Raymond Adams

Abstract

Leading neuropathologist. Born on Feb 13, 1911, in Portland, OR, USA, he died from complications of congestive heart failure on Oct 18, 2008, in Boston, MA, USA, aged 97 years. “I have always taken it as one of our responsibilities to explore new areas in neurology”, Raymond Adams told an interviewer in 1995. Adams, who was chief of neurology at Massachusetts General Hospital (MGH) for 26 years, is known for the diversity of his research interests and for modernising neurology from a largely descriptive field to a science. “What Dr Adams brought to the table was the hard science of pathology and married it to neurology to create neuropathology”, said Michael Waters, an assistant professor of neurology at the University of Florida College of Medicine. “He was the single most important person with respect to modernising neurology into a hard science.” In the 1940s, Adams examined thousands of brains under the microscope as a neuropathologist at Boston City Hospital and showed that most strokes are due to brain embolism originating in the heart. “He had an incisive way of trying to understand clinical manifestations in the patient of what he saw under the microscope”, says Allan Ropper, executive vice chairman of neurology at Brigham and Women's Hospital in Boston and the last chief resident to serve under Adams at MGH. During this time, Adams also studied the neurological and neuropathological effects of Haemophilus influenzae infections, liver disease, and hepatic coma in children. Working with immunologist Byron Waksman at MGH in the 1950s, Adams developed an animal model that simulated multiple sclerosis and Guillain-Barré syndrome that is “still the closest model there is”, according to Ropper. “The idea was novel and implementation was spectacular”, Ropper says. David Louis, a pathologist at MGH and professor at Harvard Medical School, agrees: “He was a true pioneer in the pathology of muscle disease, particularly multiple sclerosis.” Recognising a need for paediatric neurologists, Adams also helped to establish the Child Neurology Service at MGH in the late 1950s and later assisted in creating the Eunice Kennedy Shriver Research Center for Mental Retardation, of which he was the first director. “He really felt [mental retardation] was an under served and under studied aspect of brain science”, says Ropper. In response to surgical advances in organ transplantation in the late 1960s, an Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death was set up and Adams was a member. Along with fellow neurologist and committee member Robert Schwab, Adams described a type of irreversible coma characterised by damage to the cerebral hemispheres and brainstem as being equivalent to brain death and developed tests for determining the extent of damage in a patient. The landmark 1968 report established the modern neurological definition of brain death. Adams graduated from the University of Oregon in 1932 and then received his MD from Duke University School of Medicine. After a brief psychiatry fellowship at Yale University, he moved to Boston City Hospital to study neuropathology. After a decade there, he became chief of neurology at MGH in 1951, a position he held until he retired in 1977. Adams became a professor of neuropathology at Harvard Medical School in 1954 and was chair of the school's department of neurology from 1966 to 1970. Adams wrote many articles and books, including Adams and Victor's Principles of Neurology, a definitive neurological textbook first published in 1977. A devoted mentor, more than 200 professors and department chairmen and chiefs trained under Adams. A clinical research training fellowship in neurogenetics was established in his name in 2002. “He was prescient in recognising the importance of applying genetics to neurology. The advances we are in the midst of right now are happening because of the durable framework and foundation that he and his colleagues laid in describing the underlying neuropathology”, says Waters, who was the first recipient of the award and met with Adams in 2004. Adams' second wife, paediatric neurologist Maria Salam-Adams, predeceased him. He is survived by a son, three daughters, and a stepdaughter.