How a Doctor Can Heal and Sustain Not Only Patients, but Also Their Families
A Remembrance of Charles Poser’51
Charles Marcel Poser’51, a neurologist internationally renowned for his expertise in multiple sclerosis, died Nov. 11, 2010. He was 86. After escaping Nazi-occupied Belgium with his family, he grew up in New York City and attended George Washington High School and City College. After returning from Army service in World War II, he graduated from City College and earned his M.D. degree from P&S in 1951. He trained at the New York Neurological Institute under Dr. H. Houston Merritt. During a Fulbright Fellowship to Belgium, he studied degenerative neurological diseases and was encouraged to study the diseases of myelin, including multiple sclerosis. The author of hundreds of scientific articles and several influential books, Dr. Poser published the first definitive system for measuring and describing MS. The Poser Criteria were quickly adopted worldwide, withstood the test of time for many decades, and only now are being superseded by newer criteria based on improved imaging technology.
Dr. Poser held teaching posts at the University of Kansas, University of Missouri in Kansas City, University of Vermont, Boston University, Boston’s VA Hospital, and Beth Israel-Deaconess, a Harvard affiliate.
Historian Ellen Fitzpatrick, Ph.D., delivered the remarks below at a January memorial service for Dr. Poser. Dr. Fitzpatrick is the Carpenter Professor of History at the University of New Hampshire and a scholar specializing in modern American political and intellectual history. Dr. Poser treated Dr. Fitzpatrick’s two sisters, who had MS, and became a lifelong friend.
Listening To Patients: Farewell to a Doctor of the Greatest Generation
By Ellen Fitzpatrick
I’m honored to have the opportunity to share a few memories of Charles and to speak as a friend, a family member of two of his patients, and by extension, for those two patients who cannot be here today. We were all privileged to know Charles, who shaped our lives in so many profound and lasting ways.
I met Charles Poser in 1989, not long after my sister Betsy was diagnosed with multiple sclerosis. I was then a beleaguered young assistant professor at Harvard and one of the upsides of the job were the many wonderful people I met at the university. One was a neurologist – Bruce Price – who recommended Dr. Poser to me as the best person to consult on my sister’s condition. I still recall Bruce’s description of Charles: “He is a world renowned expert on multiple sclerosis, with the manner of a country doctor.” In retrospect, I’m not sure what country Bruce was referring to! For the Charles Poser I came to know was a Renaissance man of remarkable experience and refinement – European in so many ways – but also thoroughly American in his sensibilities.
I can remember to this very day the first time I saw Charles. I had secured an appointment with him for my sister and on the day of that initial visit, we sat in a clinic waiting room at Beth Israel watching doctors come and go. As they appeared, carrying charts, their white coats flying, I couldn’t help but wish that some would be this august Dr. Poser and that others would not be. When Charles called out my sister’s name, I felt right then and there an immediate sense of relief. His look of authority, and businesslike tone were offset by his crisp blue Oxford shirt, his khakis, rep tie and best of all LL Bean moccasins. THAT was country!
As the three of us sat down that day in the examining room, Charles took a careful history, did a thorough exam, and reviewed the available tests and scans. His wide knowledge and vast experience with demyelinating disease was more than evident, of course. But it was the dry sense of humor, the wit, the twinkle in his eye, his searching intellect, the ready skepticism, his evident concern and his focus on the way forward that won us over instantly. Those qualities meant as much to my sister and to me at that moment as his reputation and expertise. And as the years unfolded, they really meant everything. As Betsy once wrote in an essay when she was finishing, with great difficulty, her undergraduate degree, she had the help of “my wonderful neurologist Dr. P, who seems like a member of my family.”
In fact, before long Charles and Joan welcomed us into their lovely home on what were often difficult trips to Boston for my sister, who lived on the other side of the state and was already struggling with the early manifestations of her disease. I recall vividly one wonderful evening around the winter holidays when he invited us both to dinner at their Boston brownstone. Joan appeared with a silver tray holding champagne flutes and with evident pleasure Charles popped the cork, poured the bubbles and handed us each a glass. As I reached for my flute, I saw a momentary look of worry pass over my sister’s face – for Charles had just that day started her on a new medication. “Am I allowed to drink this?” she asked, suddenly a patient again to her physician. “Of course,” he replied as he dismissed her concerns with a wave of his hand. “Just don’t tell your doctor,” he added, without skipping a beat.
Over the two decades that followed, Charles took care of Betsy and then helped when my youngest sister also became ill with the same disease. In fact, he took an interest in virtually every person and problem I ever raised with him – readily seeing friends with mysterious neurological symptoms, seemingly intrigued by the challenge of unraveling the riddle that lay beneath. One close friend of mine who consulted Dr. Poser for chronic pain called me after meeting Charles for the first time. He took a very careful history, she reported. And at one point, while doing so, he asked, “Miss --, how much do you drink?” “Dr. Poser, I don’t drink at all,” she replied. “Well,” Charles said, “no wonder you are in pain!” What struck her most forcefully about Dr. Poser, she remembers to this day, was that he really listened to what she had to say. We could fill this room many times over, I have no doubt, with patients who would say the same thing. How rare a quality in these hurried times and yet how essential for healing.
My friendship with Charles and Joan ripened over the years. And as I think over the decades, I remember, of course, so many wonderful evenings and encounters, full of lively conversation, laughter, political analysis – there was little debate for we almost always agreed – great food, and warm company. But I especially recall the Posers’ compassion and generosity. One example particularly stands out in my memory. And that was when Betsy had come to Boston simply for a visit with me – one that was not occasioned by the need for medical treatment but one that – alas – within 24 hours found us in the Beth Israel emergency room because my sister was seizing uncontrollably. It was a weekend, as I recall – of course! – and as the hours unfolded, a parade of nurses, medical students, interns, and residents attended to my sister. Charles was paged. From my vantage point at my sister’s bedside, I could see the ER resident leap for the phone when the intercom alerted him that Dr. Poser was on the line. The resident spoke for some time and then turned and signaled to me. Dr. Poser wanted to speak to me, he said with evident surprise. I got on the phone – it was now perhaps 7 p.m. – and Charles asked me how I was doing. “Okay,” I replied wearily. “Well, Joan and I would like you to come right over here for dinner when you leave the hospital,” Charles instructed. I protested that I was likely to be detained for some time yet. “That’s okay,” he said. “We will wait for you.” And they did. A terrible day thus ended with warmth, and light, and the feeling that life would go on for both my sister and for me.
Thus in time, what began as a relationship formed in the context of my sister’s illness, changed into something more enduring. Betsy was no longer able to travel. I saw Charles and Joan entirely socially – and this gradual evolution was imperceptible really because from the start he had always seemed like more than my sister’s physician. He became an important part of my life – truly a friend regardless of whatever circumstance or need. In fact, what I realized in the months of his final illness, was that although Charles had been my sister’s doctor, he had also taken care of me. He showed the way forward. He lightened the burden of a terrible disease. He made it possible for me to live with loss and the chronic illness of my beloved sisters. And he did this all by example – never by instruction, never by giving advice, never by telling me what to do or think. He did it simply by being who he was … a man who had seen the very worst of what life in the 20th century had to offer but who nonetheless never lost his zest for experience and his joie de vive.
His own life told a powerful story. He had lost loved ones without bitterness, seen suffering on a world stage, experienced the horrors of warfare, seen the ravages of incurable illness. But he enjoyed life, and found ways of delighting in its richness and beauty through his travel, his sea shell collection and military medical badges, the sculptures he made, the books he read, the wine he drank, the movies he watched, the delicious food Joan made him, the friends from every background and station he collected and whose accomplishments he celebrated, the sons and grandson he spoke of with pride and the wife whose love and companionship allowed him to be the physician, scholar, and man we all knew publicly. He went on from life’s reversals and looked with wisdom and vigor for the chapter that lay ahead. He sought an unfolding future of adventure throughout his many years. And in doing all this, he invited us in and never let us go until he ceased to be.
I still expect the phone to ring every now and then and to hear “Ellen, this is Charles.” But I will still hear his voice and I will remember his example for the remainder of my own days. It was the great privilege of my life to have known this remarkable man. I will always cherish his kindness, his compassion, his friendship and the hand he extended to me and to my entire family.