In memoriam Heinz E. Lehmann, 1911 - 1999
Maurice Dongier, MD
J Psychiatry Neurosci 1999;24(4):362.
© 1999 Canadian Medical Association
In 1937, a young physician, a graduate from the University of Berlin, escaped from Nazi Germany to Canada. After 3 months at the Montreal General Hospital, he was recruited by the Verdun Protestant Hospital, later to become the Douglas Hospital, and placed in charge of about 750 patients (half of the beds at that time). In 1947, he became clinical director of the hospital, then in 1962, director of research and education, and in 1965, full professor at McGill University. From 1971 to 1974, he served as chairman of the Department of Psychiatry at McGill. Heinz Lehmann remained on staff at the hospital for more than 60 years, living until his retirement with his family in a little house on the hospital campus. During all these years, until 1998, he maintained his personal tradition of meeting patients on Christmas Day, shaking hands with everybody.
Paranoia, as we all know, is not limited to our patients. Lehmann recalled his memories of the days during the Second World War: "One night, I was typing a letter in my home, when somebody threw a stone in my window, yelling, 'You spy, stop sending messages in Morse.' " Another example: in those days the hospital budget did not allow the purchase of phenobarbital (the main sedative then available) in capsule form. "At night, once my visits to patients were over, I was busy making capsules using bottles of powder. Incidentally, this started the rumour that I was an addict because nobody in his right mind would work in the pharmacy at 2 am."
Lehmann can still be seen in short movies produced by the National Film Board in the 1950s to educate the general public about mental illness. Always modest, sometimes looking shy, he reads texts on the symptoms of depression, chronic delusions and schizophrenia; he interviews patients to demonstrate their symptoms; and he studies the effect of occupational therapies in patients with regressed schizophrenia.
A passionate clinician and inquiring mind par excellence, Lehmann used his knowledge of foreign languages to its full extent. In 1953, he noticed in a French journal (L'Encéphale, if my memory is correct) an article by Jean Delay and Pierre Deniker on the effects of chlorpromazine as a tranquillizer and antipsychotic. He got an appropriate supply from a Rhône-Poulenc representative, tried it on 230 patients with schizophrenia, and in 1954 published the first North American article on a neuroleptic in the Archives of Neurology and Psychiatry. As a result of his findings, the average length of stay for schizophrenia in the Verdun Protestant Hospital soon dropped by half.
In 1957, he read the initial publication by Roland Kühn in German in a Swiss journal on the use of imipramine to treat depression; he started a clinical trial, carefully measured the efficacy and side effects of the first antidepressant, and once again was credited for this therapeutic advance, which quickly spread to the whole continent. Although he never looked for honours, in the following years he received innumerable prizes, honoris causa doctorates, and distinctions such as the prestigious Albert Lasker Award of the American Association of Public Health.
Lehmann's interest in clinical research went well beyond psychopharmacology, however, as evinced by his some 300 publications, chapters and books on psychotherapy, psychosocial approaches, after-care services, community psychiatry and assessment tools such as the Verdun Psychological Battery to measure the severity of psychopathology. His teaching constantly opposed the reductionist trends of biological psychiatry, and he fought against a de-institutionalization process that was not accompanied by sufficient community support. A clinician above all, he fascinated his students and residents, even in his last weeks, by the richness of his experience.
He was a fervent adept of what he called "bootstrap research": unpretentious clinical research carried out with limited means and often without publicity. He was somewhat puzzled, as chairman of the Research Centre Board of Directors, by its current developments and the presence of some 30 professional researchers and innumerable technicians and students. He was fond of reminiscing about the psychophysiological laboratory that he had created with minimal means in the 1940s.
It is typical of his personality that he asked that his body be shown in Douglas Hall, at the heart of the hospital to which his life had been devoted. It was there that he was paid final respects from patients, staff and colleagues.
Without any doubt, no contemporary Canadian psychiatrist had the international prestige or commanded such high unanimous respect as Heinz Lehmann. None has contributed as much to the progress of the treatment of our patients. None deserves more the distinction of having his name on the annual prize for excellence in psychiatry awarded by the Quebec Psychiatric Association.
Douglas Hospital Research Centre, Verdun, Que.