Michael Lesch

Abstract

Cardiologist, medical educator, and administrator who co-discovered a rare genetic syndrome. He was born on June 30, 1939, in Queens, NY, USA, and died in his sleep on March 19, 2008, in Patagonia, Argentina, aged 68 years. Michael Lesch was a medical student working at Johns Hopkins Hospital in Baltimore, MD, USA, when he and his mentor, William Nyhan, identified a rare inherited disorder that now bears their names. It was 1962, and the researchers first identified the condition in two young brothers both of whom compulsively bit their fingers and lips, despite not wanting to behave in this way. Lesch-Nyhan syndrome, characterised by excessive production of uric acid, was subsequently found to result from a deficiency of the enzyme hypoxanthine-guanine phosphoribosyltransferase, an X-linked recessive gene. As Nyhan told The New York Times, “Mike worked full time and essentially did 100 percent of the lab work documenting that this was an inborn error of purine metabolism”. Despite Lesch and Nyhan's discovery, much about the hereditary condition remains mysterious. Treatments for the symptoms and complications of this syndrome, however, mean affected people can live much longer than they did previously. As his career progressed, Lesch gained substantial prominence as a cardiologist, a medical administrator, and a devoted teacher, but the work he did as a student continued to attract attention. “Many people didn't realise this was something he did in his twenties”, remembers Henry Greenberg, associate director of cardiology at St Luke's Roosevelt Hospital in New York. “The only time he would talk about it was when he was asked. I think he prized what he had done, but it was not what he wanted to be judged on.” Lesch had attended Columbia University in New York before entering Johns Hopkins School of Medicine, Baltimore, MD. After specialising in cardiology, he held a series of increasingly prestigious administrative posts, beginning as chief of cardiology at Northwestern University's medical school in Chicago. “He became chief of medicine pretty early in his career, and really knew how to be a chief”, says Greenberg. “He was pretty good at reading the tea-leaves; he wasn't a chief who needed to scream at people. He would tell you, here are the realities of the institution, here's what I can do.” Those skills later took Lesch to Henry Ford Hospital in Detroit where he became chair of medicine, and in 1998 he was appointed chairman of the Department of Medicine at St Luke's-Roosevelt Hospital Center in New York and Professor of Medicine at the Columbia University College of Physicians and Surgeons. Bruce Polsky, who is now interim chairman of the Department of Medicine at St Luke's-Roosevelt, was one of the first people Lesch appointed at the New York centre. He says Lesch was a dedicated mentor who encouraged his staff to be intellectually and politically honest: “He taught us that your integrity and your word have great value, that you have to deliver good and bad news in a straightforward way.” Greenberg also recalls that forthrightness. “He was an extraordinarily effective chief”, he says. “People understood that he was being straight and they understood the ground rules.” Lesch also continued teaching preclinical medical students as well as making clinical rounds with junior doctors, often 6 or 7 days a week, for months of the year, even while serving as the department chair. “He loved to teach”, Polsky said. “He wanted to be able to communicate not only the information, but the values of being a physician, and he did it in a very egalitarian, down to earth manner.” That earthiness was part of Lesch's considerable charm, recalls Polsky. Although his native Queens accent was diluted as he moved around the country, for example, he loved hamming it up with colleagues when the opportunity arose, he says. Lesch was also a keen fisherman, and every year would take an expedition to the Arctic Circle and Patagonia in Argentina for fishing. It was during one of those trips to South America that he died suddenly in his sleep. He is survived by his wife, Bella Lesch, two children, and six grandchildren.