Harold Francis Falls was born on November 26, 1909, in Winchester, Indiana, and his early childhood was fraught with challenges. His mother died when he was just 3 years old. Young Harold was sent to live on a farm with his paternal grandmother and her second husband; he stayed for 5 years. Dr Falls credited his stepgrandfather for stimulating his initial interest in observing individual differences through work on the farm. His father eventually remarried when Harold was 8 years old, after which Harold was able to return and live with him and his new stepmother in Detroit, Michigan. He matriculated in and then graduated from the Detroit public school system, after which Harold enrolled at the University of Michigan in 1928 and in its medical school in 1932.
During his senior year in college, Dr Falls built on his childhood farm experiences that taught him how details of breeding led to the best hogs and tallest corn. In a fortuitous choice of classes, he took a course in the genetics of corn hybridization that further instilled in him an interest in recognizing differences in living things and in genetics per se.
Throughout his clinical years in medical school, Dr Falls was able to choose elective courses in ophthalmology and was quite taken by the specialty and also by the faculty of the department. Following internship at the University of Michigan Hospitals, Dr Falls was offered a spot in the ophthalmology residency program, and on its completion, he joined the University of Michigan faculty.
During his internship, Dr Falls met Lee R. Dice, PhD, then the director of the Laboratory of Vertebrate Genetics at the University of Michigan. Medical genetics, as a branch of human genetics, is a relatively recent field in the history of medicine in this country, having begun around 1940 when Dr Dice established the University of Michigan Heredity Clinic. This clinic was the first of its kind in the United States. Wartime departures of senior faculty gave the newly minted ophthalmologist Dr Falls an opportunity to step into the leadership role in the Heredity Clinic. As its young medical director, Harold F. Falls, MD, contributed half of the clinic's early family pedigrees. His astute observational and clinical skills became legendary in the University of Michigan Medical School. Dr Falls' pioneering work in describing a variety of mendelian traits, a number of which were seminal contributions, has earned him distinction as arguably the founder of medical genetics in the United States.
The University of Michigan Heredity Clinic was the forerunner of the university's Department of Human Genetics. Formed in 1957, it, too, was the first such department in the country. Dr Falls was associated with that department for many years and continued, throughout his career as an ophthalmologist, to contribute substantially to the genetics literature. He is especially famous for identifying and clarifying X-linked inheritance patterns and may have been the first to describe what became known as the Lyon hypothesis in his article1 on Cooley anemia. Six other disorders owe their discovery and entry into the peer-reviewed literature to Dr Falls: amyloidosis II; autosomal dominant cleft lip and palate; keratoconus, cleft lip and palate, and genitourinary abnormalities, along with short stature and mental retardation in 2 siblings; familial retinoschisis in 3 sisters; X-linked chorioretinal degeneration wherein the female carriers showed a “tapetal” retinal abnormality; and an elucidation of X-linked retinoschisis in an article2 where earlier reports of a “congenital vascular veil in the vitreous” by Mann and MacRae3 plus a report of an “X-linked retinal detachment” by Sorsby et al4 were finally interpreted correctly.
There are many additional genetic entities in which Dr Falls, in his key combination of observant clinician and thoughtful and disciplined scientist, played a major role, as can be seen from his bibliography of 99 peer-reviewed publications, including 52 as first author. He and his colleagues produced major contributions about the genetics of retinoblastoma and aniridia. Dr Falls was widely recognized for his genetics prowess and, in 1953, was named to deliver the prestigious Jackson Memorial Lecture at the Annual Meeting of the American Academy of Ophthalmology and Otolaryngology. His title was “Clinical Detection of Genetic Carrier State in Ophthalmic Pathology.” This was the same year that DNA was discovered by Watson and Crick.
Dr Falls was an outstanding clinician and educator and had a mind like a steel trap. He knew more about genetic disease than anyone in the University of Michigan Medical School and was well known by the library staff as the most widely read faculty member across all disciplines. In teaching his residents, he would make their heads spin with his easy recitation of genetic syndromes and their clinical signs. Dr Falls would show slide after slide, each demonstrating a particular finding well known to him because it was often he who had first recognized it and described it in the literature. Many of us around the country who were lucky enough to have been taught by Harold Falls have vivid memories of learning from him in the clinic, the operating room, and the classroom. His teaching has turned out to be indispensable as it was incorporated into our clinical practices.
This man was much more than a famous medical geneticist, clinician, and educator. Dr Falls was a fine athlete, excelling at softball and basketball. He greatly enjoyed fishing and golf, which he often played with his wife, Emeline. Following his retirement from the university in 1975, Dr Falls continued to participate in departmental affairs, teaching residents and attending conferences. He continued to perform research and publish his findings.
Among the numerous honors and awards bestowed on Dr Falls during his career and afterward, the one that will perpetuate his name and his contributions to medicine is the Harold F. Falls Collegiate Professorship in Ophthalmology and Visual Sciences at the University of Michigan. Established by his former residents, colleagues, former patients, and friends, this professorship serves as a fitting tribute from the many people whose lives were directly influenced by this remarkable man. And the name of Harold Falls will live on in perpetuity, associated forever with the institution at which he obtained his collegiate, medical, and professional education and to which he devoted his professional life.
Dr Falls died on May 27, 2006, in Brighton, Michigan. His death was noted nationally by an article in the New York Times. He is survived by his wife, Emeline, who, as a nurse, accompanied Dr Falls on some of his many genetics field trips; his 3 children, Hariette (James) Gray, Timothy (Patty) Falls, and Thomas (Judith) Falls; and grandchildren, Kelly Falls, Thomas James Falls, MD, Jennifer (Brian) Moss, Carolyn Gray, Eric Falls, Jonathon Falls, and Andrea Falls (Tony) Isaacs.
Correspondence: Dr Lichter, Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105 (plichter@med.umich.edu).