Horst Oertel’s Embattled Montreal Years and the Founding of the McGill Pathological Institute
Context.— Although pathology at McGill’s teaching hospitals famously began with William Osler, he left Montreal before the medical school had established a pathology department. Objective.— To explore the early history of academic pathology and its leadership at McGill, with a primary focus on the second department head, Horst Oertel. Design.— Available primary and secondary historical resources were reviewed. Results.— John George Adami, the first professor of pathology, recruited Oertel in 1914, and Oertel became acting department head when Adami enlisted. At the end of World War I, Adami did not return, and Oertel was appointed department head. In the early 1920s, using Rockefeller Foundation and other philanthropic funding, Oertel oversaw the establishment of a new McGill Pathological Institute; unfortunately, he based the institute upon an autopsy-centric 19th-century German model, even though surgical pathology and clinical pathology were beginning to blossom elsewhere in North America. As a result, McGill missed an opportunity to lead in these arenas. The paper dissects Oertel’s fascinating but tumultuous professional career at McGill, including his battles with renowned neurosurgeon/neuropathologist Wilder Penfield, medical museum/congenital heart disease specialist Maude Abbott, and McGill’s Dean of Medicine Charles Martin, who expected the newly created institute to raise the faculty’s research profile by promoting collaborative clinical research. Oertel was a legendary educator who wove history, philosophy, and humanities into his pathology lectures. Conclusions.— Oertel’s legacy at McGill was mixed. Although he was considered strong academically, more forward-looking and collaborative leadership could have positioned McGill near the forefront of North American pathology.
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2
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This month, January 2016, we celebrate the 90th anniversary of the Archives of Pathology & Laboratory Medicine. First published in January 1926 as a specialty journal of the American Medical Association, the ARCHIVES is one of the oldest continuously published pathology journals in the United States. The ARCHIVES’ first editor (1926–1950), Ludvig Hektoen, MD, of Chicago, a founder of immunopathology, was chair of the Department of Pathology at the University of Chicago and director of the John McCormick Institute of Infectious Disease. Among the discoveries in immunopathology attributed to Dr Hektoen are homologous erythrocyte hemagglutination during blood transfusions, the principles of the accelerated response following a booster shot (specific anamnestic reaction), and the use of adjuvants to augment the immune response. Dr Hektoen was an advisor to the American Medical Association, and editor of the Journal of Infectious Diseases (published since 1904), the Proceedings of the Institute of Medicine of Chicago, and the Transactions of the Chicago Pathological Society. His original editorial board consisted of 3 anatomic pathologists, an experimental pathologist whose research was in avitaminosis, and an internal medicine doctor who had once been a pathologist. The second editor (1950–1954), Granville Bennett, MD, was famous in bone and joint pathology and was chair of the Department of Pathology at Tulane University. Subsequently, he became the first full-time appointed chair of the Department of Pathology at the University of Illinois College of Medicine and later dean of the University of Illinois College of Medicine. The third editor (1954–1963), Paul Cannon, MD, was chair of the Department of Pathology at the University of Chicago. He was an expert on protein deprivation and its effects on the immune system. During and after World War II, his work with the US military on protein malnutrition led to many medical advances in plasmapheresis, stomach tube feeding, and intravenous feeding. The US military also enlisted his help in the development of the K ration. The fourth editor (1964–1973), D. Murray Angevine, MD, was an expert in immunity with a focus on rheumatoid arthritis and vasculitis. He was chair of the Department of Pathology at the University of Wisconsin and later scientific director of the Armed Forces Institute of Pathology, leader of what was the largest pathology group in the world at that time. The fifth editor (1974–1983), Kenneth Brinkhous, MD, was chair of the Department of Pathology at the University of North Carolina at Chapel Hill. Dr Brinkhous developed the partial thromboplastin test, developed the first effective treatment for hemophilia (factor VIII), and was the first scientist to receive 50 years of continuous research funding from the US National Institutes of Health. The sixth editor (1984–1997), William W. McLendon, MD, was chair of both the Department of Hospital Laboratories and the Division of Laboratory Medicine at the University of North Carolina School of Medicine. It was under his leadership that the Department of Pathology and Laboratory Medicine was formed at the University of North Carolina in 1995. The clinical laboratories there are named after him, the William W. McLendon Clinical Laboratories. Two important events occurred during Dr McLendon’s tenure. In 1984, the ARCHIVES became a joint publication of the American Medical Association and the College of American Pathologists (CAP), making ARCHIVES a member benefit for CAP members, which gave the ARCHIVES the greatest circulation of any peer-reviewed pathology journal in the world, a title which it continues to hold currently. It was in 1995 that the ARCHIVES became the official journal of the CAP. The seventh editor (1998–2003), Kenneth D. McClatchey, was a DDS as well as an MD, with a master’s degree in oral pathology. He was famous in both surgical pathology (head and neck pathology) and clinical pathology (microbiology). After serving as associate chair, vice chair, and director of laboratories at the University of Michigan, he became chair of the Pathology Department at Loyola University Medical Center, Maywood, Illinois. Dr McClatchey served on the CAP Board of Governors from 1986 to 1992. When Dr McClatchey died rather suddenly and unexpectedly at age 61, ARCHIVES Associate Editor Gregorio Chejfec, MD, took over as acting editor in January 2004. Dr Accepted for publication September 18, 2015. From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas. The author has no relevant financial interest in the products or companies described in this article. doi: 10.5858/arpa.2015-0393-ED Reprints: Philip T. Cagle, MD, Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin St, Main Building, Room 227, Houston, TX 77030 (e-mail: pcagle@ HoustonMethodist.org).
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The nine years from 1975 through 1983 were years of pressure, concern, and exploration for philanthropic foundations. Changes in the economy, the tax laws, and the federal government’s spending priorities had a major impact on foundation giving. Steady increases in the inflation rate during the 1970s reduced the real value of foundation grant dollars. At the same time, the depressed stock and bond markets reduced the value of foundation assets from which those grant dollars were drawn. The ability of foundations to recover was greatly hindered by the tax code, which at the time required foundations to pay out in grants virtually all of the earnings on their assets. During the early 1980s, the inflation rate gradually fell, the stock market recovered, and, beginning in 1982, the tax law was changed enough to stop the drain on foundation assets. Alongside these improvements, however, came new demands for foundation funds. Foundations responded to this increased demand in different ways. Some reduced their giving in order to rebuild their assets. Others, though frustrated by the impossibility of filling all gaps left by federal funding reductions, felt challenged to fund more efficient and effective programs, in human as well as in material terms. The fluctuation in dollars given is shown in Exhibit 1. Some of the biggest givers in 1980 were not among the biggest funders three years later. This essay highlights patterns in foundation giving in health. It is based on data from samples of foundations in each of three years–1975, 1980, and 1983. The samples ranged from 304 foundations in 1975 to 528 in 1983, and involved a review of over 7,000 grants each year. Foundations were classified each year as large, medium, small, or very small, based on their total giving in real dollars (adjusted for inflation). Interpretation of these data is influenced by information on foundations’
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