Anyone who knows me knows that I am no longer young. Yet I have teachers. My patients are my teachers and some of my colleagues are (still) my teachers. At this stage in the student/teacher relationship we often teach each other: we debate, we discuss, we disagree, we commiserate, we laugh. As one of my general pediatrics colleagues told me the other day “what you do is hard; not everyone can love your patients”. But I know someone who can and does -- now, sadly, past tense could and did: Bryan Lask.
For those of you who knew him, you are weeping alongside me to have lost him. And Bryan did not go gently into that good night. He did not want to go. He had a mountain of research ideas for us to go over in the newly built Kartini Clinic conference room we had dedicated in his honor in March 2015. He skyped about science and neurobiology and life with his most cherished colleague, the one he really admired and looked up to: Ken Nunn. He sat in the easy chair in his London flat -- decorated with books, more books, and paintings -- and read and wrote. Wow, did he write! He had just decided to have his genome analyzed through 23andMe after my husband Steve and he discovered their common ancestry and relatedness through the great Jewish diaspora that sent the Lasks to England and the Nemirows to Ellis Island. He was endlessly curious. And like many of us, as he got older he got more interested in and connected to his ancestry and, in his case, his Jewish ancestry. We talked a lot about that. Areligious as he was, his last text to me offered me the consolation of his wish for us to see each other one more time, to talk again, on another plane, in another existence.
Bryan was the quintessential scientist and researcher, but I know that his final thoughts were not with medicine. They were surely with his family. Health updates he sent to all of us, towards the end, were increasingly not about his health, but about his grandchildren: three little boys and one precious girl in whom he delighted with every breath he took. And of course there were his own two sons and Judith.
One of the last things we did together as Steve and I travelled to London this spring to say goodbye to him -- at his insistence -- was go the theater. He loved the theater. And typical for this social and well-connected man, no sooner had we stepped into a little restaurant across from the theater than he was recognized by a man he had not seen in many years, with whom he had once been at school. Bryan was already in a lot of pain, it was hard for him to walk, but he drew himself up to his full height (not very tall) and chatted delightedly with this school chum who now knew of him only by his reputation.
For those of you who did not know him let me introduce Bryan Lask (1941-2015) and his work. Bryan was a professor with an almost comical tail of titles behind his name: Professor Bryan Lask, FRCPsych., FRCPCH, FAED, M.Phil., MB., BS., LRCP, MRCS, but he preferred to be called 'Bryan'. Don’t get me wrong, despite the soft voice and cultured accent he was something of an authoritarian and commanded respect. He did not tolerate being ignored. He was Professor of Child and Adolescent Psychiatry at St George’s, University of London and Honorary Consultant Psychiatrist to South West London and St George’s Mental Health NHS Trust; he was Consultant Psychiatrist and Medical Advisor to Huntercombe Hospitals, in Maidenhead, Stafford, and Edinburgh, UK and Honorary Consultant Psychiatrist to Great Ormond Street Hospital for Children as well as Visiting Professor, University of Oslo, and Research Director, Regional Eating Disorders Service, Ulleval University Hospital, Oslo, Norway. Who could ignore all that?
Although in the early years of our friendship we argued a lot about the biological basis for eating disorders, as I was then far more convinced than he about the brain-based etiology, he came to be a leading proponent of research on eating disorders as brain disorders. Together with Ian Frampton he wrote Eating Disorders and the Brain; with Ken Nunn and Tanya Hanstock Who’s Who of the Brain; with his long-time collaborator Rachel Bryant-Waugh Eating Disorders of Childhood and Adolescence as well as Eating Disorders: A Parents Guide. He authored literally dozens and dozens of scholarly journal articles and was on the editorial board of several newer, more far-thinking journals in eating disorder research.
Bryan was an intrepid traveler and he loved Oregon. What’s not to love, one might ask? A few years ago he flew in to Portland with six or seven young Norwegian graduate students in tow to “mine the data” Kartini Clinic has accumulated on children with anorexia nervosa. They all camped out at our house in the wine country, bunking together crammed into the guest house and on the couches in the living room, while the Professor had the bedroom of honor (which he -- and we -- called ‘his room’ from then on) and sun bathed in the rare summer sun looking out over the Cascade volcanoes. The graduate students marveled at how we made our own bread and cooked at home (they had heard that Americans only ate fast food), they saw their first hummingbird. Under Bryan’s supervision they set up headquarters in Steve’s painting studio, and plugged in a bank of computers which could talk to Kartini computers to extract their data on “seasonality of birth and its possible correlation to anorexia nervosa”. Bryan kept them all on course, he was strict about quality control in data collection, he encouraged them to tell me their theories (about which I was sometimes skeptical, but politely interested). He was a great synthetic thinker and could draw many threads of ideas together in a way that could be examined objectively. He kept everyone on task. I cooked.
Bryan’s son Gideon now owns a painting Steve did of him that summer: Bryan in a field of Oregon cornflowers. That is how we shall think of him.
The very last thing this man did for his Kartini colleagues, for me, was to send us a little girl with a rare and awe-inspiringly difficult diagnosis: pervasive arousal/withdrawal syndrome (PAWS). On his recommendation the family travelled to Oregon. For a few months he helped guide her treatment. He gave me the courage to treat her. And then he was gone. Her daily improvement, her nearly miraculous healing is now a testament to his inspiration. She is quite possibly the last child he treated. I hope she will live and thrive and one day know the gift of healing and where it started. Could there be a better epitaph?