Remembering Saul R. Korey, M.D.: 50 Years, A Lasting Legacy

Saul Roy Korey was born on April 12, 1918, in New York City, the elder of two sons of a physician. His younger brother had Down's syndrome and died at the age of 3.

Following high school, he attended Cornell for two years; he left after learning that, at age 16, he could be accepted to the medical school at the University of Western Ontario, in Canada.

Six years later, at just 22, he graduated first in his class with the gold medal and B. T. Mughal Prize in Psychiatry. When his parents attended the graduation, he presented his mother with an open program and said, "Look, they left me off the listing of graduates." Before she could get too dismayed, he closed the program to show her the cover — where, in honor of his class position, his photo and name were prominently displayed.

Shortly after completing his one-year internship in 1940– 41, Korey was drafted into the Coast Guard. An injury he sustained on board ship led to an assignment at the Marine Hospital in New Orleans. Around the time he got out of the hospital, he met and married Doris Broder, who joined him in Louisiana.

While at NI, Dr. Korey met Dr. Irving London, a hematologist who was completing a basic science fellowship, studying the hemoglobin molecule. Dr. Korey followed this example; upon completion of his own residency, he sought a three-year research fellowship in neurochemistry, studying with Dr. David Nachmansohn at Columbia and Dr. Severo Ochoa at New York University. This was highly unusual at the time. Today, it would be the equivalent of completing an M.D./Ph.D.

Following his research fellowship, Dr. Korey was recruited to the neurology service at Case Western Reserve Medical School, in Cleveland, where he remained until 1955.

In 1953, Yeshiva University broke ground for the construction of a new medical school that would bear the name of the great physicist Albert Einstein. It would be the first medical institution in the United States under Jewish auspices; a fundamental concept of the medical school — insisted upon by Dr. Einstein — was that it would be open to all individuals seeking medical education. At the time, already existing medical schools had tacit quotas concerning the acceptance of students from various backgrounds, including Jews, blacks and Italians.

Two years later, prior to the medical school's opening in September 1955, Dr. London — Einstein's first chair of medicine — invited Dr. Korey to join him among the founding faculty members of the College of Medicine. He recruited Dr. Korey to head up the neurology division.

At age 37, Dr. Korey moved back to New York, where he worked closely with Dr. London to establish Einstein as one of the best research medical schools. He told his friend and colleague, "Harvard, move over!"

As Dr. Korey set up the division of neurology, he recruited recent graduates from the NI residency, including Labe Scheinberg, M.D., Robert Katzman, M.D., Isabelle Rapin, M.D., and Elliot Weitzman, M.D., as attending physicians to run the neurology service and residency at the new Bronx Municipal Hospital Center (now Jacobi Medical Center)— Einstein's teaching hospital at the time. Dr. Korey fully expected all these recruits to do research in addition to their clinical duties.

To round out the core of his program, Dr. Korey sought basic science investigators from various disciplines outside neurology to conduct research with the division's neurologists. Among them were young specialists in organic chemistry (William Norton, Ph.D.); biochemistry (Robert Ledeen, Ph.D.); neurochemistry (Kunihiko Suzuki, M.D.); neuropathology (Robert Terry, M.D., Nicholas Gonatas, M.D., and Kinuko Suzuki, M.D.); and neuropsychology (Louis Costa, Ph.D.). All of them were to focus their efforts on innovative, multidisciplinary basic research on human diseases, notably Tay-Sachs and Alzheimer's diseases.

"They took the index of Merritt's Textbook of Neurology and they went through it to pick promising candidates for study," explained Dr. Rapin. "They determined that Tay-Sachs disease and Alzheimer's disease weren't being studied by anyone else, so there wouldn't be competition. Also, a disease like Tay-Sachs, a uniformly fatal genetic disorder that occurs mostly in infants of Jewish descent, though rare, would, with the Ashkenazi Jewish population in New York, be approachable.

"At the time there was an entire ward of about 20 children with the disease in the Jewish Chronic Disease (now Brookdale) Hospital, in Brooklyn. Dr. Korey met with their parents to explain his research plan and to engage the collaboration of a number of them, who gave him access to their children's medical information and further studies."

In addition, Dr. Terry received the first grant supporting Alzheimer's research ever given by the National Institutes of Health (NIH). The team also focused on the more common neurologic disease multiple sclerosis, taking advantage of Dr. Norton's expertise in lipid chemistry.

In pursuing their work, Dr. Korey believed that clues from the bedside could and should be examined at the laboratory bench, and vice versa. "He encouraged interaction between clinicians and scientists, as well as engaging patients and their families as collaborators in the study," noted Dr. Solomon Moshé, a current Einstein faculty member. "This is an important part of the legacy that he left us."

Long a proponent of a multidisciplinary approach to tackling clinical puzzles, in 1957 Dr. Korey and Dr. Milton Rosenbaum, chair of psychiatry, sought and received a grant from the NIH to support an interdisciplinary program geared to postdoctoral fellows in the neurosciences. The grant also allowed Dr. Korey to invite distinguished visiting professors to give lectures and be available for discussions with interested fellows. In addition, it supported research relevant to the nervous system in several departments, as well as providing protected time for young clinician-researchers. This grant continued for 37 years, and served as a key factor in the establishment of Einstein's department of neuroscience.

Among Dr. Korey's lasting contributions to the College of Medicine was his role, along with Dr. London, in convincing the dean at the time, Dr. Marcus Kogel, and Einstein's Board of Overseers that the College of Medicine needed a basic science research building. In the year before his death, Dr. Korey was involved in the details connected to the construction of the Ullmann Research Center for Health Sciences. Unfortunately, during the year that the building was completed, he was diagnosed with pancreatic cancer. He died on September 27, 1963, six months before the new building opened. Ullmann helped expand the research capabilities at Einstein, including providing a home for the first liver center in the United States to receive NIH funding.

Earlier in 1963, a paper written by Albert Szent- Györgyi, a Nobel Prize winner who worked at the Marine Biological Laboratory, in Woods Hole, appeared in Science. It had described a product in urine, called retine, as a cure for cancer.

"When Saul was diagnosed with cancer, all of us who knew about this retine idea thought that we would be remiss if we didn't do our best to get this retine ourselves," recalled Dr. Bill Norton. "I drove up to Woods Hole with Stan Samuels, warning Szent-Györgyi that we were coming. He told us how to make this product and how much urine it was going to take.

"When we got back, we set up a carboy with a funnel on it in every men's room in the Forchheimer Building and directed everyone to use it." (A carboy is a large glass container that has a small neck at the top, which is often used in science labs.)

Colleague Robert Ledeen noted, "People thought we were crazy, but we were on a mission. Our goal was to collect enough of this material so that it might be possible to try this treatment on Saul."

"Some told us that there wouldn't be a doctor here that would give it to Saul," added Dr. Norton. "But we were convinced that we had to do it."

Obtaining the retine from the urine involved an arduous process that included boiling the collected matter down and extracting the by-product. Despite their best efforts, "Saul died before we got any product out that was significant," said Dr. Norton. "It was a great idea, and it tied everybody together, but it wasn't enough." "It's just one indication of how the department as a whole felt about Saul, and how urgent we felt it was to get him back if we possibly could," said Dr. Ledeen.

In 2012, the College of Medicine introduced a new faculty award at commencement, the Saul R. Korey Award for Translational Medicine and Science. The award honors the memory of Dr. Korey and his continuing influence at the medical school and beyond with regard to neurology, neuroscience and translational medicine. It recognizes a faculty member who exemplifies Dr. Korey's philosophy of conducting collaborative research in the laboratory that addresses questions raised through clinical work with patients.

When Dr. Moshé received word of his honor and the date it was to be given, he realized he had a scheduling conflict. He was supposed to attend an NIH-sponsored workshop on autism in Washington, DC. "I'd been working with the organizers for a long time and now I needed to make arrangements to leave early," he recalled. "But all I had to say was ‘I got the Saul Korey Award. I'm going back to get my award,' and everyone involved knew what that meant. The legacy of Saul Korey is much broader than our institution."

The award at Einstein is one of three honors that have been established to honor Dr. Korey's memory. There also is the Saul R. Korey Medical Student Essay Award, established in 1971 and presented by the American Academy of Neurology (AAN), and the Saul R. Korey Lectureship, established in 1989 by former Korey collaborator and Einstein faculty member Dr. Robert Terry and administered by the American Association of Neuropathologists.

The AAN award seeks to stimulate interest in the field of neurology as an exciting and challenging profession by offering a highly competitive award for the best essay in experimental neurology, judged on the basis of the quality of the scholarship and on suitability for an audience of general neurologists.

The Korey Lectureship honors Dr. Korey's vision of an interdisciplinary approach to the study of neurological diseases by basic and clinical scientists that has inspired generations of colleagues and trainees. Dr. Terry, who generously contributed a portion of the prize funds to endow the Korey Lectureship, has summarized the qualities of the Korey Lecturer as "someone who has been an active member of the association...a working neuropathologist... responsible for diagnostic work as well as teaching and research…The Korey Lecturer, then, is someone who has ‘done it all' and ‘done it well.'"

Although he was initially drawn to neurology, Barry's own calling proved to be in psychiatry. He maintained a practice in Westchester County, and headed the borderline inpatient unit at New York Medical College until his premature death at age 52, on September 13, 2008, of ocular melanoma.

Cathie ultimately attended Einstein and pursued a career in internal medicine after first spending 10 years as a community organizer in New York and in the Midwest. She recalled, "One of my fondest memories as a child was going into my father's lab with him."

The family spent every summer in Woods Hole, Massachusetts, where the famous Marine Biological Laboratory is a renowned haven for neurologists and neuroscientists. "All the men would spend the morning in their labs while the women and children were at the beach," said Cathie. "There were only men doing research there, and the only women I recall who were part of the overall scientific community were Drs. Isabelle Rapin, Salome Waelsch and Berta Scharrer—all of whom were members of the Einstein faculty. They were the only female role models in science or medicine that I can remember encountering at that time, and they made a huge impression on me."

She also remembered an occasion when she was about 7 years old and someone asked her what she wanted to be when she grew up. When she replied "a nurse," her father corrected her, saying, "‘No, you'll be a doctor.' He wanted me to know that it was possible, even though at the time there weren't many female doctors."

While Dr. Korey often worked until 1 a.m., using his slide rule to work out mathematical problems in the absence of computers, he also made time for family. Saturday afternoons meant trips into New York City that culminated in visits at his parents' home at 111th Street and Broadway.

"Our father was very close with his parents. He spoke with them every day," recalled Cathie.

She added, "We weren't aware of his influence at Einstein so much, but I do recall his compassion. He had a good friend, a talented scientist who was hospitalized with what would ultimately be diagnosed as schizophrenia. The friend felt isolated because of his illness and I remember my father would have him over to dinner and made sure to keep his friend in the fold, involved in discussions of the field. It was very touching."

In just eight years, Saul Korey established a tight-knit team of researchers and physician-scientists; many of these individuals remained at Einstein for 20 years or more after his death. These people carried forward the interdisciplinary approach to examining issues identified at the bedside and applying theories explored in the laboratory.

The interdisciplinary grant that he received in 1957, which continued for 37 years, may also one day return, thanks to the efforts of Drs. Steven Walkley and John Foxe. The duo plans to submit a similar grant for Einstein's Rose F. Kennedy Intellectual and Developmental Disabilities Center (IDDRC) to provide interdisciplinary training for grad students and postdocs, as well as to seek other possible funding.

"When we wrote the successful grant application for the Rose F. Kennedy IDDRC program, which was awarded funding in 2011, John and I discussed the idea of having a training program that would allow graduate students and postdocs to do work—basic science work—on intellectual disability and, at the same time, have close interactions with physicians and patients in the clinic," said Dr. Walkley. "In conceptualizing such a program, I recalled my experience as a young faculty member here at Einstein, when there were these ID fellows doing work in the Kennedy Center across disciplines. I learned that ‘ID' stood for ‘interdisciplinary,' and that these ID fellows had been funded by a grant that Saul Korey had proposed to the National Institute of Mental Health."

He continued, "So it's really that model that we would like to resurrect now as part of the renaissance of the Kennedy Center. We want to have ID fellows, postdoc fellows and grad students working in basic science labs but really also working with clinicians, or in some cases clinicians working in basic science labs, where particular diseases involving intellectual disabilities in children are the primary focus."

"Many people who were trained by Saul went and changed the face of neurology," noted Dr. Moshé. "Working in the department of Saul Korey, you immediately realize the immense ability that collaborations bring out. Because of the people he recruited, and the way he made us think, we developed the idea of a physicianscientist from day one."

He added, "So, after Saul Korey, there were Bob Katzman, Bob Terry, Bill Norton, Bob Ledeen, the Suzukis, Isabelle Rapin, Labe Scheinberg, Herb Vaughan, Stan Samuels, Herman Buschke, Herb Schaumburg, Cedric Raine and many more. And now, there are me, Mark Mehler and Steve Walkley, Robbie Burk, Bernice Morrow and many others. And we keep increasing the number of people who are emulating Saul's work."

"Korey was a pioneer in his time, and created the model of interdisciplinary scholarship that has been the cornerstone of our institution since its inception," said Dr. Mark Mehler, current chair of the department that now bears Dr. Korey's name.

"In spite of his passing at the young age of 45, just eight years into Einstein's establishment, Saul Korey remains an integral part of our College of Medicine, its culture and its reputation as a leading research, clinical and teaching institution. With his spirit of creativity and humanism, he embodied our current motto, ‘Science at the heart of medicine.' That essence is part of his enduring legacy at Einstein."