Article
The Beginnings of the Southern Child/Pediatric Neurology Society
Journal of Child Neurology 1-6 ª The Author(s) 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0883073814524440 jcn.sagepub.com
Paul Richard Dyken, MD1 and John B. Bodensteiner, MD2
Abstract The founding and early development of the Southern Pediatric Neurology Society was in many ways parallel to that of the Child Neurology Society. The organization started out as the Southern Child Neurology Society but the name was changed at the time of incorporation so as to avoid confusion of identity and purpose with the larger Child Neurology Society. Although there are archives of early days and the later development of the Southern Pediatric Neurology Society, the details have never been set down in a narrative explaining the events that led to the development of the organization. In this paper, we try to produce a written record of the history of the founding and early development of the Southern Pediatric Neurology Society. Keywords history, Southern Pediatric Neurology Society, SPNS, Southern Child Neurology Society Received December 10, 2013. Accepted for publication January 06, 2014.
At the 37th Annual Meeting of the Southern Pediatric Neurology Society (SPNS), several younger members of the organization asked the few ‘‘old-timers’’ who attended this meeting to compose some sort of document describing the beginnings and evolution of this small society. Paul Dyken was the first president and founder, when it was called the Southern Child Neurology Society, and John Bodensteiner was an attendant at the third meeting of the society, twice president and a regular attendee of almost all subsequent meetings. Thus, the coauthors of this composition believed it was their responsibility and within their power to write this essay describing the history of the founding and early development of the society. We chose to publish this essay in the Journal of Child Neurology because Dr Roger Brumback, MD, the founding editor of the journal, was a strong and ardent supporter of the Southern Pediatric Neurology Society for many years. The usage of terms must be clarified. At first, in the early 1970s, this small organization was intended to be a regional subunit of the Child Neurology Society (CNS). For this reason, it was initially called the Southern Child Neurology Society or ‘‘club’’ as a few of the small group of early child neurologists preferred. Some, recognizing the club-like nature of the organization, prefer to call it humorously, the Organization of Li’l Neurologists (OLN). In 1975, the first organizational meeting was held and the group was given its first name, that is, the Southern Child Neurology Society (SCNS). But, in 1995, the SCNS was incorporated as the Southern Pediatric Neurology Society (SPNS) on the advice of lawyers so as not to confuse the organization with other organizations with similar abbreviations. Thus, both the terms SCNS and SPNS stand for the
same organization. The final determination, however, is that the society, whatever its name, has now been in existence, holding annual meetings, for nearly 40 years. The first organizational meeting of the Southern Child Neurology Society was in 1975. The archives of the society can be found in Dr Dyken’s medical files in Mobile, Alabama. Review of the correspondence found in these files was useful in documenting this true-fiction essay; the non-anecdotal material still remains our (possibly opinionated) point of view.
The Early Days Although the first organizational meeting was on February 1, 1975, it was not until January 26, 1976, that the first scientific meeting took place. Both of these meetings were held at the Braniff Place Hotel in New Orleans, and followed the yearly meeting of the Southern Society for Pediatric Research (SSPR). The first thoughts for a regional meeting of southern child neurologists, however, developed years prior to 1975 and related to the formation of the Child Neurology Society. The CNS was founded by Ken Swaiman and 7 other pediatric neurologists from the upper Midwest in the winter of 1972 at 1 2
Mobile, Alabama, USA Mayo Clinic, Rochester, MN, USA
Corresponding Author: John B. Bodensteiner, MD, Child and Adolescent Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Email: [email protected]
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LaCrosse, Wisconsin. The objective of the meeting was to form a national society. Long before this major meeting, however, several smaller ‘‘club-like’’ meetings had been held with essentially the same members in attendance under the banner of the Upper Midwestern Group of Child Neurologists. Paul Dyken was then Director of Pediatric Neurology at the Milwaukee Children’s Hospital (now Children’s Hospital of Wisconsin) and Chairman of the Neurology Department of the Medical College of Wisconsin. He was member of the Upper Midwest group as well as being one of the 8 original founders of the CNS. At these informal get-togethers, papers were presented to small audiences of faculty and trainees, and there was a camaraderie which became the very definition of ‘‘club-like.’’ Yet, the meetings were still academically oriented. Richard Allen, the Director of Child Neurology at the University of Michigan in Ann Arbor and another of the founding fathers of the CNS, was also asked to attend the LaCrosse meeting. On the day the meeting was to begin, Dr Allen caught a flight from Ann Arbor to Milwaukee where Dr Dyken was to pick him up. Together, they were to drive across the state to La Crosse for the meeting starting that night (a Friday in January). It happened to be snowing that morning and the snowstorm, a pretty violent one at that, continued into the afternoon as they set out in Dyken’s Chevy. While driving through the blinding snow storm to the LaCrosse meeting of 1972, Drs Allen and Dyken discussed the proposals by Swaiman for holding the meeting in the first place, and the wisdom of the formation of a new society specifically for child neurologists. Dyken expressed his view that a more exclusive ‘‘clublike’’ organization would be better than one likely to become large and unwieldy, much like the American Academy of Neurology (AAN) had become at that time. Dr Allen cautiously mentioned that a plan had already been developed to form a much larger group and continuing as a small group was unlikely. While dodging sliding automobiles on the ice-covered highway, Dyken became convinced that an organization much like the American Academy of Neurology was predestined, and he would not bring up the subject of a smaller ‘‘club-like’’ CNS again in the conversation. The name of the nascent society was discussed at length at the first get-together at a bar. When the issue of the name of this new organization was brought up, specifically whether to call the society ‘‘child neurology’’ or ‘‘pediatric neurology,’’ one of the founding fathers wrote on a napkin ‘‘CNS’’ (and circulated it to the other members). Those present wholeheartedly agreed that the group should call themselves the Child Neurology Society, since their ‘‘core’’ was more with the central nervous system than with child health in general. The handwritten note, written by Dyken but collected and saved as a memento by Dr Swaiman, can still be found within the Archives of the Child Neurology Society at the University of Minnesota in Minneapolis. The first official meeting of the CNS was scheduled to be held in Ann Arbor (at Dr Allen’s suggestion) in the fall of 1972. Here, Dr Swaiman was elected president, and Douglas Buchanan gave the first Hower Award lecture. Dr Buchanan
was the mentor in child neurology of 2 of the CNS founding fathers, Dr Manuel Gomez and Dr Paul Dyken. Early in the organization of the CNS, it was decided to separate the society into regions and that a ‘‘Councillor’’ would be elected for each region. This was done to take away the stigma that this society was exclusively for Midwesterners. Councillors from East, West, Midwest, and South were to be elected by the general membership, but members were to be located in the area in which they practiced. Dr Jim Schwartz was elected the Councillor from the South at the first meeting. Dr Dyken had moved from Milwaukee to Augusta, Georgia, in June 1972 to become the Director of Pediatric Neurology within a Department of Neurology newly formed by his friend Joe Green, at the Medical College of Georgia. Dr Schwartz was then in Atlanta at the Grady Hospital and at Emory University though he was born in Milwaukee, and his father (considered by many the father of Pediatrics in Milwaukee) was still in limited practice there when Dyken was at Milwaukee Children’s Hospital. Dr Schwartz later became president-elect at the third meeting of the CNS at Madison, Wisconsin, in 1974. Also at Madison, Paul Dyken was elected the new Councillor from the South. At this third CNS meeting, several members of the southern section had suggested forming a smaller group meeting. It was well known that the Councillors were elected by the entire membership and not by just the southern members. A ‘‘club-like’’ organization seemed like a good idea, and Dyken charged forward in communicating with all the members listed in the CNS registry as being from the South. It is of interest that Arkansas, in spite of Civil War history, was considered by the rather uninformed Midwestern Yankees to be located in the Midwest in the original CNS division into representative areas. Dr Dyken, at this time on the executive board of the CNS, after much correspondence with the president at the time, Dr Manuel Gomez, eventually got the 2 Arkansas representatives, who really wanted to join the South, reclassified as southern state representatives. As it turned out, there were 54 Southern CNS members listed. Adding the 2 members from Arkansas made a total of 56 automatic, initial members of what was to be called the Southern Child Neurology Society. Of these, approximately 80% seemed in favor of developing such an organization. It was overwhelmingly agreed that the ‘‘club’’ should be clinically oriented and informal in format, although being academic in type. It so happened that an organizing meeting had been arranged by Dr Dyken in conjunction with the annual meeting of the Southern Society for Pediatric Research, where the latter organization would loan a room at the end of their conference at no charge for the purpose. The Southern Society for Pediatric Research meetings were scheduled to close at the Braniff Place Hotel in New Orleans on February 1, 1975. Dr Caroline Duncan, in her quiet fashion, supported having the first organizational meeting, particularly because it was to be held in New Orleans. Several key letters of approval were sent to the older leaders of the specialty who then worked in the South, such as Tom Farmer (from North Carolina) and Dave Clark (from Kentucky). These 2 gentlemen ran sections for the American
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Board of Psychiatry and Neurology (ABPN) and both Farmer and Clark were directing examinations in New Orleans in the first or second week of 1975. Dr Dyken was examining for Dr Farmer, and Caroline Duncan was examining with Dr Clark. Many Child Neurologists, including Drs Manuel Gomez and Bruce Berg (and several Southerners as well), were to be at these meetings. It was decided to have a short pre-formation meeting of the ‘‘club’’ at this juncture. Unfortunately, little organizational work was accomplished because of the lure of fine culinary establishments in town made known to the group by Drs Gomez and Berg. Dr Gerry Golden came to this preorganizational meeting. Although he could not attend the already scheduled February meeting, Dr Golden later gave much support to the formation of the Southern CNS. Dr Caroline Duncan was also very supportive of the formation of our Southern organization. There were 11 southern child neurology members at this first organizational meeting in February of 1975. There is no written record about who was physically present at this meeting; however, Dr Dyken remembers Caroline Duncan (from New Orleans), Paul Dyken (from Augusta), Ron David (from Richmond), JT Jabbour (from Memphis), Pat Hartlage (from Augusta), Gwen Hogan (from Jackson), John Benton (from Birmingham), Ray Mackay (from San Antonio), Joel Ruttman (from San Antonio), Richard Curless (from Miami), and Robert Boehm (from Memphis). The list is from memory and it is possible the following members may have also attended this first meeting: Robert Baumann, Carmela Tardo, Susan Iannoconne, and Ed Myer. At the meeting, to stress the relationship to the parent CNS, the members definitely wished to call the organization the Southern Child Neurology Society. It was also decided that there be only 1 officer, called ‘‘the Chairman’’ (who was later to be called the President). Paul Dyken was to be the first Chairman or President, and it would be his duty, as with the presidents to follow, to organize the scientific meetings, the first of which was to be in a year (1976). Caroline Duncan (who refused to be an officer) was to help in the local arrangements, because for a conference in January or February, New Orleans was considered a desirable location. We wanted to have a small meeting with the hopes of an open bar (Dr Dyken was the Chairman of the organization at this point) and it was to be at the Braniff Place Hotel as long as the Southern Society for Pediatric Research would provide us a with a free room. We did not wish to sever any relationships with Pediatrics or Neurology but wanted to call ourselves the Southern Child Neurology Society, because most of the members considered the organization to be a regional branch of the parent CNS. It was even considered by the incoming president that the office be given to the elected Councillor from the South of the CNS, but this was disapproved because the southern members of the CNS did not have control of who would be elected Councillor from the south because the Councillors of the CNS were voted for by the general membership of the CNS. The principles of the organization established at that first organizational meeting of the Southern Child Neurology Society are contained in Appendix A. The actual first scientific meeting of the Southern Child Neurology Society was stuck on at the end of the Southern
Society for Pediatric Research’s 2-day meeting (on January 24, 1976). Nine papers were given. Each was allowed a 20-minute period for presentation. They were given on one afternoon: January 24, 1976, between 2 and 5 PM, at the Braniff Place Hotel in New Orleans (Appendix B). It was thought that the meeting was very successful. Dyken was re-elected as the second Chairman or President and all the rules mentioned previously were to be continued and the expenses assumed by the chairman and local arrangement person. The following letter was sent to all ‘‘Southern CNS Members’’ after this meeting: Dear Southern CNS Member, The recent first scientific meeting of the Southern Child Neurology Society was attended by 19 members of our organization (if you include one resident, one wife and 2 bellhops who brought in the drinks). Seriously 15 active members of a total membership of 64 must be considered a very successful turn out. Eight very fine informal papers were presented. I personally learned a lot about galactosemia, amoebic meningoencephalitis, neurological complications of amniocentesis, SSPE and SSPE-like syndromes, Reye’s syndrome, infantile spasms, other myoclonic syndromes and in general a great deal of potpourri concerning our specialty of child neurology. Those giving papers should be highly complimented!! At the brief business meeting which followed the scientific meeting, before all of us stuffed ourselves at our favorite New Orleans restaurant, the following suggestions were made into law (remember that laws are made to be broken!): 1) A second ‘‘chairman’’ of our organization was selected for the next year. The chairman’s responsibility is to organize the annual meeting, to select the papers and to pass on occasional BS to the membership. 2) Because of the convenience of having our small meeting in juxtaposition to the various meetings which meet in New Orleans in late January of each year and because of the excellent local arrangement committee (chaired by Caroline Duncan with active support from Carmela Tardo and Susan Iannoccone), our next meeting was scheduled for January, 1977, in New Orleans. 3) It was stated that a similar format to our first meeting be established in the future with encouragement of trainees to submit papers to our group. These represent the major points of discussion in our business meeting which can be shared with all who were not fortunate enough to be able to attend. Sincerely, Paul R. Dyken, MD Second Chairman Southern Child Neurology Society
The second scientific meeting of the Southern Child Neurology Society was held again at the Braniff Place Hotel in New
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Orleans on January 29, 1977. The scientific program consisted of 11 papers (Appendix C). At this second meeting, Ray Mackay was elected the third president of the Southern Child Neurology Society and was to be responsible for the program at the third meeting of the Southern Child Neurology Society in 1978. The third meeting was memorable for it was not held in a plush hotel like the Braniff Place but in the rather gloomy basement of the old Charity Hospital in New Orleans. The meeting was held here for financial reasons. The Southern Society for Pediatric Research meeting was to be held in the morning of that day, and 3 papers by southern child neurologists were to be presented at this meeting. Yet the Southern Society for Pediatric Research could not furnish us a room at no expense, so Ray Mackay and Caroline Duncan decided to put an afternoon session up at the Charity Hospital at no organizational expense. Paul Dyken can still remember wandering around that huge facility in a panic and finally being greatly relieved to see Dr Caroline Duncan pushing a cart down the hall with a variety of liquid refreshments on board. ‘‘Maggie’’ was headed to the meeting held in the basement. Caroline furnished all the refreshments at her own expense, a factor that endeared her to all the members attending, senior and junior alike. The third meeting was the first that Dr John Bodensteiner attended. He had been brought to the meeting by Dr Gerry Golden and was a junior faculty member at the University of Texas Medical Branch at Galveston. Dr Bodensteiner also believed the meeting to be unique for several reasons. He remembers sitting patiently in the audience, hearing Dr Dyken present a unique case with a hereditary midline hemangioma and dolichocephaly in which Dyken incorrectly misquoted some statistics on changing head size without properly presenting the physics of the matter. John pleasantly corrected Dr Dyken’s error and what was to be a lifelong friendship, unbeknown to the participants at that time, was established. The pick-up of the error in the small group atmosphere of the meeting and voicing it in public without fear of animosity on the part of either the presenter or the commentator became the operational norm for this small ‘‘club-like’’ society. This attitude still lives on today. The program given at the third annual afternoon meeting of the Southern Child Neurology Society is in Appendix D. As mentioned, 3 papers were given at the Southern Society for Pediatric Research meeting by members of the Southern Child Neurology Society. These were by Ron David on ‘‘Normal Intelligence in Microcephalics,’’ Lee Chalhub on ‘‘Recognition and Management of Reye Syndrome,’’ and John Bornhofen on ‘‘Ultrastructural Study in Pelizaeus-Merzbacher Disease.’’ Dr Ron David was elected the fourth president at the afternoon meetings. He and other Southern Child Neurology Society members as well attended both the Southern Society for Pediatric Research morning meeting and the Southern Child Neurology Society afternoon meetings. The Third Annual Meeting of the Southern Child Neurology Society of 1978, as usual, was enjoyed by all. After the meeting, Drs Golden, Bodensteiner, and Dyken went to dinner at the rather expensive Manali’s. It was at this dinner, after
waiting for a good hour to be seated, that Dr Dyken was to demonstrate the proper way to eat unshelled barbecued shrimp much to the amazement of Dr Bodensteiner who had never before seen anybody eat the entire shrimp, shell and all (Bodensteiner had only known frozen cardboard shrimp before, an unintended consequence of being brought up in the upper Midwest). With a little prompting, Dr Bodensteiner can still be persuaded to recount the evening. Thus, the beginning and the early evolution of the Southern Child Neurology Society/Southern Pediatric Neurology Society was completed. During the subsequent decades, there have been several traditions established at the annual meeting. The Dr Caroline Duncan Award was the first, established to honor Dr Duncan and her contributions to the Southern Pediatric Neurology Society throughout its existence. The Caroline Duncan award was presented each year to the best paper/abstract presented by a Student/Resident. The Journal of Child Neurology/Sage award was established by Dr Roger Brumback with a generous stipend included, at the 21st annual meeting of the Southern Pediatric Neurology Society and is given each year to the best paper/abstract presented at the meeting, including eligibility for the junior members of the society. Over time, the focus of the meeting has shifted somewhat, so that now the students and residents are the only ones presenting papers at the annual meeting. The Duncan award is now given to a presenter who has not completed training, as an encouragement to them and an inducement to consider an academic career in Child Neurology just as Dr Duncan encouraged so many of her students to do so. In addition to the awards given for the best presentations/ abstracts, there are 2 lectures given by invited guests each year, the Dyken Scholarship Lecture and the Bodensteiner Presidential lecture. The Dyken Scholarship lecture is so named in recognition of his contributions to the society throughout the life of the Southern Pediatric Neurology Society and similarly the Bodensteiner Presidential lecture is so named to recognize contributions, past and ongoing, to the organization. The most recent of the established traditions is the Jean Teasley Social Hour reception following the meeting when the members and the presenters have a chance to get to know each other in an informal setting that fosters camaraderie and encourages intellectual exchanges between junior and senior attendees. The Southern Pediatric Neurology Society as an organization has had 39 consecutive annual meetings (as of 2013) with a stated purpose of providing opportunities for residents, students, and junior faculty to present research in an informal, nonthreatening setting. The opportunity to interact with other child neurologists in a small, informal setting without fear of embarrassment is, if not unique, certainly unusual in these times. Furthermore, we believe that those junior child neurologists, who have had the opportunity to participate in such exchanges, cherish the occasion and make up the largest part of the group of pediatric neurologists who regularly attend the annual meeting of the Southern Pediatric Neurology Society.
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Appendix A
2.
The Archives of the SC/PNS (Southern Child/Pediatric Neurology Society) reveal the following principles for the organization of the Southern Child Neurology Society proposed at the first organizational meeting in 1975.
3.
1. All of the southern members of the Child Neurology Society listed in this registry would be given automatic membership in the society. 2. The annual meeting would be informal and clinically oriented. Booze would be allowed, as it was at the organizational meeting. 3. Junior members would be encouraged to give papers and join the society. 4. There would be only 1 officer for the organization who would be responsible for scheduling the annual meeting and organizing the program. 5. Paul Dyken was to act as this first Chairman or President of the organization. The only other member of the organization who also attended the 38th annual meeting in 2012 was Caroline Duncan. It was suggested that she also be an officer but she withdrew her name, offering her name to become a local arrangements person as an aide to the Chairman. 6. No dues were required and no registration fees were anticipated. 7. A relationship to the annual meeting of the Southern Society for Pediatric Research in New Orleans would be continued as long as it was not expensive for the chairman and local arrangements person.
Appendix B These were the titles, the speakers, and the location of the presenters at the first meeting of the Southern Child Neurology Society. 1. 2. 3. 4. 5. 6. 7. 8. 9.
Thoughts on Galactosemia by Ruttman, Texas Amoebic Meningoencephalitis by David, Virginia Subdurals After Amniocentesis by Duncan, Louisiana Pertinent and Planned Observations on SSPE by Jabbour, Tennessee SSPE-Like Syndromes by Jabbour, Tennessee Reyes Disease by Hartlage, Georgia New Diagnostic and Treatment Plans for Infantile Spasms by Dyken, Georgia Childhood Myoclonic Syndromes by Dyken, Georgia Potpourri by Everyone
Appendix C The papers presented at the second meeting of the Southern Child Neurology Society meeting January 29, 1977. 1. At 1:00 PM, Pat Hartlage and guest Jill Trefz from Augusta, Georgia gave a paper on ‘‘Neonatal Phosphorylase Deficiency.’’
4.
5.
6.
7.
8.
9.
10.
11.
At 1:20 PM, Joel Ruttman from San Antonio, Texas gave another paper on ‘‘Galactokinase Deficiency in Two Siblings.’’ At 1:40 PM, a paper, ‘‘An Extrapyramidal Syndrome With Ophthalmoplegia, Optic Atrophy and Seizures,’’ was given by William Logan, who was then at Charlottesville in Virginia. Twenty minutes later, at 2:00 PM, Caroline Duncan and guest Charles Kaufman, both from New Orleans, gave a presentation on ‘‘Acute Familial Intermittent Encephalopathy.’’ This was followed at 2:20 PM by the presentation by San Antonio Texans John Seals and Ray Mackay of ‘‘Normokalemic Periodic Paralysis With Cardiac Conduction Defect.’’ At 2:40 PM Caroline Duncan and guest Paul McGarry presented ‘‘Unilateral Megalencephaly. An Indication for Hemispherectomy?’’ At 3:00 PM guest Dean Timmons from Akron, Ohio spoke on ‘‘Turner-Like Phenotypes With Unusual Chromosome Patterns.’’ At 3:20 PM, Lawrence Ch’ien and guest G. Economides from Memphis, Tennessee spoke on ‘‘Seizures and Sydenham’s Chorea.’’ Mackay and Seals gave a second paper at 3:40 PM, on ‘‘Immunoglobulin Abnormality in the SchwartzJampel Syndrome.’’ At 4:00 PM , like clockwork, Robert Boehm and J. T. Jabbour from Memphis gave a paper on ‘‘Bilateral Carotid Occlusion in Children.’’ The 11th paper was started at 4:20 PM when all of those in the audience, except the speaker who was Mary Andriola, were getting quite hungry. Mary (then from Clearwater, Florida) gave a very lengthy but good discussion on ‘‘Hypoparathyroidism vs. Hypomagnesiumemia in Ophthalmoplegia Plus.’’
Dr Dyken, who did not give any papers at this meeting but was serving as the monitor, stood up and waved to the speaker many times during the last 20 minutes of Dr Andriola’s 40-minute talk (scheduled for 20 minutes like all the presentations). Dr Andriola just smiled sweetly, although knowingly, at his frantic efforts, and continued to the end of her talk, resulting in the business side of the meeting being severely shortened.
Appendix D Program of the Third Annual Meeting of the Southern Child Neurology Society 1:00 PM. ‘‘The Prevalence of Epilepsy in Two Groups of Southern School Age. Children’’—Robert Baumann, Martin Marx, and Mary Leonidakis; Lexington, Kentucky.
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Journal of Child Neurology 1:20 PM. ‘‘Subarachnoid Hemorrhage Complicating Acute Poststreptococcal Glomerulonephritis’’—Martin DeBeukelaer and Gilbert Young; Charleston, South Carolina. 1:40 PM. ‘‘Alice in Wonderland Syndrome in Juvenile Migraine’’—Gerald Golden; Galveston, Texas. 2:00 PM. ‘‘Persistent Hyperreflexia in Polyradiculopathy’’—Roy Elterman; San Antonio, Texas. 2:20 PM. ‘‘Familial Muscle Cramps’’—John Bodensteiner; Galveston, Texas. 2:40 PM. Break and Business Meeting.
3:40 PM. ‘‘Persistent Midline Capillary Hemangiomas of the Metopic Area: An Apparent Autosomal Dominant Syndrome’’—Floyd Harr and Paul Dyken; Augusta, Georgia. 4:00 PM. ‘‘Developmental Aphasia: The Basic Neurology’’—R. D. Brooke Williams; Memphis, Tennessee. 4:20 PM. ‘‘Aflatoxin and Reyes Syndrome’’—Gwendolyn Hogan; Jackson, Mississippi. 4:40 PM. ‘‘Recurrent Hypersomnia, Hyperplasia, Hypersexuality and Personality Change or ‘Kleine-Levin Syndrome’’’—Gualberto Marrero; Augusta, Georgia.
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The Beginnings of the Southern Child/Pediatric Neurology Society
Journal of Child Neurology 1-6 ª The Author(s) 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0883073814524440 jcn.sagepub.com
Paul Richard Dyken, MD1 and John B. Bodensteiner, MD2
Abstract The founding and early development of the Southern Pediatric Neurology Society was in many ways parallel to that of the Child Neurology Society. The organization started out as the Southern Child Neurology Society but the name was changed at the time of incorporation so as to avoid confusion of identity and purpose with the larger Child Neurology Society. Although there are archives of early days and the later development of the Southern Pediatric Neurology Society, the details have never been set down in a narrative explaining the events that led to the development of the organization. In this paper, we try to produce a written record of the history of the founding and early development of the Southern Pediatric Neurology Society. Keywords history, Southern Pediatric Neurology Society, SPNS, Southern Child Neurology Society Received December 10, 2013. Accepted for publication January 06, 2014.
At the 37th Annual Meeting of the Southern Pediatric Neurology Society (SPNS), several younger members of the organization asked the few ‘‘old-timers’’ who attended this meeting to compose some sort of document describing the beginnings and evolution of this small society. Paul Dyken was the first president and founder, when it was called the Southern Child Neurology Society, and John Bodensteiner was an attendant at the third meeting of the society, twice president and a regular attendee of almost all subsequent meetings. Thus, the coauthors of this composition believed it was their responsibility and within their power to write this essay describing the history of the founding and early development of the society. We chose to publish this essay in the Journal of Child Neurology because Dr Roger Brumback, MD, the founding editor of the journal, was a strong and ardent supporter of the Southern Pediatric Neurology Society for many years. The usage of terms must be clarified. At first, in the early 1970s, this small organization was intended to be a regional subunit of the Child Neurology Society (CNS). For this reason, it was initially called the Southern Child Neurology Society or ‘‘club’’ as a few of the small group of early child neurologists preferred. Some, recognizing the club-like nature of the organization, prefer to call it humorously, the Organization of Li’l Neurologists (OLN). In 1975, the first organizational meeting was held and the group was given its first name, that is, the Southern Child Neurology Society (SCNS). But, in 1995, the SCNS was incorporated as the Southern Pediatric Neurology Society (SPNS) on the advice of lawyers so as not to confuse the organization with other organizations with similar abbreviations. Thus, both the terms SCNS and SPNS stand for the
same organization. The final determination, however, is that the society, whatever its name, has now been in existence, holding annual meetings, for nearly 40 years. The first organizational meeting of the Southern Child Neurology Society was in 1975. The archives of the society can be found in Dr Dyken’s medical files in Mobile, Alabama. Review of the correspondence found in these files was useful in documenting this true-fiction essay; the non-anecdotal material still remains our (possibly opinionated) point of view.
The Early Days Although the first organizational meeting was on February 1, 1975, it was not until January 26, 1976, that the first scientific meeting took place. Both of these meetings were held at the Braniff Place Hotel in New Orleans, and followed the yearly meeting of the Southern Society for Pediatric Research (SSPR). The first thoughts for a regional meeting of southern child neurologists, however, developed years prior to 1975 and related to the formation of the Child Neurology Society. The CNS was founded by Ken Swaiman and 7 other pediatric neurologists from the upper Midwest in the winter of 1972 at 1 2
Mobile, Alabama, USA Mayo Clinic, Rochester, MN, USA
Corresponding Author: John B. Bodensteiner, MD, Child and Adolescent Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Email: [email protected]
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LaCrosse, Wisconsin. The objective of the meeting was to form a national society. Long before this major meeting, however, several smaller ‘‘club-like’’ meetings had been held with essentially the same members in attendance under the banner of the Upper Midwestern Group of Child Neurologists. Paul Dyken was then Director of Pediatric Neurology at the Milwaukee Children’s Hospital (now Children’s Hospital of Wisconsin) and Chairman of the Neurology Department of the Medical College of Wisconsin. He was member of the Upper Midwest group as well as being one of the 8 original founders of the CNS. At these informal get-togethers, papers were presented to small audiences of faculty and trainees, and there was a camaraderie which became the very definition of ‘‘club-like.’’ Yet, the meetings were still academically oriented. Richard Allen, the Director of Child Neurology at the University of Michigan in Ann Arbor and another of the founding fathers of the CNS, was also asked to attend the LaCrosse meeting. On the day the meeting was to begin, Dr Allen caught a flight from Ann Arbor to Milwaukee where Dr Dyken was to pick him up. Together, they were to drive across the state to La Crosse for the meeting starting that night (a Friday in January). It happened to be snowing that morning and the snowstorm, a pretty violent one at that, continued into the afternoon as they set out in Dyken’s Chevy. While driving through the blinding snow storm to the LaCrosse meeting of 1972, Drs Allen and Dyken discussed the proposals by Swaiman for holding the meeting in the first place, and the wisdom of the formation of a new society specifically for child neurologists. Dyken expressed his view that a more exclusive ‘‘clublike’’ organization would be better than one likely to become large and unwieldy, much like the American Academy of Neurology (AAN) had become at that time. Dr Allen cautiously mentioned that a plan had already been developed to form a much larger group and continuing as a small group was unlikely. While dodging sliding automobiles on the ice-covered highway, Dyken became convinced that an organization much like the American Academy of Neurology was predestined, and he would not bring up the subject of a smaller ‘‘club-like’’ CNS again in the conversation. The name of the nascent society was discussed at length at the first get-together at a bar. When the issue of the name of this new organization was brought up, specifically whether to call the society ‘‘child neurology’’ or ‘‘pediatric neurology,’’ one of the founding fathers wrote on a napkin ‘‘CNS’’ (and circulated it to the other members). Those present wholeheartedly agreed that the group should call themselves the Child Neurology Society, since their ‘‘core’’ was more with the central nervous system than with child health in general. The handwritten note, written by Dyken but collected and saved as a memento by Dr Swaiman, can still be found within the Archives of the Child Neurology Society at the University of Minnesota in Minneapolis. The first official meeting of the CNS was scheduled to be held in Ann Arbor (at Dr Allen’s suggestion) in the fall of 1972. Here, Dr Swaiman was elected president, and Douglas Buchanan gave the first Hower Award lecture. Dr Buchanan
was the mentor in child neurology of 2 of the CNS founding fathers, Dr Manuel Gomez and Dr Paul Dyken. Early in the organization of the CNS, it was decided to separate the society into regions and that a ‘‘Councillor’’ would be elected for each region. This was done to take away the stigma that this society was exclusively for Midwesterners. Councillors from East, West, Midwest, and South were to be elected by the general membership, but members were to be located in the area in which they practiced. Dr Jim Schwartz was elected the Councillor from the South at the first meeting. Dr Dyken had moved from Milwaukee to Augusta, Georgia, in June 1972 to become the Director of Pediatric Neurology within a Department of Neurology newly formed by his friend Joe Green, at the Medical College of Georgia. Dr Schwartz was then in Atlanta at the Grady Hospital and at Emory University though he was born in Milwaukee, and his father (considered by many the father of Pediatrics in Milwaukee) was still in limited practice there when Dyken was at Milwaukee Children’s Hospital. Dr Schwartz later became president-elect at the third meeting of the CNS at Madison, Wisconsin, in 1974. Also at Madison, Paul Dyken was elected the new Councillor from the South. At this third CNS meeting, several members of the southern section had suggested forming a smaller group meeting. It was well known that the Councillors were elected by the entire membership and not by just the southern members. A ‘‘club-like’’ organization seemed like a good idea, and Dyken charged forward in communicating with all the members listed in the CNS registry as being from the South. It is of interest that Arkansas, in spite of Civil War history, was considered by the rather uninformed Midwestern Yankees to be located in the Midwest in the original CNS division into representative areas. Dr Dyken, at this time on the executive board of the CNS, after much correspondence with the president at the time, Dr Manuel Gomez, eventually got the 2 Arkansas representatives, who really wanted to join the South, reclassified as southern state representatives. As it turned out, there were 54 Southern CNS members listed. Adding the 2 members from Arkansas made a total of 56 automatic, initial members of what was to be called the Southern Child Neurology Society. Of these, approximately 80% seemed in favor of developing such an organization. It was overwhelmingly agreed that the ‘‘club’’ should be clinically oriented and informal in format, although being academic in type. It so happened that an organizing meeting had been arranged by Dr Dyken in conjunction with the annual meeting of the Southern Society for Pediatric Research, where the latter organization would loan a room at the end of their conference at no charge for the purpose. The Southern Society for Pediatric Research meetings were scheduled to close at the Braniff Place Hotel in New Orleans on February 1, 1975. Dr Caroline Duncan, in her quiet fashion, supported having the first organizational meeting, particularly because it was to be held in New Orleans. Several key letters of approval were sent to the older leaders of the specialty who then worked in the South, such as Tom Farmer (from North Carolina) and Dave Clark (from Kentucky). These 2 gentlemen ran sections for the American
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Board of Psychiatry and Neurology (ABPN) and both Farmer and Clark were directing examinations in New Orleans in the first or second week of 1975. Dr Dyken was examining for Dr Farmer, and Caroline Duncan was examining with Dr Clark. Many Child Neurologists, including Drs Manuel Gomez and Bruce Berg (and several Southerners as well), were to be at these meetings. It was decided to have a short pre-formation meeting of the ‘‘club’’ at this juncture. Unfortunately, little organizational work was accomplished because of the lure of fine culinary establishments in town made known to the group by Drs Gomez and Berg. Dr Gerry Golden came to this preorganizational meeting. Although he could not attend the already scheduled February meeting, Dr Golden later gave much support to the formation of the Southern CNS. Dr Caroline Duncan was also very supportive of the formation of our Southern organization. There were 11 southern child neurology members at this first organizational meeting in February of 1975. There is no written record about who was physically present at this meeting; however, Dr Dyken remembers Caroline Duncan (from New Orleans), Paul Dyken (from Augusta), Ron David (from Richmond), JT Jabbour (from Memphis), Pat Hartlage (from Augusta), Gwen Hogan (from Jackson), John Benton (from Birmingham), Ray Mackay (from San Antonio), Joel Ruttman (from San Antonio), Richard Curless (from Miami), and Robert Boehm (from Memphis). The list is from memory and it is possible the following members may have also attended this first meeting: Robert Baumann, Carmela Tardo, Susan Iannoconne, and Ed Myer. At the meeting, to stress the relationship to the parent CNS, the members definitely wished to call the organization the Southern Child Neurology Society. It was also decided that there be only 1 officer, called ‘‘the Chairman’’ (who was later to be called the President). Paul Dyken was to be the first Chairman or President, and it would be his duty, as with the presidents to follow, to organize the scientific meetings, the first of which was to be in a year (1976). Caroline Duncan (who refused to be an officer) was to help in the local arrangements, because for a conference in January or February, New Orleans was considered a desirable location. We wanted to have a small meeting with the hopes of an open bar (Dr Dyken was the Chairman of the organization at this point) and it was to be at the Braniff Place Hotel as long as the Southern Society for Pediatric Research would provide us a with a free room. We did not wish to sever any relationships with Pediatrics or Neurology but wanted to call ourselves the Southern Child Neurology Society, because most of the members considered the organization to be a regional branch of the parent CNS. It was even considered by the incoming president that the office be given to the elected Councillor from the South of the CNS, but this was disapproved because the southern members of the CNS did not have control of who would be elected Councillor from the south because the Councillors of the CNS were voted for by the general membership of the CNS. The principles of the organization established at that first organizational meeting of the Southern Child Neurology Society are contained in Appendix A. The actual first scientific meeting of the Southern Child Neurology Society was stuck on at the end of the Southern
Society for Pediatric Research’s 2-day meeting (on January 24, 1976). Nine papers were given. Each was allowed a 20-minute period for presentation. They were given on one afternoon: January 24, 1976, between 2 and 5 PM, at the Braniff Place Hotel in New Orleans (Appendix B). It was thought that the meeting was very successful. Dyken was re-elected as the second Chairman or President and all the rules mentioned previously were to be continued and the expenses assumed by the chairman and local arrangement person. The following letter was sent to all ‘‘Southern CNS Members’’ after this meeting: Dear Southern CNS Member, The recent first scientific meeting of the Southern Child Neurology Society was attended by 19 members of our organization (if you include one resident, one wife and 2 bellhops who brought in the drinks). Seriously 15 active members of a total membership of 64 must be considered a very successful turn out. Eight very fine informal papers were presented. I personally learned a lot about galactosemia, amoebic meningoencephalitis, neurological complications of amniocentesis, SSPE and SSPE-like syndromes, Reye’s syndrome, infantile spasms, other myoclonic syndromes and in general a great deal of potpourri concerning our specialty of child neurology. Those giving papers should be highly complimented!! At the brief business meeting which followed the scientific meeting, before all of us stuffed ourselves at our favorite New Orleans restaurant, the following suggestions were made into law (remember that laws are made to be broken!): 1) A second ‘‘chairman’’ of our organization was selected for the next year. The chairman’s responsibility is to organize the annual meeting, to select the papers and to pass on occasional BS to the membership. 2) Because of the convenience of having our small meeting in juxtaposition to the various meetings which meet in New Orleans in late January of each year and because of the excellent local arrangement committee (chaired by Caroline Duncan with active support from Carmela Tardo and Susan Iannoccone), our next meeting was scheduled for January, 1977, in New Orleans. 3) It was stated that a similar format to our first meeting be established in the future with encouragement of trainees to submit papers to our group. These represent the major points of discussion in our business meeting which can be shared with all who were not fortunate enough to be able to attend. Sincerely, Paul R. Dyken, MD Second Chairman Southern Child Neurology Society
The second scientific meeting of the Southern Child Neurology Society was held again at the Braniff Place Hotel in New
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Journal of Child Neurology
Orleans on January 29, 1977. The scientific program consisted of 11 papers (Appendix C). At this second meeting, Ray Mackay was elected the third president of the Southern Child Neurology Society and was to be responsible for the program at the third meeting of the Southern Child Neurology Society in 1978. The third meeting was memorable for it was not held in a plush hotel like the Braniff Place but in the rather gloomy basement of the old Charity Hospital in New Orleans. The meeting was held here for financial reasons. The Southern Society for Pediatric Research meeting was to be held in the morning of that day, and 3 papers by southern child neurologists were to be presented at this meeting. Yet the Southern Society for Pediatric Research could not furnish us a room at no expense, so Ray Mackay and Caroline Duncan decided to put an afternoon session up at the Charity Hospital at no organizational expense. Paul Dyken can still remember wandering around that huge facility in a panic and finally being greatly relieved to see Dr Caroline Duncan pushing a cart down the hall with a variety of liquid refreshments on board. ‘‘Maggie’’ was headed to the meeting held in the basement. Caroline furnished all the refreshments at her own expense, a factor that endeared her to all the members attending, senior and junior alike. The third meeting was the first that Dr John Bodensteiner attended. He had been brought to the meeting by Dr Gerry Golden and was a junior faculty member at the University of Texas Medical Branch at Galveston. Dr Bodensteiner also believed the meeting to be unique for several reasons. He remembers sitting patiently in the audience, hearing Dr Dyken present a unique case with a hereditary midline hemangioma and dolichocephaly in which Dyken incorrectly misquoted some statistics on changing head size without properly presenting the physics of the matter. John pleasantly corrected Dr Dyken’s error and what was to be a lifelong friendship, unbeknown to the participants at that time, was established. The pick-up of the error in the small group atmosphere of the meeting and voicing it in public without fear of animosity on the part of either the presenter or the commentator became the operational norm for this small ‘‘club-like’’ society. This attitude still lives on today. The program given at the third annual afternoon meeting of the Southern Child Neurology Society is in Appendix D. As mentioned, 3 papers were given at the Southern Society for Pediatric Research meeting by members of the Southern Child Neurology Society. These were by Ron David on ‘‘Normal Intelligence in Microcephalics,’’ Lee Chalhub on ‘‘Recognition and Management of Reye Syndrome,’’ and John Bornhofen on ‘‘Ultrastructural Study in Pelizaeus-Merzbacher Disease.’’ Dr Ron David was elected the fourth president at the afternoon meetings. He and other Southern Child Neurology Society members as well attended both the Southern Society for Pediatric Research morning meeting and the Southern Child Neurology Society afternoon meetings. The Third Annual Meeting of the Southern Child Neurology Society of 1978, as usual, was enjoyed by all. After the meeting, Drs Golden, Bodensteiner, and Dyken went to dinner at the rather expensive Manali’s. It was at this dinner, after
waiting for a good hour to be seated, that Dr Dyken was to demonstrate the proper way to eat unshelled barbecued shrimp much to the amazement of Dr Bodensteiner who had never before seen anybody eat the entire shrimp, shell and all (Bodensteiner had only known frozen cardboard shrimp before, an unintended consequence of being brought up in the upper Midwest). With a little prompting, Dr Bodensteiner can still be persuaded to recount the evening. Thus, the beginning and the early evolution of the Southern Child Neurology Society/Southern Pediatric Neurology Society was completed. During the subsequent decades, there have been several traditions established at the annual meeting. The Dr Caroline Duncan Award was the first, established to honor Dr Duncan and her contributions to the Southern Pediatric Neurology Society throughout its existence. The Caroline Duncan award was presented each year to the best paper/abstract presented by a Student/Resident. The Journal of Child Neurology/Sage award was established by Dr Roger Brumback with a generous stipend included, at the 21st annual meeting of the Southern Pediatric Neurology Society and is given each year to the best paper/abstract presented at the meeting, including eligibility for the junior members of the society. Over time, the focus of the meeting has shifted somewhat, so that now the students and residents are the only ones presenting papers at the annual meeting. The Duncan award is now given to a presenter who has not completed training, as an encouragement to them and an inducement to consider an academic career in Child Neurology just as Dr Duncan encouraged so many of her students to do so. In addition to the awards given for the best presentations/ abstracts, there are 2 lectures given by invited guests each year, the Dyken Scholarship Lecture and the Bodensteiner Presidential lecture. The Dyken Scholarship lecture is so named in recognition of his contributions to the society throughout the life of the Southern Pediatric Neurology Society and similarly the Bodensteiner Presidential lecture is so named to recognize contributions, past and ongoing, to the organization. The most recent of the established traditions is the Jean Teasley Social Hour reception following the meeting when the members and the presenters have a chance to get to know each other in an informal setting that fosters camaraderie and encourages intellectual exchanges between junior and senior attendees. The Southern Pediatric Neurology Society as an organization has had 39 consecutive annual meetings (as of 2013) with a stated purpose of providing opportunities for residents, students, and junior faculty to present research in an informal, nonthreatening setting. The opportunity to interact with other child neurologists in a small, informal setting without fear of embarrassment is, if not unique, certainly unusual in these times. Furthermore, we believe that those junior child neurologists, who have had the opportunity to participate in such exchanges, cherish the occasion and make up the largest part of the group of pediatric neurologists who regularly attend the annual meeting of the Southern Pediatric Neurology Society.
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Appendix A
2.
The Archives of the SC/PNS (Southern Child/Pediatric Neurology Society) reveal the following principles for the organization of the Southern Child Neurology Society proposed at the first organizational meeting in 1975.
3.
1. All of the southern members of the Child Neurology Society listed in this registry would be given automatic membership in the society. 2. The annual meeting would be informal and clinically oriented. Booze would be allowed, as it was at the organizational meeting. 3. Junior members would be encouraged to give papers and join the society. 4. There would be only 1 officer for the organization who would be responsible for scheduling the annual meeting and organizing the program. 5. Paul Dyken was to act as this first Chairman or President of the organization. The only other member of the organization who also attended the 38th annual meeting in 2012 was Caroline Duncan. It was suggested that she also be an officer but she withdrew her name, offering her name to become a local arrangements person as an aide to the Chairman. 6. No dues were required and no registration fees were anticipated. 7. A relationship to the annual meeting of the Southern Society for Pediatric Research in New Orleans would be continued as long as it was not expensive for the chairman and local arrangements person.
Appendix B These were the titles, the speakers, and the location of the presenters at the first meeting of the Southern Child Neurology Society. 1. 2. 3. 4. 5. 6. 7. 8. 9.
Thoughts on Galactosemia by Ruttman, Texas Amoebic Meningoencephalitis by David, Virginia Subdurals After Amniocentesis by Duncan, Louisiana Pertinent and Planned Observations on SSPE by Jabbour, Tennessee SSPE-Like Syndromes by Jabbour, Tennessee Reyes Disease by Hartlage, Georgia New Diagnostic and Treatment Plans for Infantile Spasms by Dyken, Georgia Childhood Myoclonic Syndromes by Dyken, Georgia Potpourri by Everyone
Appendix C The papers presented at the second meeting of the Southern Child Neurology Society meeting January 29, 1977. 1. At 1:00 PM, Pat Hartlage and guest Jill Trefz from Augusta, Georgia gave a paper on ‘‘Neonatal Phosphorylase Deficiency.’’
4.
5.
6.
7.
8.
9.
10.
11.
At 1:20 PM, Joel Ruttman from San Antonio, Texas gave another paper on ‘‘Galactokinase Deficiency in Two Siblings.’’ At 1:40 PM, a paper, ‘‘An Extrapyramidal Syndrome With Ophthalmoplegia, Optic Atrophy and Seizures,’’ was given by William Logan, who was then at Charlottesville in Virginia. Twenty minutes later, at 2:00 PM, Caroline Duncan and guest Charles Kaufman, both from New Orleans, gave a presentation on ‘‘Acute Familial Intermittent Encephalopathy.’’ This was followed at 2:20 PM by the presentation by San Antonio Texans John Seals and Ray Mackay of ‘‘Normokalemic Periodic Paralysis With Cardiac Conduction Defect.’’ At 2:40 PM Caroline Duncan and guest Paul McGarry presented ‘‘Unilateral Megalencephaly. An Indication for Hemispherectomy?’’ At 3:00 PM guest Dean Timmons from Akron, Ohio spoke on ‘‘Turner-Like Phenotypes With Unusual Chromosome Patterns.’’ At 3:20 PM, Lawrence Ch’ien and guest G. Economides from Memphis, Tennessee spoke on ‘‘Seizures and Sydenham’s Chorea.’’ Mackay and Seals gave a second paper at 3:40 PM, on ‘‘Immunoglobulin Abnormality in the SchwartzJampel Syndrome.’’ At 4:00 PM , like clockwork, Robert Boehm and J. T. Jabbour from Memphis gave a paper on ‘‘Bilateral Carotid Occlusion in Children.’’ The 11th paper was started at 4:20 PM when all of those in the audience, except the speaker who was Mary Andriola, were getting quite hungry. Mary (then from Clearwater, Florida) gave a very lengthy but good discussion on ‘‘Hypoparathyroidism vs. Hypomagnesiumemia in Ophthalmoplegia Plus.’’
Dr Dyken, who did not give any papers at this meeting but was serving as the monitor, stood up and waved to the speaker many times during the last 20 minutes of Dr Andriola’s 40-minute talk (scheduled for 20 minutes like all the presentations). Dr Andriola just smiled sweetly, although knowingly, at his frantic efforts, and continued to the end of her talk, resulting in the business side of the meeting being severely shortened.
Appendix D Program of the Third Annual Meeting of the Southern Child Neurology Society 1:00 PM. ‘‘The Prevalence of Epilepsy in Two Groups of Southern School Age. Children’’—Robert Baumann, Martin Marx, and Mary Leonidakis; Lexington, Kentucky.
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Journal of Child Neurology 1:20 PM. ‘‘Subarachnoid Hemorrhage Complicating Acute Poststreptococcal Glomerulonephritis’’—Martin DeBeukelaer and Gilbert Young; Charleston, South Carolina. 1:40 PM. ‘‘Alice in Wonderland Syndrome in Juvenile Migraine’’—Gerald Golden; Galveston, Texas. 2:00 PM. ‘‘Persistent Hyperreflexia in Polyradiculopathy’’—Roy Elterman; San Antonio, Texas. 2:20 PM. ‘‘Familial Muscle Cramps’’—John Bodensteiner; Galveston, Texas. 2:40 PM. Break and Business Meeting.
3:40 PM. ‘‘Persistent Midline Capillary Hemangiomas of the Metopic Area: An Apparent Autosomal Dominant Syndrome’’—Floyd Harr and Paul Dyken; Augusta, Georgia. 4:00 PM. ‘‘Developmental Aphasia: The Basic Neurology’’—R. D. Brooke Williams; Memphis, Tennessee. 4:20 PM. ‘‘Aflatoxin and Reyes Syndrome’’—Gwendolyn Hogan; Jackson, Mississippi. 4:40 PM. ‘‘Recurrent Hypersomnia, Hyperplasia, Hypersexuality and Personality Change or ‘Kleine-Levin Syndrome’’’—Gualberto Marrero; Augusta, Georgia.
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