In Memory of Bernard J. Carroll (1940 – 2018)
by Michael Feinberg
Writing an appreciation of Barney and his work in Ann Arbor is difficult for me, for several reasons. He had many different research endeavors there and it is hard to describe them all. Additionally, I feel like a son being asked to write a eulogy for his father. I admired him, I learned and gained a lot from him, but a son is always at a distance from his father.
The dexamethasone suppression test (DST) has to head the list. Barney came to Michigan with the most basic work done and spent seven years evaluating and treating patients, refining the DST and interpreting results before publishing his landmark paper in 1981. It is characteristic of him that he wrote the paper and several others while on sabbatical - Barney had an endless appetite for work. The DST led to many other papers written by other members of our group, always with his close involvement.
He enlarged on the DST in two directions. We studied other putative endocrine markers for endogenous depression and found little to add to the DST. The endocrine studies led to separate studies on post-partum depression and PMS, focusing on the role of prolactin. We also set up sleep EEG studies, following Kupfer and Gillin; the results added to what we learned from the DST. Barney also brought the Carroll Rating Scale for Depression with him and set up studies standardizing it on its own and in comparison with the Hamilton Rating Scale. This led to three papers on the Carroll scale.
This work required funding. Barney had continuous grant support from NIMH and a five-year grant from the State of Michigan to help bring our lab and questionnaire results to the state hospital system.
All of this required a clinical base with good patient flow. Barney immediately established an outpatient lithium clinic which served the entire state of Michigan and drew patients from Ohio. Three years later, he shrank a 24-bed inpatient unit to 12 beds and put our outpatient depression clinic into the available space. Coordination of care brought to perfection: same patients, same staff, same physical space.
And simultaneously, there was the “bench science” work. Studies on better ways to measure blood cortisol, measurement of platelet MAO inhibition and work on animal models. Barney thought and theorized broadly about the biological bases of mania and depression, and through much of his career was active in developing clinical and clinical model states to investigate the latter. His laboratory contributions included an opiate-based murine model of mania which proved to be sensitive to Lithium and Rubidium. Subsequent collaboration with Katz and Roth developed, a chronic stress-related condition in rats that bore neuroendocrine, psychomotor, and hedonic similarities to clinical major depression, and which proved useful in identifying novel potentially therapeutic agents. The model remains in active laboratory use after some three decades. One of Barney’s singular gifts was a willingness to allow others to assume leadership roles as projects evolved; the development of the stress model was a case in point. Finally, Barney was not afraid to challenge established dogmas. Indeed, scientific dissent was one of his long-standing delights and his clinical model presented at the Dahlem conference reformulated depression as a set of multidimensional axes with autonomous neurochemical underpinnings. The model was heuristically valuable in identifying the role of central pain in depression and potentially increased periods of vulnerability to suicide.
Perhaps most important is what was not directly publishable. Barney set up a research environment, taught us, nurtured us and produced several independent research scholars and their many contributions to the field. This included setting up a fellowship program drawing scholars from around the world.
February 21, 2019