A pioneer of psychopharmacology who strove to build bridges between people and countries: Tom Ban (1929-2022)

Um pioneiro da psicofarmacologia que se dedicou a construir pontes entre pessoas e países: Tom Ban (1929-2022)

Thomas Arthur Ban (1929-2022)

There is an apocryphal ancient Chinese curse that says, “may you live in interesting times.” But “interesting times” are rather a mixed blessing, full not only of dangers but also of challenges and opportunities. Thomas Arthur Ban or just Tom Ban as he liked to be called (November 16, 1929 – February 4, 2022 – figure), one of the pioneers in psychopharmacology¹, was born in Budapest, Hungary, in 1929, the only child of middle-class parents. From adolescence, he showed a lifelong penchant for literature, poetry, philosophy, and history. At age sixteen, Tom Ban was awarded a prize in a national student literary competition for an essay where he explained the transformation of the 19th century novel in the early 20th century as resulting from the influence of Freud and psychoanalysis². But he decided for the medical school and, as a medical student, he won another prize, this one for a manuscript he wrote on post-traumatic epilepsy. He received his medical degree from the Medical University of Budapest (later renamed Semmelweis University) in 1954 and was a resident psychiatrist at the Hungarian National Institute of Psychiatry and Neurology from 1954-1956. There, under the enlightened teaching of György Sándor, he gained his first experience with a new drug: chlorpromazine.

But in October 1956, the Hungarian people rose in arms against the Stalinist government of the Hungarian People’s Republic and the geopolitical domination of Hungary by the Soviet Union, a historical tragedy that still resonates eerily with today’s current international events.

The bloody suppression of the uprising by the Soviet army killed 2,500 Hungarians and compelled 200,000 more to seek political refuge in the Western countries³. When the Hungarian revolution began, Thomas Ban was on vacation in the Balkans. He returned briefly to Budapest and left just before the Russian tanks rolled in and the borders were shut down completely. From Vienna, Thomas Ban applied successfully for a grant from the prestigious Wilbur Penfield’s Montreal Neurological Institute, in Canada, and in January 1957 he began his fellowship there. By some providential twist of fate, the great neurosurgeon and neuroscientist Wilder Penfield was aware that this foreign candidate had won the first prize for a work on post-traumatic epilepsy in his homeland and was interested in this promising researcher.

In 1958, Thomas Ban became a resident psychiatrist at the Verdun Protestant Hospital in Montreal. He chose this institution mainly because he had heard about the pioneering work the noted German-born psychiatrist Heinz Lehmann, considered one of the fathers of modern psychopharmacology, was doing on the new wonder drug chlorpromazine⁴. He eventually joined the latter research team, first as a junior investigator, and later as a colleague and friend. He received the diploma in psychiatry at McGill University with distinction in 1960 and the thesis was later published as a monograph, “Conditioning and Psychiatry”⁵, the first of his more than 60 books, with a foreword by Horsley Gantt, one of the last living pupils of Pavlov.

Even before receiving his diploma, Tom Ban called Ewen Cameron attention and was admitted in the departmental chairman at McGill University to work at the Allan Memorial Institute as a junior staff of his research team⁴. Ewen Cameron was then the most important psychiatrist in Canada, having served as president of the American Psychiatric Association (1952-1953), Canadian Psychiatric Association (1958-1959), American Psychopathological Association (1963), Society of Biological Psychiatry (1965), and World Psychiatric Association (1961-1966). Ewen Cameron recruited psychiatrists, psychoanalysts, social psychiatrists, and neuroscientists to develop an eclectic psychiatry program at McGill University. In the early 1940s, Ewen Cameron ran the McGill psychiatric inpatient unit on an “open door” basis and introduced the practice of the day hospital, the first one in North America. Despite his very progressive approach to psychiatric care, Ewen Cameron’s professional reputation was sullied after his death by a reassessment of the research standards he adopted and the partnerships that he established, many of which would be considered ethically unacceptable nowadays⁶. Tom Ban called our attention that one should consider everything in a historical perspective² before making a judgment about a time when the ethical aspects were different from today⁴. Anyway, after Cameron’s premature death in 1967, the focus of the department shifted slowly but inexorably from eclectic to psychodynamic.

During his years at the Department of Psychiatry of McGill University, Tom Ban published more than 150 scientific articles on psychopharmacology, more than a hundred with Heinz Lehmann. In 1969, he published “Psychopharmacology”⁷, the first-ever textbook in this discipline, based on his then more than ten years of experience in teaching psychopharmacology.

Tom Ban was awarded the McNeil Award of the Canadian Psychiatric Association in the late 1960s for having developed a conditioning test battery for the study of psychopathological mechanisms and psychopharmacological. He worked at Verdun Hospital as a senior psychiatrist (1960-61) and Chief of Clinical Research Services (1961-71). He was a demonstrator at McGill University (1960-653), lecturer, (1963-65), assistant professor (1965-70), and Associate Professor and Director of the Division of Psychopharmacology (1971-76). He was also the Head of the National Reference Center of the World Health Organization Collaborating Reference Center Network for the Study of Psychotropic Drugs (1972-1976) and Director of the World Health Organization Training Program in Biological Psychiatry (1972-1976). No less important, in 1963 Thomas Ban married Joan Evelyn Valley, from Barrie, Simcoe, Ontario, who was destined to become his lifelong companion.

In 1976, Tom Ban joined the department of pharmacology of Vanderbilt University, which was already known as one of the best in the United States. He was appointed Professor of Psychiatry at Vanderbilt in 1976 and became Emeritus in 1995. Professor Ban was also the Director of the Clinical Research Service of the Tennessee Neuropsychiatric Institute (1976-1983), Director of the Division of Psychopharmacology of the Department of Psychiatry of the Vanderbilt University (1983-1995), and Consultant of the Division of Mental Health of the World Health Organization in Genève, Switzerland (1981 to 1983). After retirement, Tom Ban, his wife Joan, and their son Christopher moved to Toronto, where he continued to work every day.

While in Vanderbilt University, Thomas Ban maintained a high degree of research productivity but his publications revealed a renewed interest in issues such as psychopathology, nosology, and the history of psychopharmacology. While the two first subjects are consistent with his classical European psychiatric training, the latter reflected an implicit realization that his life and career were interwoven with historical events of great significance and complexity.

Two of Tom Ban´s important psychopathological productions were the Composite Diagnostic Evaluation of Depressive Disorders (CODE-DD) and the Diagnostic Criteria for Research (DCR) Budapest-Nashville. The CODE-DD⁸ is a comprehensive poly-diagnostic method that uses a semi-structured interview to elicit psychiatric symptoms and diagnostic decision trees to organize them into several psychiatric diagnoses. The KDK Budapest was created by a team of Hungarian psychiatrists in the Department of Psychiatry of the Semmelweis University under the leadership of Bertalan Pethö. The DCR Budapest-Nashville⁹, the English adaptation of the Hungarian KDK, was developed in collaboration between Pethö’s team in Budapest, Hungary, and Ban’s team at Vanderbilt University. The DCR Budapest-Nashville represented an attempt to synthesize the experience of different psychiatric schools (Karl Leonhard, Carl Wernicke, Karl Kleist, Emil Kraepelin, Manfred Bleuler, among other pillars of psychiatry) in the identification of pathognomonic and holistic characteristics of psychiatric illnesses.

Tom Ban understood the importance of keeping alive the memories of these momentous events. He joined efforts with several like-minded colleagues to document the early history of psychopharmacology. In 1988, Ban and Hans Hippius published “Thirty Years CINP: A Brief History of the Collegium Internationale Neuro-Psychopharmacologicum”¹⁰. This was followed by “The History of Psychopharmacology and the CINP, As Told in Autobiography ” (a series of five volumes, sponsored by the CINP and edited by Thomas A. Ban, David Healy, Edward Shorter), “An Oral History of Neuropsychopharmacology: The First Fifty Years, Peer Interviews” (a series of ten volumes, sponsored by the American College of Neuro-Psychopharmacology and edited by Thomas A. Ban) and more recently by the “International Network for the History of Neuropsychopharmacology INHN 2013¹¹, and “Lithium in Psychiatry in Historical Perspective”¹², his last book. Tom Ban was also the founding editor of the International Network for the History of Neuropsychopharmacology (INHN), a network of neuropsychopharmacologists of different generations and professional backgrounds committed to documenting, preserving, and disseminating all contributions relevant to the history of neuropsychopharmacology.

Tom Ban is gone but will not be forgotten. Not only because he was scientifically and clinically involved in the development of many of the drugs that are now part of the conventional psychiatric armamentarium. Neither because he was such an astute observer and a devoted chronicler of the birth of modern neuropsychopharmacology. But Tom Ban will be remembered mainly because he has been a good friend, student, partner, family man, conversationalist, and mentor. Born in the nightmarish dawn of World War II, he struggled to survive the Nazi genocide and to flee from the Soviet straitjacket. Once this survivor found himself in the safe, welcoming environment of North America, he showed a deep appreciation of the values of friendship, loyalty, partnership, and connection and build a network of friends and collaborators from all over the world that few would be able to emulate. Tom Ban was above all a man who strove to build bridges between people and countries in the world of psychopharmacology and psychiatry.

ACKNOWLEDGMENTS

The authors manifest their gratitude to Peter R. Martin, Carlos Morra, Jose de Leon, David Healy, Edward Shorter and Barry Blackwell for having shared with them their moving memories of a beloved friend, student, partner, family man, and mentor.

REFERENCES

• ¹
  Shorter E. History of psychiatry. Curr Opin Psychiatry. 2008;21:593-7.
• ²
  Martin PR. Eulogy for Thomas Arthur Ban (November 16, 1929-February 4, 2022). Available from: https://www.inhn.org/index.php?id=4288&L=1 Accessed on: Mar 1, 2022.
  » https://www.inhn.org/index.php?id=4288&L=1
• ³
  Pastor P. The American Reception and Settlement of Hungarian Refugees in 1956-1957. Hungarian Cult Stud. 2016;9:197-205.
• ⁴
  Ban TA. They used to call it psychiatry. In: Healy D (ed.). The Psychopharmacologists 1. 1st ed. Boca Raton: CRC Press; 2019. p. 587-620.
• ⁵
  Ban TA. Conditioning and psychiatry. Chicago: Aldine Publishing Company; 1964.
• ⁶
  Lemov R. Brainwashing’s Avatar: The Curious Career of D. Ewen Cameron. Grey Room. 2011;45:60-87.
• ⁷
  Ban TA. Psychopharmacology. Baltimore: Williams & Wilkins Company; 1969.
• ⁸
  Ban TA. CODE DD Composite Diagnostic Evaluation of Depressive Disorders. Brentwood: JM Productions Inc; 1989.
• ⁹
  Pethő B, Ban TA. DCR Budapest-Nashville in the diagnosis and classification of functional psychosis. Psychopathology. 1988;21:149-240.
• ¹⁰
  Ban TA, Hippius H. Thirty Years CINP: A Brief History of the Collegium Internationale Neuro-Psychopharmacologicum. New York: Springer-Verlag; 1989.
• ¹¹
  Ban TA, Blackwell B, Gershon S, Martin PR, Wegener G. International Network for the History of Neuropsychopharmacology. INHN 2013. Cordoba: INHN Publisher; 2020.
• ¹²
  Ban TA, Angst J, Blackwell B, Gershon S, Malewska-Kasprzak M, Permoda-Osip A, et al. Lithium in Psychiatry in Historical Perspective. Cordoba: INHN Publisher; 2021.

Publication Dates

• Publication in this collection
  17 June 2022
• Date of issue
  Apr-Jun 2022

History

• Received
  7 Apr 2022
• Accepted
  10 May 2022