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Show Fanfare for the Uncommon Neuro-Ophthalmologist: A Tribute to Irma Miller Lessell The last 2 decades of the 20th century represented the golden years for neuro-ophthalmology. The field found its identity and was recognized as a specialty requiring unique training, character, and intelligence. Neuro-ophthalmology developed its voice with the founding of North American Neuro-Ophthalmology Society, Interna-tional Neuro-Ophthalmology Society, and numerous other guilds, representing specific interests and regions within the field. During that time, an explosion of young talent burst on the scene, most of them trained by a handful of well-known mentors, now considered the founders of neuro-ophthalmology. Among them was Simmons Lessell MD at Harvard Medical School, whose protégés have risen to leadership positions in the new century. What these former fellows of Dr. Lessell say is that their fellowship was really under the tutelage of 2 Drs. Lessell-Simmons and Irma. They were dependent on one another, and the fellows were dependent on both. Sadly, Dr. Irma Miller Lessell died in August 2014 at age 79, only 8 months after pancreatic cancer was discovered. At meetings, Irma tended to sit knitting near the podium like Madam Lafarge at the guillotine. A colleague once remarked that Irma was most likely accomplishing more than anyone else in the auditorium, and he was probably correct. Irma lived several lives: as a wife, a mother, a doctor, and a scholar. As a student, she excelled at every level and became only the third person to receive the MD degree summa cum laude at her medical school despite the fact that she did not begin medical school until she was 38. During the 17-year hiatus between the end of college and the start of medical school, Irma became the homemaker. Irma was a balabusta (literally owner of the kitchen), a Yiddish noun that conveys her passion and focus better than the English equivalent. A balabusta's house is spotless and orderly, the pantry well-stocked, her cooking excep-tional, and a gracious hostess. A woman who could do nothing in moderation, Irma's kitchen, large as it was, could not begin to accommodate all of the nonperishables she accumulated: spices lined the stairs down to the basement where enough canned food was available to easily survive a long siege. She never ran out of anything. Irma, for whom boiling an egg was a challenge when she first married, became an exceptional cook and even catered her 4 sons' bar mitzvahs; 3 of them while she was a medical student! She took great pride in her formal dinners, for which she would write out the menu in calligraphy. She was a cook-book collector with hundreds of volumes filling the book-cases in almost every room in the house and overflowing onto the floor in most of them. Besides cooking, Irma indulged in other hobbies such as needlepoint, shopping, and, of course, fishing. Anyone who was lucky enough to fish with her can testify to her skill and enthusiasm. While on the water, she kept a heavy camera with a long lens around her neck so that she would not miss an opportunity to capture a beautiful plant or bird. In keeping with her principle of doing nothing in moderation, she bought every item of fishing equipment and parapher-nalia known to man (or woman). There were perhaps 10 items attached to her lanyard. The pockets on her fishing vest were brimming with fly boxes and other items that she viewed as requisites including a complete make-up kit, brushes, combs, and nail files. Irma took great pride in her appearance and adorned herself with bracelets, rings, neckla-ces, and pins at all times even when fishing, sleeping, or bathing. A woman living in a man's world, she refused to give up her femininity and stated at a young age that if she ever had the money, she planned to be a clothes horse. It is fair to say that she achieved that goal: she accumulated clothes the way a philatelist collects stamps. Even though she might never actually wear an item, she took pleasure in owning it. With the encouragement of her friends and family, Irma decided to go to medical school at the age of 38. She spent e24 Borchert and Lessell: J Neuro-Ophthalmol 2015; 35: e24-e25 In Memoriam Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. years listening to physicians tell medical stories at parties and finally decided that it was her turn to take part. Having been greatly influenced by Norman Geschwind, she chose Neu-rology expecting to concentrate on higher functions, which at the time meant aphasia and related phenomena and not dementia as it does now. During residency, however, she surprised herself and the faculty by changing course and deciding to do pediatric neurology. In her practice, she alloyed neuro-ophthalmology with pediatric neurology. Irma was a gifted diagnostician, and she took special delight in diagnosing glaucoma, a maculopathy or a detachment that had been missed by the referring ophthalmologist who thought mistakenly that the patient had neurogenic visual loss. She remained a scholar, and, throughout her career, she played a significant role in the education of the trainees, some of whom grew to see her as a surrogate mother, albeit one with whom they could discuss cases and neuro-ophthalmology while keeping up with them drink for drink (If she was sufficiently inebriated, Irma would develop downbeat nystagmus which she enjoyed displaying as a neuro-ophthalmic party trick). The fellows loved her most of all because she would sneak in reprints of papers on topics on which she knew they would be quizzed. The fellows reveled in surprising Simmons by citing obscure but pertinent references thanks to her assistance. Irma did not seem outwardly to be an ardent feminist but while she did not "talk the talk," she certainly "walked the walk." In her first job after college as an electron microscopy technician in the laboratory of the distinguished and world renowned chair of anatomy, she quit on the spot when he told her to bring him coffee. When the Lahey Clinic was wooing her, the president, who was a true martinet, inter-viewed her. He bragged to her that that the clinic had many female physicians. Irma had the temerity to correct him, pointing out that he was wrong; she had reviewed the staff list and there were only 3. One time, she approached her chairman and asked whether it was just a coincidence that she, the lowest paid member of the department, happened to be the only woman. She got her raise. She refused to be treated as less-than because she knew she was not. By simply acknowledging her own skill and worth, Irma helped to change the way women are treated in medicine. After a fruitful career, Irma retired from medicine and returned to her alma mater, Wellesley, where she devoured courses in the subjects that would redress the deficiencies of the premed curriculum. As always, she bought and read every available book or article; took, read, and re-read meticulous notes. She even planned her vacations so that she did not miss a single class. In the event that she had to miss a day, she had another student to record the lecture for her so she would never be behind. She accumulated so many credits in retirement that she could nearly have qualified for a second bachelor's degree had she formally enrolled. There are many very bright people, but among them, scholars are the exceptions. Irma was truly a scholar, hungry for knowledge, and prepared to expend energy to delve deeply. She was nearly, but not quite, a polymath because she eschewed subjects that did not interest her, as any intelligent person should do. Irma and Simmons, her husband of 59 years, loved an Etruscan sarcophagus in the Boston Museum of Fine Arts because the relief on the lid depicts a husband and wife lying in bed covered only by a diaphanous cloak, still gazing at each other and touching after the passage of millennia. They saw themselves like the Etruscan couple and wished that it would never end. For the rest of us, losing Irma Lessell means losing a mentor, a scholar, and a friend. She changed the lives of everyone she knew with her fierce passion and surprising gentleness. There are no words to describe the great loss her friends and family feel at her death, all that is, left is this a piece of advice borrowed from the parable of the good Samaritan in the gospel of Luke: "Go and do thou likewise." Mark S. Borchert, MD Department of Ophthalmology, Children's Hospital Los Angeles, USC/Keck School of Medicine, Los Angeles, California Simmons Lessell, MD Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts Borchert and Lessell: J Neuro-Ophthalmol 2015; 35: e24-e25 e25 In Memoriam Copyright © North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited. |
