The final monumental work of the late Professor David Marsden – Marsden’s Book of Movement Disorders – is due for publication this month, almost thirty years on from when the project was initially conceived. In homage to the ‘father of movement disorders’, his friend and colleague, Ivan Donaldson, has written a personal reflection on great contribution and influence David had on the field of movement disorders.
By Ivan Donaldson
When, at the tender age of 34 years, Charles David Marsden was appointed as inaugural Professor of Neurology at Kings College Hospital and the Institute of Psychiatry in London, the now well-established neurological subspecialty of movement disorders did not exist. I first met him two years after he took up this chair and was so seduced by his enthusiasm, depth of knowledge, and friendly manner, that I went to work with him. He had already developed two research laboratories, one devoted to investigating the physiological mechanisms underlying posture, balance, and movement in health and disease; and the other to elucidating the underlying brain biochemistry. At the same time he was running a very busy neurology clinic.
Prior to then, knowledge of the diseases, which fascinated him so much, was to a large extent descriptive. David sought to find their causes, the mechanisms by which they had their ill effects, and effective therapies for them. In addition, he strongly advocated that a number of muscular spasms, which had previously been thought to have a psychological basis, were actually organic. He recognised that several apparently unrelated conditions, such as writers’ cramp, facial grimacing, and spasmodic movements of the neck, were really different focal expressions of the same underlying disorder, namely dystonia. Subsequent scientific discoveries, including genetics, proved him to be correct. He was instrumental in persuading the UK Parkinson’s Disease Society to establish a ‘brain bank’, which has led to many important scientific studies that have greatly increased our knowledge of the condition.
The importance of movement disorders was also given a boost when in 1987 David was appointed to the prestigious chair of Clinical Neurology at the Institute of Neurology and National Hospital for Neurology and Neurosurgery at Queen’s Square, London. There he was instrumental in establishing a new research unit into human movement and balance, directly funded by the Medical Research Council, and he helped set up functional neuro-imaging. He travelled widely and became a visiting professor at over 40 institutions worldwide.
In 1986 he and Stanley Fahn had established the International Movement Disorder Society and the movement disorder journal, of which they became the editors. This journal broke new ground by using video — the perfect medium in which to demonstrate disordered movement. The field of movement disorders, consisting of conditions in which disturbance of movement does not result from weakness, was born. Although there were other pioneers, the depth, breadth, and quality of David’s original contributions and his pivotal role in promoting the widespread recognition of the field lead me to suggest he deserves the epitaph of ‘father of movement disorders’. Even if such claim to paternity should be disputed, he was undoubtedly a leading figure in the delivery suite.
David’s work output was prodigious. He has left over 800 publications in peer reviewed scientific and medical journals. His papers are not only erudite, but make the complex seem simple. He would often compose and dictate them quickly, frequently with his colleagues sitting around at the end of a hard day’s work, while sipping a glass of wine and smoking a cigarette.
It was in 1983, while spending sabbatical in David’s department that he and I decided to write a comprehensive book on movement disorders. It proved to be a monumental task but when he died unexpectedly in 1998, at the age of 60, only the last chapter remained to be written and this was completed shortly afterwards. Then came the process of updating the tome, itself a mammoth undertaking in a rapidly changing field. For this I owe an enormous debt of gratitude to my other two co-authors, Kailash Bhatia and Susanne Schneider. David was a modest man and he would not have chosen the book’s title, but it is a fitting posthumous tribute to such a great man. I have never met anybody who could range so authoritatively from the basic sciences to the clinic, and to do it so clearly, succinctly, and modestly.
David appeared sophisticated and urbane but I believe he was shy and simple at heart. He was a private individual who was dedicated to his work and he did not allow himself a lot of time to relax. He took home a tremendous amount of work and regularly corrected manuscripts while travelling to and from work on the train. He also had a fascination for miniature railways and steam trains and belonged to a local club of enthusiasts. He planned to spend more time at this hobby when he retired. Sadly, it was not to be.
Ivan MacGregor Donaldson MB. ChB, MD, FRACP, FRCP (Lond) is Director at the New Zealand Brain Research Institute, Christchurch, New Zealand. Formerly he was Consultant Neurologist at Christchurch Hospital and Associate Professor at Christchurch School of Medicine and Health. Marsden’s Book of Movement Disorders is co-authored by Ivan Donaldson, Christopher David Marsden, Susanne Schneider, and Kailash Bhatia, and publishes this month.