Neurologist Lewis P. Rowland, MD, FAAN — the consummate editor, teacher, mentor, scientist, chairman, organizer, leader, basketball player, friend, and above all else a romantic and dedicated husband – had a singular purpose: to make things, especially people, better.
The field was dealt an immeasurable loss when the news broke that he had died of a stroke on March 16 at age 91. Dr. Rowland, a leader in the neuromuscular field, died surrounded by his wife, Esther, children and grandchildren, at the same hospital where he inspired hundreds of future neuroscientists and neurologists and helped care for people with amyotrophic lateral sclerosis (ALS) and other neuromuscular diseases.
He was Bud to all. During his six-decade career he chaired two major neurology departments – first at the University of Pennsylvania School of Medicine from 1967 to 1973 and then at Columbia University Medical Center from 1973 to 1998. He served as editor-in-chief of Neurology for a decade (1977 to 1987) and served as president of the American Academy of Neurology (1989-1991) and the American Neurological Association (1980-1981). He was editor of three neurology textbooks — Merritt's Textbook of Neurology, Current Neurologic Drugs, and Clinical Cases in Neurology — and scores of journal articles. He was founder and co-director of the Houston Merritt Clinical Research Center for Muscular Dystrophy and Related Diseases at Columbia University Medical Center as well as founder and co-director of the Eleanor and Lou Gehrig MDA/ALS Center until 1999. He was mentor to many.
Howard I. Hurtig, MD, a neurologist who was hired by University of Pennsylvania neurology chair Bud Rowland in 1969 and remained at Penn for his entire career, had this to say of his lifelong friend and colleague: “Bud imprinted dozens of talented, aspiring young people with his rare blend of fatherly respect, love of science and specialty, devotion to family, and humanistic compassion for those we serve. He had high capacity for moral outrage, high standards for scholarship and written communication, unwavering integrity and professionalism, world-class humor and wit, unselfish collegiality, and a refreshing instinct for timely self-deprecation. To have been Rowland-trained is an enduring and cherished badge of honor and self-satisfaction.”
Lewis P. Rowland was born in 1925 and raised in Brooklyn. He seemed to know by kindergarten that he wanted to be a doctor. By medical school – he went to Yale – he was drawn into studying muscle. He trained as a biochemist. Neurology intrigued him and at first, he was interested in muscular dystrophy. Early in his career he began seeing ALS patients — a disease that would come to define his life work.
He won many awards in his career — too many to mention here — and mentored hundreds of young scientists and neurologists.
“He was a mensch,” said Robert P. Lisak, MD, FAAN, the Parker Webber Chair in Neurology and professor of neurology, immunology and microbiology at Wayne State University in Detroit. He met Bud Rowland in 1961 when he was a freshman in medical school. Dr. Lisak completed his residency at Penn so the two grew even closer. Dr. Rowland took an instant liking to the young man when he learned that they went to the same high school in Brooklyn, Erasmus Hall, which was the second oldest high school in the country.
Dr. Lisak said Dr. Rowland's wit was legendary among the residents. He recalled one encounter in particular — a prominent New York middle-aged woman showed up now and again for total parenteral nutrition, TPN. She was referred as having a myopathy but was actually bulimic. On one visit, the rather short husband approached the then 6'1 Rowland and demanded that she come in more often for TPN. Dr. Rowland smiled and shook his head. Walking away with Dr. Lisak and other residents, he said: “What does that SOB think we are, a filling station?”
When the residents were ready to say good-bye, they bought their chief three gifts: a toy-filling pump, a pair of glasses with ptosis crutches (Dr. Rowland was legendary for dozing at meetings; still half asleep, he would still ask the best questions), and a paper picker-upper because he never missed an opportunity to bend down and pick up an errant bit of paper. At the softball games — he played basketball, as well — the gentle giant would always fess up to a foul. “You take your work seriously,” he used to say. “But never yourself.”
His former residents interviewed recalled Dr. Rowland's daily rounding with patients. He was never without his black book, writing down almost everything about the patient and the thoughts of the residents. What do you think of this or that? Why?
“He'd always quiz us and keep pushing so that we would learn how to think,” said Stanley H. Appel, MD, FAAN, the endowed chair of neurology and director of the Neurological Institute at Houston Methodist. Dr. Appel was a student at Columbia in the late 1950s, and he said Dr. Rowland became the strongest proponent for his career.
Dr. Appel, who had done his undergraduate work at Harvard, wanted to return to Boston for his residency. His mentor was happy to pen a letter of recommendation: “The guy may not know as much as he thinks, but he knows more than most people,” Dr. Rowland wrote.
Like Dr. Rowland, Dr. Appel ended up devoting his life work to ALS. “Bud never took an easy way,” he said. Oh, and about Erasmus Hall. Dr. Appel went to Boston Latin, the oldest public high school, and the two had a longstanding public joke about it until Dr. Appel proved that Boston Latin (circa 1635) had been around more than a hundred years before Erasmus Hall, which opened its doors in 1786.
“He was open-minded and fought against discrimination on every level,” added Dr. Hurtig, the Elliott Professor of Neurology at the Perlman School of Medicine at Penn. “He cared about the underdog and was never afraid to speak his mind.” Dr. Hurtig was at Cornell in the 1960s when the late Fred Plum told him about a new program gaining steam at Penn. Bud Rowland was chair. He looked at the young doctor's resume — he was born in Mississippi — and Bud said: “What's this s...t about Mississippi?” Dr. Hurtig fell in love with him on the spot.
Roger Rosenberg, MD, FAAN, the Zale Distinguished Chair and professor of neurology and director of the Alzheimer's Center at University of Texas Southwestern Medical Center, remembers writing his first scientific paper with Bud Rowland in 1968. He was a resident at Columbia's Neurological Institute. While most remember Rowland's red pen, Dr. Rosenberg recalls blue ink and at least 20 revisions. He was working on a scientific paper on progressive ophthalmoplegia that was due to neurogenic disease. It had extended previous studies that indicated it was always due to a myopathy. Almost 30 years later, Dr. Rowland called him. “Roger, we were wrong.” He'd been going through the archives and a case caught his eye. He called one of the patients and asked her in for another exam. It led him to new diagnosis. The patient actually did have muscle disease. They re-wrote the paper, which was published in 1996 in Archives of Neurology. “Bud,” his colleague said, “When will this be over?” In classic Bud style, he answered: “It aint over until it's over.”
“He made everyone feel important,” added Terrence Cascino, MD, FAAN, professor of neurology at the Mayo Clinic in Rochester and president of the American Academy of Neurology. “He was so highly esteemed and yet so down to earth.”
“He was my hero,” added Susan B. Bressman, MD, FAAN, professor of neurology at the Icahn School of Medicine at Mount Sinai. In 1981, she was set to go into a stroke fellowship at Cornell. She bumped into Columbia's Stanley Fahn at the airport; he'd just received a grant to start a dystonia center. He wanted her in movement disorders. Her Cornell fellowship was in three weeks. Dr. Fahn called Dr. Rowland who picked up the phone and called Fred Plum. “She's staying here,” was all the chairman said, and hung up.
“I loved being around Bud,” Dr. Bressman said. “He was open, and he let you be creative and question anything. He was blind to color and gender and status. He treated everyone the same. He taught us to stop using jargon at the bedside, speak simply, and deliver the news with warmth and compassion.”
Lisa DeAngelis, MD, FAAN, chair of neurology at Memorial Sloan-Kettering Cancer Center in New York, agreed. She got to know Bud Rowland in the early 1980s during her residency at Columbia. “He was a feminist,” she said. “He was enormously generous in time and spirit. He had so much joy in the practice of neurology, teaching and research. We learned how to be objective and still be warm and compassionate with our patients.”
“His interest and passion was boundless,” added Neil Schneider, MD, PhD, who is now director of the MDA/ALS Center at Columbia. When Dr. Schneider finished his residency at Harvard, Dr. Rowland convinced him to return to Columbia, where he'd done his medical and doctoral work. He took the younger scientist physician around to meet his ALS patients. “His love of science and medicine was contagious. I was smitten.”
Dr. Rowland was a symbol of how things change in science and medicine over half a century and how some things stay very much the same. “He brought energy and enthusiasm to everything he did,” said Steven P. Ringel, MD, FAAN, professor and vice chair of neurology at the University of Colorado Medical School, who served with him as cofounding editor of Neurology Today.
“If he could help someone, he would,” added Ralph Sacco, MD, FAAN, chairman and professor of neurology and executive director of the Evelyn F. McKnight Brain Institute at the Miller School of Medicine of the University of Miami. On the day that Bud Rowland died many of his colleagues were at an AAN meeting in Las Vegas, including Dr. Sacco. Upon hearing the news, they bent their heads and closed their eyes for a minute or two of silence, each one recalling their own warm Bud Rowland moments.
“Is someone's legacy the great ideas or the great people,” asked Dr. Appel. “How many great ideas are there? Look what Bud accomplished with all the people he influenced. He pushed us. He provoked us. He made us better in so many ways.”
During an AAN oral history project recorded in 2012, Dr. Rowland said: “I think the most important thing is to pick good people and then leave them alone. I'm not even sure that that's what I did, but I didn't interfere with people. I would encourage them. I guess it's the same thing I try to do when I'm an editor. When I'm an editor I try to help people say what they want to say. Say what they mean. I think when I'm involved with somebody's training, I want to help them do what they want to do. I can't remember ever wanting to stop somebody from doing what they wanted to do.”