Colonel Stephen A. Harrison, M.D. – The passing of a Titan

In the poem "For Whom the Bell Tolls", John Donne writes that "each man's death diminishes me, for I am involved in mankind. Therefore send not to know for whom the bell tolls, it tolls for thee." And so it is with the sudden and shocking passing of Colonel Stephen Andersen Harrison M.D.. We are all the less. The pall cast by Stephen's departure, which would only ever be too soon, gives us needed pause to reflect on who walked among us too briefly. Stephen was born, raised and went to medical school in Mississippi, where he grew into the humble, straight backed young man with a ready smile and disarming wit that were so widely admired. Anyone with a hand in raising him, especially his parents, should be justly proud. Stephen was a natural leader, the gifts of which he decided early in his life to employ in the service of his country in a full and distinguished career in the United States Army. Stephen joined the Army as a medical resident, completing his internal medicine residency and a gastroenterology fellowship at the Brooke Army Medical Center. Happily for the field, his fellowship piqued but did not satisfy his interest in hepatology. He went on to complete a fourth-year advanced liver disease fellowship at Saint Louis University where he met one of the authors of this remembrance. Stephen would frequently reflect on a tome of amusing and intimate events recalled while under the exceptional tutelage of Dr's Bruce Bacon, Adrian Dibisceglie, Elizabeth Brunt and Brent Tetri, with all of whom he remained a good friend throughout his career. If Stephen Harrison's character was forged in rural Mississippi, the scientist was forged in Saint Louis. On completion of his advanced liver disease fellowship, he returned to his métier in the Army, in a career that spanned 20 years, where he achieved the rank of Colonel, became Director of Graduate Medical Education at the Brooke Army Medical Center, Gastroenterology Consultant to the Army Surgeon General and served two wartime tours in the Middle East. He famously drew and discharged his sidearm to dispatch a snake that had taken up an ill-advised and brief residence in his boot. Stephen completed his service in the Army in 2016, having managed to combine his years of service with a flourishing career in translational science, focused primarily on the study of metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH). Stephen's contributions span from the nascence of clinical trials in what was NASH, now MASH, to advanced phase studies published in towering journals such as Nature Medicine, the Lancet and the New England Journal of Medicine, including seminal results of the phase III trial that led to the FDA approval of resmetirom, the first therapy for liver fibrosis due to MASH, shortly before Stephen's passing. Among his many skills as a physician scientist, he would distill from each study, no matter the scale or outcome, that which would inform the design and conduct of studies that followed. He was a true visionary. Along the way, in the fashion of the leader he was, he developed a network of capable centers with the support they needed to succeed in the design and conduct of a trove of clinical trials to advance the field. The advance of MASLD treatments would have been significantly slower without his contributions. Privately, recognizing the inevitable and mounting price he paid for his legion accomplishments in time away from his cherished first love, his family, he recently undertook to remain in the field only until we had at least one approved therapy. He kept his promise. At the time of writing, Col Stephen A. Harrison M.D. has an h-index of 106, is cited ∼9,000 times per year, and has led many of the studies that will come to fruition in the coming years. In addition to publications in highly prestigious journals, Stephen has always been a great supporter of the Journal of Hepatology with many major papers published over the past few years. We are proud that alongside this obituary, the current issue displays an Expert Opinion on liver biopsy evaluation in MASH trials and a mini-series review article on promising new pharmacological agents for MASH. The disease burden of MASH is inexorably meeting the same fate as the erstwhile snake that crossed paths with Stephen in the desert and, to an important degree, at the same hand. As remarkable as Stephen's scientific contributions are, they do not begin to explain the grief felt at his loss. Stephen has few peers as a physician scientist. He has fewer still as a human. Everyone with the good fortune to know Stephen felt he was their friend. And they were right. He had a legendary work ethic. "If the birds are chirping, I should be working," he famously reflected, among many Harrison aphorisms, one morning before dawn at his home in Texas. Stephen also possessed equal measures of optimism and kindness, extending a hand to any who might need or benefit from it. He would often quietly slip away for a day from a hectic AASLD meeting, in the middle of a packed agenda, to celebrate his daughter's birthday by her side. When two of the authors of this remembrance were ill with COVID-19, he arranged for meals to be delivered to our home every day, calling daily like a concerned brother. His good nature and generosity were unfailing. In his passing, Colonel Stephen Andersen Harrison M.D., leaves a void. We will fill it with gratitude. We extend our heartfelt condolences to his wife Renee, daughter Anna-Lauren, and son Taylor and to all that loved and admired him. A Titan walked among us.