MCKHANN 281Mind, Brain, Body, and Behavior
I. G. Farreras, C. Hannaway and V. A. Harden (Eds.)
IOS Press, 2004
A Forty-Year Journey
Guy McKhann
I want to describe a 40-year journey. I was a Clinical Associate at the
National Institutes of Health (NIH) from 1957 to 1960, when my men
tors were Richard L. Masland and Donald B. Tower, in neurochemistry.
Gerald Fischbach then asked me in 2000 to return to work with him,
Audrey Penn, and Story Landis as associate director for clinical re
search in the institute, so I have a perspective on the National Institute
of Neurological Disorders and Stroke’s (NINDS) intramural research
program that is a little different than that of others. In my comments I
would like to take the tack of discussing what the Neurology Institute
actually did for neurology.
When I arrived at the NIH in the late fifties, neurology, like psychia
try, was unsure what its roots were. To some extent, it overlapped with
neuropsychiatry. But that was not biological psychiatry; at the time it
was Freudian psychiatry. How did that overlap with neurology? It was not
an easy marriage. On the other hand, there was the question of whether
neurology was simply a branch of internal medicine. Was the brain, like
the liver or the heart, part of internal medicine? Why should neurology
be considered a separate entity?
I think one can argue that what the NINDS brought to the table was
the introduction of neuroscience to neurology. For clinicians, neuro
science should be our natural base and that is how we should link the
fields. And I think that what occurred over the intervening period of
time between 1960 and 2000 is very much due to what went on in the
Neurology Institute in the 1950s and 1960s. As an aside, it is rather ironic
that we fought so hard to separate ourselves from psychiatry 50 years
ago and yet now neurology and psychiatry are very much coming back