In Memoriam Ramzi S. Cotran: December 7, 1932 — October 23, 2000

Barry M. Brenner

“... and, when he shall die, Take him and cut him out in little stars, And he will make the face of heaven so fine, That all the world will be in love with night, And pay no worship to the garish sun.” —Romeo and Juliet, Act 3, Scene 2

Since the dawn of recorded history, no guild or profession has enjoyed a more noble reputation than medicine. This is so not only because of their power to relieve suffering but also because medicine's practitioners throughout the ages have been persons of wisdom, compassion, and humility. Such were the qualities that marked the life of Ramzi Cotran, which sadly ended in Boston on October 23, 2000, after a courageous battle with metastatic ocular melanoma.

Ramzi Suliman Cotran was born in Haifa, Palestine (Israel), on December 7, 1932. Bookishness, curiosity, and high intelligence were in evidence early on, leading his loving and devoted parents to send him to highly regarded boarding schools in Jerusalem and Beirut, Lebanon. He then attended The American University of Beirut, where he earned baccalaureate (1952) and M.D. (1956) degrees with honors. Armed with excellent recommendations and a strong desire to acquire the most rigorous training in pathology, young Dr. Cotran emigrated to Boston to train at the renowned Mallory Institute of Pathology at Boston City Hospital, where from 1956 to 1959 he served consecutively as Intern, Senior Assistant Resident, and Chief Resident. After a 1-yr fellowship at Sloan-Kettering Institute in New York City, Dr. Cotran returned to Boston and Harvard Medical School (HMS) in 1960, advancing rapidly in academic rank and responsibility, ultimately to the Frank B. Mallory Chair in Pathology at HMS (1972) and Chairman of the Departments of Pathology at Brigham and Women's Hospital (formerly Peter Bent Brigham Hospital) (1974) and Children's Hospital Medical Center (1990).

Dr. Cotran's career was marked by excellence in several contemporaneous endeavors, including diagnostic pathology, research, teaching, and administration. As a pathologist, Dr. Cotran emerged as an internationally recognized authority on renal biopsy interpretations, routinely consulted as the “pathologist's pathologist” for his opinion in difficult cases and for his exceptionally lucid insights and recommendations. His research focus initially reflected the rich environment at the Mallory Institute and, in particular, the interest in mechanisms of renal infection and inflammation imparted by his early mentor, Dr. Edward Kass. Over the years, this interest broadened to include vascular biology, including the central role of the endothelium in the evolution of such diverse forms of vascular injury as atherosclerosis, altered permeability and permselectivity, tumor angiogenesis, microvascular ischemia, neointimal proliferation, and, most recent, the role of endothelial cell activation in leukocyte adhesion and migration. For this body of work, including nearly 200 publications, Dr. Cotran was a much-sought lecturer and author, recipient of many honors, member of more than 20 academic societies, and holder of multiterm appointments to editorial boards of 11 distinguished journals of pathology, nephrology, and cardiovascular biology and medicine.

In teaching and mentoring in pathology, Dr. Cotran was without peer in his influence and legacy. In his many years of contact with students, residents, fellows, and junior faculty at Harvard, Dr. Cotran directly guided hundreds of talented individuals, ultimately garnering the much coveted Lifetime Achievement Award in Mentoring from HMS in 2000. But his influence as an educator and scholar in pathology extended far beyond the confines of Harvard, due largely to his role as lead author through five editions of The Pathologic Basis of Disease, the world's most widely read textbook of pathology. In this endeavor, which began in association with Dr. Stanley Robbins, the work grew considerably in size and scope under Dr. Cotran's guidance and now serves students and physicians in virtually every country and on every continent.

These achievements in research and teaching led Dr. Cotran quite naturally to executive responsibilities in departmental leadership and, coupled with his devotion to the discipline of pathology generally, to efforts to advance the foundations and evolving architecture of academic pathology, again not only at Harvard but throughout the world. As a result, Dr. Cotran is widely regarded as the leading visionary of modern academic pathology in the past half-century. If the most important trait of an academic chairperson is the ability to recognize and nurture academic potential and promise, Dr. Cotran has been described as being blessed with homozygosity for this trait. As Chair of Pathology at Brigham and Women's Hospital and also more recently at Children's Hospital, Dr. Cotran brought great synergies to these programs and attracted the nation's best and brightest residents and fellows, eventually retaining many in his own departments or seeing them emerge as academic leaders in programs throughout the world. Among his many awards and prizes, Dr. Cotran was particularly pleased to receive special peer recognition for his academic leadership with the highly coveted Distinguished Service Award of the Association of Pathology Chairmen in 1992. Service to medicine, pathology, and nephrology nationally took up much of Dr. Cotran's last few years and included the Institute of Medicine of the National Academy of Sciences and ascendancy from Councilor to President of the American Society of Nephrology. His gentle but firm guidance, exacting standards, and commitment to issues larger than himself were recognized with many academic and societal honors and awards, including election to the American Academy of Arts and Sciences in 1993, receipt of the Gold-Headed Cane Award of the American Society of Investigative Pathology in 1998, and the John P. Peters Award of the American Society of Nephrology in 1999. And HMS, the institution that he loved and served so well for more than 4 decades, bestowed its highest accolade by establishing the Ramzi S. Cotran Professorship in Pathology in September 2000.

Though tireless in his pursuit of academic and institutional excellence, Ramzi Cotran leaves in the memories of his family, friends, and colleagues a treasure of recollections of a warm, courteous, and generous man. Though he was entitled to walk with the greatest of his profession in the 20th century, he revealed in his daily attitude no such awareness of his achievements or influence and therefore demanded no audience. Instead, he devoted himself to his wife, Kerstin, of more than 40 years, their 4 talented children, Paul, Leila, Suzanne, and Nina, and their 11 loving grandchildren. In this respect, he thrived on simple pleasures in the unlofty give and take of everyday life, always displaying a youthful vitality and ever-present and genuine sense of modesty.

From these and the many other fine threads that became the glorious tapestry that was the life of Ramzi Cotran, we see revealed his special virtues of humanity, selflessness, purpose, and kindness. Long after the tapestry reduces to dust, Dr. Cotran's contributions to science and medicine will remain indelible and imperishable. And, for those who are fortunate to have been touched by him personally, we know better how to be.