Psychiatry lost one of its most creative thinkers, Tim Crow, on November 10, 2024. He was a Fellow Emeritus of the ACNP and was accepted into membership in 1990. For 20 years he headed the Division of Psychiatry of the MRC Clinical Research Centre at Northwick Park Hospital in Harrow, UK. Since 1994 he was the founding director of the Prince of Wales International Centre for SANE Research at Oxford University.

Tim’s research had a major impact on our understanding of the nature of psychoses. He began with the electrical stimulation of brain cells and confirmed the projections of the locus coeruleus system to the cerebral cortex [1]. With Eve Johnstone and his colleagues at Northwick Park, in 1976 he published the first study reporting significant ventricular enlargement in patients with chronic schizophrenia compared to controls, a landmark study [2]. Later, Tim proposed a division of schizophrenia into Type I, with positive symptoms based on dopamine dysfunction and Type II, with negative symptoms based on brain structure [3], which led to much subsequent research examining the phenomenology of the schizophrenia syndrome.

Tim also became intrigued by the loss of the uniquely human normal cerebral asymmetries which led him to speculate evolutionarily on the relationship between asymmetries and the development of both language and schizophrenia; he concluded that “schizophrenia is the price that Homo sapiens pays for language” [4]. Tim initially sought a virus or other infectious agent as a cause of schizophrenia, but later in his career became intrigued by genes located on the sex chromosome, specifically those on the X chromosome with corresponding homologies on the Y. He focused most of his work on protocadherin X/Y, a gene responsible for crucial aspects of brain development [5].

As well as being known as a good scientist, Tim was also known for being good company. He had a wry and sometimes quirky sense of humor and always enjoyed sharing a laugh. One of the attractions of attending the Biennial European Winter Workshop on Schizophrenia, of which he was the cofounder and co-director, was the opportunity to get caught up with Tim and to hear his take on the latest research or scientific controversy. It was at the Winter Workshop that he challenged the much-accepted dogma that schizophrenia and manic-depressive illnesses were distinct and independent entities.

Tim’s passing is truly the end of an era that our generation was privileged to experience. He leaves behind a legacy of research and moreover, he was a role model for how to pursue science. He was an amazing scholar whose fierce ability to debate scientific issues, no matter how controversial or with a view contrary to that of others, fired the field in a way that no other colleague we know could do. He was solely after the truth, which is how all scientists should be. The progress he made toward a better understanding of schizophrenia, as well as the way he lived the science, will be instilled in our collective memory for years to come.