Eugene Braunwald and the Rise of Modern Medicine

Eugene Braunwald and the Rise of Modern Medicine

Thomas H. Lee
Copyright Date: 2013
Published by: Harvard University Press
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  • Book Info
    Eugene Braunwald and the Rise of Modern Medicine
    Book Description:

    Much of the improved survival rate from heart attack can be traced to Eugene Braunwald's work. He proved that myocardial infarction was an hours-long dynamic process which could be altered by treatment. Thomas H. Lee tells the life story of a physician whose activist approach transformed not just cardiology but the culture of American medicine.

    eISBN: 978-0-674-72656-7
    Subjects: History, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Preface
    (pp. ix-xiv)
  4. Introduction: The Window
    (pp. 1-6)

    One afternoon in 1965, Eugene Braunwald stood on the sidewalk of a quiet street in Vienna, one block off the Schottenring, the main thoroughfare in the city’s First District. Looking up, he could see the windows of the living room on the second floor of Number 4 Zelinkagasse. He had lived in that spacious apartment with his parents and younger brother until 1938, when Germany had annexed Austria. Braunwald had been only eight years old that spring, but he could remember the crowds cheering the arrival of Nazi soldiers and then of Adolf Hitler himself. He remembered watching from those...

  5. 1 Flight from Europe 1929–1939
    (pp. 7-21)

    When Eugene Braunwald was born in Vienna, on August 15, 1929, it was one of the great cultural centers of the world. It had lost much of its political significance with the collapse of the Austro-Hungarian Empire in 1918, but the city was the home of important musicians, artists, and intellectuals, including Sigmund Freud (1856–1939), Karl Kraus (1874–1936), Arthur Schnitzler (1862–1931), and Robert Musil (1880–1942). A major reason for Vienna’s vibrancy was that, for Jewish families like that of Eugene Braunwald, it was perhaps the most welcoming city in eastern Europe.

    The family of Eugene Braunwald’s...

  6. 2 An American Education 1939–1948
    (pp. 22-31)

    In the fall of 1939, Brooklyn was a destination that was obvious and ideal for families like the Braunwalds. Brooklyn comprised nearly 2.7 million people in 1940—more than double the number who had lived there in 1900 and more than fourfold the number of residents (600,000) in 1880. One reason for Brooklyn’s rapid growth during this era was the opening of the Brooklyn Bridge in 1883, which allowed access to Manhattan without use of a boat. Shortly thereafter, Brooklyn joined the other four boroughs to form the modern New York City. Then, as now, Brooklyn had a good deal...

  7. 3 Medical Education and Training 1948–1952
    (pp. 32-58)

    Just as it was no accident that the family of Eugene Braunwald landed in Brooklyn in 1939, it was no accident that he enrolled at New York University School of Medicine nine years later. For a young Jewish immigrant in New York City who could not afford to leave the region, there were virtually no medical-school options besides NYU. And even that option was barely available to Eugene in 1948.

    Jews had been accepted in increasing numbers to medical schools in New York and other American cities from 1880 to 1925, but a backlash against the rise in Jewish applicants...

  8. 4 Internship and Research at Mount Sinai and Bellevue 1952–1955
    (pp. 59-74)

    Life was changing in almost every way imaginable for Eugene Braunwald in the summer of 1952. He had always been a student and had never lived outside his parents’ home. But now, not quite twenty-three years old, he was a doctor, and he was married. He and Nina moved into a small apartment at 235 East 70th Street—midway between the two hospitals where they were doing their internships.

    Eugene Braunwald was at Mount Sinai Hospital, on the Upper East Side, while Nina remained downtown at Bellevue. Both of them had every-other-night call schedules—meaning that on alternate nights and...

  9. 5 Clinical Associate at the NIH 1955–1957
    (pp. 75-95)

    In the summer of 1955, Eugene and Nina moved from 235 East 70th Street in Manhattan to a new apartment on the grounds of the National Institutes of Health (NIH) in Bethesda, Maryland. They were exhilarated. “Everything was brand new,” he recalled. “The apartment house was brand new, and we were the first occupants of our little apartment. Everybody was moving in, and it was an extraordinary feeling. For the first time since leaving Vienna in 1938, I felt that I belonged to something.

    “During the whole period from the age of nine, I had always felt like an outsider....

  10. 6 Johns Hopkins Hospital 1957–1958
    (pp. 96-113)

    Like many immigrants, the young Eugene Braunwald was attracted to the security and acceptance that comes with affiliation with respected institutions. He had not wanted to go to just any college when he was sixteen years old, or to just any medical school when he was nineteen, or to just any internship program when he was twenty-two. When he had learned that he could not continue his residency training at Mount Sinai in 1953, he had not wanted to go to some obscure hospital just so he could complete his training requirements in 1957. His options had been limited at...

  11. 7 The “Golden Years” at the NIH 1958–1968
    (pp. 114-177)

    When Eugene Braunwald returned to Bethesda in 1958, the period that came to be called the NIH’s “Golden Years” was in full swing. The NIH was the place to be, in part because there was nowhere else to go—at least nowhere that offered comparable opportunities. Most medical schools did not yet have the research infrastructure needed to support young investigators, or to surround them with bright people in other disciplines who would show them new techniques and give them new ideas.

    External factors like the Doctor Draft were major influences on medical researchers, but something was changing in the...

  12. 8 Building a Medical School in San Diego 1968–1972
    (pp. 178-213)

    Late in 1966, Braunwald was contacted by Joseph Stokes III, who had become the first dean of the medical school at the University of California at San Diego (UCSD) two years before. Stokes was a Harvard-trained epidemiologist who had a strong background in cardiology, and could thus appreciate the importance of Braunwald’s work at the NIH. He invited Braunwald to San Diego, where Braunwald met with the university’s basic-science researchers. UCSD was building a new medical school and creating a brandnew Department of Medicine. Its administrators had an ambitious vision for the way in which clinical and basic sciences could...

  13. 9 Rebuilding the Brigham 1972–1980
    (pp. 214-246)

    In 1972, as Eugene Braunwald prepared to come to Boston, the United States was in social and political turmoil. The previous decade had witnessed the assassinations of John F. Kennedy, Robert F. Kennedy, and Martin Luther King, Jr., and the eruption of riots and widespread protests in American cities. The escalating Vietnam War had aroused skepticism about the policies and pronouncements of U.S. leaders. That skepticism became even stronger after June 16, 1972, when a security guard foiled a break-in by supporters of President Nixon at the Democratic National Committee headquarters in Washington’s Watergate Hotel.

    Although Braunwald did not cultivate...

  14. 10 Growth and Integration 1980–1996
    (pp. 247-275)

    As the 1980s began and the Brigham’s Department of Medicine was hitting its stride, Eugene Braunwald might have turned back to his research with greater intensity, or he might have given more time and energy to his roles as a clinician and teacher. Instead, in that decade and beyond, his work as a department chairman and as a researcher changed in ways he had never anticipated.

    When Braunwald left the NIH in 1968, he knew he was entering the “real world”—a world in which there were “normal” patient populations, not just the rarefied few who were referred by their...

  15. 11 Research in Evolution 1939–1948
    (pp. 276-311)

    When deeply immersed in administrative responsibilities, most physicians in academic medicine reduce their direct involvement in research, or stop altogether. They move into the roles of supporter, facilitator, and observer for the research of others. But throughout his years as chairman of a department of medicine, Braunwald was always reluctant to step back too far from research—he enjoyed the thinking, the meticulous preparation, and the bright young people. Just the smell of the dog labs would lift his spirits.

    In 1971, just a few months before he moved to Boston, he had published what he would always consider his...

  16. 12 Textbooks and Education in Evolution 1939–1948
    (pp. 312-326)

    For young Eugene Braunwald, the sense that writing and editing medical textbooks were noble activities began to emerge late at night in 1953, when he was an intern at Mount Sinai Hospital. He would often go to the hospital’s library after his last new patient had been “worked up” and his other work was done. On those library visits, he would frequently see his first professional role model, the cardiologist Charles Friedberg, working on his classic textbook,Diseases of the Heart.¹ Braunwald, the young intern, introduced himself to the great professor, and occasionally they would chat briefly. Friedberg’s book was...

  17. 13 The Still Years
    (pp. 327-340)

    In the summer of 2009, shortly before he turned eighty, Eugene Braunwald was greeted by one of his former trainees, who asked how he was doing. “I’m in my ‘Still Years,’” he said. “Do you know what that means?”

    His former trainee said that he did not. Braunwald continued, “It’s that point in life when people run into you, and they ask, ‘Are youstillworking full time? Are youstilldoing research? Are youstilltraveling to meetings around the world? Are youstilldrawing a salary? Are youstillediting? And sometimes they ask, ‘Are youstillenjoying...

  18. Appendix: Impact on the Field
    (pp. 343-354)
  19. Notes
    (pp. 355-370)
  20. Index
    (pp. 371-383)