*The Four Horsemen of American Neurology

DeJong (1907-1990), Baker (1908-1988), Sahs (1906-1986), Forster (1912-2006)

The Four Horsemen of American Neurology
Rong-Chi Chen, M.D.
In celebrating the 60th anniversary of the American Academy of Neurology (AAN), the 2007 Annual Report of AAN posted the picture of the founders of AAN, the Four Horsemen in the cover page with a title “LEADING THE WAY FOR 60 YEARS”. In the PROLOGUE, it is written as

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“Lieutenant Colonel Joseph A. Resch came home from the war in 1946.The young man from Wisconsin had served seven years in the US Army Air Force and managed the hospital services for a fighter wing in New Guinea. Now, at the age of 32, he was at the University of Minnesota, working on his residency in neurology and looking forward to settling down with his family and establishing his career.
But Joe Resch was concerned about the future. Neurology had been something of a stepchild to psychiatry in the United States. Could he make a go of it in private practice? Would he need to find an academic position? How would he continue training and stay current as neurologic research advanced? He could not join the New York-based American Neurological Association; it was a closed group devoted primarily to East Coast academics.
Resch pressed the University of Minnesota neurology department chair A.B. Baker: why wasn’t there a neurology organization that young professionals like him could join? Where could a resident or practicing neurologist congregate with his or her peers and receive continuing education to sharpen the skills necessary to treat patients effectively?
Baker knew Resch was right. The times were changing. The recent world war had left tens of thousands of American soldiers wounded in body and psyche. Many had brain injuries that required ongoing treatment and rehabilitation. They needed more neurologists.
If neurology was to move from its symbiotic relationship with psychiatry and stand as a distinct practice of medicine, it must organize and grow. Baker seized the moment, and the American Academy of Neurology was born in 1948.”

In the next page of the 2007 Annual Report, A LETTER FROM THE LEADERSHIP stated:
“A need plus an idea how to address that need. That simple equation doesn’t produce a solution without a key third component: leadership.
A.B. Baker did not launch the American Academy of Neurology single-handedly. He was fortunate to have at his side the wisdom and counsel of Adolph Sahs, Francis Forster, and Russel DeJong. These “Four Horsemen” were the vanguard, drawing in the likes of Joe Brown, Clark Millikan, Pearce Bailey, Alexander Ross, David Ruskin, and Howard Fabing. They came from academia and from the military. From the Mayo Clinic and UCLA and Boston University and the University of Michigan. Some have been remembered; many more have receded into history. But they all played vital roles in the expansion of neurology in post-war America, and because of them the AAN has been blessed with six decades of growth, fostered by countless leaders whose abilities and visions have charted our course….”

MISSION STATEMENT of AAN:
“The Amnerican Academy of Neurology is a medical specialty society established to advance the art and science of neurology, and thereby promote the best possible care for patients with neurological disorders by:

1. Ensuring appropriate access to neurological care;
2. Supporting and advocating for an environment which ensures ethical, high quality neurological care;
3. Providing excellency in professional education by offering a variety of programs in both the clinical aspects of neurology and the basic neurosciences to physicians and allied health professionals.
4. Suporting clinical and basic research in the neurosciences and related fields.”

I am very fortunate and grateful to have the chance of to be enrolled in the neurology residency program of one of these Four Horsemen, Prof. Francis M. Forster in Madison, University of Wisconsin in 1971. In 1972 while the department was celebrating Frank’s 60th birthday, we had the chance of seeing the Four Horsemen together in Madison. Our teachers told us, that the training in Minnesota was very “tight” with courses after courses and exams after exams. On the contrary, the training in Wisconsin was “loose” and liberal, offering opportunities of learning for the trainees to pickup by themselves. The final achievements of the trainees of these 2 systems in the American neurology are the same.
On returning home to Taiwan, I had the chance of joining Prof. Chun-Jen Shih to establish the Taiwan Neurological Society and helping my teacher, Prof. Tsu-Pei Hung to establish the independent Department of Neurology in National Taiwan University. I was privileged to be the 4th President of the Taiwan Neurological Society and also the first chief editor of the official journal published by TNS, Acta Neurologica Taiwanica. I joined the American Academy of Neurology while I was in Madison and the American Neurological Association years after I returned to Taipei.
In 1988 I visited Madison again when Frank already retired and went back to Cincinnati. Around 1993, I took a chance to visit Frank and Helen in Cincinnati. Although they both are in history now, the teaching and affectionate care they offered to me will stay in my memory forever, so are also the friendship of the teachers and colleagues of the Neurology Department of University of Wisconsin.