Leon Eisenberg

Leon Eisenberg
Born August 8, 1922
Philadelphia, USA
Died September 15, 2009
Cambridge, Massachusetts, USA
Nationality American
Occupation Child psychiatrist, social psychiatrist, medical educator
Religion Jewish (secular)
Spouse(s) Ruth Harriet Bleier, MD
Carola Eisenberg, MD
Children Mark Philip Eisenberg, MD;
Kathy Bleier Eisenberg,
Alan Edward Guttmacher, MD (stepson);
Laurence Guttmacher, MD (stepson)

Leon Eisenberg, M.D., D.Sc. (August 8, 1922 – September 15, 2009)[1] was an American child psychiatrist, social psychiatrist[2] and medical educator who "transformed child psychiatry by advocating research into developmental problems" (David DeMaso). He was credited with a number of "firsts" in medicine and psychiatry - in child psychiatry, autism, and the controversies around autism, randomized clinical trials (RCTs), social medicine, global health, affirmative action,[3] and evidence-based psychiatry. Having retired in 1967 from Johns Hopkins Hospital Department of Child and adolescent psychiatry (he was the chairman of the department after Leo Kanner)[4] and from Harvard Medical School in 1988, he continued as The Maude and Lillian Presley Professor of Social Medicine and Psychiatry Emeritus (and actively serving - lecturing, researching and writing, and mentoring) in the Department of Global Health and Social Medicine of the Harvard Medical School in the Longwood Medical Area of Boston until a few months before his death in 2009. He received both his BA and MD degrees from the Perelman School of Medicine at the University of Pennsylvania, taught previously at both the University of Pennsylvania and Johns Hopkins University, and was Chief of Psychiatry at both Johns Hopkins Hospital in Baltimore and the Massachusetts General Hospital in Boston during formative periods in psychiatry for each institution.

Medical accomplishments

The reasons Leon Eisenberg is listed as a famous figure in world and American psychiatry are numerous. Leon Eisenberg identified rapid return to school as the key to treatment in the management of the separation anxiety underlying school phobia. He completed the first outcome study of autistic children in adolescence and recognized patterns of language use as the best predictor of prognosis. Of the two first studies of the outcome of infantile autism, he reported the American study in the American Journal of Psychiatry in 1956, and the UK study was reported in JCPP shortly afterward by Victor Lotter and Sir Michael Rutter. That was a time when a narrow rather than a broad definition of autism was in fashion. It is of interest that the poor prognosis was evident both in the narrowly and broadly defined cases and that, because many of the cases now called autistic would have been called "mental retardation: moderate to severe", they would have joined other such children with a relatively poor outcome.

He was Principal Investigator (PI) on the first grant from the Psychopharmacology Branch of NIMH for RCTs in child psychopharmacology. From a concern for evidence-based care, well before the phrase was coined, he introduced randomized controlled trials (RCTs) in psychopharmacology and showed that "tranquilizing" drugs were inferior to placebo in the treatment of anxiety disorders, whereas stimulant drugs were effective in controlling hyperactivity. He completed the first RCTs of psychiatric consultation to social agencies and of the utility of brief psychotherapy in anxiety disorders. He published a forceful critique of Konrad Lorenz's instinct theory. He established the usefulness of distinguishing "disease" from "illness". He has highlighted the environmental context as a determinant of the phenotype emerging from a given genotype, and from the late 1990s through 2006, he had been involved with developing conferences and resources for medical educators in various specialties that would help them incorporate, into courses with their current and future students, the tidal wave of new information in genomics yet to puzzle future clinicians. This interest may have been encouraged by his stepson, Dr. Alan Guttmacher, Acting Head of the National Human Genome Research Institute. For many decades, Leon Eisenberg had criticized psychoanalysis from a number of platforms.

The scientific contributions of Dr. Eisenberg include:

Specific publications referring to the above achievements are contained in his bibliography

Leon Eisenberg is proudest of the Diversity Lifetime Achievement Award he received in 2001 for his role in inaugurating affirmative action at HMS in 1968 and sustaining it as Chairman of the Admissions Committee from 1969 to 1974. He regards that as his most important contribution to Harvard Medical School.

With his wife, Dr. Carola B. Eisenberg, former Dean of Students, first at MIT, then at Harvard Medical School, he has been active with Physicians for Human Rights, which as an organization received a Nobel Peace Prize in 1997 for its International Campaign to Ban Landmines.

In mid-2009 (June 22, 2009), a Leon Eisenberg Chair in Child Psychiatry was named at Children's Hospital Boston. The first chairholder of the Leon Eisenberg Professorship in Child Psychiatry is David R. DeMaso, MD, HMS Professor of Psychiatry and Psychiatrist-in-Chief at Children's Hospital Boston.

His brief (~30 pages) autographical memoir (a walk through the history of psychiatry, yet to be published posthumously by Acta Psychiatrica Scandinavica - in mid- or late-2010) "Were we asleep at the switch?" [See below] was written from his home.

Humor

Among his friends and professional colleagues, Leon Eisenberg was known for his humor and friendly wit which he shared in lectures, publications, and even as Recording Secretary for the American Academy of Arts and Sciences (sometimes in the forum of haiku).[6]

Collecting his humor is difficult (often it was in personal e-mails), but many agree that a few typical scenarios recurred:

Close friends (and fans) described his stories as customized for each occasion (so they never tired of hearing the same stories repeated because, with customization, they never were the same story or joke).

Former President of Case Institute of Technology (then Case-Western Reserve), Dr. Edward M. Hundert, while he was a medical student (class of 1984) at Harvard Medical School, played the part of Leon Eisenberg in the HMS Class Folies, in which (as his character) he sang the supposedly satirical but actually most complimentary tune, "I feel witty!"

Death

Leon Eisenberg died of prostate cancer at his home in Cambridge, Massachusetts on September 15, 2009.[8]

Memorial Services were held in Cambridge, Massachusetts, in September 2009, and in Boston, Massachusetts, at the Harvard Medical School, on March 12, 2010.

Timeline of Leon Eisenberg's life and achievements

Eisenberg in 2007

Memberships, offices, and committee assignments in professional societies

Editorial boards

Academic committees

Leon Eisenberg served on seemingly countless academic and other committees at Johns Hopkins, Harvard, Massachusetts General Hospital, and Children's Hospital Boston. He was typically among the first thought and invited to such committees because of his breadth.

Attempts to identify a full set of such committees are proceeding.

Themes of most recent writing

Leon Eisenberg is credited by numerous colleagues with "simple and direct" prose (Arthur Kleinman, Norma Ware, etc.). He will be remembered most for his writings in these areas, though his encyclopedic comprehension reached much more broadly:

Later autobiographical reflections: "Were We Asleep at the Switch?"

Leon Eisenberg had written from his home a 38-page ‘mini-autobiography’ which he named "Were We Asleep at the Switch?" Eisenberg argued that, while medical scientists were worrying about the tedious science at the base of medical practice and healthcare decisions for the general public, "money" and monied interests had been making de facto decisions for the populace about how things that affected them deeply were going to be done. In this view, the overwhelming impact of economic considerations over emerging bodies of expert knowledge may have rendered and might continue to render futile the professional contributions of many brilliant, timely, and concerned working scientists.

In February 2012, the German weekly publication Der Spiegel reported in its cover story that Eisenberg spoke of Attention Deficit Hyperactivity Disorder (ADHD) in his final interview, seven months before his death, that ADHD was the prime example of a "fabricated disease". Eisenberg remarked that instead of prescribing a 'pill', psychiatrists should determine whether there are psychosocial reasons that could lead to behavioral problems.[10] It should be noted that Jörg Blech the author of the Der Spiegel article is critical of the healthcare industry, and authored a book in 2006 entitled "Inventing disease and pushing pills: pharmaceutical companies and the medicalisation of normal life".[11]

Earliest papers

Select publications

Many of Leon Eisenberg's books and papers have been translated into both European and non-European languages and have been widely cited.

Papers written from consulting

Kleinman A, Eisenberg L, Desjarlais R (Eds) (1995), World Mental Health: Priorities and Problems in Low-Income Countries. New York: Oxford University Press.

Awards

Awards named for Leon Eisenberg

Several late-in-life and posthumous awards were developed to continue the historic legacy of Leon Eisenberg.[14]

See also

References

  1. Boston Globe obituary
  2. The Creation of Psychopharmacology, David Healy, 2002, cites Eisenberg's role in evidence-based social psychiatry
  3. Shanks Thirty Years of Affirmative Action at Harvard Medical School: A Mixed Method Program Evaluation, U Mass EdD Thesis by Alane Shanks (2004)]
  4. Kanner L and Eisenberg L. Child psychiatry; mental deficiency. American Journal of Psychiatry 1955: 111:520-523
  5. Video of the announcement of the Leon Eisenberg Chair in Psychiatry at Children's Hospital Boston, in which Dr. William Beardslee, a colleague, notes the grounds for Eisenberg's being considered the founder of preventive psychiatry
  6. AmAcad
  7. This story was retold by colleague Dr. Arthur Kleinman at the announcement of the Leon Eisenberg Chair at Children's Hospital Boston, between 1:13:00 and 1:14:00.
  8. Benedict Carey, Dr. Leon Eisenberg, Pioneer in Autism Studies, Dies at 87 The New York Times. Retrieved on October 3, 2009.
  9. Eisenberg, L. Marketplace Medicine: Prescription for Disaster. Academe: Bulletin of The American Association of University Professors 1999;85:26-30
  10. Von Blech, Jörg Schwermut ohne Scham
  11. Blech, Jörg - "Inventing Disease and Pushing Pills"
  12. Online reference in Territori per la Salute Mentale through Google Books
  13. [Online reference in La cura degli altri. Seminari di etnopsichiatria edited by Luigi Attenasio through Google Books]
  14. Eisenberg Name Associated with Two New Honors, 23 Apr 2010
  15. LEND Boston bio
  16. Amazon Author page for James C. Harris, MD
  17. Luis Salvador Carulla - Google Scholar Citations
  18. Face perception
  19. Bucharest Early Intervention Project
  20. Deinstitutionalisation (orphanages and children's institutions)
  21. Eisenberg Name Associated with Two New Honors

External links