George Robert (Bob) DeLong, MD (1936-2019)

by Mark S. Wainwright, MD, PhD, FAAN

DeLong (2014 meeting)

George Robert (Bob) DeLong, former Chief of the Children's Neurology Unit at Massachusetts General Hospital and Emeritus Professor of Pediatric Neurology at Duke University was born in Lafayette, Indiana in 1936 and passed away in Exeter N.H. on 7/10/2019.  DeLong had life-long interests  in neurodevelopmental diseases including metabolic disorders, infantile autism, childhood manic-depression, and epilepsy.  His career exemplified the finest traditions of scholarship, clinical practice, leadership and devotion to the care of his patients in Child Neurology. 

DeLong grew up in Indiana in a farming community imbued with qualities of decency and the value of honest work which were formative for him and where he met Nancy, his wife of 61 years.  After graduating from DePauw University in 1957, he completed medical school at Harvard, served as chief resident in neurology at the Massachusetts General Hospital and was appointed Chief of the Children's Neurology Unit at MGH and Harvard Medical School in 1969. During medical school he developed an interest in the links between neuronal development and behavior which he first pursued at the bench using reaggregate neuronal cultures at the National Institutes of Health. The links between developmental neurobiology and the complexities of human behavior remained a sustained interest as he shifted his focus to clinical research.  His interest in the basic sciences never waned, just transmuted to treating the clinic as a laboratory.

While at MGH DeLong was struck by a clinical finding (a pattern of aggressive behavior) in some of his patients, then found pre-clinical research publications  (the effects of Lithium on aggression in fish) to suggest a new therapy.  Although the diagnosis of manic-depression in children was considered controversial DeLong successfully treated a number of patients with Lithium. His report in the Journal of Pediatrics in 1978 was one of the first descriptions of bipolar  disorder in children, and part of a life-long focus on the treatment of mental illness and retardation in children.

DeLong moved to Duke University in North Carolina in 1988 where he retired as Emeritus Professor of Pediatric Neurology in 2007.  While at Duke, he began to focus on the genetic determinants of mental illness and mental retardation. He established a multi-disciplinary autism clinic, one of the first of its kind.  Working with the Center for Human Genetics at Duke, this collaboration lead to numerous publications on the genetics of autism. Again, he was not satisfied with describing disorders or to give in to prevailing opinion and was one of the first people to successfully use an SSRI in the treatment of autistic children. 

Visitors to the DeLongs’ home in Chapel Hill would be struck by the large map of the world that covered an entire wall, which was dotted with dozens of red pins. Each pin represented a place he and Nancy had visited.  Many were over one province in China: Xinjiang, where iodine deficiency was endemic and refractory. A visit to Ecuador in 1980 had sparked DeLong’s interest in the effects of nutrition on the developing brain, an interest that  culminated in the 1990s with a program he created in Xinjang to treat iodine deficiency. Through the 1990s, he worked with physicians and government officials there to create a novel program of iodination of irrigation water to increase iodine in soil, crops, animals, and humans. Speaking no Chinese but with his typical good humor and persistence, he shared his insight that iodine delivery could be achieved through the water supply.  In 1997-1999, DeLong’s method of iodine dripping was extended to cover a population of  2.6 million  people. This approach was later replicated in Inner Mongolia and expanded to trials of iodinated salt blocks in Tuva, a Siberian Russian republic. A major expansion of the program began in 1997, supported by Eunice Kennedy Shriver through the Kennedy Foundation, Kiwanis International, and UNICEF.   The impact of this program in China was enormous, resulting in an average increase in IQ of 16  points and a near 50% decrease in infant mortality. 

DeLong was a self-described autodidact and iconoclast with an atypical career path who worked in areas (psychiatry, public health) in which (in his own words) he was not trained.   His contributions to these fields reflect his compassion for of the burdens of mental illness and retardation, and his commitment to finding treatments based on advances in basic science.  DeLong’s warmth and curiosity included his trainees and faculty to whom he also extended a similar kindness and generosity of spirit.  For them, he was both welcoming at his home with Nancy, and provided an example to emulate of unquenchable curiosity, meticulous attention to patient care and the determination to understand and treat psychiatric illnesses in childhood. He also had encyclopedic knowledge of neurogenetic disorders, neuro-oncology and  neonatal neurology. His enthusiasm, curiosity and ability to combine advances in basic science research with clinical observations in children with psychiatric disorders were exceptional and made an impact on all who worked him, another part of his legacy to our field.

DeLong was a recipient of numerous awards. He received the Harvard Shriver Center Prize for Mental Retardation Research in 1995; the E.H. Christopherson Award and Lectureship of the American Academy of Pediatrics in 2002 awarded annually for “contributions to international child health”, and an Honorary Doctor of Science degree from Depauw in 2003.  In 2014 at the Child Neurology Society Annual Meeting, DeLong received the CNS Lifetime Achievement Award  in recognition of his achievements and service to this field.  Former trainees and colleagues came from all over the US, Australia and Lebanon to see him receive this well-deserved honor.  Slowed by a 30-year struggle with Parkinson’s disease, DeLong’s sense of humor, modesty, devotion to his family, and love of child neurology were still fully apparent. As he stood to accept the award and acknowledge the applause of his peers,  first paying tribute to Nancy and to his children, he expressed his only disappointment after an inspiring and extraordinary career: “My only regret is that I cannot do it all again.”