One of the giants in modern medicine, Dr. A. McGehee Harvey, a shy, thoughtful man who trained dozens of the country's top doctors and never forgot to listen to patients, died yesterday at Johns Hopkins Hospital, the place he loved and labored in for more than 50 years.
Dr. Harvey, 86, suffered a stroke, but before he passed away about 1 p.m. yesterday, a procession of physicians and nurses stopped by to see the former chief of medicine. Many considered him to be a generation ahead of his time, a brilliant internist and crack diagnostician who took into account the whole patient, not just the parts.
"He was truly one of the great physicians of the 20th century," said one of his students, Dr. Eugene Braunwald, the Hersey Professor of Medicine at Harvard Medical School, a position that is the equivalent of physician-in-chief. "It would have been very easy for him to let Hopkins rest on its laurels, but he wasn't satisfied with it. He moved it into a totally new generation."
But in addition to overseeing the birth of 15 new divisions at Hopkins' medical school during the 1950s, 1960s and early 1970s, Dr. Harvey also saw to the details. He noticed the pale fingernails on a patient that other doctors had overlooked; he invited the residents intimidated by his reputation for casual dinners at his house on St. Paul Street.
"He had this wonderful habit of being very quiet and letting other people speak," said Dr. Gert H. Brieger, the William H. Welch professor of the history of medicine at Hopkins.
"Dr. Harvey was one of the sagest men on the faculty," said Dr. Thomas B. Turner, a longtime friend and dean emeritus at Johns Hopkins School of Medicine. "He was a man who saw the future clearer than most."
Appropriately, the building named after Dr. Harvey sits at the heart of the Hopkins campus. And so does his legacy.
At age 34, when Dr. Harvey was appointed to the prestigious post of chairman of the Hopkins' department of medicine, he had already established a distinguished career as a researcher in neuromuscular diseases, such as myasthenia gravis. He was the youngest person ever named to the post, and Time magazine featured a story on him. Many physicians were skeptical that he could be a good administrator and clinician.
But it didn't take long for Dr. Harvey, known to friends and colleagues as "Mac," to establish himself in his new role.
On morning rounds, while visiting each patient, residents would report to him the details of the cases.
"He wouldn't just listen to what we said; he'd ask the patients some more questions," said Dr. Richard J. Johns, the Distinguished Service professor of biomedical engineering and a longtime student of Dr. Harvey. "He would figure out what was the matter with folks who we were stumped by."
Puzzling liver disease
In one case, Dr. Johns recalls a patient with a liver disease that puzzled the physicians. Harvey asked the patient where he worked. The answer was a candy factory on Monument Street. It turned out the man had contracted a type of jaundice carried by rats in the factory.
Dr. Victor A. McKusick, the world-renowned geneticist who trained under Dr. Harvey and succeeded him as chairman of the Department of Medicine, said Dr. Harvey drilled his students in taking careful histories and physical exams while exhaustively analyzing data.
"He was not a martinet. He expected high performance and you didn't want to let him down," said Dr. McKusick. "He was a superb teacher."
Dr. Harvey's application of scientific methods and clinical problem-solving got him called upon for difficult cases around the world. In 1969, Dr. Harvey and his wife, Dr. Elizabeth Treide Harvey, flew to the Soviet Union to care for the daughter of deposed Soviet Union leader Nikita S. Khrushchev. She had lupus. He also treated two presidents of Peru and Indian leader Jawaharlal Nehru.
In many ways, Dr. Harvey patterned himself after Sir William Osler, the legendary first physician-in-chief at Hopkins, who believed that the patient was the source of medical knowledge. Dr. Osler taught his students to never speak to a new patient without pencil and notebook. As much a humanist as a scientist, he blended the two philosophies in his famous textbook, "The Principles and Practice of Medicine."
During his 27-year term as chief of medicine, Dr. Harvey resurrected this classic, writing it in the same room as Dr. Osler had -- under the hospital's historic dome.
At the time, he wrote that his purpose was "to produce a book which is built around the patient rather than the disease." The text is still being published today.
"He was a very worthy successor to Dr. Osler," Dr. McKusick said.
Dr. Harvey took a personal interest in every student he trained. They say he encouraged them, even when their interests took them out of his realm.
16 department heads
"He was very loyal. Years after I left, he did very good things for me," said Harvard's Dr. Braunwald, who said he modeled himself after Dr. Harvey. "He probably trained more chiefs of medicine and professors of medicine than anybody in the world."
The numbers show that Dr. Harvey taught more than 2,000 medical students and nearly 1,000 residents. Sixteen became heads of departments, and eight became deans of medical schools.
A native of Little Rock, Ark., Dr. Harvey earned his bachelor's degree at Washington and Lee University and then his medical degree at Hopkins. He did his residency there from 1934 to 1937. In those days, residents lived in the hospital, earning only room, board and laundry services.
A few years ago, Dr. Harvey recounted how he almost made a fatal mistake his first week in the emergency room. He told a hemophiliac who had bumped against a chair that he could go home.
The patient responded, "You look like a nice young man. I think you'd better admit me to the hospital." Dr. Harvey said he did, and the man required many blood transfusions.
After his residency, Dr. Harvey accepted a fellowship at the National Institute for Medical Research in London and also worked at the Johnson Foundation for Biophysics at the University of Pennsylvania. He was also appointed an assistant professor of medicine at Vanderbilt University Medical School, and during World War II, he served in the U.S. Army Medical Corps with the Hopkins 18th General Hospital.
Dr. Harvey made a hobby of building hardwood furniture, friends say. He was also an athlete and a great conversationalist. But most of his time was dedicated to Hopkins, for which he had a deep love.
After retiring as chief of medicine in 1973, he became absorbed in recording the history and tradition of Hopkins. Some described him as an informal ambassador for the institution.
As Hopkins' School of Medicine's chief archivist, he chaired the Centennial of Hopkins in 1989 and wrote nine books on scientific and medical discoveries throughout history. Among his many honors was the George M. Kober Medal, the highest honor of the American Association of American Physicians.
Dr. Edward D. Miller, dean and CEO of Johns Hopkins Medicine, said yesterday that Dr. Harvey made significant contributions to what he called a "golden era" in American medicine.
"The Hopkins family mourns not only the loss of a dear colleague, but also the passage of the era he helped make great," Dr. Miller said.
Ronald R. Peterson, the hospital's president, called Dr. Harvey a "true gentleman" who always asked how he was doing.
Dr. Harvey typically spent most of his retirement speech thanking others and giving them credit for his accomplishments. But he did take the opportunity to remind physicians of his credo:
"The human side of medicine will always be kept foremost in all that is done -- that in spite of the rapidly increasing technological trappings of hospital medicine, it will never be forgotten that in every patient there is a person."
Dr. Richard S. Ross, former chief of cardiology and dean of the School of Medicine, who also trained under Dr. Harvey, concluded yesterday: "He is one of the Hopkins greats who now goes up on the pedestal with the rest of them."
Dr. Harvey is survived by his wife of 41 years, a retired Hopkins physician, and four children: Dr. Jenette Harvey Wheeler, a physician, and Elizabeth Baker Harvey, an epidemiologist, both of Philadelphia; Dr. Joan Harvey Lotzes, a physician in Pittsburgh; and George Treide Harvey, a physicist in Princeton, N.J.
Funeral services are scheduled for 10: 30 a.m. Monday at the Episcopal Church of the Redeemer on North Charles Street in Baltimore.
Memorial donations made be to the A. McGehee Harvey Memorial Fund, care of The Fund for Johns Hopkins Medicine, Reed Hall, 1620 McElderry Street, Baltimore, Md., 21205.
Pub Date: 5/09/98