In Memoriam

Because John Knott touched the personal and professional lives of technologists in so many ways, it seemed impossible for any one person to pay adequate tribute so ASET has chosen to print tributes from a few of the people moved by him. This group includes his technology students, colleagues in the education of technologists, colleagues in the founding of the Joint Review Committee and of ABRET, Mrs. Ellen Grass, co-authors, and clinical neurophysiologists. John Knott may be physically gone from us but all of us with whom he worked during his more than 50 years in EEG and neurophysiology will always be aware of his spirit present, urging us to use our minds and settlefor nothing less than excellence.

Educator

Dr. Knott created the EEG Laboratory at the University of Iowa in 1939, one of the first in the nation. In so doing, he was instrumental in developing, and later defining, the position of EEG technician/technologist that we have inherited. Dr. Knott led and shaped our profession in many ways through countless hours of dedicated scientific endeavors in electroencephalography and in service to EEG technology.

He served wisely as a member and as chair of the Joint Review Committee on Education in EEG Technology (JRC/EEG), a natural expression of his concern for the standards and quality of education in EEG. In 1965 and 1968, he chaired conferences on training and, at the University of Iowa, developed one of the first schools of EEG technology. He created a genealogy of technologist “generations” that have been influenced by those he instructed. Numerous notable electroencephalographers received their education under his guidance. He was the mentor of many and a true scholar. We are in his debt but much enriched because he cared.

– Margaret Gordon, R. EEG T.

Dr. Knott didn’t produce EEG practitioners (technologists or physicians) who would be readily identified by the use of a particular montage or certain technique. By stressing the basics, he taught us to think more logically and determine the necessary steps to problem solving. This elementary idea has had life-wide and life-long applications. His skill as a wordsmith, the ability to communicate clearly, was demonstrated in ABRET questions, in Journal articles, as well as in person-to-person interactions. And now words cannot do justice to our friend and colleague.

– Maxine Wilson-Young, R. EEG T., R. Е. Т.

John Knott was an instructor and a mentor to many of us in the field of EEG. His standard was excellence before it became part of a catchy phrase. He taught EEG but instilled his standards in many aspects of life, not just professional. He insisted that one look deeper and perhaps work harder than one intended, and in doing so he was able to bring out more of each individual’s talent. I’ve talked to many of his students over the years and have always been amazed that he had affected so many people the same way, yet each of us left him feeling unique. He will be missed.

– Tom Billinger, R. EEG T.

It is no easier to commit to paper the experience of having been a student of John R. Knott, Ph.D. than it would be to write a treatise on learning how to think and appreciate knowledge through life. His questions were often open ended and even his stated opinions had a way of asking to be challenged. Each discussion left you with a new thought to mull over or an idea to be investigated. At the fore of this process was the principle that all technical, clinical, and research endeavors must serve to advance the field of electroencephalography, a principle that could not be compromised. It is my sincere hope that all students will have the opportunity to enjoy a great teacher and colleague in the tradition of John R. Knott, Ph.D., and more importantly, the opportunity to have a true friend.

– Jon F. Peters, Ph.D.

Occasionally one has the opportunity to meet someone who will have a dominant impact on his or her career. For me this was a meeting of the Central Society of EEG Technicians, held in Chicago in the 1960s. There was a panel discussion and among the participants was John R. Knott, Ph.D. This panel discussed, among other things, training requirements for EEG Technicians. During this meeting it was very apparent, even to a novice like me, that this was a man quite different from those for whom I had worked in the past. He clearly stood for educating EEG Technologists and for high quality work, concepts that were not very popular at that time. I soon had the privilege of meeting Dr. Knott in our laboratory at the Cleveland Clinic. He had come to visit his dear friend, Dr. Charles E. Henry. This visit occurred while he was on the famous first tour of examining candidates of ABRET in 1967. It was during that visit that I really decided to become involved in EEG at a national level. He advised me to become registered as an EEG Technologist if I wanted to become a credible influence in EEG.

Dr. Knott worked throughout his career for the betterment of EEG Technologists. Through his efforts, training programs for EEG Technologists became a reality. He not only started such a training program at the University of Iowa, he also was instrumental in assuring that similar training programs were of exceptional quality throughout the United States. He achieved this by working with EEG Technologists, Electroencephalographers, and the American Medical Association in establishing the Joint Review Committee for Education in Electroencephalographic Technology (JRC/EEG) to provide nationally recognized accreditation of EEG technology training programs. This work was in addition to his already heroic efforts in establishing certification examinations for EEG Technologists. He promoted the concept that ABRET should be run by EEG Technologists. Although this did not happen during his years on the Board of ABRET, it did occur while he was active in EEG.

Of course he had numerous publications in the EEG literature. The most significant to me as a technologist were the two volumes he co-authored with a technologist friend and a neurologist electroencephalographer, Fundamentals of EEG Technology. I had the pleasure of working with Dr. Knott on various committees and boards, and regarded him as a friend and colleague. I, along with many others, will miss him. Those who do not, surely never knew him.

– George Klem, R. EEG T.

Employer

I started working in the EEG Laboratory for John Knott in 1966. Several key themes characterized the operation of the laboratory. Teamwork was obvious from the start. Almost immediately, there was a picnic for students, researchers, and laboratory staff. We were encouraged to work together. John’s loyalty to the employees was integral. He would back them up even when they didn’t deserve it! And the employees returned the loyalty. The group of former employees, students, and colleagues became known as the Knott Heads.

Fostering teamwork was immediately apparent, but it took a while to appreciate his insight. In the first few months (late 1966), I was working on instrumentation for two different areas: something called “evoked potentials” and “sleep studies” in children. It would be years before these were standard procedures. Students from the EEG Technology program later realized that they had had a head start in evoked potential technology. Five or six years after their training, students were digging out their notes on evoked potentials. Just as he knew which areas held promise, he instinctively knew which would have a negative impact on EEG.

The most obvious characteristic of the laboratory was emphasis on teaching. Other activities were put on hold when we were teaching or developing teaching materials. His goal was straightforward: the graduating technologist should be able to work in any laboratory. The technologist should be able to operate any electroencephalograph and produce a recording acceptable to any electroencephalographer. Over the years I observed laboratories where employees were trained to perform steps A, B, and C on a particular instrument for a particular EEGer. The employees were then locked into working at that laboratory, hoping that the technology or the EEGer would not change. In one respect, the EEG Technology program held an internal disadvantage. The graduates had their pick of laboratories; we did not have our pick of graduates!

Along with teaching came an emphasis on sharing your knowledge, writing. My writing skills were on a par with many of my engineering classmates: in our senior year we were trying to pass the basic rhetoric exam. John coaxed me into writing a paper, only to return it with more red correction marks than there was text. Years later I found that he came by this editing trait naturally. On our bookshelf is a Webster’s New International Dictionary. The General Editor was Thomas A. Knott, John Knott’s father.

We discussed methods of teaching EEG instrumentation. After many years of struggle, there were instrumentation standards for the clinical electroencephalograph. Teaching filter function and such had become almost easy. The problem is that EEG technology is experiencing a change. With a smile, John said that concerns about new technology had a familiar ring. In the early 1950s, technologists (and EEGers) had to solder, make their own supplies, convert instrumentation intended for other purposes, and make their own frequency analyzers. Again “new technology” has been injected into EEG. Digital components and software intended for other purposes are being used in EEG. The challenge for the technologist, as well as the instructor, is to understand and make the best use ofthis technology. Indeed, the technologists of today are in a situation similar to their counterparts of the 1950s, perhaps even more difficult, more confusing! It is John’s historical perspective and insight in this area that we will miss the most.

– Peter J. Seaba, M.S.E.E.

ABRET Organizer

Close to 30 years ago, ABRET came into being. The moving force behind this formation was Dr. John R. Knott. Dr. Knott supported our efforts to give identity, credence, and professionalism to the serious practice of EEG Technology and devoted endless hours on our behalf. To those of us fortunate enough to work with him these many years ago, he became our leader and guide, our activist. He traveled across the entire United States, organizing regional examinations and convincing technologists that, through ABRET, there was a road to increased professional status. The regional examinations were held over weekends; the evenings and nights were for the travel. Within a 2–3 year span, there wasn’t a month that went by without one if not two examinations being held at diverse locations. The group of candidates was small. The body of examiners was also small, but always included qualified technicians, as we were known at that time. By his presence, his great gift for communication, he became a friend to all technologists. Resentment made way to understanding and acceptance of the new order of EEG Technology with its demands for higher standards and knowledge. He had a unique capacity to teach, particularly the technical aspects of EEG Technology. His great concern was that we be “technically” oriented, as opposed to being “pseudo-readers” of the records we produced. He motivated us to become the correctly trained eyes for the electroencephalographer. Much recognition for his dedication to us was accorded him in his lifetime; his reticence in accepting our tributes is legendary. Now we may once more honor the man for his devotion to all technologists past, present, and future.

– Nina Kagawa, R. EEG T. (1964)
– Dorothea Brittenham, R. EEG T. (1964)

Author

It was with deep personal regret that we learned of the death of Dr. John Knott. Dr. Knott was one of the pioneers of clinical electrophysiology and was justifiably regarded as one of the founders of electroencephalography in this country. He took pride in telling of his experiences in the early days when records were run, read, and reports written by the “electroencephalographer.” From those experiences he gained an everlasting respect for the technologists. In pursuit of his goals, he became a staunch supporter of electroencephalographic technology training in the United States. He felt that the foundation of excellence in any laboratory should begin with the technologist who possessed the technical skills and firm understanding of the diverse basic principles which contribute to the field of clinical electroencephalography. He made certain that those around him possessed these skills and that they used them to the best of their ability.

Having worked with Dr. Knott as co-authors of Fundamentals of EEG Technology, we came to know just how strongly he felt an obligation to share his knowledge with all persons performing EEGs-the well-trained, the selftrained, the trainee, those who knew him, and those who may have never seen him. Certainly, the two of us were the students who learned the most from him during the time we collaborated on the books.

We feel privileged to have known Dr. Knott and will always cherish our association with him.

– Fay S. Tyner, R. EEG T.
– W. Brem Mayer, Jr., M.D.

Clinical Electroencephalographer

A major facet of a long and treasured dialog with John Knott was our mutual preoccupation with montages and their structure. The need arose when the number of channels considered desirable for electroencephalography was rapidly increasing, and the use of cumbersome individual selector switches (two per channel) was being replaced by the “Master Input Selector Switch.” The advantage in time saved and accuracy was obvious. We at Grass Instrument Co. considered ourselves responsible for detecting any sources of error in the montage design desired by the purchasers of such switches. Consequently we needed to understand and encourage the use of logical selections of popular schema as suggested by the American EEG Society. Dr. Knott was the frequent line of communication, and helped us to understand the basic principles of montage design. His small brochure, titled “A Rationale for Developing Montages for 16, 8, and 10 Channel EEG Instrumentation,” was written in 1975 and revised in 1976. His advice assisted us greatly. He also played a role in the American EEG Society Guidelines No. 7, published in 1980. There is not a technologist today that does not daily benefit from these basic contributions to the state of the art of input selection of electroencephalography. I feel privileged to have had this partnership with him.

– Ellen R. Grass

John R. Knott has died at the age of 81 years. He died after many years of suffering from a pulmonary ailment, which he endured with stoicism, strength, and wisdom. He was one of the last EEG pioneers. The young psychologist became confronted with the new method of EEG in the 1930s, influenced by his mentor L. E. Travis. Soon he stood on his own feet: constantly striving for better technology and greater understanding of the frequency components of EEG and, in particular, of its development in the course of human maturation. As a radio amateur since adolescence, his interest in electronics was not limited to biological amplifiers; he remained faithful to his old hobby until the very last period of his life. In this manner, he became a veritable wizard in the world of oscillators and amplifiers. This phenomenal technical know-how was just the basis of his comprehension of the EEG phenomena. The EEG signal, its polarity and propagation, was the cornerstone in his edifice of EEG comprehension. Modern dipole theories were viewed with restraint and suspicion (sharing this view with other true leaders of the field).

His EEG Laboratory at the University of Iowa in Iowa City was brilliantly organized. Supervision and constant training of the technical staff were of paramount importance. (What he did for EEG technologists in this country is legendary.) I joined John Knott’s staff in 1960; he simply needed an assistant of faculty rank on a permanent basis. Over the ensuing five years, I realized that my knowledge of EEG (stemming from eight years of hurried EEG experience in the “old country”) was-at best-deficient. What I really learned in Clinical Electroencephalography, I learned from John Knott.

In collaboration with Rex Ingram-an outstanding neuroanatomist with strong neurophysiological inclinations-John Knott explored the function of brainstem structures in animal experiments in the late 1950s. In the 1960s, he became interested in EEG and conditioning and, thereafter, in the significance of the contingent negative variation. In the years of collaboration with John, much attention was paid to the 14 and 6/sec positive spike pattern. Its psychiatric and psychological significance was hotly debated (until interest in this pattern started to fade). His mastery of clinical EEG included all ages. Little is known that John Knott was also a pioneer of depth EEG recordings, an explorer of deep structures, in collaboration with the neurosurgeon Russell H. Meyers, an investigator of the basal ganglia and motor disturbances (from 1949 to 1951).

John Knott’s personal influence accounts for the establishment of a strong neuro-electrophysiological school in Iowa City. Charles Shagass came from Montreal and turned into a leader in the field of evoked potential research (with the use of paired stimuli) in psychiatric illness. For some reason, the EEG Laboratory (and Division of Clinical Neurophysiology) administratively were a part of the Department of Psychiatry (under the benign leadership of Paul Huston-a warm personal friend of John Knott and also a radio amateur). Harold Shipton came somewhat later: Grey Walter’s coworker, an electronic engineer of highest rankanother legendary person. (The unforgettable “Shippy” is still active in St. Louis.) Did the import of outstanding colleagues result in smooth collaboration? Unfortunately, it did not. We all knew that John Knott was one of the greatest in the world but also deplored the difficulties surrounding the collaboration. He was an irascible man-but it was always good to forget such outbursts as quickly as possible. Behind the difficult facade was a wonderful human being.

John Knott was a marvelous family man and his house was pervaded with human warmth and culture. One had to know him in order to realize that he was a “Renaissance man,” a polyhistor: a man of unbelievable knowledge. He was an earthy neuroscientist, a man who could solve the most trivial problems disturbing the household. He loved the arts and especially music. (What delightful evenings when we listened together to the then widely known Iowa String Quartet!) Nature also gave this tall and physically impressive man an athletic body (too early impaired by ceaseless cigarette smoking). His wonderful wife Ginniea scientist in the field of child development-provided for him a peaceful home. John Knott used his knife-sharp critical intellect quite often with little display of wisdom. On the other hand, John Knott displayed an absolutely admirable sense of wisdom and justice to everybody who worked with him on an examining board. In this situation, he was an embodiment of justice and fairness. Paul Huston’s retirement inflicted much psychological harm on John Knott who was neither a diplomat nor a master of the compromise. His own retirement being near, Albert Grass-one of his most faithful friends-invited him to Boston, providing him with a guest professorship. Working facilities were found at Boston University where he worked until his ailment forced him to return to Iowa City. In those last years and months of agonizing suffering, his mind remained clear and his critical intellect as sharp as ever.

Farewell, John! May your disciples and friends never forget you-may your name always stand in golden letters in the historical accounts of EEG! May eternal peace be given to you!

– Ernst Niedermeyer, M.D.

A Reminiscence

The Editor invited “a paragraph!!!” Length not specified-but even if I used one of Hans Berger’s four-page paragraphs, it would be inadequate to express my personal feelings about the passing of John Knott. The memories go back to shared graduate student days of research and writing in Iowa in 1937. Then there were the war years, when we were fortunately both stationed by the Navy near Newport, RI. John then went back to Iowa and shared sustained work visits to me in Hartford. We used to drive from there in an open MG roadster to the annual EEG meetings in Atlantic City. Subsequently, Cleveland became a frequent overnight stop as he drove to Boston for consultations and sailing. One of our rare disagreements (politics excepted) was when he left Iowa City for Boston. Eventually, we almost literally moved John and Ginny back to SUI where they belonged. Although it seemed to me that he never achieved the local recognition as elder statesman that he deserved, and for several years was unable to travel, he remained remarkably active and productive. Woe to the editor who engaged in careless editing! EEG in general and ASET in particular are eternally in his debt for his (yes, his) two volumes on EEG Technology. Every time you try to run a better record or attend a course or participate in an ABRET exam, you are perpetuating John’s memory in the best possible manner.

– Charles E. Henry, Ph.D.

Originally published in:

The Neurodiagnostic Journal, 33(2), 81–89, 1993
DOI: https://doi.org/10.1080/00029238.1993.11080436