The man renowned for his research and

insights into the peripheral neuropa-

thies, particularly those in chronic kidney

failure, diabetes mellitus, and Guillain-Barré

syndrome (GBS), “resisted” the medical ca-

reer path as a young man. In a recent inter-

view with “NerveCenter,” Arthur K. Asbury,

MD, FRCP, Van Meter Professor of Neurol-

ogy Emeritus at the University of Pennsylva-

nia Perelman School of Medicine in Philadel-

phia, Pennsylvania, revealed that his mother,

father, older brother, both grandfathers and a

great grandfather were physicians.

It was assumed that he would also choose

medicine, but Asbury explained that he

wanted the decision to be his alone. He had

that opportunity during active duty with the

US Army. From 1951–1953, “I was com-

pletely away from the influences and expec-

tations of family and everybody,” he reflects.

“It was a great time, because I was just on

my own. That’s when you find out who you

are.” Serving with the guided missiles group

at Fort Bliss near El Paso, Texas, during the

Korean War, he thought for a time that elec-

trical engineering might be his calling; in the

end, it was medicine he chose.

He applied to the University of Cincin-

nati, in his hometown, at the medical school

where his father, a renowned surgeon, head-

ed the alumni association and was also the

medical school’s champion fundraiser. “The

dean said, ‘We can’t turn you down, but

please don’t embarrass us,’ ” says Asbury.

He didn’t. After graduating at the top of

his class from medical school, Asbury was

accepted for training at Massachusetts Gen-

eral Hospital (MGH) and Harvard Medical

School in Boston, Massachusetts, in medi-

cine and, eventually, neurology and neuro-

pathology.

Training and Early WorkAsbury’s gravitation to neurology was “kind

of a fluke,” as he tells it—and “he’s a great

storyteller,” notes colleague and former men-

tee Mark J. Brown, MD, Professor of Neu-

rology at the Perelman School of Medicine.

Between his first and second year in medi-

cal school, Asbury was looking for a summer

job. A friend was leaving his job as an EEG

technician to pursue another opportunity.

Asbury stepped into the position, and the

work took his interest. “It was one of the few

tests that we had in those days that was in-

formative about brain dysfunction,” he says.

Soon after he returned to school, he began to

participate in research in the neuropathology

lab. “I was hooked,” he says.

At MGH, one of the country’s most

sought-after training programs, Asbury’s

work on the peripheral neuropathies blos-

somed. Following two years’ residency in

medicine, he took a year of neurology. “After

two months on the neurology service,” he

recalls, “I knew that I had made the right de-

cision, and I’ve never looked back.” During

the second year of his three-year residency in

neurology, he was taught by E. Peirson Rich-

ardson, Jr, MD, Director of the neuropath-

ology lab, and by another giant in the field,

the Chair of Neurology, Raymond D. Adams.

As his mentors, Richardson and Adams were

always available for questions and advice re-

garding his research and clinical training.

Asbury spent 11 years at MGH, rising to

a junior faculty position. During this time, he

produced one of many seminal papers on the

peripheral neuropathies. He, Barry Arnason,

and Ray Adams were able to define GBS as

an inflammatory process by performing care-

ful post-mortem studies of nerves of patients

who had had GBS.1 The work changed the

way neurologists viewed GBS, says J. Rich-

ard Baringer, MD, Chair Emeritus of the

Department of Neurology at the University

of Utah in Salt Lake City. “Before that paper,

GBS had been thought of as some kind of

toxic process,” he says.

Baringer was Asbury’s first intern when

he began as an assistant resident at MGH,

and they have remained close friends for

more than 50 years. Together, they moved to

NERVECENTER

ARTHUR K. ASBURY PLAYED A LEAD ROLE IN THE GROWTH OF ACADEMIC AND WORLD NEUROLOGY

In On The Ground Floor

January 2012

Arthur K. Asbury, MD, FRCP

The tools that are available to study the nervous system are now so much more advanced from the crudeness of what we

were doing 30, 40, and 50 years ago.—Arthur K. Asbury, MD, FRCP

A16 Volume 71, No. 1

the University of California, San Francisco

School of Medicine in 1969, recruited by

Robert Fishman, MD. According to Asbury,

“Bob Fishman made it his business to try to

recruit all the young neurologists from Co-

lumbia Medical Center and from Mass Gen-

eral.” Three neurology services were formed:

one at San Francisco General Hospital with

Frank Yatsu, MD, as Chief; another at the

UCSF Hospital where Fishman was Chief;

and the third at the Fort Miley VA Medical

Center, where Asbury and Baringer ran the

clinical service plus research labs in neuropa-

thology and neurovirology, respectively. The

UCSF neurology residents rotated through

all three hospitals. “The big experiment was

fabulously successful,” recalls Asbury. “In a

six- to eight-year period, UCSF became a

major academic center of medicine in the

country. We in neurology were part of that

and it was very exciting.”

Asbury’s clinical and experimental re-

search comprised an important component

of UCSF’s growing stature in neurological

research. Brown, a neurology resident at the

University of Rochester in 1972, recalls, “I

knew from my mentors—Drs. Bob Joynt,

Berch Griggs and the late Bill Markesbery—

that Dr. Asbury was one of the very top neu-

romuscular neurologists in the country. He

directed a beautiful new and well-funded

neurology research facility at the San Fran-

cisco VA hospital. The emphasis was on neu-

ropathologic methods, including the then-

relatively new tool, electron microscopy. I

knew that if I joined Dr. Asbury as a fellow,

he would teach me about peripheral nerve

diseases. I would become involved in human

diabetic neuropathy research. I had other fel-

lowship opportunities, but this was the one

that best fit my goals for the future.” The

two went on to collaborate on multiple proj-

ects and journal publications. When Asbury

moved to Penn to chair the department of

neurology there, he recruited Brown to be a

junior faculty member. They have continued

to work together for four decades.

“As a faculty mentor, I try to do many of

the same things for others that Art Asbury

did for me,” Brown says now. I am thankful

to him whenever I am able to ‘pay it for-

ward.’ My career path may have been quite

different if I had not gone to work in his

laboratory in 1973.”

A Wide World ViewServing as Chief of the Neurology Service

at the VA Hospital and as Vice-Chair of the

Department, Asbury was soon promoted to

Professor in Residence of Neurology and Pa-

thology.

In 1974, he moved to the University of

Pennsylvania as Chair of Neurology. Subse-

quently, he has held multiple leadership posi-

tions there, including 10 years in Dean and

Vice Dean roles, and a brief stint as an Execu-

tive Vice President of the University in charge

of the Medical Center. His publishing credits

are voluminous, including over 225 peer-

reviewed journal articles, monographs, chap-

ters, and reviews. He served two full terms

as Chief Editor of the Annals of Neurology, a

post from which he drew immense satisfac-

tion. Asbury has served in leadership capac-

ity for national neurology organizations – he

was President of the American Neurological

Association -- and has been Vice President of

the World Federation of Neurology.

He has expanded upon his observations

in GBS, collaborating with long-time friends

and colleagues, including the late Jack Grif-ff

fin, and also Guy McKhann and David

Cornblath, who direct their own centers.

They and others worked with Chinese col-

laborators every summer from 1990 to 2000

to work out the basis for a paralytic syndrome

seen in Chinese children.2 Together, they de-

lineated a new form of GBS called acute mo-

tor axonal neuropathy (AMAN) that occurs

as a summertime epidemic each year in the

North China countryside, completely spar-

ing city dwellers. Over 50 publications by

this group delineate the changes in thinking

about GBS.

Asbury feels fortunate, he says, to have

entered neurology when it was in its infancy

as a discrete medical specialty. He is very pos-

itive about the health of neurology, especially

academic neurology. “It’s done nothing but

get bigger and better,” he says. “The tools

that are available to study the nervous system

are now so much more advanced from the

crudeness of what we were doing 30, 40, and

50 years ago. There are now dozens of ap-

proaches to neural function and dysfunction

that can be used to understand the basis of

disease. This, in turn, has led to great strides

forward in the management and therapy of

neurological disorders.”

References1. Asbury AK, Arnason BG, Adams RD. The in-

flammatory lesion in idiopathic polyneuritis: its role in pathogenesis. Medicine. 1969;48:173-216.

2. McKhann GM, Cornblath DR, Ho TW, et al.WAcute paralytic disease of children and young adults in northern China. I. Clinical and electro-physiologic aspects. Lancet. 1991;338:593-597.

GRETCHEN HENKEL

DOI: 10.1002/ana.22697

NERVECENTER

In 1980, Estelle Benson started a patient support group after her husband’s bout with GBS. Her letters to hospitals in the surrounding Philadelphia area yielded only one return call. It was Asbury. “He said, ‘You are the piece of the puzzle we’ve YYbeen waiting for: patient support. How can I help you?’ ” Asbury dispatched Da-vid Cornblath and Gareth Perry, two of his trainees, to attend the nascent group’smeetings held around the Benson’s dining room table. “Art Asbury has been my mentor all these years,” she says.

On October 28 and 29, 2011, the GBS-CIDP (chronic inflammatory demyelinat-ing polyneuropathy) Foundation International awarded Asbury its Citizen of the Year Award.YY Former mentees, now world-class researchers, gathered in Philadel-phia to pay tribute to Asbury’s work. The award was not a plaque or a chalice,but the sponsorship of three students to attend the next Peripheral Nerve Society meeting in Rotterdam in June. “We felt it was a fitting gift,” says Benson. “Art is always teaching and feels it is important for students to be trained in and excited about this field.”

The Patient Connection

January 2012 A17