Campus & Community

Memorial Minute: Ramzi S. Cotra

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At a meeting of the Faculty of Medicine on May 28, 2003, the following Minute was placed upon the records.

Ramzi S. Cotran, the F.B. Mallory Professor of Pathology at Harvard Medical School, and the Chairman of Pathology at the Brigham and Women’s Hospital, died at home on Oct. 23, 2000, at the age of 67. He was arguably the most influential leader of the modern discipline of pathology in this country in the latter half of the 20th century, and an internationally recognized scholar, educator, and clinician-scientist. But, above and beyond these professional accomplishments, he will be fondly remembered for his outstanding human qualities – as a loyal friend, devoted mentor and wise counselor.

Born in Haifa, Palestine, Cotran received both his B.A. and M.D. degrees from the American University of Beirut. He pursued postgraduate training at Boston City Hospital’s Mallory Institute of Pathology and at Memorial Sloan-Kettering Cancer Center. He rose through the academic ranks at Harvard Medical School, and in 1972 was named the Frank B. Mallory Professor of Pathology. Two years later, he was selected as Chairman of the Department of Pathology at the (then) Peter Bent Brigham Hospital, and continued in this leadership role for almost three decades, as the institution merged into the Brigham and Women’s Hospital and ultimately became a founding member of the Partners Healthcare System. In 1990, he also was appointed Chairman of Pathology at the Children’s Hospital Medical Center, a position he held concurrently, until the time of his death.

In 1956, when Ramzi Cotran arrived at the Mallory Institute of Pathology at the Boston City Hospital, it was immediately apparent that he was destined for greatness. Highly personable, and articulate with an engaging smile and cheery “hel – lo,” his most remarkable attributes were his intensity, commitment to excellence, a brilliant, probing mind and a prodigious memory. Not suprisingly, he was a remarkably quick learner and during his residency years became involved in investigative work – a path he would passionately pursue throughout his career. He became a research fellow with Dr. Edward Kass, himself a young and talented faculty member becoming widely known in academic circles. Their seminal studies on the consequences of recurrent urinary tract infections in young women established the importance of these seemingly transient episodes in the pathogenesis of chronic pyelonephritis. This was the beginning of a life-long interest in diseases of the kidney, which would bring Cotran international recognition as a clinician-scientist (long before this career path became so popular).

In the early 1960s, Ramzi Cotran spent two years in the laboratory of Dr. Guido Majno at the Harvard Medical School quadrangle, employing electron microscopy to probe the structural basis of small blood vessel permeability in inflammation, again making what would subsequently be recognized as fundamental contributions to the field. It was at this time that he first collaborated with Dr. Morris Karnovsky, then a junior faculty member in the Quadrangle Department, and established a relationship and friendship that continued throughout his life. Cotran’s sojourn in the “Central Department” enlivened both its teaching and research activities, and, in particular, the weekly Friday lunches, where the entire faculty, from both the hospital and the quadrangle, would meet for lively conversation under the aegis of Dr. Arthur T. Hertig. Returning to the Mallory, now with a junior faculty appointment, he was, remarkably, the sole representative of Harvard Pathology at the Boston City Hospital. Nevertheless, Cotran rapidly established research and training programs, attracted trainees, and began to build a unit of considerable standing in academic and clinical pathology. It was during these formative years that he first showed his remarkable abilities as a diplomatic, effective and inspiring administrator, leader, and skillful teacher. Above all, he was a wonderfully nurturing and caring mentor.

Cotran’s teaching skills soon gained him appointment as chair of the Renal Section of the HMS Pathophysiology Course. Under his leadership this course became a jewel in the HMS curriculum, and he subsequently became a leading figure in HMS Pathology teaching for the next three decades. In addition to his superb organization, Cotran’s personal lectures were beautiful models of clarity, pedagogy and awareness of the needs of the students. Throughout his career, he would remain devoted to medical education at all levels, undergraduate and postgraduate. A major embodiment of this commitment was his co-authorship and then senior editorship of one of the most widely read medical textbooks, “Robbins’ Pathologic Basis of Disease.” Translated into more than a dozen languages, this “bible” of disease pathogenesis and pathophysiology has enlightened thousands of medical students (and their teachers), worldwide. As one of his former students commented, “His boundless joy in sharing his knowledge reflected his unique love for medicine and his love for students.”

From his earliest days at the Mallory Institute, Cotran exhibited a real aptitude for investigative pathology. This aspect of his career would be remarkably productive both for his personal contributions (more than 180 publications in the areas of renal and vascular disease) and in his sparking of an interest in research of a large number of young trainees, who would go on to make significant contributions in their own right. Ramzi was a wonderful collaborator – devoted to the truth, appropriately skeptical of his own data and that of others, and always willing to challenge the current “wisdom” in the field. His collaboration with Judah Folkman in the area of tumor angiogenesis, which was initiated at the old Boston City Hospital, when they were both young assistant professors, and then continued following their parallel migrations to the Children’s Hospital and the Brigham, helped provide a conceptual context to that nascent field. His deliberate recruitment of a small group of young investigators to the Brigham in the early to mid-70’s, including Venkatachalam, Abbas, Rennke, Gimbrone, Madara, Pober, Davies, Bevilacqua, and Collins, helped to establish the Brigham and Women’s Hospital at the forefront of experimental pathology, and, in particular, the newly evolving field of vascular biology.

In 1974, following the retirement of Dr. Gustave Dammin, Ramzi Cotran was the obvious choice to become the Pathologist-in-Chief at the (then) Peter Bent Brigham Hospital. The Department of Pathology had 13 faculty (only three tenured) all crowded together on the ground floor of the long since demolished Tackaberry Building on Shattack Street. Under his stewardship, the Department was grew to more than 70 faculty (11 with Professorial rank) and an equal number of residents and fellows. Cotran’s department thus became the second largest research-intensive department at the Brigham and Women’s Hospital, and known nationally as a model for a truly integrated academic department. During this period, Cotran partnered with Dr. Eugene Braunwald, the then recently recruited Hersey Professor and Chief of Medicine at the PBBH, to help develop a blueprint for the new Brigham and Women’s Hospital that reflected an enlightened interdisciplinary spirit. His leadership rapidly extended beyond the boundaries of Shattuck and Francis streets to the national academic pathology scene, where Cotran became recognized as a “pathologist’s pathologist” and a “chairman’s chairman”. He freely gave of his time and energy to further the welfare of his discipline as a whole. During his tenure at the Brigham, Cotran trained scores of clinicians and researchers, who went on to populate the world of academic pathology in this country and abroad, including more than 15 past and current departmental chairs and deans – an impressive record, indeed! Ramzi Cotran’s contributions were recognized by numerous awards and honors, including the Gold Headed Cane Award of the American Society for Investigative Pathology, the Distinguished Service Award of The Association of Pathology Chairs, and the Lifetime Achievement Award in Mentoring and the Dean’s Award for Support and Achievement of Women Faculty (both at HMS). He also was elected a member of the Institute of Medicine of the National Academy of Sciences.

Beyond these impressive personal contributions, Ramzi Cotran was, above all, a mentor. He was an enthusiastic coach, unflagging sponsor, fierce protector and an extraordinary role model for scores of young physicians who struggled with the realities of an academic career. He did so without prejudice, respectful of each one’s chosen path, and showed true joy in the individual’s accomplishments. Ramzi Cotran’s integrity, sincerity and fairness engendered a deep sense of trust in his mentees who, with his coaching, would discover their strengths, refine their professional goals, and thus map a pathway to success. He set no limits before them, but tempered their dreams with practical realties. He was direct, honest, and readily gave constructive criticism. And, as one of his mentees observed, “…Ramzi was always right! His wisdom is ingrained in each of us who benefited from his insightful attention. When we face each new decision, a new problem, we first think ‘What would Ramzi do?’”

This brings us to perhaps the most endearing quality of this remarkable man – and that was his humanity. Ramzi loved people. He knew a large number, but unlike the majority of well-connected individuals, he really knew them, heart and soul, as well as by their Curricula Vitae. He loved a good party (be it the Dean’s Christmas Party or the chief resident’s TGIF), a good race (be it the Falmouth footrace or the Kentucky Derby), a good joke, the latest gossip, and above all his family – Kerstin (Kris), his wife of four decades, his son Paul and his daughters Nina, Leila, and Suzanne, and his many beloved grandchildren. Ramzi lived his life with great gusto and style, and faced his illness with courage and realism. In his own words, “I have loved every moment of my professional life… My goal has been to create an environment where researchers and clinicians can work together. Their growth and success has given me the greatest pleasure.” This is the essence of Ramzi Cotran’s legacy.

Respectfully submitted, Michael Gimbrone, Chairperson
Ernest Barsamian
Eugene Braunwald
Morris Karnovsky
Vinay Kumar
Janina Longtine
Stanley Robbins
Robert Sackstein
Franz von Lichtenberg