Friday, March 02, 2007

Roy Hertz and the triumph over choriocarcinoma

Today's history of medicine class was a combined affair: first- and second-year students heard Dr. Lynn Loriaux's talk on his old friend and colleague Dr. Roy Hertz, M.D., Ph.D., M.P.H. (1909-2002), endocrinologist and developer of the parabiotic technique, co-developer of the first successful chemotherapeutic treatment for a metastatic cancer, discoverer of avidin/biotin bonding (a precursor to radioimmunoassay), and early pioneer of the birth control pill.

Loriaux opened the talk by noting that Hertz "was not well-loved" (this being a wild understatement, we gather) and a "reluctant clinician" who had intended to study comparative literature until a C in Latin poetry caused him to change his major to biology. His brilliance as a researcher was immediately apparent, however: as part of his graduate research on the role of the pituitary gland, he developed the parabiotic technique in which two animals are joined and made to share a single blood supply.

When the newly-created NIH began recruiting scientists, Hertz was hired on in the physiology division, where he was given 18 beds to do with as he pleased. He soon turned to an investigation of choriocarcinoma, a malignant placental tumor with a nearly 100% fatality rate. Hertz was not the one who first suggested the use of methotrexate in the treatment of choriocarcinoma, however. It was Dr. Min C. Li, who had participated in earlier research to determine methotrexate's effect on estrogen levels, who first saw the possibility of exploiting the drug's suppression of cGH to treat this aggressive and deadly cancer. Li had been hired as clinician for Hertz' ward, and together they went on to test the drug on three patients.

In this day and age of IRBs, such a study would never have happened. They didn't know what the dosages should be, they weren't even sure it would work--but it did, and three women were completely cured of their cancer. It was the first apparent cure of metastatic cancer by chemotherapy.

Hertz went on to test the drug in men; when these tests proved unsuccessful, Hertz realized that choriocarcinoma in women is a fetal transplant, with some paternal genetic material--and hence, some component of immune system rejection. This was the beginning of the understanding of the role the immune system in cancer biology.

Largely on the basis of Hertz and Li's success with the treatment of choriocarcinoma, President Richard Nixon declared a "war on cancer" in 1971.

Loriaux noted that Hertz' temperament made him many enemies over the course of his career, and that as a result, he wound up moving from post to post, each of which "ended in grief" after a short period. His legacy was already fading into obscurity. It was due to Loriaux's efforts that Hertz was finally brought back to the NIH as an emeritus scientist, and allowed to fill out the rest of his days there, pursuing AIDS research.

But he will not be entirely forgotten: we have an oral history interview with Roy Hertz here in the PNW Archives Collection, in which we hear, in his own words, the story of his brilliant career. It was conducted by then-student Jonathan Yarris, shortly before Hertz passed away in 2002.

Thursday, March 01, 2007

"They Called Them Angels"

This being the first day of National Women's History Month, it seems fitting that a new book on the history of nursing will soon be available at the OHSU Main Library:

They Called Them Angels: American military nurses of World War II, by Kathi Jackson, will hit the new book shelf next Monday (March 5). Originally published in 2000, this 2006 edition is a reprint--testimony for the unexpected popularity of the first print run.

In these times, when we honor the valor of our soldiers overseas (whether or not we honor the path to war), it's amazing to read about women who not only risked their lives but risked their reputations, in an era when they were often expected to stay at home and devote themselves to housekeeping and child-rearing. Some amazing stories of WWII nursing from our own nurses here in Oregon, who served with the University of Oregon Medical School volunteer unit, General Hospital 46, can be read in our oral history interviews; our archives contains the wonderful scrapbook of Colonel Strohm's Nurses (Accession 2000-006) as well as a wonderful collection of materials from Army nurse Naida Hurlburt Hoffman (Accession 2003-004).

So, let us begin to celebrate this month by celebrating our female healthcare providers and our female soldiers, and let us hope that we each, men and women alike, will be able to rise to the challenges we face.

(I realize I am stereotyping a bit in this post: not all nurses are female; in fact, we also recently received a book on the history of men in nursing, called, appropriately enough, Men in Nursing: history, challenges, and opportunities, edited by Chad O'Lynn and Russell Tranbarger. Also an excellent resource; however there is no National Men's History Month...)

Wednesday, February 28, 2007

People like you

I thought all our lurkers out there might be interested in some statistics on patrons here in the Historical Collections & Archives, which I have spent some of the morning laboriously calculating by hand (it's just like your grade school teacher told you: you do need to know math once you get to be an adult).

We break our patrons into two broad categories: those who actually physically come to the History of Medicine Room to examine materials, and those whose questions we answer remotely via email. Additionally, we classify patrons into four types: OHSU faculty/staff, OHSU students, researchers from other universities, and unaffiliated or independent researchers. Being such a coarse granularity of categorization, the system is not without its disadvantages, but it works well for our current purposes.

The time period under review is from my debut on the scene here in HC&A back in August of 2003 through last month (talk about currency!). Here is the breakdown:

In-House Use:
OHSU faculty: 31
OHSU students: 4
Other universities: 19
Unaffiliated/Independent: 14
Total: 68

E-Reference:
OHSU faculty: 70
OHSU students: 7
Other universities: 18
Unaffiliated/Independent: 104
Total: 199

While these numbers might seem low to the reader unfamiliar with research in archives, keep in mind that each researcher might visit us (or email us) dozens of times as their investigations progress. Also keep in mind how tough it is to be a med student (or a nursing student, or a dental student): there just is not that much time in the day.


What do these numbers mean to you? They mean: come on down! If you have a question about our collections, don't be shy if you're unaffiliated with OHSU. And if you are affiliated with OHSU, look at all your colleagues who are making time to drop by and see what we have to offer. If you're a student here, just wait until your research year during your residency: there are many historical topics to be mined with great payoff for modern medicine.

Don't be the last kid on the block to have a history project in the works!

Tuesday, February 27, 2007

Learn something new everyday!

The post title is both a broad exhortation and a specific component of this job: the great thing about knowledge is that, generally speaking, the more you have the more you want, and the History of Medicine Room is where I feed my habit.

Today, I had the pleasure and privilege of reading a draft departmental history written by one of our patrons. In it I learned that, among many other achievements, the OHSU Department of Surgery, Division of Vascular Surgery, is the home of the very first vascular surgery residency program ever certified by the Accreditation Council for Graduate Medical Education (ACGME). OHSU received this accreditation in 1984; today, there are over 100 vascular surgery fellowship programs in the United States.

Modern history (while often new to me!) can be easier to record: the faculty members are still with us, appearing on campus periodically in the manner of many an emeritus professor, able to regale us with stories of the old days.... But what happens when the old days are really old? No one alive today remembers the Matson brothers, twin doctors who practiced in Portland in the first half of the 20th century. As a result, they can only make it into a written history if the original source materials are consulted. (Well, maybe the Matsons could be discovered through the magic of the web, at the Oregon Clinic web site and at RootsWeb.com)

For all of you out there who enjoy hearing an older colleague's stories of the "way it was," or even your father's stories about growing up: get those stories down on something! If you don't have the time or patience to write it up, record it (put that cell phone to a better use!). Someday, you'll thank yourself.

Monday, February 26, 2007

In memoriam: Kenneth Carl Swan (1912-2007)

The OHSU community learned on Friday of the death of longtime faculty member Dr. Kenneth C. Swan, who was the first full-time paid head of a department when he came to the Medical School in 1944 as chair of the Department of Ophthalmology. Although Dr. Swan had retired as Professor Emeritus in 1978, he remained an active participant in university events. His wife, Virginia, passed away just this past December.

Dr. Swan was born in 1912 in Kansas City, MO, and moved with his family to Oregon in 1913. He was educated at the University of Oregon (B.A., 1933) and University of Oregon Medical School (M.D., 1936), then interned at the University of Wisconsin and completed a residency at University of Iowa (1937-41). With funding from the Oregon State Elks Association, Dr. Swan opened the nation's first Children's Eye Clinic here in 1949. In 1945, he invented the first synthetic artificial tears, from methylcellulose; with Dr. Paul Bailey, he developed the Ames Recording Ophthalmoscope. Dr. Swan was nationally recognized for his research on various drugs and their effects on the eye; the physiology of ocular movements and abnormalities of coordination; and the causes and prevention of blindness. He was a member of numerous societies; past Chairman, American Board of Ophthalmology; past member and chair of several NIH study sections and councils; and winner of numerous awards, including the ARVO Proctor Medal, the AOS Howe Medal, and the UOMS Alumni Association Meritorious Achievement Award.

On Friday, OHSU President and ophthalmologist Dr. Joseph Robertson described Dr. Swan as
"the heart and soul of the ophthalmology department, Casey Eye Institute. From the beginning of his long career at OHSU in 1944, he shaped the education of ophthalmologists in Oregon and throughout the Pacific Northwest. He spent countless hours with residents, and contributed equally to patient care and research. Dr. Swan's work with his Department of Ophthalmology colleagues led to important innovations, including the first microscope for ocular surgery and the creation of new drugs and other therapies. His career was remarkable for his being the recipient of the Howe and Proctor medals, being president of ARVO, and serving on the National Advisory Council for the National Eye Institute. He will be no less remembered, however, for the unfailing courtesy and congeniality that led to lasting friendships.

Many of us knew and loved Dr. Swan and respected him as a physician. Perhaps we can best remember him by living his legacy: providing the best possible eye care for patients, pursuing knowledge and sharing it with others. Dr. Swan touched many lives, and his greatest wish was to enable others to do the same. The profession has lost an extraordinary member, and we will miss him, but his mission lives on in those he taught.
To hear Dr. Swan's story in his own words, you can listen to the oral history interview conducted with him ten years ago, in which he discusses his career and the history of ophthalmology.