Norman Geschwind was born in New York City on 8 January 1926. Neither medicine nor science more generally was his early intellectual attention. As a student at Boy’s High School in Brooklyn, New York, his primary interests were literary; at that time he also became attracted to mathematics, which became his chosen subject when he entered Harvard University in 1942. During his first two years at Harvard Geschwind began to think about entering medicine and precociously applied to Harvard Medical School, only to be turned down. His undergraduate education was interrupted when he was drafted into the Army in 1942. Returning to Harvard in 1944, Geschwind changed his major, moving to the Department of Social Relations, which was an amalgam of social and personality psychology, and cultural anthropology. Because of a belief that the understanding of behavior lay in the understanding of life experience and culture. Geschwind again applied to Harvard Medical School, and was accepted. He was bent on becoming a psychiatrist. At that time it seemed obvious to him that a knowledge of physiology, anatomy, and biochemistry was totally irrelevant to the study of human behavior. This conviction began to erode when he took neuroanatomy from Dr. Marcus Singer; two topics Singer dealt with struck him and were later to become significant areas in his research: epilepsy and aphasia.
Following his graduation from Harvard Medical School in 1951. Geschwind went to the National Hospital in London, first as a Mosley Travelling Fellow (1952-53) and then on a United States Public Health Service fellowship (1953-55). During his stay he was greatly influenced by Sir Charles Symonds, who made him see the importance of neurological mechanisms in the study of disorders. Geschwind became Chief Resident in neurology at the Boston City Hospital in 1955, under Dr. Derek Denny Brown, who reinforced the anti-localization biases that he had acquired in England. Geschind’s main interest had yet to focus on the neurological study of behavioral systems, and he began his two years (1956-58) as a research fellow in the Department of Biology at the Massachusetts Institute of Technology with the intent of studying muscle disease.
In the 1958, Geschwind became a staff neurologist at the Boston Veterans Administration Hospital, where Dr. Fred Quadfasel was Chief of Neurology. The VA offered Geschwind his first opportunity to see a large number of aphasics, including the chronically aphasic. It was in this context that his clinical interest developed into his life-long scientific interest in the study of the neurological foundations of language functions and other higher mental processes. encouraged by Quadfasel, Geschwind began his scholarly study of the classic texts of neurology at this time. From 1962 until 1966, he was Chief of Neurology at the Boston VA Hospital and Associate Professor of Neurology at Boston University, where he was Professor and Chair of the Department of Neurology from 1966-68. In the early 1960s Geschwind played a central role in establishing the Boston University Aphasia Research Center at the VA Hospital. The Aphasia Research Center was unique in its inception and has been the focal point of interdisciplinary aphasia research in the US since its foundation.
Geschwind was appointed James Jackson Putnam Professor of Neurology at Harvard Medical School in 1969, succeeding his teacher Denny Brown. Geschwind occupied that chair until his death on 4 November 1984. During his years at Harvard he continued to pursue his research on aphasia. Throughout his career his research interests were not, however, restricted to the study of aphasia. He made major contributions to the study of epilepsy, anatomy, notably in the domain of lateral asymmetries, and dyslexia, among other areas. Geschwind’s contributions to he study of neural mechanisms of higher mental processes reside not only in his extensive research but also in his inspired teaching of medical students and training of residents. Beyond this, throughout his career, he actively encouraged and supported interdisciplinary research involving linguists and cognitive psychologists. He significantly shaped the neurological climate in the US and Europe during his life, an influence which lives on in his students.
In the mid-20th century anti-localizationism dominated neurological thinking about the aphasias and other disorders of higher mental processes. when Norman Geschwind joined the Neurology service at the Boston Veterans Administration Hospital in 1958, he shared the anti-localizationist biases of the day. He had come to this tradition through his years study in England (1952-55) and during his residency under Dr. Derek Denny-Brown at Boston City Hospital. After he had been at the VA for some time, he began to feel uncomfortable with what he had been taught. The VA Hospital had an aphasia unit which afforded Geschwind the opportunity to see many patients. It became increasingly obvious to him that aphasic patients differed from each other in their clinical pictures and that these differences clearly appeared to be associated with the location of the responsible lesion.
Dr. Fred Quadfasel was Chief of the Neurology service at the VA Hospital when Geschwind went there. Quadfasel had worked under Goldstein in Germany and, prior to coming to the US in the 1930s, head served as an assistant to Bonhoeffer, who had been one of Wernicke’s first assistants. Early in 1961, Geschwind encountered the work of R.E. Myers on the effects of lesions of the corpus callosum in animals. At the time, Geschwind assumed that lesions to the corpus callosum had no effects in humans. By chance, about this time, Quadfasel gave Geschwind a copy of Dejerin’s (1982) paper on pure alexia without agraphia in which a lesion of the posterior portion of the corpus callosum in conjunction with a lesion of left visual cortex was seen as responsible for the disorder. Within a few weeks of reading Dejerine’s paper, Geschwind saw his first patient with this syndrome; over the years he was to see many more such patients. Just a few weeks later Edith Kaplan, a clinical neuro-psychologist at the VA, showed Geschwind a patient she had tested who wrote aphasically with his left hand but nonaphasically with his right. Geschwind realized that this patient must have a callosal syndrome. Not long after encountering this patient. Geschwind pursuing his review of the of the older literature discovered that Liepmann had discussed callosal syndromes in man. Geschwind and Kaplan’s case, the modern callosal syndrome, was originally reported in late 1961, at the Boston Society for Neurology and Psychiatry (1962).
Geschwind attended a meeting on dyslexia in Baltimore in 1961 wher he had occasion to discuss his ideas about cortico-cortico connections with the eminent neuropsychologist Oliver Zangwill. Zangwill urged him to write up an extended account of his views. That account was published in Brain in two parts in 1965, as “Disconnexion Syndromes in Animals and Man”. Bolstering his arguments on the basis of the older literature, animal research, and his own clinical experience, Geschwind developed a connectionist model, exploring its implications not only in the domain of aphasia but also for the apraxia and agnosias. With the publication of ‘Disconnexion Syndromes’, it was no longer possible to dismiss the older literature on aphasia and simply to deny the thesis of localization and connectionism.
The force of Geschwind’s argument throughout his life was that behavioral disorders must be analyzed in terms of explicit hypotheses as to the underlying neural mechanisms. He did extensive research on the acquired alexias and the functional neurological distinction between alexia without agrphia and alexia with agraphia (Geschwind 1962, 1966; Benson and Geschwind, 1969; Heilman et al., 1973). Following Dejerine, he analyzed the former disorder as a disconnection syndrome; the latter disorder he treated as an impairment to a ‘center’ committed to visual language functions.
In the early 1960s Geschwind and his colleagues established the Boston University Aphasia Research Center at the VA. The center was original in its inception, a multidisciplinary unit for the neurological, psychological, and linguistic study of the aphasias, and has been a focal point of aphasia research since its founding. In later years, Geschwind worked with a number of neurologists to whose future research careers in aphasia he gave significant direction; among these were Kenneth Heilman, Elliott Ross, and David Caplan. These people, as well as those who worked with Geschwind in his other areas of interest – epliepsy, neuroanatomy, and developmental dyslexia, primarily – have carried on in the tradition he invigorated, enriching and arguing with his basic approach to the study of behavior in a neurological context. Beyond his inspired teaching of medical students and training of residents and fellows, he actively encouraged and supported interdisciplinary research involving linguists and psychologists. He is, ultimately, largely responsible for the current richness and enthusiasm of aphasia research; the robustness of the field today is his legacy.