Charles Miller Fisher (Dec 1913 – Apr 2012), is considered the father of modern vascular neurology and one of the giants of neurology in the 20th century.

He was born on 05 December 1913 Waterloo, Ontario. He completed his MD from University of Toronto Medical School in 1983. He spent three years in German prison camp as a doctor for other prisoners. He worked at Massachusetts General Hospital on the stroke service, where he had a long career in stroke neurology.

Louis R. Caplan, MD, Professor, Beth Israel Deaconess Medical Center wrote a biography titled ‘Stroke in the 20th Century’ on Charles Miller Fisher. To quote from article of Louis R. Caplan:

Fisher was a dedicated teacher and mentor. He spent 5 or more hours each day with his stroke fellows.
His forte was showing how to learn and explore a symptom, sign, phenomenon, or behavior by careful bedside and laboratory analysis and by thorough reading of the literature. His method is captured in a presentation given at his formal retirement titled “Fisher’s Rules,” which was published in the Archives of Neurology.

Charles Miller Fisher
Charles Miller Fisher

Fisher’s Rules
1. The bedside can be your laboratory. Study the patient seriously.
2. Settle an issue as it arises at the bedside.
3. Make a hypothesis and then try as hard as you can to disprove it or find the exception before
accepting it as valid.
4. Always be working on one or more projects; it will make the daily routine more meaningful.
5. In arriving at a clinical diagnosis, think of the five most common findings found in a given
disorder.
6. Describe quantitatively and precisely.
7. The details of the case are important; their analysis distinguishes the expert from the journeyman.
8. Collect and categorize phenomena; their mechanism and meaning may become clearer later if enough
cases are gathered.
9. Fully accept what have you heard or read only when you have verified it yourself.
10. Learn from your own past experience and that of others.
11. Didactic talks benefit most the lecturer. We teach others best by listening, questioning, and
demonstrating.
12. Write often and carefully. Let others gain from your work and ideas.
13. Pay particular attention to the specifics of the patient with a known diagnosis; it will be helpful
later when similar phenomenon occur in an unknown case.
14. Be a good listener; even from the mouths of beginners may come wisdom.
15. Resist the temptation to prematuirely place a case or disorder into a diagnostic cubbyhole that
fits poorly.
16. The patient is always doing the best he can.
17. Maintain a lively interest in patients as people.

His notable contribution include describing the clinical syndrome of the transient ischemic attack (“mini-stroke”). He proved the relationship between stroke and the formation of blood clots in the heart in patients with atrial fibrillation. He also showed the relationship between stroke and carotid artery stenosis, which made preventive surgery possible and greatly reduced the incidence of subsequent strokes. In 1956 he reported a variant of Guillain–Barré syndrome nowadays known as Miller Fisher Syndrome.

Charles Miller Fisher was inducted into Canadian Medical Hall of Fame for his contributions in the field of neurology.

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