In Memoriam: Harold O. Conn, M.D.
Authors: James L. Boyer, Guadalupe Garcia-Tsao, Roberto J. Groszmann
Journal: Hepatology (2011)

Harold O. Conn, M.D., a world-renowned hepatologist, President of the American Association for the Study of Liver Diseases in 1972-1973 and a 50-year faculty member of the Yale University School of Medicine and the Yale Liver Program, died on October 9 at age 85 in Pompano Beach, Florida . Conn was a pioneer in the basic understanding and treatment of cirrhosis and its complications and published more than 200 peer-reviewed articles in national and international medical journals. His major scientific contributions to the field related to studies on the accuracy of serum ammonia measurements, characterization of spontaneous bacterial peritonitis, the evaluation of prophylactic portacaval shunts in clinical trials, the radiologic and endoscopic evaluation of esophageal varices, and the treatment of portal systemic encephalopathy with lactulose. He was the first to use the term "spontaneous bacterial peritonitis" and was responsible for the frequently quoted "West Haven" criteria of hepatic encephalopathy. He was frequently asked to editorialize and often used a unique sense of humor to make the articles more enjoyable. He published 17 original articles, reviews, and editorials in the New England Journal of Medicine and many others in prominent journals, including HEPATOLOGY and Gastroenterology. He was a consummate critic and editorialized extensively on topics that ranged from clinical study design, assessment of the accuracy or safety of diagnostic procedures, including effectiveness of liver biopsy in liver cancer, and the use and risks of the Sengstaken-Blakemore tube for the treatment of bleeding esophageal varices. Conn was born in Newark, New Jersey, on November 16, 1925, the fourth of four children of Joseph and Dora Conn, second-generation American parents who had emigrated from Southeastern Europe. He was an all-state high school swimmer who left New Jersey to earn B.S. (1946) and M.D. (1950) degrees from the University of Michigan thanks to the financial support of his older brother, Jerome Conn, a physician and faculty member at the Ann Arbor School. After interning at the Johns Hopkins Hospital in Baltimore, Maryland, he was the chief resident at Yale-New Haven Hospital and earned a 2-year fellowship with Dr. Gerald Klatskin at Yale, one of the early founders of the discipline of hepatology. Later, Conn set up his own liver unit at the West Haven Veterans Affairs Hospital, where many future hepatologists were trained, including two of the authors of this obituary (R.J.G. and G.G-T.). Other trainees included Andy Blei, Colin Atterbury, Mario Chojkier, David Kravetz, Milton Mutchnick, Bruce Tottman, Michael Phillips, and John Fessel. Hal, as he was called by friends and colleagues, attracted trainees from other countries, among them Guadalupe Garcia-Tsao from Mexico, Gregory Taggard from Australia, Simon Bar-Meir from Israel, and Jean-Pierre Vinel and Thierry Poynard from France. One of his proudest professional accomplishments was "The Histopathology of the Liver" by Klatskin and Conn, published in 1995, 9 years after Gerald Klatksin died and 3 years after Conn had retired. The book was a benchmark reference for the histopathological diagnosis of chronic liver diseases. It was his last big project, as he had contracted a disease unknown to him (normal pressure hydrocephalus; NPH). His NPH was erroneously diagnosed for 10 years as Parkinson's disease and greatly affected his ability to walk or think clearly until the correct diagnosis was made. A miraculous remission followed brain surgery, and at age 78, he became an expert about, and a spokesperson for, NPH awareness. In the decade that followed, he wrote a dozen meaningful articles about NPH, its prevalence, and heredity and appeared on national radio and TV programs. In addition, he made himself available to advise patients and the families of friends as a good Samaritan about the diagnosis and treatment of NPH. He became a member of American Airlines' 2 million mile club in 1990, which were primarily accumulated from giving lectures. He was an excellent lecturer, the skills for which he credits his brother, Jerome, who spoke at many of his classes and later discovered Conn's Syndrome I (primary aldosteronism). Conn, a workaholic who spent countless hours researching articles, is the namesake for the Conn Center, a classroom at Yale's Cushing/Whitney Medical Library. He was also an avid squash player who contributed the "Conn Family Court" to Yale's Brady Squash Center. Conn was also well known for his innovative holiday cards incorporating the family name. He is survived by his wife of 60 years, Marilyn Barr Conn, of Pompano Beach, Florida, three children, Chrysanne (Richard) Vogt of Northford, Connecticut, Steven (Emily Resnik Conn) of Woodbridge, and Dorianne Conn (Jeff Balch) of Evanston, Illinois, and six grandchildren. The authors gratefully acknowledge Steven Conn for his many personal insights.