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.

Robert C. Darling 19081998 OVER THE PAST 11 YEARS P&S JOURNAL HAS PUBLISHED ABOUT 30 short biographies of P&S faculty members from the 1940s on. The editorial board, the editor, and the writer have tried to convey some sense of the great variety that characterizes this extraordinary group of people. But in one way, maybe not so varied. A critical reader might survey the list and find only an unbroken series of success stories. The Columbia medical faculty has included almost every conceivable personality type. All have possessed unusual ability of one kind or another, but not all have achieved what we call success. It is time to present some accounts of P&S faculty careers that seemed less than spectacular for any number of reasons: shyness, inarticulateness, a lack of aptitude for academic politics, a preoccupation with science that precluded a desire to communicate its subject matter, linguistic ineptitude, specialization in a subject that was simply absent from the radar screen of the medical student of the time.
Such is the story of Robert C. Darling, the Simon Baruch Professor of Physical Medicine and Rehabilitation, who chose a field that most medical students of his era regarded as humdrum: In the age of biochemical miracles achieved by geneticists and therapeutic triumphs that became daily bread for cardiac surgeons, the care of incommunicative oldsters with gait disturbances seemed less than enticing.
I plan to tell a few stories of teachers we remember with difficulty or not at all, but who gave us something valuable even if we failed to notice. Using an old-fashioned idiom, we might think of them as Columbia's unsung worthies.
Robert Darling belongs in the category of under-recognized professors because he worked in a small department with which medical students had little or no contact. He was a basic scientist of extraordinary gifts and large achievements, but even when he became well-established on the P&S campus, his field was viewed by most members of the faculty as rather questionable, perhaps not really an academic discipline. Over a 20-year span of time, Darling changed that view.
Born in upstate New York during the presidency of Theodore Roosevelt, Darling excelled at Harvard College (summa cum laude, 1929) and at Harvard Medical School (magna cum laude, 1934), pursued informal study in Europe on a coveted traveling fellowship, and undertook a medical residency at Presbyterian Hospital in New York. Aiming toward a career in physiology, he spent some years in the study of chronic diseases (not a popular subject with most medical students and residents) with Andre Cournand, David Seegal, Dickinson Richards, and others.
In the early years of World War II he was recruited by the Fatigue Laboratory at Harvard to study topics of military relevance, especially thermoregulation in man (pertinent to the Allied War in the Pacific). Much of his work of the early 1940s was classified. Joining the P&S faculty after the war (after a struggle because the Fatigue Lab regarded him as essential and kept him as long as possible), he worked mainly at the Cardiopulmonary Laboratory at the First (Columbia) Medical Division at Bellevue Hospital under the direction of Nobelists Richards and Cournand. Widely regarded as one of the brightest stars in that group of gifted scientists, Darling developed the mathematics and physics necessary for studying mixtures of gases in the lung, work leading to methods for measuring lung volume and residual air.
By the 1940s Darling was locally and nationally recognized as an authority in most aspects of the human body's response to physical injury — excessive heat or cold or pressure, "the bends" of caisson workers, etc., for which he was invited to write chapters in leading textbooks of medicine (e.g., Cecil's).
Darling's scientific contributions and his deep experience in chronic diseases brought him to the attention of the P&S Faculty of Medicine which was about to convert its Department of Physical Medicine to a broader, more science-oriented unit. Darling became executive officer in 1952 and, six years later, chairman of physical medicine and rehabilitation; the chair was endowed by the financier Bernard Baruch in honor of his father, Simon, a physician who had specialized in hydrology, external application of water to the body, an early form of physiatry.
The faculty member most active in engineering the transformation and growth of the department was Robert Loeb, chairman of medicine. His active participation in this new department helped bring rehabilitation medicine — up to then something of a poor relation — into the ranks of established medical specialties. This was true at P&S, in New York City, and nationally.
That recognition was speeded up and greatly enhanced by the scientific expertise, character, and personality of Darling himself. He was probably a better scientist than most medical school chairmen of that era. Further, he was gifted at rapid scientific intuition. While working with pediatrician Paul di Sant'Agnese on salt and water metabolism in young patients with cystic fibrosis, he was asked one day what he thought might be the basis for certain of their electrolyte abnormalities. He thought hard for a few minutes and answered, "I don't know, but it might be something wrong with their sweat glands." This turned out to be true, and while the now established exocrine defect does not explain everything, the low sodium found in the "sweat test" remains a definitive diagnostic marker.
Darling's training in internal medicine was thorough. He made painstaking rounds on his inpatients and recruited internists, neurologists, and orthopedists to do the same. Last, perhaps most important, there was his personality. A large, solid man with a deep voice, he always seemed to be at peace, a valuable attribute in a clinical field wherein change in a patient's condition moves with excruciating slowness. The writer once ill advisedly asked Dr. John Downey whether he thought Darling might be sort of a saint. Wisely, he replied, "Well, I don't know about saint but the only time I ever saw him be unsaintly was the time he tried to stop smoking."
His patience and forbearance made Darling a superb teacher. No question was too elementary. He had time to answer it. He never talked down but would not quit explaining until he knew the questioner understood thoroughly. His communications — spoken or written — were simple and clear.
By the time he retired in 1973 his department had an active research program (thermoregulation, respiratory physiology), a house staff, an inpatient service, and programs in occupational and physical therapy. Undergraduate medical students were beginning to take an interest. Darling himself was recognized, indeed honored, by his election to the presidency of the leading American scientific society in the field.
Robert Darling's career embodied a perfect case study in what is supposed to happen to a medical school department when it gets married to basic science. Legacies of his contribution to Columbia are to be found in a library on the first floor of Harkness Pavilion and in a physiological laboratory located in the basement of the Black Building. Perhaps his most valuable gift to the University is a living memory of the ultimate grownup, a man who was truly mature. Patient and forbearing, he was never in a hurry.


ACKNOWLEDGMENTS
The writer wishes to thank Dr. Gerard M. Turino for information about Dr. Darling's scientific work, especially in pulmonary medicine. Professor John A. Downey succeeded Dr. Darling as chairman and was generous with his time and patient in answering the writer's many questions. Rosemary Bleha, a retired senior secretary in the department, gave many details about what Dr. Darling was really like. If this profile has a semblance of life, Dr. Downey and Ms. Bleha deserve the credit.

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