Born in Waterloo, Ontario, in 1913, Fisher received all his pre-university education in that part of southwestern Ontario. He then studied medicine at the University of Toronto, graduating in 1938, and interning at Henry Ford Hospital in Detroit until the fateful summer of 1939. Then, along with thousands of fellow members of the Canadian militia, he was called to service. He reported to Montreal and worked at the Royal Victoria Hospital until the navy required his medical assistance.

In the summer of 1940, he was sent to England as one of 12 naval surgeons seconded to the Royal Navy. After his training, Surg.Lt. Cmdr. Fisher was assigned to an armed merchant cruiser, HMS Letitia, that was patrolling in the North Atlantic. Then, while in Halifax being refitted, the Letitia was damaged and Fisher found himself on HMS Voltaire en route to West Africa, via Trinidad, to join an inbound convoy. The Voltaire was not a lucky ship. On April 4, 1941, a German surface raider appeared, undetected until far too late.

The sick bay, fortunately empty, was obliterated in one broadside. The ship sank. The survivors, about half the crew, were transferred to a German prison ship that took them to Bordeaux. Fisher then found himself in Marlag-und-Milag Nord — bleak, wind-blown country in northwestern Germany. He was transferred later to Sandbostel.
 

While in Montreal C. Miller Fisher made a discovery regarding the carotid artery as a cause of strokes. This was of such great importance that he was invited to Harvard in 1954 where he remained as professor of neurology. He had earlier endured some challenging expereinces that included his years as a prisoner of war in Germany after the ship on which he was medical officer was sunk in the south Atlantic.

When repatriated in the autumn of 1944, Fisher had been a POW for three years. He returned to the Royal Victoria Hospital and, after several refresher courses, began studying at the Montreal Neurological Institute. There he came under the influence of Dr. Wilder Penfield. In 1947 he received his Fellowship in the Royal College of Physicians and Surgeons of Canada, and five years later this same college awarded him its Prize in Medicine.

Fisher’s first major contribution to world medical knowledge came when he was still a medical resident. He was becoming more and more interested in the neurological components of cerebrovascular disease, including hypertension. While dissecting the brains of patients dying after suffering strokes, he noted a relationship between embolism from the heart and infarction of brain tissue, a fundamental observation that now is part of the standard understanding of the disease process.

His major contribution came after 1947 while in Montreal. In his studies of stroke victims he began to suspect that many of these emboli might have a source other than the heart and he suspected the carotid artery. This was difficult to prove because at this time autopsies did not allow dissection of the neck for cosmetic reasons.

By private arrangements with funeral homes, he explored this artery and to his amazement he found a rough calcified nodule covered with thrombus (blood clot) where the artery divides — an obvious source of emboli of all sizes. Such patients had an auditory murmur and a palpable vibration felt over this section of the artery.

Thus was born the concept that the carotid artery was indeed the chief offender in strokes and surgeons quickly responded by opening the artery and carefully removing the offending plaque.

A major neurological study for forty years has been: which cases should be treated by long-term anticoagulants and which should receive surgery.

This was such an important discovery that Harvard University and the Massachusetts General Hospital induced him to leave Canada. He accepted and has remained in Boston ever since 1954 as an esteemed professor of neurology.

From Fisher came the concept of transient ischemic attacks, or TIAs, now widely recognized as a common and important disorder for those about to suffer strokes. Fisher proposed the use of anticoagulant drugs to prevent strokes in patients who were experiencing TIAs.

Fisher has been a compassionate clinician, a dedicated and innovative pathologist, a talented teacher and researcher, and a distinguished contributor to the literature of science. He has coined many terms that have become part of the day-to-day vocabulary of medicine: these include not only the TIA but also “subclavian steal,” “transient monocular blindness” (TMB), and “ataxic hemiparesis.” By describing in the autopsy room what is known as Creutzfeldt-Jakob disease (also known as spastic pseudosclerosis) he made it possible to diagnose the disease in the living patient.

Many former students now run laboratories and clinical programs throughout the world. These men and women have extended their teacher’s work and proselytized his teaching principles, which are sometimes referred to as “Fisher’s Rules” and have a distinct Oslerian ring to them. Examples are “The bedside can be your laboratory; study the patients seriously,” and “Fully accept what you have heard or read only when you have verified it yourself.” By his own adherence to these and similar “rules,” Fisher has improved the life-style and life expectancy of millions of human beings around the world.

Charles Roland