculty and administration, and who could help continue attracting top minority students from around the country.
What Eisenberg made happen in 1968, said Poussaint, "had an impact on diversity efforts all around the country. ...Leon cared." At Harvard, he said, Eisenberg was regarded by many administrators, faculty and staff as a "moral compass."
Kravitz, the George Packer Berry professor of neurobiology at HMS, emphasized that Eisenberg had a deep commitment to increasing and supporting diversity at the School throughout his career. "He was always the first person to be involved," Kravitz said, "and he spoke with authority and with knowledge."
"There are too few tzaddiks [righteous people] in the world," Kravitz added, "and I am greatly saddened that one of them is now gone."
The rise of affirmative action at HMS occurred around the same time that the MGH Psychiatry Department became transformed from a relatively small conclave of mostly psychoanalysts to one of the most intellectually diverse departments in the country.
"Leon created an incredible academic environment-probably there has never been an environment quite like that as measured by the number of trainees who went into full-time academic careers," said Arthur Kleinman, the Esther and Sidney Rabb professor of anthropology at Harvard and professor of medical anthropology at HMS, who entered the Psychiatry Department soon after Eisenberg arrived.
Howard Hiatt, HMS professor of social medicine and of medicine at Brigham and Women's Hospital and former dean of the Harvard School of Public Health, said, "Leon Eisenberg set standards for his colleagues and his students-standards of which we could be proud."
In 1980, Eisenberg was invited by then HMS dean Daniel Tosteson to build the Department of Social Medicine (recently renamed the Department of Global Health and Social Medicine). Under the stewardship of Eisenberg and then Kleinman, it helped to ignite the careers of students such as Paul Farmer and Anne Becker, the current chair and vice chair of the department, and Jim Yong Kim, the previous chair, who now is president of Dartmouth College. According to Kleinman, the entire lineage has been shaped by its exposure to Eisenberg.
"Leon, together with Arthur, created the environment that allowed all of us to study social sciences relevant to medicine," said Farmer, who in 1990 received joint degrees in medicine and anthropology. Subsequently, Farmer trained at Brigham and Women's Hospital and, along with Kim, was a founder of Partners In Health, which Eisenberg had supported since its founding. "Without the MD-PhD program Leon crafted in the mid-80s, without his example and teaching and mentorship, it would have been impossible for us to pursue academic careers in social medicine. The fact that he also supported the development of a new paradigm in social medicine permitted his students to develop service projects that eventually led to new training possibilities for the next generation of physicians."
"I would say Leon follows in the great footsteps of the physician-psychologist-philosopher William James," said Kleinman, "because James argued powerfully for the broad range of normal experience, for our tolerance of multiple ways of being human."
"Leon Eisenberg is one of the seminal figures in American medicine and in psychiatry of the past half century," Kleinman said. "He is surely one of Harvard's greats."
Eisenberg leaves his wife, Carola, an HMS lecturer on social medicine and former dean of students at the School; children Kathy and Mark Eisenberg and stepchildren Alan and Larry Guttmacher; grandchildren Nadja and Jerzy Eisenberg-Guyot, Joshua and Rachel Guttmacher, and John and Kathleen Thornton; daughters-in-law Kristin Guyot, Blake Adams, Terry Caffery, and Brigid Guttmacher; and sisters Essie Ellis and Libby Wikler. A public service will be announced in the future.
In lieu of flowers, donations may be made to:
Physicians for Human Rights, 2 Arrow Street, Suite 301, Cambridge, MA 02138 (www.PHRUSA.org); or
Partners In Health, P.O. Box 845578, Boston, MA 02284 (www.PIH.org<http://www.pih.org/>).
** In June 2009, the (endowed) Leon Eisenberg Chair in Child Psychiatry was established at Children's Hospital Boston.
Leon Eisenberg NYT
EISENBERG--Leon. It is with deep sorrow that the American Academy of Arts and Sciences mourns the passing of Leon Eisenberg, distinguished physician and researcher, inspired teacher and mentor, advocate of social medicine, and dedicated Fellow of the Academy for over forty years. To the medical community, he contributed pathbreaking work in child psychiatry and an abiding concern with the relation between the practice of medicine and the lives of patients. As the Communications Secretary of the Academy for seven years, he informed our work with his gentle humor and his wide-ranging knowledge and interests. He helped to ensure that merit and diversity were the hallmarks of our membership and that the communication of information and ideas across fields and professions was our responsibility to society. We extend our deepest sympathy to his wife, Carola; to his family; and to all those touched by his wisdom and generous spirit. Emilio Bizzi, President Louis W. Cabot, Chair of the Academy Trust and Vice President Leslie Berlowitz, Chief Executive Officer
About the Academy
For over 225 years, the American Academy of Arts and Sciences has been honoring excellence and providing service to the nation and the world. Through independent, nonpartisan study, its ranks of distinguished "scholar-patriots" have brought the arts and sciences into constructive interplay with the leaders of both the public and private sectors.
The Academy was founded during the American Revolution by John Adams, James Bowdoin, John Hancock, and other leaders who contributed prominently to the establishment of the new nation, its government, and its Constitution. Its purpose was to provide a forum for a select group of scholars, members of the learned professions, and government and business leaders to work together on behalf of the democratic interests of the republic.
In the words of the Academy's charter, enacted in 1780, the "end and design of the institution is...to cultivate every art and science which may tend to advance the interest, honour, dignity, and happiness of a free, independent, and virtuous people."
The British Journal of Psychiatry (2000) 176: 1-5 Editorial
Is psychiatry more mindful or brainier than it was a decade ago?
~
LEON EISENBERG, MD
Dr. Leon Eisenberg [wikipedia] characterizes as "brainless" that style of psychiatry which emphasizes only culture and social setting (trivializing genes, neurochemistry and neural hardware), and as "mindless" that style of psychiatry which does the opposite, emphasizing only genes, neurotransmitters, etc.(while trivializing culture, social context, and so on).
Here's his conclusion, with which I hope we can all whole-heartedly agree:
Biomedical knowledge is essential for providing sound medical care but it is not sufficient;
The doctor's transactions with the patient must also be informed by psychosocial understanding. Neither mindlessness nor brainlessness can be tolerated in medicine. The unique role of psychiatry will be its contribution to a new paradigm: brain/mindfulness, integrating neurobiology with behaviour in its social context. That is the intellectual challenge ahead.
Gene vs Culture Coevolution
Genes give rise to culture, societies with this culture then affect the fitness of its members, and hence culture guides genetic evolution. The product is us.
Culture guides genetic evolution, and in a more immediate way chemical environment (nutrition, toxins), especially of the young and yet unborn, guides the expression of genes.
The evidence for gene-culture coevolution is extremely clear, and the two ideological positions, one that trivializes genes and the other that trivializes culture are obviously wrong and ideological.
Is psychiatry more mindful or brainier than it was a decade ago?
The Social Brain: A Unifying Foundation for Psychiatry
Academic Psychiatry 26:219, September 2002
2002 Academic Psychiatry Letter
Key Words: Psychiatry, Scientific Foundation Brain and Social Interaction
TO THE EDITOR: The Research Committee of the Group for the Advancement of Psychiatry (GAP), a specialty think tank, has addressed psychiatry's need for a unifying scientific foundation. Such a foundation would consider the disorders commonly treated by psychiatrists in terms of the physiological baseline from which they depart, much as heart disease is understood as deviation from normal cardiac function. The relevant physiological focus for
psychiatry is the social brain.
The social brain is defined by its function--namely, the brain is a body organ that mediates social interactions while also serving as the repository of those interactions. The concept focuses on the interface between brain physiology and the individual's environment. The brain is the organ most influenced on the cellular level by social factors across development; in turn, the expression of brain function determines and structures an individual's personal and social experience. The social brain framework may have greater direct impact on the understanding of some psychiatric disorders than others. However, it helps organize and explain all psychopathology. A single gene-based disorder like Huntington's disease is expressed to a large extent as social dysfunction. Conversely, traumatic stress has structural impact on the brain, as does the socially interactive process of psychotherapy.
Brains, including human brains, derive from ancient adaptations to diverse environments and are themselves repositories of phylogenetic adaptations. In addition, individual experiences shape the brain through epigenesis; that is, the expression of genes is shaped by environmental influences. Thus, the social brain is also a repository of individual development. On an ongoing basis, the brain is further refined through social interactions; plastic changes continue through life with both physiological and anatomical modifications.
In contrast to the conventional biopsychosocial model, the social brain formulation emphasizes that all psychological and social factors are biological. Nonbiological and nonsocial psychiatry cannot exist. Molecular and cellular sciences offer fresh and exciting contributions to such a framework but provide limited explanations for the social facets of individual function.
The social brain formulation is consistent with current research and clinical data. Moreover, it ultimately must:
-
Unify the biological, psychological, and social factors in psychiatric illness.
-
Dissect components of illness into meaningful functional subsets that deviate in definable ways from normal physiology.
-
Improve diagnostic validity by generating testable clinical formulations from brain-based social processes.
-
Guide psychiatric research and treatment.
-
Provide an improved language for treating patients as well as educating trainees, patients, their families, and the public.
-
Account for the role of interpersonal relationships in brain function and health.
The concept of the brain as an organ that manages social life provides significant power for psychiatry's basic science. Burgeoning developments in neural and genetic areas put added demands on the conceptual structures of psychiatry. Findings from such incoming work must be juxtaposed and correlated with the behavioral and experiential facets of psychiatry to give it a complete and rational basis. Psychiatry's full and unified entry into the realm of theory-driven and data-based medical science has been overdue. The social brain concept allows psychiatry to utilize pathogenesis in a manner parallel to practice in other specialties.
Thinkers Expain Why Things Are The Way They Are In The World -- WHAT ARE MEMES? Memes
Richard Dawkins invented the term "meme'' in 1976
meme: (pron. 'meem') A contagious idea that replicates like a virus, passed on from mind to mind. Memes function the same way genes and viruses do, propagating through communication networks and face-to-face contact between people. Root of the word "memetics," a field of study which postulates that the meme is the basic unit of cultural evolution. Examples of memes include melodies, icons, fashion statements and phrases.
- (1) construct an eight-layered paleopsychological stratum for displaying levels of consciousness and complexity; and
- (2) use this multilayered scaffolding for defining and dealing with racial, ethnic, economic, religious, political, and nationalistic tension-zones, hot-spots, and potentially dangerous conflicts.
- ALSO READ An Explanation of Spiral Dynamics
Memes and Vmemes What are they? Read about
Spirals Of Ccomplexity: Cultures And Civilization In The 21st Century