In Memoriam: Henry J. Binder, MD

This obituary was prepared by Loren Laine, MD; Michael H. Nathanson, MD, PhD; and Fred S. Gorelick, MD.

As members of the Section of Digestive Diseases and the Yale community, we wish to remember the journey and accomplishments of Henry J. Binder, MD, a long-term pillar of our community. After graduating with a major in zoology from Dartmouth College, Henry attended medical school at New York University, followed by honing his clinical skills during a medical residency at Bellevue. In 1963, Henry joined Howard Spiro's recently formed Section of Gastroenterology here at Yale for his GI fellowship, publishing studies on malabsorption and intestinal transport in The New England Journal of Medicine and Journal of Clinical Investigation. These two studies presaged Henry's lifelong academic pursuits linking human physiology to gastrointestinal disease with the goals of advancing science and developing new therapies.

After completing his GI fellowship at Yale, Henry served as a gastroenterologist and captain in the Air Force at Travis Air Force Base, an instructor in GI at the University of Chicago, and finally returned to Yale in 1969 to work with the transport physiologist, Peter Curran, PhD. Henry's basic and translational research achievements led to his Yale promotions to professor of medicine in 1978 and cellular & molecular physiology in 1994. His subsequent sabbaticals in Zurich, Lausanne, and at Barts and the London Medical School influenced the direction of his work, introducing key technologies such as molecular cloning and the use of isolated membrane vesicles to study ion transport. His international collaborations with luminaries such as B.S. Ramakrishna, MD; Graeme Young, MD; and Michael Farthing, MD, created opportunities to translate his mechanistic observations to clinical care.

Henry's first independent study at Yale in 1971 provided a mechanistic explanation for the bile acid-induced diarrhea seen with dysfunction of the distal ileum. His early work also linked fat- and bile-acid malabsorption to the enhanced oxalate malabsorption and renal oxalate stones observed in individuals with ileal disease. Subsequent impactful studies, many of which were conducted with V. M. (Raj) Rajendran, PhD, included findings that overturned dogma by showing that colonic crypt cells are constitutively absorptive, not secretory. Perhaps Henry's most impactful research began in the 1980s with the first examination of the effects of short-chain fatty acids (SCFA), a product of colonic bacterial metabolism of dietary carbohydrate, on colonic ion movement. His key observation was that SCFA could increase colonic NaCl absorption. This observation led to the development of a new oral rehydration solution (ORS) formulation for the treatment of diarrheal disease that included a starch that could only be digested in the colon and produced SCFA. The remarkable outcome, shown in the 2000 New England Journal of Medicine, was the first ORS formulation that could improve both patient survival and significantly reduce cholera-induced diarrhea. This led to a clinical trial of a new ORS solution sponsored by the Gates Foundation.

Henry will be remembered for his unwavering commitment to education and training. In 1972, he established the NIH-sponsored Training Program in Investigative Gastroenterology, which continues to this day. This research training pathway for MDs, MD-PhDs, and PhDs has produced many successful investigators who became leaders in GI research worldwide. These include Mark Donowitz, MD; Geoff Sandle, MD, PhD; John Dobbins, MD; Emily Foster, MD; Scott Harris, MD; Chul Hyun, MD, PhD; Lorraine Racusen, MD; Satish Singh, MD; Todd Zimmerman, MD; Josh Korzenik, MD; Tom Ullman, MD; Sadasivan Vidyasagar, MD, PhD; Selvi Krishnan, PhD, and Kazi Hoque, MD, to mention just some of the more than 25 of his trainees.  Through his T32 leadership, Henry provided valuable guidance to other trainees who went on to become academic leaders, including Nadia Ameen, MBBS; Jonathan Cohn, MD; Fred Gorelick, MD; Sohail Husain, MD; Steven Leach, MD; and Uma Sundaram, MD. His many seminal contributions to GI physiology education, including authoring, editing, and publishing instructive slide sets and scientific reviews, have educated many trainees and faculty in the pathobiology of the GI tract.

Of these many achievements, foremost is Henry's unwavering commitment to intellectual clarity, scientific rigor, honesty, and tenacity. Henry and his family have been unwavering in their support of Yale School of Medicine’s mission and emblematic of that support is the family's endowment of the Henry J. and Joan W. Binder Professorship and Lectureship.

Henry is survived by his wife Joan, their children Sarah and Stephen, his daughter-in-law Kris Estes, his son-in-law Forrest Maltzman, and two granddaughters, Noa and Mica Maltzman.

Henry will be missed.