Leon Eisenberg, pioneering child psychiatrist, dies at 87

Leon Eisenberg, the Maude and Lillian Presley Professor of Social Medicine Emeritus at Harvard Medical School (HMS), died on Sept. 15 at the age of 87. 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 an 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.

When his turn came to apply in 1942, 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 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 Mount 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,” he once said. But he soon found psychoanalysis “politically unacceptable,” and asked, “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 felt 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.

“Leon Eisenberg is one of the seminal figures in American medicine and in psychiatry of the past half century,” 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. “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 lieu of flowers, donations may be made to Physicians for Human Rights, 2 Arrow St., Suite 301, Cambridge, MA 02138, or Partners In Health, P.O. Box 845578, Boston, MA 02284.