Presidents Message

Dear Members,

I wish to thank you all for electing me as the President of the Society for the year 2017-18. I will discharge the duties to my best of ability and will contribute to the growth of the society.

The recently concluded NPSICON-2017, organized by the Department of Neuropathology; NIMHANS, Bangalore was truly outstanding.  Over 250 delegates registered for the conference. All the scientific sessions were well conducted and attended. The sessions on ‘dangal’ and ‘debate’ were unique and kept the delegates spell- bound and captured their imagination. On the behalf of the society, I wish to express our appreciation as well as congratulations to each and every member of the organizing committee in making this conference memorable.

I wish to communicate with you more frequently and at least once in a month. The best way to begin this process is by sending a series on ‘Legends in Neuropathology’. In the current age of digital pathology, historical events in neuropathology may not be relevant but it should be remembered. I also do believe this will add useful information and motivate younger generation of neuropathologists of our society.

With my best wishes and warm regards

Radhakrishnan.

DARAB K DASTUR (1924-2000)

October 6, 2017

My dear Friends,

It is a festival time in most parts of our country. The festival of lights (Deepawali) is around the corner. I send my best wishes to you and your family on this occasion and also pray to Almighty to bless you all with happiness and success in your career and life.

In continuation with the series on- Legends in Neuropathology, I have great pleasure in sending a write-up on Prof.Darab K Dastur.I would urge the younger members of the society to kindly spare some of your time and read  these ‘write-ups’. Any suggestions or criticisms are most welcome.

Dr. Darab K. Dastur, the celebrated Indian neuropathologist, and the most gentle of humans, left for heavenly abode on 16, February 2000.. At the time of demise, he was the Director of the Department of Neuropathology and Applied Biology of the Bombay Hospital. In the forty-five years of his career Dr. Dastur made significant investigations into at least three important disorders rampant in our country, namely leprosy, neurotuberculosis, and the neuropathology of pediatric malnutrition.

Dr. Dastur was born in Mumbai in the year 1924.He has his schooling at New Era public school which is located very close to Chowpatty beach.. After obtaining a B.Sc. in zoology and botany from the Wilson College, he received the medical education at the city’s famous Grant Medical College and Jamshetjee Jejeebhoy Hospital, graduating MBBS in 1949. He commenced his neuropathological work and research under his mentor, Dr. VR Khanolkar, at the Tata Memorial Hospital, Mumbai even while studying for his M.D. in medicine, which he obtained in 1952. It was Dr. Khanolkar who infused interest in leprosy, assigning to him the project “Cutaneous Nerves in Leprosy: Correlation of cutaneous sensibility with histopathological changes in nerves in Skin Biopsies”. The biopsies were obtained from patients at the Acworth Leprosy Hospital. This work, using the technique of intra-vital staining of dermal nerves recommended by Dr. AGM Weddell, earned Dr. Dastur a M. Sc. degree by research in 1953. The studies were also published in the prestigious journal Brain. At the Tata Memorial Hospital Laboratories, Dr. Dastur’s senior colleague was Dr. CGS Iyer another neuropathologist who devoted his life to the study of leprosy.

After a stint at the National Institute of Mental Health, Bethesda in the U.S. under a Rockefeller Fellowship studying brain circulation and metabolism, Dr. Dastur returned to Mumbai. In 1964 he founded and developed the Neuropathology Unit at the Grant Medical College and jamsetjee Jejeebhoy Hospital, holding the post of professor of Neuropathology till his retirement in 1981. His principal collaborator in leprosy research here, on a US Government funded project on “Nerve Lesions in Leprosy”, was Dr. NH Antia, the plastic surgeon. Experts from other disciplines in these and other institutes too sought his expertise and help. Drs. Noshir H Wadia, BS Singhal, EP Bharucha and Anil D Desai (Neurology); Drs. Gajendra Singh, RG Ginde, SN Bhagwati and Homi M Dastur (Neurosurgery); Drs. PM Udani and PE Bharucha (Paediatrics); Dr. Vasant Talwalkar (Paediatric surgery) have served as co-authors on several papers.

Prominent amongst his publications are the several papers in international and national journals and texts on neurological disorders on subjects as diverse as craniovertebral anomalies, spinal dysraphism, nutritional disorders, Wilson’s disease, tuberculosis, toxicology, degenerative disorders, slow virus infections and brain tumours, on which he has just written a book, which is in print. His publications resulting from such multi-disciplinary studies are frequently cited internationally.

The proforma which was to accompany any biopsy from a referring unit was famously detailed and many a neurology and neurosurgery resident learnt the hard but useful lesion that this pathologist was very PARTICULAR about full clinical documentation! One of the memorable characteristics of Dr. Dastur was his belief that it was the pathologist’s duty to examine the patient as well as the tissues. Every patient whose biopsy he was expected to report on, was, whenever possible, personality examined. It took some time for the clinicians to get used to the presence of this lanky figure in their wards, taking a detailed history, carrying out a meticulous examination of the patient and then comparing his own notes with those provided to him by the resident doctor. He was never too busy to teach but laid down exacting requirements. He communicated his enthusiasm and sense of wonder to generations of post-graduate students from the clinical disciplines and from the basic sciences as he demonstrated details on the gross specimen and through the microscope at length. The “brain-cutting sessions” conducted once weeks with some ceremony are fondly remembered by all those who were privileged to participate.

He received numerous awards for his professional accomplishments and the Rameshwardas Birla National Award for Outstanding Research (1991). He was VR Khanolkar Orator in 1989 and Dorothy Russell orator at Queen square, London. Professor HM Zimmermann named him one of the “39th Neuropathologists of the 20th Century”. It is truly outstanding feat and a matter of pride for all of us.

Dr. Dastur’s credo of life was summed up by in one word – “Work”. A liberal in his personal philosophy, Dr. Dastur, a Zorastrian by birth, gained much inspiration from the Bhagwad Gita, and according to his wishes was cremated with Hindu rituals. Grieving their loss are his devoted wife Hilla, their two children, two grandsons, not to speak of numerous students, staff and professional associates.

Harry M. Zimmerman MD (1901-1995)

August 30, 2017

Dear friends and colleagues

It is the festival time in God’s own country!!. The ‘Onam’ festival season has already begun here in great festive mood. This is the time when King Mahabali visits us and wishes to see his people in a happy frame of mind and spirits. It is a festival celebrated by all citizens of Kerala regardless of caste and religion. Those of you who wish to learn more about this may either visit here during Onam season next year or get more information by goggle.

I send herewith a write-up on Prof.Harry M Zimmermann. I am sure it will be a interesting material to read.

Best wishes

Radhakrishnan.

Dr. Harry M. Zimmerman, Professor Emeritus at Albert Einstein College of Medicine and Chairman Emeritus of the Department of Pathology at the Montefiore Medical Center, died at the age of93, on Friday 28 July 1995.

Dr. Zimmerman was truly great, not only as a scientist but also as a human being. He was a pioneer of neuropathology, and he devoted his life to its progress.

Dr. Zimmerman was born in Wilno Province, Russia (now Vilnius, Lithuania) on 28 September 1901. In 1909, his parents brought him to the United States of America and settled in New Haven, Connecticut. Dr. Zimmerman must have been an exemplary child and was schooled at the attached school of Yale University. He subsequently studied at Yale Medical School, graduating in 1927.

As a resident in the Department of Pathology at Yale, Dr.Zimmerman was offered a fellowship by Dr. Milton C. Winternitz, Chairman of the Department of Pathology and Dean of the Medical School. The fellowship permitted one year’s study abroad. Dr. Winternitz encouraged Dr. Zimmerman to gain neuropathological training because Dr. Wintemitz had an intention to establish a neuropathological section in the Department of Pathology at Yale.Dr. Zimmerman chose to work with Professor Walther Spielmeyer at the Deutsche Forschungsanstalt fur Psychiatrie in Munchen. Professor Spielmeyer was well known as a world authority in neuropathology. Among those whom Dr. Zimmerman met in Munchen were A. Opalsky, M. Bielschowsky, H. Spatz and  Hirasawa from Niigata. On the day of their arrival, Dr. Hirasawa and Dr.Zimmerman were encouraged by Professor Spielmeyer to go to the beer hall together. From that time on, they developed their lifelong friendship. They have their names on the name list of the institute. On his return to Yale early in 1930, Dr. Zimmerman began setting up the neuropathology section where he would remain as assistant and associate professor until 1944. During his early years at Yale he was mainly interested in nutritional diseases, particularly experimental works of peripheral neuropathy induced by Vitamin B-complex deficiencies.

In 1933, aged 32, Dr. Zimmerman met the pioneer neurosurgeon Dr. Harvey Cushing, famous for his distinguished career at Harvard, who came to Yale bringing with him several thousand brain tumor specimens. Dr. Cushing was interested in and encouraged Dr. Zimmerman’s research and he became a close professional friend. Dr. Zimmerman made histological examination of brain tumors of Dr. Cushing’s patients. Harry M.Zimmermann‘s financial stability which enabled him to develop his world renowned laboratory in neuropathology. Numerous future scholars of pathology, neuropathology, neurology, and neurosurgery not only in the USA but also from France, Greece, India, Israel, and other countries, including more than 100researchers from Japan,  sought Dr.

Zimmerman’s expertise and were trained by Dr. Zimmerman. The lifelong friendship between Dr. Zimmerman and Dr. Hirasawa was the reason many from Japan came to Montefiore. Among these was Dr. Asao Hirano, who later succeeded to the Harry M.Zimmerman Chair in Neuropathology. The neuropathology conference every Thursday morning and neuroradilogy conference every Friday morning became known around the world. One of the most telling episodes in Dr. Zimmerman’s life was the role he played in establishing the new medical school, now known as the Albert Einstein College of Medicine. It was Dr. Zimmerman who sought Einstein’s agreement to use his name for the unnamed medical school.

Dr. Zimmerman’s histological diagnoses of brain tumor established his reputation as a world famous neuropathologist. Through this association, Dr. Zimmerman met many outstanding scholars who came to study under Dr. Cushing. Among them was Dr. M. Nakata, from Niigata, the father of Japanese neurosurgery, who spent time in Dr. Cushing’s department in1936. From about this time on, Dr. Zimmerman started his historic research on experimental brain tumors with implantation of chemical carcinogens. The results were first reported in 1941and subsequently in 1943 and 1944. Dr. Thomas Rivers from the Rockefeller Hospital asked Dr. Zimmerman to join the Naval Medical Research Unit.Dr. Zimmerman visited Guam, where he noted an extraordinary incidence of amyotrophic lateral sclerosis in the Chamorro natives. Later, he went to Okinawa and studied Japanese B encephalitis. During the war, he became friendly with Admiral Chester Nimitz and also collaborated with Dr. Albert Sabin on the future discovery of the oral polio vaccine.Dr. Zimmerman returned to the USA in 1946 and had to decide what direction to proceed in. One telephone call decided his course. The call came from Henry L. Moses, President of the Board of Montefiore Hospital for Chronic Diseases l He offered Dr. Zimmerman the leadership of Montefiore’s Laboratory Division.

Dr. Zimmerman was honored repeatedly. Among many awards he received was the Order of the Sacred Treasure, given by the Japanese Emperor in 1973. Mr. Okuno, the Minister of Education, Science and Culture, presented the Order and thanked Dr. and Mrs. Zimmerman for doing so much for Japanese medical students and their families in the USA.Dr. Zimmerman was honored with the Gold-Headed Cane by the American Association of Pathologists in 1982. He was given Honorary Membership in the International Society of Neuropathology in 1982. He was also an Honorary Member of our Japanese Society of Neuropathology. He came to Japan every 6 years, the last time in September 1990, when he attended the XIth International Congress of Neuropathology in Kyoto to give the main lecture on 39 neuropathologists of the20th century.Dr. Zimmerman liked weekend visits to his country home in beautiful Harwinton, Connecticut, where he enjoyed driving and fixing his tractor. He loved tending his garden.Dr. Zimmerman once said to Mr. Okuno that whenever his father was asked his age he always replied that he was 104 years told. Dr. Zimmerman too lived a long life, dying at 93.

Dr. Zimmerman retained his lucidity until the last moment of his life. One day, he repeatedly asked, ‘It’s July 28th today, isn’t it?’ He had his fingernails cut and wished to shave, wash up, and brush his hair. It was the day of his death. As Dr. Toyokura said, he was like an old-time Japanese warrior taking to the field. He lived his life nobly and single-mindedly like a warrior. He will live forever in our hearts and minds.

Bernd W. Scheithauer, MD (1946–2011)–Mentor, Friend, and Prodigy

August 1, 2017.

My dear colleagues,

In continuation on the series- ‘Legends in Neuropathology’, I am sending herewith a ‘write-up’ on BW Scheithauer- Mentor, Friend and Prodigy.

So far I did not find comments to any one of my earlier ‘write-ups’. Hence I would urge all the members, the younger generation in particular to kindly spare some of your time and read them. I have little doubt in my mind that you will get positive motivation and enhance your thought process. This will certainly pave way for the success in your professional career.

With best wishes
Prof.VV. Radhakrishnan.

The medical community was greatly saddened by the untimely death of Bernd W. Scheithauer, MD. During his distinguished 35-year career, he was revered as one of the leading experts in surgical neuropathology, but also cherished as a friend, mentor, and colleague to so many around the world.

Bernd Walter Scheithauer was born in Gelenau, Germany on August 30, 1946, the son of Walter and Renate (Scholz) Scheithauer. This time in history was particularly difficult for the family and German citizens in general. Because of their refusal to join the Nazi party, his parents were taxed heavily. After the war, they found few opportunities in the now Soviet-occupied part of East Germany. Simple survival was a daily challenge and they escaped to West Germany while Bernd was still an infant. While there, Bernd proved to be an insightful and sensitive young boy. Renate shares a story about Bernd, at age 4, where the two of them walked by a candy store one day and stopped to admire the chocolate in the window. After a minute, Bernd turned to his mother and said: ‘ that’s OK; I know that one day we’ll have enough money to buy chocolate.’ Bernd’s formal education began in Germany, but at age 7, the family immigrated to the United States in search of a better life, despite the fact that none of them spoke a word of English. Opportunity eventually knocked in the Northern California coastal town of Eureka, where Mr. Scheithauer worked as a sheet metal craftsman and Mrs. Scheithauer found employment at Bank of America. Bernd’s father was meticulous in his work and refused to sacrifice quality by rushing a job. Like Bernd, every detail had to be just right. Similarly, Bernd adored his mother, enjoying a lifelong extraordinarily close relationship. From her, he inherited generosity and compassion.

Bernd loved growing up in Eureka and often talked about returning to North California someday. He particularly relished the ocean and the giant redwoods. One of his child-hood hobbies, coin collecting, explains his future reputations a pack rat, since he loved to collect glass slides, gross photos, and magnetic resonance imaging scans from ‘‘great cases’’; he also collected historical medical books. His childhood love of reading led to his future passions for history, archeology, and photography, traveling, and learning in general. In high school and early adulthood, he also took up weightlifting. As with everything, Bernd threw himself fully into the sport, winning numerous competitions, including the title of ‘‘Strongest Teenager in California.’’

After graduating from nearby Humboldt State University Arcata, California, in 1969, Bernd started his medical training at Loma Linda University School of Medicine in Loma Linda, California, from which he graduated in 1973.His stellar performance during the pathology course became the new standard by which future students were compared. In fact, the faculty there had fully hoped that Bernd would join their staff after training, but that was not to be. After a year of internship at Loma Linda, Bernd completed 2 years of anatomic pathology residency, 2 years of neuropathology fellowship, and 1 year of surgical pathology fellowship at Stanford University Medical Center in Palo Alto, California. It was there that he worked with the internationally renowned neuropathologist, Lucien J. Rubinstein, MD, an association that firmly placed him on his path to success. When speaking about his former mentor, Bernd seemed to have some mixed emotions. Initially, Dr.Rubinstein disapproved of Bernd’s plan to master general surgical pathology as well as neuropathology, feeling that time in general pathology would detract from more important scientific and scholarly neuropathologic activities. This approach is perhaps more easily understood when considering that at that time, such a combination was exceptionally rare.

Fortunately, Bernd stuck to his convictions, recognizing that the basic rules of pathology don’t change once you go above the neck. The current generation of combined surgical pathologists/diagnostic neuropathologists, a model which is now fairly common, owes a debt of gratitude to Dr Scheithauer for leading the charge .Despite the initial disapproval for Bernd’s career path, Dr Rubinstein appreciated his fellow’s innate talent and became one of his greatest advocates. He not only helped him procure his faculty position at the Mayo Clinic in Rochester, Minnesota, but also insisted on his participation at World Health Organization meetings that ultimately led to the second ‘‘blue book’’ on brain tumors published in1993. Dr Scheithauer was always extremely grateful for this help and for all that he learned from Dr Rubinstein, Bernd spoke about the latest development of the time, glial fibrillary acidic protein immunohistochemistry. As fate would have it, he accepted a faculty position at the Mayo Clinic, the perfect match for an energetic and ambitious tumor neuropathologist. Mayo has occasionally been described as the ‘‘golden handcuffs,’’ since despite being in rural Minnesota, the amazing technical support makes it difficult to consider leaving Mayo. With this unbeatable combination, the next 32 years at Mayo were associated with an unprecedented level of feverish productivity, albeit perhaps with an occasional deterrent. Within a few years he started a consultancy service and grew into one of the busiest in the world, with thousands of cases referred annually. Bernd always loved a challenging case and took great pride in solving the seemingly impossible. No matter how much he had already seen, he found something new and exciting at every sign-out.

In terms of academic achievements, it’s difficult to summarize Dr Scheithauer’s 120-page CV briefly, but a few interesting facts are to be highlighted. It’s no secret that Bernd adored and thrived on projects, writing, and editing. At last count (with several papers still in progress), he published around 750 peer-reviewed articles, 8 textbooks/fascicles, and 80 book chapters, as well as numerous editorials, letters, and reviews. Virtually every topic of central nervous system, pituitary, and peripheral nerve tumor pathology was covered. Likewise, his texts have been widely considered the ‘‘bibles’’ of the field, often co- written with close friends and colleagues, such as Peter Burger, MD; Kalman Kovacs, MD, PhD; Eva Horvath, PhD; and James Woodruff, MD. Seminal papers often focused on practical issues of tumor classification, grading, and new entities. Despite the impressive publication record, Bernd would probably consider his greatest legacy to be his teaching and mentoring. Officially, he trained more than 100 neuropathologists from across the world, but unofficially, there are hundreds more whom he influenced both within the United States and abroad. Probably more than anyone else, Bernd was an international ambassador for surgical neuropathology, hosting visitors from and teaching courses in all 4 corners of the globe. He was an amazingly generous mentor who sprang to life when teaching anyone interested in his craft. To think how much we’ve lost with Bernd’s passing is overwhelming. However, it’s comforting to know that Bernd lives on in the hearts of countless people he has personally touched and trained. Today, you can’t read a textbook on brain tumors without finding Bernd’s influence on every page

Bernd is survived by his mother, Renate Scheithauer,; his son, Hans,; his daughter, Monika Maxey, and a grandson, Aiden. His second grandson is on the way at the time of Bernd’s demise and will receive the middle name of Bernd in honor of Dr Scheithauer.

RAYMOD D ADAMS (1911-2008)

July 4, 2017.

Dear colleagues,
Greetings to you all from Thiruvananthapuram!!
I am sure by now most of you would be enjoying the rainy season that is currently in full swing and must be getting respite from hot and sultry climatic conditions in particular northern parts of the country..
In continuation with the series on-‘Legends in Neuropathology’, this time I am sending a ‘write-up’ on Raymond D Adams. I do hope that this will be interesting to read.

Best wishes
Radhakrishnan.

Raymond Delacy Adams considered by his peers the pre-eminent neurologist of the twentieth century and Bullard Professor of Neuropathology Emeritus at Harvard Medical School died on Oct. 18, 2008 at Brigham and Women’s Hospital. Dr. Adams was born in spare circumstances in a rural area near Portland, Oregon in 1911, the first child of William Henry Adams, an oil truck driver and Union Pacific baggage clerk, and Eva Mabel Morriss.

Dr. Adams’s childhood was spent outdoors in sports, a harbinger of his vigorous adult pursuits of tennis and golf, but he began to work at physically demanding jobs from an early age. After graduating high school at 17 he crewed on an oil tanker from Alaska to Salvador. His first aspiration was to become a professional baseball pitcher but at the insistence of his parents he entered University of Oregon and chose to study psychology. He attended the new Duke University School of Medicine in its third class by serendipity and remained a great supporter of the school. It required great effort to make ends meet while studying.

Dr. Adams began his training in psychiatry as a Rockefeller fellow, first at the Massachusetts General Hospital and later at Yale. He could not reconcile the then grip of psychoanalysis with what he knew of brain diseases and he left for Boston City Hospital to study the physiological causes of mental and neurological diseases under Dr. Derek Denny-Brown. Relegated to the neuropathology laboratory, over ten years and thousands of gross and microscopic brain examinations, he developed the basis for modern clinicopathological correlation that was to establish HMS and MGH as the academic centers of American Neurology at the time.

He came to prominence as a neuropathologist and neurologist during a ten year career at Boston City Hospital. He was recruited to the Massachusetts General Hospital in 1951, where he directed the neurology program for over 25 years. Adams was a spectacularly successful builder of institutions. When he took over the department at Massachusetts General Hospital, the entire neurology staff amounted to a handful. He built the first large program in pediatric neurology with specialized faculty, residency training, and new research laboratories. As a part of this effort he founded the Eunice K. Shriver Center for mental retardation research and patient care. His combined staff numbered in the hundreds by his retirement. The birth of the Neuroscience Study Program, with founders at MIT, the creation of the Department of Neurobiology, and the emergence of a general university doctoral program in Neuroscience at HMS were all supported by Dr. Adams. His HMS course in neuropathology was legendary in its breadth for a generation of medical students. He relished teaching, all from slides he had collected and distributed to each student, abandoning this role only when he felt the curriculum no longer accorded adequate time for his efforts.

Many of his academic contributions were seminal. In cerebrovascular disease, he and Miller Fisher determined that the major cause of ischemic stroke was embolus rather than thrombosis and that the principal source was the heart. This laid the groundwork for attention to atrial fibrillation and the necessity of anticoagulant prophylaxis. Other contributions in the field of vascular disorders included a detailed elaboration of the syndrome of basilar occlusion and aortic dissection. His studies of a range of bacterial infectious processes and of syphilis directed attention to the leptomeninges as the primary site of disease that secondarily led to vascular damage and infarctions. He ascertained the features clinically and cytopathologically in a wide spectrum of hepatic disorders including encephalopathy following upon Eck fistula undertaken surgically for cirrhosis and varices that is now called hepatic encephalopathy. Studies of liver disease arose naturally out of a wider attention shared with Maurice Victor to the various syndromes with differential topographic expression associated with alcoholism and where they emphasized the importance of underlying nutritional deficiency and in particular deficiency of B vitamins..

Other contributions include characterization of the clinical and pathological features of primary CNS lymphoma, designating them as reticulum sarcoma; a range of inflammatory, metabolic and degenerative disorders of muscle and peripheral nerve; the establishment of the clinical characteristics and concept of normal pressure hydrocephalus (NPH); and his initiative in the neurology of the developing fetus and child. The creative and productive career of Raymond Adams must be viewed as the conceptual platform for the era of molecular neurobiology, imaging and computational cognitive neuroscience. He strongly supported an eclectic view of psychiatric disease, considering them to be problems of the brain, and stood behind numerous psychiatrists who had been ostracized from the community, at the time dominated by psychoanalysts.

Dr. Adams published over 250 original papers and seven monographs. His lasting influence on American medicine began as one of the founding editors of Harrison’s Principles of Internal Medicine, for which continued to write almost all the neurology material through six editions. The other editors chided Ray gently that his neurological treatises in the book led them to consider renaming it to the “Principles of Internal Medicine and the Details of Neurology.” Ray took their advice and he and Maurice Victor wrote Principles of Neurology, the true classic of the field now in its 9th edition and considered by far the leading textbook in the field. In association with Bryan Kakulas, he edited a book on muscle diseases.

All his trainees have remarked on Ray’s personal availability and his dedication to teaching. He was demanding, direct and honest, and always courteous. Team morale and collegiality were pervasive as result of his model behavior, looming personal presence, and work ethic. All were aware that they were part of an enterprise inspired by Ray Adams that constructed the core for the intellectual growth of neurology in the second part of the twentieth century. He is widely credited with establishing neurology’s and neurosciences’ place in modern medicine. He will be greatly missed by his colleagues and students.

Prof. Edward Pierson Richardson, Jr. (1918-1998)

June 8, 2017

Dear colleagues,

Greetings to you all from God’s own country!!
The south-west monsoon arrived here about a week with plenty of rains. Currently it is progressing towards the rest of the country. I am sure some of you will be already enjoying the rains by now and others will also get their share of rains soon.
In continuation on ‘Legends in Neuropathology’, I send herewith the ‘write-up about Professor Edward Pierson Richardson. I am sure most of would derive inspiration by reading this.

With best wishes
Radhakrishnan.

Prof. Edward Pierson Richardson Jr (EPR) was born at Massachusetts General Hospital (MGH), Boston on April 3, 1918, and the descendent of an illustrious Boston medical family with long standing medical roots. Both his Father (Edward Pierson Richardson) and Grandfather (Maurice Howe Richardson) were the Professors of Surgery at Harvard Medical School (HMS). His Mother- Clara Shattuck came from a distinguished line of Harvard physicians. In her honour, the road leading to Harvard Medical School is named as 25 –Shattuck Road.

EPR graduated from HMS in 1943. His long association with MGH began with an internship in Medicine and was only interrupted by service as a Neuro –Psychiatrist in US Army between 1944- 1946. He rejoined MGH in 1946 as a Resident in the Department of Psychiatry. During this period he was strongly influenced by Doctors, Stanley Cobb and Charles S Kubik who were both Neuropathologists. In 1947 –48, he visited National Hospital for Nervous Diseases, Queen’s Square, London where he met Dr J Godwin Greenfield the noted neuropathologist, who confirmed EP’s burgeoning interest in neuropathology.

He returned to MGH in 1949 as an Assistant in Neuropathology to Charles S Kubik, the Chief of Neuropathology at MGH. From here, Prof EPR’s interest turned primarily towards Neuropathology and with the retirement of Dr Kubik, he took over the Directorship of Neuropathology Laboratory (Later named as Charles S Kubik Laboratory for Neuropathology). Prof. EPR led the Neuropathology Laboratory at MGH to International recognition. Working side by side with many illustrious physicians such as Dr Raymond D Adams, Dr C.Miller-Fisher,Dr. Benjamin Cattleman, Dr. Robert E Scully and Dr Robert T McClusky, he rose to become full Professor of Neuropathology in 1974 and then became the Bullard Professor of Neuropathology at MGH in 1984.

During Dr Kubik’s tenure as Director of Neuropathology, a tradition grew of having neuropathological teaching session on every Tuesday evening. Prof EPR continued this practice. The entire team in the Neuropathology laboratory would assemble for dinner at the Cafeteria. Following that Prof EPR would get out his ‘little black book’ of interesting cases and present the slides from one of them for analysis by the group. Later everyone would discuss their observations and diagnosis. The evening would culminate with a reading of the ‘real story’ by EPR and he also would discuss the case and correlate the neuropathological features with the clinical presentation of the case. He directed the neuropathology service  at MGH until 1989. Although he formally retired in that year he continued to work and teach until a few months before his death. Despite his many neuropathological duties, Prof.EPR remained a sought after clinician, attending regularly on the wards and engaging in a limited clinical neurological practice.

The breadth and depth of his knowledge in neuropathology was continually fed by his excitement on looking through the microscope, especially when it was rewarded by finding a hitherto unrecognized diagnostic feature or by gaining insight into a disease process. Prof. EPR’s contribution in Neuropathology is extensive and phenomenal .These include Progressive Multi- focal leuko-encephalopathy (PML), Corticobasal degeneration, granulomatous angitis of the CNS, neurological manifestations of systemic lupus erythematosus, sub- acute combined degeneration of the spinal cord, demyelinating diseases, Leuko-dystrophies, Huntington disease, Creuzfeldt-Jakob’s disease. Also remarkable was his careful analysis of hundreds Clinicopathological case studies which appeared over years in the New England Journal of medicine. All of his writings were characterized by precise wordings and clear syntax, exhaustive survey of the literature and meticulous study of the clinical material

He was widely recognized for his achievements and received numerous honors. He served on the editorial boards of many neurology, pathology, and neuropathology journals. He was elected President of the American Association of Neuropathologists for 1973-74, and in 1988, the American Association of Neuropathologists awarded him its Meritorious Service award. He was a Charter Member of and an active participant in the Diagnostic Slide Session of the American Association of Neuropathologists from its inception in 1958. He served as a consultant to the National Institutes of Health in many capacities including service on the Council of the National Institute of Neurological and Communicative Disorders and Stroke. In 1982, he received the Senior Scientist Award of the Alexander von Humboldt Foundation. He was elected a member of the Royal Society of Medicine in 1984. He was twice Litchfield Lecturer at Oxford University, first in 1975 and again in 1990. Also, in 1990 he was the Dorothy Russell Memorial Lecturer of the British Neuropathological Association. He served on the Boards of the National Multiple Sclerosis Society, The United Leukodystrophy Foundation, and The French Foundation for Alzheimer’s Research and others.

Above all, Prof.EPR was a warm, friendly, courteous, cheerful person who was unfailingly kind to all he met. His soft-spoken friendly manner endeared him to his trainees and to his colleagues. He was a paradigm of fellowship and probity and had an equanimity that was the envy of his colleagues. He was, however, never reluctant to disagree quietly but firmly with any proposed diagnosis he thought was incorrect. Such an event would suddenly alter his placid manner to one of joyful exuberance. The deep affection that he engendered in his trainees was demonstrated by the return of more than 130 of them to a celebration in his honor in 1990.I was fortunate enough to be one among them.

EPR left for heavenly abode on November 30,1998 after a long battle with Lymphoma. He was survived by his wife Peggy and his three children Clara, Margaret and Ned. At the funeral service, his brother Elliot defined three of EPR’s most remarkable qualities – Balance of mind and spirit, coherence and integrity. To these I wish to add two more qualities- Generosity and wisdom.

Lucien J. Rubinstein: Enduring Contributions to Neuro-Oncology

Dear colleagues and friends,

Greetings to you all from God’s own country!!

I do hope that most of you would have read the first ‘write-up’ on Legends in Neuropathology. In continuation with that I am sending the second ‘write-up’ on Professor Lucien J Rubinstein.

I would welcome suggestions from you, as I consider that this will make it more interesting reading material, in particular for the younger f members of our society.

Best wishes

Radhakrishnan.

E-mail: kr3050@yahoo.com

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Lucien Rubinstein was born in Antwerp, Belgium on October 15, 1924, but immigrated to England during the Second World War. After a year at Queen Mary College, he was admitted to the Medical College of London Hospital, from which he graduated as an M.D. in 1952. After his military service, he joined the staff of the Bernhard Baron Institute of Pathology at the Royal London Hospital and collaborated with Professor Dorothy Russell. After a sabbatical year in which his time was split between the University of Minnesota and the National Institutes of Health, he moved to the US permanently in 1961. After 3 years at the Montefiore Hospital in New York, in 1964 he accepted a professorship in the Neuropathology Department at Stanford University. Dr. Rubinstein became the director of the Division of Neuropathology at the University of Virginia in April 1981.

Rubinstein had a very productive life; his contributions and collaboration with Dr. Dorothy S. Russell led to the textbook Pathology of Tumours of Nervous System , which was first published in 1959. This book has been the most authoritative and scholarly work in the field of neuro-oncology.  Dr. Rubinstein wrote five editions of Pathology of Tumours of the Nervous System , the Atlas on Tumors of the Central Nervous System , 139 articles in the literature,] book chapters, more than 50 published papers presented at national and international meetings, and the translation of the Manual of Basic Neuropathology by Escourolle and Poirier. He had editorial responsibilities for Neuropathology and Applied Neurobiology, the Journal of Neuropathology and Experimental Neurology, Acta Neuropathologica, Clinical Neuropathology, Journal of Neuro-oncology, Cancer , and Virchow’s Archiv. He was an advisor to the Commission on the Histopathological Classification and Nomenclature of Tumors of the World Health Organization.

His professional life was dedicated to understanding the cytogenesis and differentiation of CNS tumors. He was a great teacher and a mentor who participated in the education of more than 50 trainees and visiting scholars from nine different countries. Neuropathology was his life and it was a pleasure so much above and beyond being a duty that he put all his soul into it; that could be well appreciated by his own words: As a pioneer in neuropathology, in his work Dr. Rubinstein set the foundation for many enduring concepts in neurosurgery, neuro-oncology, neurology, and basic tumor biology.

Dr. Rubinstein had diverse interests in life, including classical music, literature, theater, and wine. He was a good companion. Although English was not his native language, he mastered it; his colleagues admired his ability to describe morphological features with his precise English. Dr. Rubinstein passed away in 1990 due to the complications of a basilar artery aneurysm. He was in peace when he died. Just before his death he expressed to Dr. VandenBerg, “I pine for nothing. My work is finished, the book is done, and we’ve got research projects going but this can be carried on.

 

DORATHY STUART RUSSELL (1895-1983) –“An unconquered Queen”

Dorothy Stuart Russell born at Sydney, Australia in 1895.She lost her parents, when she was only 8 years of age. Thereafter, Dorothy and her younger sister Patronella were brought to England by  her aunt and uncle living near Cambridge, England. In 1909, Dorothy entered the Perse school for girls in Cambridge, where she excelled in every aspects of school life. By final year, she was the secretary of the natural science club, vice president of the ‘debating’ club, a competent hockey player and the editor of school magazine. A brilliant academic career at Perse school was followed by four years at Carton College, Cambridge, where she gained a first class in the natural sciences and was awarded a post-graduate studentship. This helped her to enter into medical profession. In 1919, she was admitted to the London Hospital Medical College. After qualifying in 1922, she joined the department of Morbid Anatomy, London Hospital. Her first five years were spent doing research on Bright’s disease, the results of which were published in 1929 by the MRC.This research work  in  the form of a thesis was submitted to the University of London for which she received a gold Medal as well as MD degree.

A switch to Neuropathology:

Dorothy met a young neurosurgeon at London Hospital- Hugh Cairns and he initiated her to take neuropathology as a career. With his help, she obtained a Rockefeller Fellowship to spend a year in North America, learning staining techniques applicable to the nervous system. She stayed few months at Boston with Frank Mallory (the trichrome and the PTAH fame !) and rest of the time at Montreal where  she studied the origin of microglia, using metallic impregnation techniques. On her return to England in 1929, she took up Neuropathology as a full career. Much of the work that she did with Hugh Cairns and together they developed the squash smear techniques for the rapid intra-operative diagnosis in patients undergoing surgery for brain tumours.She also demonstrated the mode of glioma spread and collaborated in a number of clinico-pathological reports. At the same time Dorothy was performing experimental work as well as initiated cell cultures in her laboratory. She showed oligodendroglial cells undergo rhymic contractions in vitro.

Years between 1938-1943 were turbulent because of the world-war and this resulted in the disruption of Dorothy’s academic career to some extent However, during the war period, Dorothy was examing the brain on fatal head injuries and her research output in the war years was prodigious. She demonstrated the effects of brain tissue of antiseptics, widely used in the treatment of depressed skull fractures before penicillin became available, encapsulation of brain abscesses and formation of post traumatic intracranial cysts. She also demonstrated on the effects of synthetic materials used to repair for skull defects.

The ending of the war saw Dorothy return to Whitechapel and in 1946, she became the Director of the Institute of Pathology, first woman   to hold a chair at an English university. She then focused herself on descriptive clinico-pathological work. Some of these include: effects of organic mercury poisoning on the brain, microgliomas, carcinomatous neuropathy and myopathy, the effects of surgical division of pituitary stalk, acute disseminated demyelinating encephalopathy, and slow virus diseases of the central nervous system.

In years, neuropathology was beginning to develop as a distinct speciality.In Britain, several newer generation of neuropathologists were trained with Dorothy. With the help other senior neuropathologists, a neuropathology club (later known as British Neuropathological Society) was formed. This was a forum where both clinical and experimental neuropathologists could meet regularly and discuss their work.Dorathy with the help of Rubinstein published a book ‘Pathology of tumours of nervous system’. This book provided the first text on brain tumurs which was both intelligible and comprehensive. This book went to five editions and remained the leading work even today.

It is easy to list Dorothy’s achievements as a Neuropathologist but less easy to say what she was like as person. She had a rather forbidding and sometimes aggressive public persona. As a result, many were in awe of her. Lucien Rubenstein, a close friend over three decades described her as a woman of ‘stately dignity’ and another colleague attributed her ‘rather masculine outer shell’ to barriers evolved by a woman who had succeeded in exclusively male dominated world. She was an epileptic and proved to the entire world that epilepsy need not be a bar to success. She retired in 1960 and thereafter took little part in British Neuropathology Society’s activities. She devoted herself to gardening and music. She left for heavenly abode in 1983.In her honour, British neuropathology society still conducts biennial memorial oration.

Though, Dorothy Russell left us behind almost 34 years ago, she will be remembered for one of her immortal and ever-lasting contribution-i.e.  Toludine –blue stained squash smears for the rapid intra-operative diagnosis of brain tumors that we all practice every day in our routine practice.

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