Harvard Medical School remembers Leon Eisenberg
17 Sep 2009
Harvard Medical School 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 Wickler. 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; or Partners In Health, P.O. Box 845578, Boston, MA 02284.