Carl V. Granger, Jr., MD passed away on December 29, 2019 at the age of 91. Dr. Granger was a professor emeritus and former chair of the Department of Rehabilitation Medicine at the Buffalo School of Medicine and Biomedical Sciences. He also was founder and long-term director of both the Center for Functional Assessment Research and the Uniform Data System for Medical Rehabilitation (USDMR) at the University of Buffalo.
I first met Carl in 1963 while on active duty at Camp Drum in New York where his reserve army unit was serving its two weeks of annual full-time duty. He encouraged me as one aspiring to become a physiatrist to complete my training and join those in the specialty. This was the beginning of a lifetime of friendship, colleagueship and intermittent collaboration that allowed me to know him as the gentleman, inciteful thinker, leader and scholar that characterized how he approached life.
Carl graduated from Dartmouth College and the New York University School of Medicine. He was drafted into the Army in 1954 and completed his residency in Physical Medicine and Rehabilitation while on active duty at Walter Reed Hospital. After leaving the Army, he was at Yale University and the Yale New Haven Hospital for seven years, after which in 1968 he became Chief of the Department of Rehabilitation Medicine at Tufts University until 1977.
While at Tufts and later at Brown University Carl became convinced that rehabilitation required a quantitative measure of function in order to demonstrate its effectiveness. In 1983 Glenn Gresham, MD recruited him to join the Department of Rehabilitation Medicine at the State University of New York at Buffalo with the promise he could pursue his interest in developing an effective instrument to measure function.
With the sponsorship of the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the American Congress of Rehabilitation Medicine (ACRM), Carl and Byron Hamilton, MD, PhD formed a multidisciplinary task force that developed an instrument to measure function, the FIMR instrument (FIM). There was immediate interest among rehabilitation facilities. They began to collect functional data about their patients and forward them to Carl’s group for analysis. This led to the formation in 1987 of the USDMR to handle FIM instrument licensing and handling. In 1988 the USDMR provided a mechanism for rehabilitation facilities to submit their data and receive back summary reports.
This has had incredible implications for rehabilitation world-wide. The FIM is known and used internationally. Standard hospital level inpatient rehabilitation care now uniformly uses measures of function to track the status of patients. The UDSMR data base of rehabilitation is immense and serves as an information reservoir for policy and research. The Centers for Medicare and Medicaid used the FIM as the basis for its first iteration of prospective payment for rehabilitation hospitals.
Carl was President of the American Association of Electromyography and Electrodiagnosis from 1968-69, of the AAPM&R from 1975-76 and of the International Federation of PM&R from 1978-1980. He received numerous honors including the Frank H. Krusen, MD Lifetime Achievement Award and the Walter J. Zeiter Lecture Award from the AAPM&R, the Elizabeth and Sidney Licht Award for Excellence in Scientific Writing from the ACRM and the Distinguished Academician Award from the Association of Academic Physiatrists. He was author or co-author of more than 275 scientific articles. In 2010, a review of 45,700 articles published in rehabilitation journals found that Carl was a co-author of 10 of the top 100 cited articles and was first author of five, more than twice as many as any other author.
Carl Granger has had an immense positive impact on the lives of all associated with rehabilitation but especially its patients.
A special thanks to AAPM&R member, John Melvin, MD, FAAPMR, for providing this In Memoriam of our friend and colleague.