Alfred Jaretzki III, MD.

Abstract

lfred Jaretzki III, Professor Emeritus of ClinicalSurgery at Columbia Presbyterian Medical Centerin New York City, died at age 94 on May 29, 2014.Fred, as he was known to family, friends, and col-leagues, was born in Greenwich, Connecticut. Hehad a distinguished career as a cardiothoracic sur-geon in the Department of Surgery at the Collegeof Physicians and Surgeons of Columbia University,a career that spanned nearly a half century beforehis retirement from the operating room in 1992.Fred remained highly engaged in academic surgeryand medicine after his retirement by continuingclose collaborations with neurologists who sharedhis interest in myasthenia gravis.While at Harvard College, Fred served as cap-tain of the junior varsity football team and treas-urer of the Lampoon troupe. After graduating in1941, he enrolled in Harvard Medical School, latermoving to New York City, where he spent nearlyhis entire academic career. He trained in surgeryat Presbyterian and Lenox Hill Hospitals between1944 and 1955, a period that was interrupted bymilitary service. In 1954, he was hired as aninstructor at the College of Physicians andSurgeons, beginning a 48-year tenure in theiroperating rooms as a member of the surgical fac-ulty. Early in his cardiothoracic surgery career hewas part of the team that developed synthetic vas-cular grafts. In neurology circles, Fred was knownfor the crucial role he played in the definition ofthe anatomy of the thymus and in its complete ornear-complete excision from the anterior mediasti-num as therapy in myasthenia gravis. He pio-neered the maximal thymectomy that includedboth transsternal and transcervical incisions to fullyremove thymic tissue from retrothyroid, cervical,and inferior mediastinal regions. In work per-formed with neurology colleagues from Columbiain the 1990s, he demonstrated that crude remis-sion rates with the maximal thymectomy approachexceeded those from less invasive techniques. Fredhad the reputation of being meticulous in theoperating room, attending personally to everydetail of the surgery. He publically challenged sur-gical colleagues at other institutions to demon-strate that less extensive thymectomy approacheswith less complete thymus removal were equallyeffective in managing myasthenia; in the end, hisviews that a complete resection was needed pre-vailed. Fred also led the charge to standardize clin-ical classifications and outcome assessments inmyasthenia gravis, culminating in the seminal rec-ommendations for clinical research standards pub-lished in 2000.