Background
Medical and public health innovations in the 20th century have resulted in unprecedented increases in longevity. However, with increased lifespan, the prevalence of age-related diseases also has increased. Chief among these illnesses is Alzheimer’s disease, by far the most common cause of dementia in late life. Although Alois Alzheimer first identified the disease that bears his name in 1906, little attention was given to the disorder until the past two to three decades.
 In the 1970s, clinicians and investigators at Washington University began to seek answers. Led by Leonard Berg, MD, a dementia research team eventually obtained funding from the National Institutes of Health in 1979 and inaugurated the MAP. For 30 years, the MAP and supporting NIA grants, including the ADRC, have supported seminal studies and projects that have expanded the research understanding of Alzheimer’s disease and set worldwide standards for its diagnosis and treatment.
Leonard Berg, MD (1927-2007)
Leonard Berg, MD, pioneered Alzheimer’s disease research at Washington University. A St. Louis native, Dr. Berg graduated from high school at age 15 and enrolled in the accelerated wartime pre-medicine program at Washington University. An accomplished clarinetist and saxophone player, he defrayed college expenses by playing with popular dance bands. He entered the medical school in 1945 and was barely voting age by his 1949 graduation. Dr. Berg interned at Barnes Hospital and then thrived during residency in New York at The Neurological Institute. In 1953, the Berg family moved from New York to Bethesda, MD, where Dr. Berg became one of the first postdoctoral fellows at the new Clinical Center of the National Institutes of Health. When the Berg family returned to St. Louis in 1955, Dr. Berg was offered a full-time academic appointment in the Department of Neurology at Washington University, including training in any field of neuroscience that he might choose. Dr. Berg declined, stating, “I wouldn’t be successful in research,” and instead accepted a clinical appointment as he went into private practice. In his practice, Dr. Berg encountered demented patients for whom rudimentary diagnostic considerations ranged from AD to normal-pressure hydrocephalus. To improve dementia diagnosis, in 1972 he initiated a multidisciplinary “brown bag” lunch discussion group. Eventually the group decided to conduct their own longitudinal study to compare “senile dementia” with healthy aging and developed a clinical staging instrument, the Clinical Dementia Rating, to distinguish the two conditions. By 1984, Dr. Berg’s original study had evolved into a program project grant, supported by the NIA, for which he was the principal investigator. The following year – when he was 55 years old – he was awarded one of the first 10 ADRC grants from the NIA. During this time, he helped establish the St. Louis chapter of the Alzheimer's Association to support the needs of family members of demented individuals.
In 1998, Dr. Berg joined the emeritus faculty and retired from the ADRC, passing its directorship to Eugene M. Johnson Jr., PhD, Norman J. Stupp Professor of Neurology, and John C. Morris, MD, Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology. Dr. Morris later assumed sole directorship of the ADRC and MAP. On retirement, Dr. Berg was looking forward to greatly cherished time spent with his family, but encountered several health problems. Dr. Morris had established the Leonard Berg Symposium* in 1997 to honor Dr. Berg’s contributions to the field. Held every two years in St Louis, the Symposium has grown to be a major international event in which health professionals, clinical and basic science researchers, and others learn and discuss a timely topic related to Alzheimer's disease. In spite of his health issues, Dr. Berg made every effort to attend each Symposium and enjoyed celebrity status as colleagues and attendees all were drawn to him.
Although Dr. Berg died on January 15, 2007, due to complications from a cerebral hemorrhage, his legacy lives on, not only in the Berg Symposia but also in the lives of those he mentored and the generations of mentees that followed.
 John C. Morris, MD “I simply would not be where I am today without Leonard,” says Dr. Morris, who first met Dr. Berg in 1983. “Leonard set a terrific example and was considerate enough to bring me into the world of Alzheimer’s research.” This generosity led Dr. Berg to introduce Dr. Morris to directors of Alzheimer’s research centers at meetings that they attended together, an important move for Dr. Morris’ career. “Clearly,” says Dr. Morris, “Leonard made important decisions with my career in mind.”
Though mentoring was an element in the relationship between Dr. Berg and Dr. Morris, it was not “mentoring” as defined today. “It used to be like an apprenticeship with an outstanding role model like Leonard,” says Dr. Morris. “Now, I try to serve as a role model as well and do all of the things that Leonard taught me, but also bring more structure to the mentoring experience and meet with my trainees on a regular basis to measure progress toward goals.”
Monique M. Williams, MD
One of Dr. Morris’ trainees is Monique Williams, MD, MSCI, director of the ADRC’s African American Outreach Satellite and assistant professor of medicine and psychiatry at WUSM. “Working with Dr. Morris has been such an inspiring experience for many people,” she says. “Even those who did not initially express interest in a career in aging and dementia considered going into it because they were so inspired by his example.”
Because of their high regard for Dr. Morris, in 2008 several of Dr. Morris’ mentees, including Dr. Williams, successfully nominated him for the Mentoring Award given annually by the WUSM Academic Women’s Network. In her nomination letter, Dr. Williams stated “I have been privileged to have Dr. Morris as my formal and informal mentor for more than a decade. Through the years, Dr. Morris has served as mentor to numerous junior faculty, fellows, residents, and students. I particularly wish to emphasize the considerable impact that Dr. Morris has had on the career development of women in dementia and aging research. Of the women that he has mentored during his career, several are now successful faculty at Washington University. Some of these women mentees are international researchers who have achieved success in biomedical research. Now they serve as mentors and leaders in their fields in developing nations where such opportunities for women in biomedical science are limited. In addition to MD and PhD women faculty who have benefitted from his mentoring, the majority of the nurse clinicians in the ADRC have faculty appointments. With his mentoring and support, several nurse clinicians have had first-author publications. Dr. Morris’ leadership engenders a positive and proactive multidisciplinary work environment, where opportunities for learning and teaching thrive.”
Dr. Williams says that Dr. Morris has taught her that effective mentoring should be balanced, with the mentor providing sufficient direction without being too engaged. “It is my belief that a good mentor does not always tell you what to do,” she says, “but instead gives you enough space to develop and grow to autonomy.”
Dr. Williams says that in addition to being a good role model, Dr. Morris goes several steps further and like a good parent, provides “good discipline and structure” with regular meetings and careful coaching when she writes journal articles and grants.
“Dr. Morris embodies all of the characteristics that one looks for in an exceptional mentor, including consistency and accessibility,” says Dr. Williams. “Even if he is away at a meeting in Europe, you always know that he will address your questions or issues quickly, despite the distance, time difference and an incredibly busy schedule.”
Dr. Williams incorporates what she has learned from Dr. Morris into her own mentoring style. “A great mentor usually has a great mentoring pedigree,” she says, referring to Dr. Berg and Dr. Morris. “Great mentors often have great mentors and so on and so on. Therefore, mentoring is multigenerational as well as multidimensional.”
 Stephanie M. Seaton, PharmD Candidate
Stephanie Seaton, a PharmD candidate at the St. Louis College of Pharmacy, has received the benefits of great multigenerational mentoring as one of Dr. Williams’ mentees. “Dr. Williams’ positive outlook on her roles in projects and her day-to-day responsibilities is inspiring,” says Ms. Seaton. “Even when a roadblock slows down the momentum of a project, Dr. Williams is the first to persevere. She works diligently to find new methods to carry on and propel the project to a new echelon.”
Catherine M. Roe, PhD
Cathy Roe, PhD, agrees. Dr. Roe has had the benefit of training with Dr. Williams as well as Dr. Morris, who is her primary mentor. “Dr. Williams is a wonderful friend and colleague. In addition to mentoring students, she actually serves as an unofficial ‘peer mentor’ to a number of junior faculty affiliated with the ADRC. When I joined the neurology department and started to get to know Monique, she started e-mailing me notices of career development seminars and other opportunities she thought I might be interested in. She has also volunteered to proofread and critique my manuscripts, which has improved their quality considerably. Given her greater experience in grant submissions, I relied on Dr. Williams for her knowledge and support when I prepared and submitted a recent K01 application. Her enjoyment of interacting with people and helping them in any way that she can is obvious, and translates into a better work environment and stronger research teams.
“I met Dr. Morris in 2002 when I was hired as a statistical data analyst in the Division of Biostatistics, a position devoted to data management and statistical analyses for ADRC projects. My promotion from a staff position to a faculty position over the years is clearly a result of Dr. Morris’ mentoring. Dr. Morris encouraged and advocated for my increasing involvement in study design and manuscript preparation for projects that I worked on, and guided me along the way. I think that Dr. Morris believes that people can surpass expectations if given the opportunity. As a mentor, his style of critique is humble and empowering – he always gives the impression that you are free to take his advice or not as you see fit, although we all know that not taking his advice would be foolish.”
Dr. Morris is humble about the accolades he receives, preferring to accept them on behalf of the ADRC team. He believes that the spotlight should be on the ADRC’s efforts to ameliorate and one day to prevent Alzheimer’s disease. “I enjoy mentoring because I have such wonderful and dedicated mentees,” says Dr. Morris. “Moreover, if we don’t develop the next generation of outstanding investigators, it will be impossible to sustain the important research advances that have been achieved in combating this terrible disease.”
*7th Leonard Berg Symposium, October 1-2, 2009, Eric P. Newman Education Center. This year’s topic is Presymptomatic Detection of Dominantly Inherited Alzheimer’s Disease. For more information: http://alzheimer.wustl.edu/Education/Berg/Berg2009/default.htm
Some of the information in this Spotlight feature previously appeared in Outlook Magazine, which is published by the Washington University Office of Medical Public Affairs. Information about Dr. Berg and the Leonard Berg Symposium courtesy of the WUSM Department of Neurology.
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