Leading authority on brain injuries dies at 94

Muriel Lezak, a neuropsychologist who wrote a landmark textbook in the early days of her discipline that became an essential guide to the description and evaluation of brain injuries and disorders, died Oct. 6 in a memory care facility in Portland, Oregon. She was 94.

Her death was confirmed by her nephew Stephen Lezak.

Lezak began working as a clinical psychologist in the late 1940s. Two decades later, at the Veterans Administration Hospital in Portland, she brought her abiding curiosity about the connection between the brain and behavior to her treatment of soldiers who had suffered neurological damage in World War I, World War II and the Vietnam War.

“I was the psychologist for neurology, neurosurgery and rehab,” she said in an oral history interview with Oregon Health & Science University in 2016. “It was like pig heaven, you know?”

Lezak became keenly interested in patients with frontal-lobe damage, which impacts creativity, reasoning, and the ability to relate to people and to plan and organize. As she dealt with interns and other medical personnel, she realized there was no book in her evolving field that comprehensively reviewed the major disorders caused by brain dysfunction and injury, or the techniques, tests and procedures to evaluate patients.

Her book “Neuropsychological Assessment” (1976) filled that gap. It also added tests that she developed to evaluate brain dysfunction, such as seeing how a patient drew a bicycle, that could provide insights into motor control and perception. She emphasized a flexible approach, adapting procedures to suit an individual patient’s problems, a departure from the standardized tests that were then common.

“There had been nothing at the time that focused on the nuts and bolts of evaluation, and she did a really nice job of looking at the pattern of a broad range of assessments before making a conclusion about a diagnosis,” Kathleen Haaland, a neuropsychologist and professor of psychiatry and behavioral sciences at the University of New Mexico School of Medicine, said in a phone interview.

Ida Sue Baron, a neuropsychologist and clinical professor emeritus of pediatrics at George Washington University School of Medicine in Washington, D.C., said in an email: “The publication of this book brought the field together coherently for the first time, by integrating the methods and the science for those of us who had no other references, and even for those not in our profession who wished to understand what neuropsychology was really all about.”

Lezak was the author of two subsequent editions of the book and a co-writer of the fourth and fifth editions; a sixth edition, likely to be published in 2023, will be renamed “Lezak’s Neuropsychological Assessment.”

At the VA Hospital, where Lezak worked until 1985, she started a support group to help military wives cope with the altered behavior of their brain-injured husbands.

“The people they were married to were no longer there; it was somebody else who was similar, looked pretty much the same, but was no longer the person they were able to love and interact with comfortably,” she said in the oral history.