John M. Freeman, a pediatric neurologist and medical ethicist who became a leading advocate of two long-abandoned therapies to control pediatric epilepsy that have shown to be effective in many cases, died Jan. 3 at Johns Hopkins Hospital in Baltimore. He was 80.
The cause was cardiovascular disease, according to Johns Hopkins Medicine, the health and research institution that includes the hospital and Johns Hopkins University School of Medicine.
Dr. Freeman’s questioning of established medical practices helped transform the treatment of pediatric epilepsy.
He became a proponent of two long-abandoned therapies, which led to their revival and acceptance as effective treatments. One required a strict, unconventional high-fat diet, known as the ketogenic diet (KD). The other involved surgery to remove half the brain of children who were tormented by unremitting epileptic seizures.
According to a Hopkins announcement of Dr. Freeman’s death:
“A high-fat, low-carbohydrate regimen that change’s the body’s metabolism so that the brain gets its energy from ketones, a fat byproduct, rather than glucose, or sugar, initially was developed in the 1920s but largely abandoned once chemical anti-seizure medications such as Dilantin (phenytoin) were created in the 1930s.
“As recently as 1995, many physicians considered KD no longer a viable treatment.”
Guy McKhann, founding head of the Hopkins Department of Neurology, explained in the announcement that Dr. Freeman’s “resurrection of KD,” which completely eliminated the epileptic seizures of many patients, was accomplished “virtually all by himself, against great skepticism and opposition.”
One of Dr. Freeman’s patients who was permanently cured of seizures because of the ketogenic diet was the son of Hollywood producer, writer and director Jim Abrahams ( of the “Airplane!” and “Naked Gun” film series), who was prompted to lead an extensive publicity campaign to promote KD treatment in the late 1990s.
Mr. Abrahams established the Charlie Foundation, named for his son, to promote the diet. He also produced an educational DVD for parents and health-care professionals, collaborated on a “Dateline” program for NBC regarding KD and produced “First Do No Harm,” a 1997 made-for-TV movie that featured Meryl Streep.
Abrahams also funded the first edition of Dr. Freeman’s book “Ketogenic Diets: Treatments for Epilepsy and Other Disorders.” The book, which is now in its fifth printing, was written with Millicent Kelly and Jennifer B. Freeman, Dr. Freeman’s daughter, who lives in New York City.
In 1990, Dr. Freeman and co-authors Eileen P.G. Vining and the late Diana J. Pillas, who was the longtime coordinator-
counselor of the Pediatric Epilepsy Center, wrote “Seizures and Epilepsy in Childhood: A Guide for Parents.”
Today, Dr. Freeman’s ketogenic diet is considered a mainstream medical treatment and is offered in more than 45 countries. New studies indicate it may be an effective treatment for autism, brain tumors, Alzheimer’s disease and diabetes.
The second medical treatment that Dr. Freeman revived was the use of hemispherectomies, or the removal of half of the brain, to end crippling seizures. In this work, he was joined by pediatric neurosurgeon Benjamin Carson.
Vining, a Johns Hopkins professor of neurology and pediatrics who recently retired as director of the John Freeman Pediatric Epilepsy Center, formerly the Hopkins epilepsy center, was a student of Dr. Freeman’s.
“When he realized that children with devastating epilepsies involving one half of their brains were doomed, he was able to convince hesitant surgeons to live in the present and begin to perform hemispherectomies again,” she said.
“He believed we had better procedures and technologies that would make it safe,” she added. “He couldn’t and wouldn’t abandon those children and their families to a life without rational option. They loved him ever since.”
John Mark Freeman was born in Brooklyn and raised in Great Neck, N.Y. He was a 1954 graduate of Amherst College in Massachusetts and a 1958 graduate of Johns Hopkins University medical school.
In 1961, he began a three-year fellowship in neurology and child neurology at Columbia Presbyterian Medical Center in New York City. From 1964 to 1966, he was a research physician while serving in the Army at Walter Reed Army Institute of Research in Washington. He later joined the faculty of Stanford University.
Dr. Freeman returned to Hopkins in 1969 and rose through the academic ranks, becoming a full professor in pediatrics and neurology. From 1969 to 1990, he was director of the Pediatric Neurology Service at Johns Hopkins Hospital, and he was concurrently director of the Birth Defects Treatment Center at the East Baltimore hospital.
In 1991, he was named the Lederer professor of pediatric epilepsy, a position he retained until becoming an emeritus professor in 2007.
In addition to his work with epilepsy, Dr. Freeman was the founding chairman of the Johns Hopkins Hospital Ethics Committee and co-director of an undergraduate medical student course in bioethics.
He also was a member of the original faculty of the Johns Hopkins Berman Institute of Bioethics and established the Freeman Family Fund in Clinical Bioethics to help support the salary of a faculty member to teach that subject.
In 2001, Dr. Freeman and co-author Kevin McDonnell, professor of philosophy at St. Mary’s College in Notre Dame, Ind., published “Tough Decisions: A Casebook in Medical Ethics.”
Dr. Freeman’s work brought him top awards from the Epilepsy Foundation of America and the Child Neurology Society.
Dr. Freeman lived in Ruxton, Md.
Survivors include his wife of 57 years, the former Elaine Kaplan; three children; a brother; a stepsister; and six grandchildren.