Leon Eisenberg


Olney High School
Leon Eisenberg, was an American child psychiatrist, social psychiatrist and medical educator who "transformed child psychiatry by advocating research into developmental problems"
He is credited with a number of "firsts" in medicine and psychiatry - in child psychiatry, autism, and the controversies around autism, randomized clinical trials, social medicine, global health, affirmative action, and evidence-based psychiatry. Having retired in 1967 from Johns Hopkins Hospital Department of Child and adolescent psychiatry and from Harvard Medical School in 1988, he continued as The Professor of Social Medicine and Psychiatry Emeritus in the of the 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; here are eight select reasons. 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 ' shortly afterward by 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 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 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, then 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:
  • the first longitudinal follow-up of Leo Kanner's original cases of autism
  • a study that identified the roots of social phobia in parental anxiety
  • the first clinical trial of the effectiveness of psychiatric consultation in a social agency
  • the first randomized controlled trial in childhood psychopharmacology
  • the first randomized controlled trial of stimulant drugs in adolescents
  • the first randomized clinical trial of brief psychotherapy
  • a forceful critique of Lorenz's theory of instincts and imprinting
  • an early statement of the distinction between "disease" and "illness"
  • a widely cited critique of the oscillation of psychiatry between brain-centered and mind-centered approaches arguing for the integration of the two
  • a synthesis of the evidence on the importance of training primary care physicians to recognize and treat depression
  • papers that highlight the molding of the brain structure by social experience
  • publications putting inheritance in an environmental context as a determinant of risk and resilience.
  • Called "the father of prevention science in psychiatry"
Specific publications referring to the above achievements are contained in his bibliography'''
Leon Eisenberg was 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.
He and his wife, Dr. Carola B. Eisenberg, former Dean of Students, first at MIT, then at Harvard Medical School, had been active with , which as an organization received a Nobel Peace Prize in 1997 for its International Campaign to Ban Landmines.
In mid-2009, a . The first chairholder of the Leon Eisenberg Professorship in Child Psychiatry is , HMS Professor of Psychiatry and Psychiatrist-in-Chief at .
His brief autographical memoir "Were we asleep at the switch?" 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 .
Attendees at the Annual Leon Eisenberg Award at the Harvard Faculty Club in Cambridge, Massachusetts, end the evening - after the Awardee's lecture - with informal sharing of 'Leon's jokes to the best of our memories.' White it's often assumed that these quips and stories were Eisenberg originals, research shows that many if not most - or even all - 'had a prior history'.
One example of 'an original' related to healthcare and medicine is:
The embarrassingly poor outcomes of the painfully expensive US healthcare system can be summed up in the words of Dolly Parton, "It costs a lot of money to look this cheap!"

Collecting his humor is difficult, but many agree that a few typical scenarios recurred:
Close friends described his stories as customized for each occasion.
Former President of Case Institute of Technology, Dr. Edward M. Hundert, while he was a medical student at Harvard Medical School, played the part of Leon Eisenberg in the HMS Class Folies, in which 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.
Memorial Services were held at Mt. Auburn Cemetery in Cambridge, Massachusetts, in September 2009, and in Boston, Massachusetts, in the New Research Building at the Harvard Medical School, on March 12, 2010.

Timeline of Leon Eisenberg's life and achievements

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. He will be remembered most for his writings in these areas, though his encyclopedic comprehension reached much more broadly:
Leon Eisenberg had written from his home a 'mini-autobiography' which he named
"Were We Asleep at the Switch?". Eisenberg suggested that a switch from 'mind' to 'body' has taken place in psychiatry as a discipline, which led to overuse of medication. He also 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.
A 2012 article in the German weekly publication Der Spiegel gives an account of an interview Eisenberg gave in 2009, seven months before his death. It quotes him as saying, "ADHD is a prime example of a fabricated disease.... The genetic predisposition to ADHD is completely overrated." Instead of prescribing a 'pill', Eisenberg said, psychiatrists should determine whether there are psychosocial reasons that could lead to behavioral problems.

Earliest papers

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

, Eisenberg L, Desjarlais R , . New York: Oxford University Press.
Several late-in-life and posthumous awards were developed to continue the historic legacy of Leon Eisenberg.