Kenneth John Ryan

Kenneth John Ryan, M.D. was born the son of a wealthy industrialist in New York City in 1926 into some comfort and good fortune. Severe financial reverses during the Depression and his mother’s death when he was ten resulted in the dissolution of his family. Thrust into the foster care system of his time, Ken lived and worked on a tomato farm on Long Island and later on a goat farm in New Jersey. He recalled with fondness the men he worked for who repeatedly encouraged him to continue his education, but he refused to eat fromage au chevre for the rest of his life. He attended five different high schools but graduated early and enlisted in the Navy at age 17. There he served on a submarine in the South Pacific and off the coast of Japan during the last year of World War II.

Upon discharge from the service in 1946, he began his undergraduate studies at night at Northwestern University, while working full time. From Northwestern he entered Harvard Medical School and graduated magna cum laude in 1952. He started his training in internal medicine at the Massachusetts General Hospital and completed it at Columbia Presbyterian Hospital in New York. He then returned to Harvard where he completed a residency in obstetrics and gynecology at the Boston Lying – In Hospital and Free Hospital for Women. A biochemistry fellowship with Nobel Laureate Fritz Lipman launched him on his quest to define the pathways of sex steroid biosynthesis. In a methodical series of studies with Olive W. Smith at the Fearing Laboratories in the late 1950s he discovered and characterized the ovarian enzyme system that synthesizes estrogens.

In 1961 Ken left Boston for Cleveland to become the Chair of Obstetrics and Gynecology at Western Reserve University. There he was instrumental in expanding the department, while teaching and research flourished with support from the NIH and private foundations. The program attracted trainees nationally and internationally to the reproductive endocrine fellowship. Teaching was of great importance at Western Reserve and carefully planned through teaching committees. Ken developed a teaching committee for reproductive biology and played a major role there as a teacher. He continued to pursue his interest in sex steroid biosynthesis with pioneering studies separating human ovary thecal and granulosa cells, and placentas from numerous species of mammals. His studies of sex steroid hormone conversion and binding in the brains of animals including cyclostomes, teleosts, amphibians, reptiles, birds and numerous mammals are considered classics.

He left Cleveland after ten years to become the first professor and chair at the new medical school of the University of California at San Diego. But, shortly thereafter, he moved to Boston for the third and final time in 1973 to become the Kate Macy Ladd and William Lambert Richardson Professor of Obstetrics, Gynecology and Reproductive Medicine at Harvard Medical School, and Chief of Staff of the Boston Hospital for Women. He quickly recognized that a free-standing women’s hospital was an anachronism that could not continue to offer superior care as medicine became increasingly complex and interdisciplinary. The strength of his vision and leadership led the Boston Hospital for Women and its staff past parochialism and into the merger with the Peter Bent Brigham Hospital and Robert Breck Brigham Hospital to form what became the Brigham and Women’s Hospital.

In addition to his scientific accomplishments and role as an educator, Dr. Ryan was a mentor to many. Shortly after his arrival in Boston in 1973 he created a four-year residency-training program where emphasis was placed on recruiting the “best and brightest” individuals who would make a difference in our specialty. He was respected and admired by his trainees for the dignity, respect, and humanity with which he treated them. He never denigrated or humiliated a trainee in public, and made it clear that he would not tolerate such behavior from others on his service. Ken’s twenty years as the Ladd Professor were notable for continuous faculty growth, a flourishing research program and the creation of numerous clinical and research fellowships. The residents he trained have become department chairs, leaders in prestigious national organizations including the NIH, and medical school deans. As one of his very successful trainees put it, “Dr. Ryan led by example. His commitment to excellence was clear in everything he did”. His commitment to those he trained continued over the years. He guided them through difficult career decisions and promoted his former students for positions in important national organizations. This legacy to women’s health care will persist for years to come.

Ken was active in public affairs at the National level having served on the President’s Committee on Mental Retardation from 1967 – 1972. In 1971 he was elected to the Institute of Medicine of the National Academy of Sciences. There he served on several committees and chaired the Committee for the Study of Basic Science Foundations of Medically Assisted Conception. He was also elected to membership in the American Academy of Arts and Science.

In the mid 1970s Congress was concerned about reports of research on aborted human fetuses, the Tuskegee syphilis study, sterilization of mentally retarded minors without parental consent, psychosurgery and a variety of other issues. President Jimmy Carter appointed Ken to chair the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. He was highly regarded in his work there for his ability to develop consensus from disparate points of view in part because he listened respectfully, regardless of how much he disagreed with the point of view being expressed. The Commission’s recommendations regarding research on human fetal material and psychosurgery, developed under his guidance, were immediately adopted into federal regulations with unprecedented speed. Subsequently, he turned the Commission’s attention to the rights of prisoners, children, the institutionalized mentally ill and handicapped individuals as subjects in medical research. He helped establish the standards of informed consent that now govern research with human subjects across the country. He wrote, “Respect for human subjects requires not only protection in the research process, but the protection for society that appropriate research affords”.

He was a courageous and unflinching champion of civil rights, patients’ rights and reproductive choice for women. When he became the Chief of Staff at the Boston Hospital for Women in 1973, one year after the Roe vs Wade decision, he established the first abortion service in a university hospital and included training in the necessary skills as a routine part of residency education. In 1975 Ken credentialed and granted admitting privileges to Dr. Kenneth Edelin, an African-American, even as he was under indictment for manslaughter in a politically motivated prosecution for performing a legal abortion at Boston City Hospital. A member of the board of trustees, who attended many meetings with Ken, most remembers the “granite quality of his integrity”. As to whether a service ought to be rendered that was politically sensitive or uneconomical, Ken’s clincher argument often was: “It’s the right thing to do.” A routine bit of business involving trustee approval of accreditation of physicians to the staff of the hospital came before the board. A member of the board noticed that one of the physicians on the list had graduated from medical school in the 1930s. Why was he now being accredited to the hospital? “It’s to right an old injustice.” Now the trustee’s curiosity was more aroused. “What was that?” The doctor, Ken explained, had been refused accreditation forty years earlier because he was Jewish. Ken did not pretty up the facts. That was not his style. He thought clearly, spoke clearly, and gave it to you right in the gut.

His belief in “broad disclosure to patients” occasionally placed him at odds with organized members of his own profession. When the FDA required an informational package insert for the patient to accompany oral contraceptives, IUDs, and estrogens, the American College of Obstetricians and Gynecologists sued on the grounds that this was an unwarranted and unnecessary infringement on the doctor-patient relationship. Ken chided them in the pages of the New England Journal of Medicine, “At a time when the credibility of organized medicine’s interest in the public good is being challenged, our parry to each governmental initiative should not be reflexively negative.”

As a scholar of ethics, he worked to search out the issues between research ethics and reproductive bioethics. He took pride in being a philosophical pragmatist. In the mid 1980s Harvard University President Derek Bok suggested that those assigned to create a Harvard University center for ethics, talk to Dr. Ryan. Ken became a founding Senior Fellow of the Ethics Center and played a major role in creating the Division of Medical Ethics in the Medical School. In 1997 Ken joined the fellows Seminar, a demanding yearlong seminar that brings to Harvard some of the most talented young scholars and teachers in ethics from all over the country and the world. He claimed that he learned more from these representatives of the rising generation than he ever had from more experienced people in the field. The fellows in the center that year came to appreciate that while Ken learns, he also teaches.

But Ken also found time to enjoy life and sought to find enjoyment in each day. In the evening or on a weekend he might be found gardening, playing tennis, preparing food, pouring a glass of wine, playing some Gershwin or an opera, reading a book on the Founding Fathers or the philosophy of William James. He and Marion, his wife of 53 years, were very close. They were true friends. Their children Kip, Chris and Allison loved him dearly and gathered often from around the country to enjoy holidays and vacations together with their families, which brought Ken great pleasure.

Ken Ryan was a gifted research scientist, a highly principled ethicist with an un-wavering moral compass, an inspirational mentor and leader, and an honest and gentle man. He will be greatly missed by all whose lives he touched.

Respectfully submitted,

Fredric D. Frigoletto, Jr., Chairperson
Leon Eisenberg
Steven Gabbe
Michael F. Greene
Rudolph Kass
Brian Little
Kenneth J. Ryan, Jr.
Isaac Schiff
Dennis Thompson