Many neurologists recall becoming interested in the field – wondering “how the brain works” – when they were quite young, especially those whose parents were neurologists themselves. But Adam Bender, MD, may have them all beat. “I consider myself the youngest person ever to decide he was going into neurology,” he said. “Almost as soon as I learned to talk I was telling people that I was going to be a neurologist. At age three, I told people that I wanted to make people's brains better, like my father did.”
With a father like Morris Bender, MD, young Adam's three-year-old ambition hardly seems surprising. The Chief of Neurology at Mount Sinai School of Medicine in New York, NY, from 1951 to 1973, the late Dr. Bender was a giant in the field; he was a pioneer in the fields of neuro-ophthalmology and disorders of perception, and was world renowned for his clinical acumen. He had been President of the American Neurological Association (ANA), so one of Morris's proudest moments was the election of Adam to membership in the ANA; they were the first-ever father-son members.
WANTING NEUROLOGY AT AGE THREE
Around Christmas, when Adam was still just three years old, Morris took Adam on rounds with him at the San Diego Naval Hospital. “He took us to see a patient who'd had a bullet wound in the head. It caused some sort of organic mental syndrome. The man had grown a small beard, and he told us he was Santa Claus,” recalled Dr. Bender, now Associate Clinical Professor of Neurology at Mount Sinai. “I said to my father, ‘Why does a bullet in your head make you think you're Santa Claus?’ ‘We can't explain how the brain works, he told me, but when something goes wrong with it, things like this can happen.’ I remember being fascinated by that, at age three.”
Morris Bender continued to take his son along on rounds throughout his childhood, often asking his opinion. “My father was very interested in plain vanilla, unbiased opinions of things,” Dr. Bender said. “He felt that physicians were often influenced by what it said in the book or literature, and didn't look at the patient as an individual entity. So he would ask me what I saw – my observations of the patient, not influenced by medical books. I was literally trained in neurology from grade school.”
Among the most fascinating rounds he attended with his father as a child, Dr. Bender said, were what Morris Bender called “Phenomenology Rounds.” Held on Saturday mornings, they drew people from all over New York, and indeed from all around the world. “He'd bring patients with interesting phenomena to present, and he had amazing insights into neurological disease processes,” said Dr. Bender. “Occasionally, he'd bring in two patients who both had aphasia and didn't make sense when they spoke. He'd have them speak to each other. Each patient would realize that there was something wrong and look strangely at the other, but he wouldn't recognize the same phenomenon in himself. It was that kind of thing that fascinated me.”
It is a lucky thing Adam Bender wanted to go into neurology; his father wouldn't countenance anything else! “As far as I was concerned there was no other path – neurology was the only specialty, and medicine was the only career,” Dr. Bender said. “Every time I hinted at possibly thinking about ophthalmology or surgery, my father would get very upset. ‘There is nothing else but neurology!’ he'd say.”
A FAMILY TRADITION
Both Morris Bender and his brother, Israel Bender, immigrants from the Ukraine who settled in Philadelphia in the early part of the 20th century, were extremely prominent in their fields. Israel Bender, who died last year at age 97, was a dentist and a pioneer in endodontics. He was still lecturing in dentistry at the time of his death. “Both brothers went to the University of Pennsylvania and were the first physicians in the family, and after that, everybody followed,” Dr. Bender said.
“Three of my cousins – Andrew Bender, Norman Leopold, and Stephen Sacks – became neurologists, influenced by my father's enthusiasm. My brother-in-law, Dr. Martin Steiner, is also a neurologist. He and my cousins Andrew Bender and Stephen Sacks all trained under my father at Mount Sinai; Norman Leopold trained elsewhere. My brother Barnaby became a dentist and was mentored by my uncle Israel; my sister Leila trained at Mount Sinai and became a psychiatrist; and my daughter, Melissa, is a fellow in infectious diseases at Massachusetts General Hospital.”
Although Adam Bender pursued his father's specialty, he drew the line at sharing a subspecialty. While Morris Bender's primary interests were in cortical neurology, particularly eye movement and perception, after his medical residency at the Columbia Service at Harlem Hospital Center and a neurology residency at Columbia's Neurological Institute in New York, NY, Adam chose to specialize in neuromuscular disease.
“I did this for two reasons. First, I had the honor to go to the NIH after residency. There, the only clinical neurology specialty available in the Medical Neurology branch was nerve and muscle disease, headed by W. King Engel,” he said. “Second, I realized it was an area where I could have my own turf, a subspecialty of neurology that my father didn't know much about. He considered it a medical subspecialty!”
INFLUENCES ON PRACTICE AND TEACHING
By the time Adam joined the faculty at Mount Sinai School of Medicine in 1975, Morris Bender had retired as Chief of Neurology, though he remained on the faculty. “Shortly after I got there, I wrote one paper with him, on a child with neuromuscular disease that he referred to me. I worked the child up and we wrote a paper together that was published in Neurology in 1977. He was very happy that we had published a paper together,” Dr. Bender said. It was the only joint paper they were to publish; Morris Bender died in 1983.
“His way of thinking influenced my approach to neurology very strongly. I am very skeptical of things that can't be proven and have a very careful clinical eye,” said Dr. Bender. “My teaching style is also very similar to his. He would tell me, ‘When you lecture, always assume that you're talking to someone who knows absolutely nothing about the field. Never assume a fund of knowledge, always explain everything you're doing and keep it extremely simple.’ I try to get down to the basics and lecture so that people really understand what I'm saying. I don't say diaphoresis when I mean sweating. I teach as if I'm talking to people, not lecturing them. That comes from my father; he was an extremely good teacher and he inspired a tremendous amount of loyalty in his staff and students.”
Like many neurologists with parents in the field, Dr. Bender said that the most important lesson he learned from his father was this: “You learn from the patient. Every patient is an individual, and the patient is the best textbook and the best research article.”