Saul J Farber

Abstract

Leader in internal medicine, renal physiologist, and dean of New York University School of Medicine. Born on Feb 11, 1918, in New York, NY, USA, he died of circulatory complications on Oct 11, 2006, in New York, aged 88 years. For decades, Saul Farber used to make medical students at New York University—including this author—tremble in fear on many Saturday mornings. That was when he ran clerkship conferences. “He would call on people, some of whom reacted with horror and dread of the fear he drove into them”, recalled Anthony Grieco, now an associate dean at New York University who first met Farber as a medical student in the early 1960s. The fear wasn't because Farber berated students; it was because they held Farber, who had an air of omniscience, in such high esteem. After students and the faculty discussant had given their conclusions and reasoning, Farber would take things to another level. An example: one patient had what looked like a dilated cardiomyopathy, probably a myocarditis of one sort or another; all the faculty and students agreed on that. Farber got up and said, “this is unknown heart disease, looking at the New York Heart Association criteria”, which he had been instrumental in formulating. “We don't know what it is, on the basis of information we have.” The pathologist then said that Farber was the only one to get the right diagnosis. “His opening gambit as a teacher and speaker was often ‘Let me tell you a story’, setting the stage for a relaxed and grateful audience, and sometimes even heard in one-on-one sessions for personal advice and guidance”, Arthur Fox, a New York University professor of medicine, said in a eulogy for Farber. “But, as others might sometimes learn, he did not suffer fools, ignore addled thinking or excuses for deviations from honesty.” As a result, generations of students were “Farberised”—taught to think analytically and critically, and not to give smug answers or run with the latest fad. Farber was an New York University lifer, earning his BA in 1934 and his MD in 1942. By 1941, while working in James Shannon's laboratory, he, Shannon, and another colleague had published a paper in the American Journal of Physiology, on the measurement of the transport maximum for glucose, which would become a classic. Farber would go on to a career of important work in renal physiology. Farber interned in Baltimore, then served in the US Marines during World War II. He returned to New York University in 1947 as a resident, and remained there for the rest of his career. In 1966, he became chair of the department of medicine and would go on to serve as acting dean, dean, and provost of the medical school and medical centre. Grieco joined Farber's laboratory as a fourth-year medical student, studying renal physiology and the action of anti-diuretic hormone. “During that time, we also were seeing patients with renal and electrolyte problems in the hospital, and would present them to him”, Grieco recalled. “There were no acid-base machines or blood gas machines in the hospital. We would take them to Dr Farber's lab and run them there.” Farber, immunology pioneer Sherwood Lawrence, and rheumatologist and author Lewis Thomas were giants at New York University, and internationally, at the time. “In those days, when Dr Farber would make bedside rounds, it was always standing at the bedside”, Grieco said. “He would always examine, point out clinical findings, and discuss, to a very high intellectual level but also to a high holistic level.” The basic sciences were extremely important to Farber. “When he became dean of the school, one of the aspects of his deanships he was most proud of was that we had some of the strongest basic science departments in our geographic area”, Grieco said. Farber's model for medical administration was a grapevine, one that allowed leaders to cross-cut their departments and divisions. Everyone reported to Farber, and everyone had access to him. One of Farber's biggest disappointments was the merger of New York University and the Mount Sinai School of Medicine in 1998. “It wasn't because he felt that one was superior”, Grieco said. “He felt it was a mistake and wasn't a natural marriage.” Farber turned out to be prescient; the merger fell apart several years later. Farber remained dedicated to New York University and its patients his entire life; on Sept 11, 2001, he showed up at the Bellevue Hospital emergency room, ready to help. He is survived by his wife, Mary Bunim Farber, a son, Joshua Farber, and a daughter, Beth Farber Loewentheil.