After the memorial

The memorial was held as scheduled on Saturday 10 October. I estimate 100-150 people attended. Although I had some hand in the planning and execution, the great majority of the organizational work was done by Huda Akil and her staff at MBNI: Ruth Friedman, Doug Smith and Tom Dixon. We all owe them great thanks and appreciation for all that they did to make the memorial a significant and memorable event.

I have posted new links to an enlarged set of photos of Elizabeth and things she loved as well as some photos of the memorial itself. The latter were taken by my son-in-law Todd McDermott and selected and edited by me.

I want to remind you that anyone who would like to make a contribution in Elizabeth's honor may contribute to the fund created to establish The Elizabeth A. Young Lectureship on Stress and Mood Disorders at the University of Michigan. Donations to the Fund can be sent to MBNI, 205 Zina Pitcher Place, Ann Arbor, MI 48109. Att: R. Freedman.

Memorial Details

The memorial will be held Saturday 10 October from 1-5 PM at the UM Museum of Art. This is located on State Street on Central Campus across from the Michigan Union. There will be a program of 1 and 1/2 to 2 hours followed by a reception. Some speakers will be scheduled, and there will be a period when anyone is welcome to make brief remarks. If you are coming from out of town and need accommodations, see the list of hotels in the previous post. Let me know (pgh@umich.edu) if you need help.

I am planning a slideshow of digital photos of Elizabeth and the things that she loved. If you have photos you would like to contribute to this, please Email me full-resolution versions, since they will be projected on a large screen.

Memorial

We have decided to hold a memorial gathering on Saturday October 10. This will be mainly personal remembrances of family, friends and colleagues with a more formal scientific conference to be organized later, perhaps in the Spring. Everyone is welcome. More details will be announced here as they develop, but I wanted to announce the date as soon as possible for planning.

For those of you from out of town who want to come, we have gathered some hotel information. The first two are in the campus area, the other two at Briarwood, a shopping mall a few miles from campus.

Campus Inn 734-769-2200: Only a few rooms at $184 single and some deluxe rooms at $214. More may open up in a week or so.

Bell Tower 734-769-3010: Only a few rooms available on October 9, more of the 10th. $165 single.

Holiday Inn Express 800-345-8082: $98 with rooms available

Kensington Court 734-761-7800: $119 with availability

An obituary has appeared today in the New York Times and will be repeated on Sunday. It can also be seen online. There is also a notice on the webpage of ISPNE, one of the many professional organizations in which Elizabeth was active

Obituary

Dr. Elizabeth Young, Professor of Psychiatry and Senior Research Professor at the Molecular and Behavioral Neuroscience Institute (MBNI) at the University of Michigan passed away on September 1, 2009 after a yearlong battle with leukemia. She was 59 years old.

Dr. Young was an internationally renowned biological psychiatrist who conducted seminal work on stress biology and its role in severe depression and other mood disorders.

Elizabeth was raised in the Detroit and Chicago area, earned her medical degree from the Ohio State University in 1976, and completed her residency in Psychiatry at the same institution in 1979.

Elizabeth came to the University of Michigan Medical School in July 1979 as a research fellow in the Department of Psychiatry. In 1981 she received a postdoctoral fellowship to work in the laboratories of Drs. Huda Akil and Stanley Watson at the Molecular and Behavioral Neuroscience Institute (MBNI). She went on to join the faculty of the MBNI and Psychiatry where she moved through the ranks to the senior positions she occupied at the time of her death.

Dr. Young was the quintessential translational physician scientist—a role she fashioned for herself before its critical importance was widely appreciated. Early in her career, she conducted fundamental research on the biology of endorphins and on the regulation of the hypothalamo-pituitary-adrenal axis by stress. Simultaneously, she undertook groundbreaking studies on the dysregulation of the stress system in major depression. Elizabeth posited that abnormal responsiveness to stress is not only a consequence of depression but may be part and parcel of the pathophysiology of mood disorders. She was fully aware of the intricacies of the stress system at the molecular, brain circuit, and neuroendocrine levels. Therefore, she realized that there were many points of vulnerability where the system could be disrupted, but also many approaches to resetting its intricate balance. It is because of these unique insights that she spent a significant portion of her career devising novel strategies to challenge the stress system and examine its responses in normal subjects and patients with mood disorders.. She analyzed the stress disruption not only in severe depression but also in related and sometimes co-morbid illnesses, such as anxiety disorders or post-traumatic stress disorder (PTSD). A particular focus of her research was understanding gender differences in mood disorders and uncovering the biological and psychosocial reasons for the increased vulnerability of women to depression and anxiety. Her body of work stands as one of the most systematic and mechanistic analyses of the biology of mood disorders in our field.

But Elizabeth was much more than a talented physician scientist. She was also a loving wife and stepmother, a caring physician, a wonderful collaborator and mentor, an ardent gardener and appreciator of the best that life has to offer, and a devoted friend. During her ordeal, she and her equally remarkable husband, Dr. Peter Hinman, maintained a blog in which they shared their trials and their triumphs with their countless friends and colleagues. Their courage, love, thoughtfulness and generosity towards their friends were inspiring. In knowing her, those of us who love her learned not only how to live well, but also how to die well.

She is survived by her husband Dr. Peter Hinman, her step-daughter Dr. Mira Hinman and two step-granddaughters Annika and Celia McDermott-Hinman.

A ceremony to honor her memory is planned for early October and a Scientific Symposium in the Spring. A Memorial Fund has been created to establish The Elizabeth A. Young Lectureship on Stress and Mood Disorders at the University of Michigan. Donations to the Fund can be sent to MBNI, 205 Zina Pitcher Place, Ann Arbor, MI 48109. Att: R. Freedman.

A longer version of this is available here

The end

Elizabeth died this morning at 3:41. She was comfortable to the end as far as we could determine. Her breathing rate increased briefly, then simply stopped, so I believe that it was as painless as possible.

The end is near

On Saturday the decision was made between all of the doctors, Mira (my daughter and Elizabeth's step-daughter) and me that Elizabeth's condition is irreversible and that we should focus exclusively on palliative care to make her last time more comfortable and without pain. She had by then lost all cognitive function and was totally unresponsive to any stimuli except pain. Indeed, she seemed at times in terrible agony -- it was horrible for all of us to watch. We disconnected all of the curative IV's and started with periodic injections of morphine and ativan. These would work for a while but quickly wore off and left her again in pain as evaluated by her contorted face and arm motions.

Yesterday afternoon we started a continuous IV drip of morphine, at first at 2 ml/hr gradually increased to 2.7 ml/hr currently. On other advice, we stopped the ativan. During the day today this has been very successful; she has slept peacefully the entire day. Her respiration rate has slowed to 4-5 breaths/hour, which everyone agrees is not due to this relatively small dose of morphine but to a general slowing of bodily function as her body shuts down. We have consulted with the palliative care department and they are alerted if the need for stronger analgesics arises.

No one knows for certain, of course, but expert estimates are that she will die within a few days and possibly within hours. It is a very sad time for us all, but it has been inspiring to see the many of her friends and colleagues that have come to visit and often to stay for long periods. Of course, we are no longer concerned with visitors bringing infection.

According to her wishes (and mine as well) she will be cremated and there will be no funeral. There will probably be a memorial later in the fall that will have both a personal and a professional component, but there are no definite plans as yet.

Continuing Downhill

Elizabeth's condition seems to be getting slowly worse each day. She is now completely immobile in bed and cognitively very impaired. It is not clear that she understands much of what goes on around her and is mainly unresponsive to questions or comments -- occasionally she will answer with a shake or nod of the head. She does object strenuously to the necessary caretaking routines which probably cause her pain and/or anxiety, but we aren't really sure.

No one really understands the causes of this state -- they could be the effect of the leukemia actually entering the brain, but they could also be due to the toxic mix of medications she has been getting, including steroids, chemo, antibiotics, ativan, IV nutrition, etc. Another possibility is that all of the above have put such a strain on her body that it is simply in the process of shutting down.

Although we will be continuing as now for a few days unless things get suddenly worse, it seems quite possible, even likely, that she will die in a relatively short time. We do not intend to apply extraordinary measures to keep her alive unless there is good reason to believe that she has a good chance for a full recovery given a bit more time, something that seems pretty distant as of today.