At 92, Dr. Joseph M. Foley is recognized around the world as a gifted and dedicated teacher who could – according to his bio from the American Neurological Association -- “reduce neurological complexities to understandable phenomena for perplexed students and colleagues”; an innovative and groundbreaking researcher who, through his work, teaching and leadership, propelled the field of neurology into the 21st Century; and a concerned and compassionate physician.

During a wide-ranging Saturday morning interview at his Cleveland Heights home – interrupted by visits from T.S. and Eliot, his cats – he shared his thoughts on growing up “ Boston Irish,” his evolutionary path into neurology, and gaining the experience and “wisdom” that comes with age.

When and where were you born?

I was born in Dorchester , Massachusetts ; Dorchester being an internal suburb of Boston . I was born on March 9th, 1916, in the middle of a vicious snowstorm. My mother, all through life, resented that she had to go out in that snowstorm when I was born.

I was the only child of my father's second marriage. He had a son by a previous marriage. He was 14 years older than I and being raised by his aunts. Essentially, I was brought up as an only child.

My father and mother were Irish immigrants. They had little education. My father worked as a garbage collector for the city of Boston . My mother was a stay-at-home wife, which was common in those days. [chuckles] She was a woman of strong, and frequently expressed, opinions.

What was it like growing up in/around Boston in the '20s and '30s?

Interesting!

I think I was 6 or 7 when I discovered that I lived between two branch libraries—one at Andrew Square and one at Uphams Corner. From the time I found the libraries, I haunted them. The librarians were kind, giving me time and talking to me and giving me things to read. They really helped to educate me.

And the Church played a part, too. In the Irish immigrant culture, the Church is a part of your life… there was one priest in particular who played an important part in my life. His family “adopted” me, and I'd go off for vacations all over New England in the summers with his nieces and nephews.

And at Boston Public Latin School there was a teacher [William Henry Marnell, who became a prolific writer] who was 20 working on his doctorate at Harvard. He was a wonderful mentor. He'd take me with him to some of his classes at Harvard… and he'd have students to his house for discussions. He got us interested in music. He encouraged us to go to the museums. He introduced us to the in-town library at Copley Square . He started us on the road to a good, liberal education.

You keep mentioning how much education you got in Boston . Was that important in your family?

Most definitely! Though my parents were uneducated, they made it clear from the beginning that I was to get an education. In the first grade, in parochial school, I knew I was going to college.

Where the money would come from was an irrelevancy. And that was true for my classmates when I went on to Boston Public Latin School , where about half my classmates were Jewish and half of them were the children of immigrants from Russia , Poland , et al.

That's an attitude toward education that one would like to see repeated now.

What made you decide to become a doctor?

I ruptured my appendix the summer I was 14. I wound up in the hospital for surgery. I had a rough time getting over the surgery and John Seth, who'd operated on me, visited often. He'd sit and talk, telling me what medical school was like, what training was like, what he did in the course of his day.

[laughs] But there was something else, too. In my adolescent fantasies, I think I was intrigued with the idea of being called “Doctor.”

But medicine wasn't a sure thing…At one point, I thought about going into social work. Franklin Roosevelt's New Deal needed a lot of social workers. And they were doing stunning work. That was inspirational.

And I thought briefly of the clergy. But I realized I'd have to be celibate for the rest of my life and there were too many good looking women around.

What made you decide on neurology as a specialty?

It was a gradual decision. I started off in college [ Holy Cross College in Worchester , MA ] thinking I'd do psychiatry. It was an interesting field and in Boston , there wasn't a single Catholic psychiatrist. I thought about breaking that barrier.

But as part of my interest in human behavior, I was also intrigued by the nervous system and the brain. When I went broke about halfway through my second year at Harvard Medical School , I got a scholarship-fellowship. It guaranteed my subsequent education, but required that I do some research, which meant that I had to find some research.

I knew Dr. Leo Alexander, a neuropathologist, because he was doing work that I found interesting and important. I latched on to him and wound up in his laboratory at the Mallory Institute of Pathology studying the hypothalamus for 2½ years. I published some things out of that research.

When I graduated from medical school in 1941, I pursue a hoped-for two-year internship at Belleview Hospital in New York City . But instead, after 19 months, I went into the Navy.

Doctors weren't drafted, they were sworn in. In November of '42 I was sworn in; in February of '43 I went on active duty.

For so many people, WWII was a life-altering experience. Did your service during the war alter your life? If so, how?

I went overseas in 1944 and was in Europe for a year and a half. I worked with the combat engineers, the first people who landed when there was an invasion.

I participated in four invasions: Normandy and three in the Mediterranean . I and my 8 corpsmen would go in just behind the combat engineers and take care of the casualties as best we could and get them on small boats and back out to the ships for care.

When I came back from Europe I was sent to a base on the West Coast from which people were being sent to the Pacific. They told me I was the Venereal Disease Control Officer, an honor I rejected out of hand. I reasoned that there had to be a lot of very nervous people at the base and that I'd could do their psychiatric work for them

The commanding officer was a reasonable guy. He said “OK, you can do the psychiatry, but you are in charge of the infectious diseases, too.”

While doing that I applied for the Navy's training programs in neurology and psychiatry. They were 90-day-wonder courses that turned out psychiatrists and neurologists. In February of 1945, I went to Philadelphia to do the psychiatry and neurology programs.

My interest in anatomy made me valuable there so they kept me on…working with some of the best people in the nation in pathology and psychiatry. One of the men I worked with was one of the founders of the American Academy of Neurology.

The 15 months in Philadelphia – a gift from Uncle Sam – was excellent training and experience.

When I went into the Navy, my interest was in behavior. The events that transpired while I was in the Navy conspired to make me a neurologist.

And you know, there's hardly a day that goes by that I don't think about something that's related to my wartime experiences.

You received the US Bronze Star and the French Croix de Guerre. What were they for?

I got them both for the D-Day Invasion in June of 1944. We were with the first unit that went ashore. We “made” the beach ready for the invasion.

When and how did you meet your wife, Alice Marie Corcoran?

I'd known her since she was a junior in high school and I was a freshman in college. We met on one of the coldest nights Boston has ever recorded – 27 degrees below zero – and her attitude the night we met was comparable. Over the next 11 years we were in and out of a relationship.

When I arrived back in New York City , August 2nd, 1944, I'd been traveling – on trains and a troop ship – for about three weeks. The first thing I did was get a suite at the Westbury Hotel – with the other doctors I'd traveled with – and order drinks and take a shower.

I knew Allie was in New York City , so the second thing I did was track her down. She was living with her roommate from college. I told her roommate to tell Allie that I'd come over that night if she was free. Her roommate didn't tell Allie it was me; she just told her that some guy was coming over.

When I banged on the door and she opened it I said “Let's get married, babe,” and three weeks later we did. We were married for 59 years when she died in 2003.

She'd trained as an industrial psychologist, but never worked at it. [laughs] That's not to say she didn't work; she raised our six kids.

What brought you to Cleveland in 1961?

I'd been at the newly founded Seton Hall College of Medicine and Dentistry in New Jersey for two years when Western Reserve University and University Hospitals approached me about a position as Director of Division of Neurology. They had a good reputation and were putting together a clinical-basic science group focused on the nervous system. When I looked at what they were hoping to do, I wanted to be part of it…because this was a chance to develop a big program in an effective university with good leadership at the time.

It wasn't just me that came. Marcus Singer [a renowned anatomist who set up CWRU's Developmental Biology Center ] brought in a flock of people and I brought seven clinical neurologists with me and we set up a combined division to study the nervous system.

What got you professionally and personally interested in aging?

I became interested in aging because of the research I was doing on diseases that are prominent in old age, particularly dementia and the movement disorders of old age. These are diseases that command attention because of their prevalence and impact.

That research – and the fact that there was a large group of patients who were, in effect, being ignored – was why [Dr. Amasa B.] “Buzz” Ford and I started University Hospitals' geriatric assessment center some years ago.

We opened the unit then because doctors needed a place where they could refer patients with dementias and other behavioral disorders. [laughs] We had to move it three times, and each time we moved the facilities got bigger and better. [ Note: The Center for the Assessment and Care of the Aging opened in 1981. In 1987 it was renamed the Joseph M. Foley ElderHealth Center .]

Throughout your life you have been an active volunteer. As an extremely busy physician, researcher, instructor, administrator, nationally recognized consultant, and parent (you and your wife Alice had six children), how did you find the time to do all that volunteering?

I don't know. I've always been conspicuous. I've always been able to give a good public speech. Rightly or wrongly, people were impressed when I'd do a public presentation.

Maybe it's that I had varying degrees of relationships with organizations and groups and maybe it's that I got in early. I was one of the founders of the Catholic Ministry of Health Care Professionals; I was one of the founders of the Cleveland area's Alzheimer's Association.

With regard to neurology, the whole field was not well developed and there was a need for leadership, both at the national and local levels. We were somewhat mission-driven and had idealistic reasons for what we were doing, but we had professional reasons, too. It was obvious that for the future of the care of the population and the future of the profession that there had to be leadership.

You know, when you live a professional life and you are busy with teaching and research and organizational stuff, there is always a conflict with the care of your family. I was fortunate that I had a wife who was tolerant and supportive. And children, too…though only one, Mara, has gone into medicine. She's a nurse practitioner.

You are 92 (as of March 9, 2008), fit and active. What are you doing to stay in such good shape?

I'm trim, yes, but I'm still too fat.

I've always eaten reasonably well. I've always engaged in exercise. Right now I have a three wheeler that I ride, but only on the sidewalks.

But I'm not sure I'm all that fit. I had a stroke in '82—though three months later I was climbing hills in Greece . I've had five bouts of cancer. I've had a heart valve replaced. I've got macular degeneration and gave up driving in 1999. Now I can read only with a reading machine and I'm heavy into talking books and music.

Probably the most important thing is that I'm adaptable…I've been able to adapt to the changes in my life.

But surviving to 92, that's a matter of good luck and good genes. My parents lived into their mid-80s.

I know people who are my age who never did a thing to promote good health and they are doing well. I know people who did everything they should have and are doing badly and shouldn't be. And I can't tell you why they aren't doing well as opposed to the others.

Where do you think the field of aging is headed? I ask you this because there is far more in the news today about ‘anti-aging' then there is about aging successfully.

I don't know how to reply to that. I don't keep up with the literature in aging like I used to. That said, I think more attention should be given to the facts of aging – what aging does, what it doesn't do – and the limitations of aging and the opportunities of aging.

As one ages one acquires a certain amount of experience and background. Some call that wisdom. I'm not sure it is, but it definitely allows you to think things through, make decisions, put things in perspective. For instance, things you would get upset about years before no longer upset you; things that you think should be changed, but aren't, you've learned how to live with them.

How do you motivate people to age successfully, to take charge, to actively and consciously age?

I'm not sure I know the answer to that. Too many people deny the onset and process of aging.

Still, some people can be motivated by what they hear and some can be motivated by what they read. But that's only when they are aware – paying attention to what is happening physically and cognitively and socially – and too many people don't do that. They just let things happen.

The danger in doing that is that as they age they accept the limitations and infirmities that come with aging without trying to make changes and accommodations to compensate. In doing that, they give up living actively, they give up being involved and retreat from the rest of the human race.

You have had a long and productive—and personally rewarding—life. When you bow out, is there any one thing you want to be remembered for?

Yes. The people I trained, that I have had some influence on over the years…They are all over the world, and some of them have been succeeded by people that I also helped train.

But it wasn't just me or the department. They were good “seeds.”

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