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P&S Journal

P&S Journal: Winter 1998, Vol.18, No.1
Faculty Remembered

This series, Faculty Remembered, features profiles of former faculty members at P&S. The author of the series is a 1951 P&S graduate and former professor of medicine. He is now special lecturer in medicine and writer-in-residence at P&S.
In the years from 1940 to 1970, P&S enjoyed a golden era: CPMC, arguably, was the leading medical institution in the world, a position it shows signs of recapturing under its present leadership. During that brilliant period of its history, one of the college's greatest luminaries was the laconic Hiram Houston Merritt, chairman of neurology from 1948 to 1968 and later dean and vice president for medical affairs (1958-1970). (Typically, he never used the name "Hiram," a Phoenician word meaning "most noble.")
The range and importance of his accomplishments were so enormous as to seem scarcely believable.

But his background, curriculum vitae, and achievements are less remarkable than his character and personality. For medical students, those years at P&S stand out in memory because the faculty comprised so many truly extraordinary people--not merely adept clinicians, scientists, and teachers, but also great human beings, of whom Houston Merritt was an outstanding example.
Dr. Merritt was born in Wilmington, N.C., a medium-sized town on the Cape Fear River near the southwestern corner of the state. He attended the University of North Carolina and Vanderbilt, taking his M.D. degree at Johns Hopkins in 1926. He spent the next four years at Yale and Harvard, training in general medicine and neurology, followed by two years in neuropathology in Munich. Returning to the United States he rose through the academic ranks at Harvard, mostly at Brigham and Boston city hospitals (1931-1944). By the time he was 40, Merritt had published 54 papers, some of them seminal, and had attained the rank of associate professor of neurology at Harvard. Moving to New York in 1944, he became chief of neuropsychiatry at Montefiore Hospital and professor of clinical neurology at Columbia, where P&S students first encountered him during the neurology clinical clerkship. Recognizing his qualities, Columbia in 1948 appointed him professor of neurology, director of neurology at the Neurological Institute, and chairman of the neurology department. His years as dean (1958-1970) saw the creation of the Black Building (the college's first structure devoted entirely to research) and the start of a productive affiliation with Harlem Hospital, emblematic of
Columbia's concern with its New York City neighbors. Despite heavy administrative burdens, Merritt made outstanding contributions within and outside of P&S in research, teaching, and social medicine. One of the pioneer clinical investigators in neurology, he was instrumental in making it an entity separate from psychiatry. From 1930 to 1979, nearly a half-century, he produced 218 articles, edited six books, and himself wrote 10 more, one a textbook of general neurology that remained the standard for 25 years. His chief interests were the cerebrospinal fluid and neurosyphilis, but his articles, in sum, dealt with nearly every conceivable neurological topic. His major research achievement, with Tracy Putnam, was the development (1936-1939) of diphenylhydantoin (Dilantin) as an effective anticonvulsive agent, showing that antiepileptic and sedative properties could be separated and devising experimental methods for inducing and suppressing epileptic seizures in animals.

In the world of neurology at large, Merritt was a member, often president, of more than 20 prestigious medical and neurological societies and was appointed to 40 or more U.S. government andlay organizations, the latter designed to improve the lot of patients with neurological diseases.

As a clinician, Houston Merritt's acumen was uncanny. Quickly, quietly, unostentatiously, he could cut through complex and confusing case histories, arriving at correct diagnoses in minutes. Watching him perform a neurological examination at the bedside was a revelation. Eliciting a patient's sensory capacity, he did it the gentlest, fastest way: Testing left and right sides simultaneously with pinpricks, he would ask, "How do they compare?" There is no quicker, simpler method; any patient could understand him. Endlessly considerate and compassionate, he accompanied his own patients to the operating room for neurosurgical procedures, allaying anxiety and giving comfort, no matter how early in the morning.
A man of very few words, his manner was unassuming and understated, never remote or austere. If you visited him in the dean's office, he would unfailingly offer you a cigar. He played poker dangerously well. It is told of him that he would while away the time at a formal, dull meeting by stealing away to an obscure room with neurology residents to shoot craps. He liked to dig for clams in the sand with his toes at his seaside place in Branford, Conn., outside New Haven.

Honored by 25 or more organizations and governments here and abroad, he never lost his earthiness and simplicity of manner. Once, at a dinner party crammed with famous people, the conversation among the great and the brilliant waxed long, technical, and contentious. Dr. Merritt, puffing on his inevitable cigar, turned to the wife of a young staff member and whispered, "These guys are all alike."

Houston Merritt, for all his honors, fame, and--it would not be too much to say--genius, remained utterly without "side," that is completely lacking in swagger, perhaps the most telling evidence of his greatness as a man.

The writer acknowledges the help of Dr. Lewis T. Rowland, the Henry and Lucy Moses Professor and Chairman of Neurology at P&S, and Paul Yohannes, Archives and Special Collections assistant.

copyright ©, Columbia-Presbyterian Medical Center

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