After 50 years studying children's brains, she's on to new frontiers

Nothing about Lucy RorkeAdams is retiring.

Not her crowded office in Children's Hospital of Philadelphia, lined with medical texts and stacks of professional journals, two microscopes at the ready. Certainly not her manner - forthright and candid, ready to provide detailed answers to every question posed.

And yet, this month, Rorke-Adams, 86, senior pediatric neuropathologist at CHOP and clinical professor of pathology and laboratory medicine at the University of Pennsylvania, will retire after a career spanning more than a half-century at Children's and the old Philadelphia General Hospital, where she served her internship and residency.

Rorke-Adams leaves a legacy of important findings on the development of the infant brain, the origin and classification of childhood brain tumors, shaken-baby syndrome, and central nervous system disorders unique to children.

All of this while serving as a part-time medical examiner for the City of Philadelphia, testifying before the grand jury in the JonBenet Ramsey case, taking care of samples of Albert Einstein's brain, and teaching medical students. In addition, she was the first female president of PGH's medical staff and the president of the medical staff at Children's.

The secret to her success?

"There's always been some new challenge in my work," she says. "Every specimen presents something new. I'm always seeing something I've never seen before."

Medicine wasn't Rorke-Adams' first choice of profession. As a 10-year-old growing up in St. Paul, Minn., entranced by radio broadcasts of the Metropolitan Opera and gifted with a "high and lovely voice," she dreamed of becoming an opera singer.

As a teen, she had a chance - a tryout with Gladys Swarthout, a famous mezzo appearing in Carmen in Chicago, who was in search of a protégé. Prepared to leave for her audition, Rorke-Adams learned that Swarthout had been sidelined by illness. Though heartbroken, Rorke-Adams dusted herself off and decided that opera "might not be my destiny."

Although she never lost her love for Mozart and Verdi, a new option soon presented itself when she read The Magnificent Obsession. The story of a playboy who decides to become a neurosurgeon after he kills a famous neurosurgeon in a drunken accident inspired RorkeAdams to choose medicine.

A fascination with the brain and the mind originally led her to psychiatry, then neurosurgery. At the University of Minnesota medical school, she was one of five women in the class of 1957. A male doctor informed her that neurosurgeons depended on referrals and that "no one would refer a case to a woman." She would have ignored him, she says, had she not recognized during her internship that surgeons seemed never to sleep.

"I realized that if I went into surgery, I'd be sleep-deprived all my life," she says. "I didn't really do well without sleep."

Thanks to a particularly inspiring teacher, a fresh specialty beckoned: pathology.

This appealed to a woman who, as a 4-year-old, loved to dissect angleworms wriggling on the sidewalks after a rain.

But the true eureka moment arrived when, on the first day of her residency at PGH, the chairman of pathology announced that, as the only woman in the group, Rorke-Adams would be assigned to do all the pediatric autopsies at the 1,800-bed hospital, since that was the "province of the ladies."

"Can you imagine if he said that today?" she says. "But it helped to establish my career path."

Following her medical training, she joined the PGH staff as both an assistant neuropathologist and as chief of pediatric neuropathology, then a fairly undeveloped field.

"Most general pathologists were overwhelmed by the study of the infant brain - it is very soft, like soft Jell-O - and the anatomy constantly changes as the baby's brain develops," she says.

In 1965, Rorke-Adams was asked to move part-time to CHOP, where she soon became the first full-time staff pediatric neuropathologist.

Rorke-Adams has quietly and not so quietly challenged accepted orthodoxy throughout her career.

She believed that too many pediatric neuropathology programs were run by "armchair philosophers" whose failure to do enough basic research was harming and even killing children.

So, in 1981, she delivered a controversial speech as incoming president of the American Association of Neuropathologists.

"I threw down the gauntlet," she says. "Many pathologists felt that adults got the same diseases as children. Kids are not miniature adults; they get their own diseases." Her speech raised questions that led to new breakthroughs in the field.

In the 1990s, she turned to animal studies to gain insight into malformations of brains and spinal cords in human babies caused by migration disorders. Before human genetics were well understood, she published a hypothesis that disordered genetic control allows neurons to migrate to abnormal, disease-causing locations, an important insight.

Yet, when gazing back on her long career, she is most pleased by the successes of her many students.

"I've had a phenomenal number of students, many of whom have gone on to stellar careers," she says. "The pride I have in transmitting the information I was able to gather during my career is a great satisfaction. . . . They build on the blocks that I set up and take the science further."

Jeffrey Golden, chair of pathology at Brigham & Women's Hospital in Boston, considers her his mentor.

"In addition to holding me to the highest standards, Lucy allowed me to do my work with a balance of freedom and guidance," he says. "She gave me the opportunity to fail, knowing she was always there with a parachute."

On her 80th birthday, Children's Hospital established an endowed teaching chair in pediatric neuropathology in her name.

Three years ago, Rorke-Adams established a different sort of legacy when she bequeathed her samples of Einstein's brain, which she received in 1967 while working at PGH, to the Mutter Museum in Philadelphia.

"He had the brain of a young person," she says. "His brain was absolutely gorgeous."

She is just as effusive in describing her husband, C. Harry Knowles, 86.

"He's a genius," she says instantly, asked to describe him. No exaggeration: He holds close to 400 patents, including one for the first handheld bar scanner intended for retailers.

She chuckles when recalling her mother's warning that, if "you go to med school, you'll never get married." Knowles, whom she married in 2013, is Rorke-Adams' third husband - she outlived the first two.

In retirement, she plans to trade in her microscope for a telescope to focus on the mysteries of the universe. She has also joined the board of Knowles Science Teaching Foundation, which her husband started to improve the quality of math and science instruction in high schools.

"I've had a fabulous career," she says. "I can't think of any better way to have spent my life. I was always given the freedom to follow my curiosity, to follow whatever leads I could. No one ever said, 'You can't do that.'

"I wish I were 35 years younger so I could start all over again."

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