Who’s Who in Orthopedics
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HIPPOCRATES
Third century BC
Hippocrates was born on the Greek island of Cos, the son of a physician. Among his contemporaries were Plato, Socrates, Xenophon, and Protagas.
It was a time of great intellectual ferment.
Hippocrates practiced in Cos and was surrounded by a group of students throughout most of his life.
He left an impressive legacy in the form of numerous manuscripts, which have survived and fascinated medical historians for generations. Not all of this material actually can be attributed to Hippocrates. However, most scholars think that the surgical books are the most likely to come from Hippocrates.
Hippocrates was familiar with the problem of dislocation of the shoulder. The Greeks were great athletes and there were the usual risks of an agrarian society. He dealt with acute dislocation, he faced the problems of delayed reduction, and there were cases of pathologic dislocations attrib- utable to suppurative conditions such as tubercu- losis. All of these problems can be seen today and are recognized by the same signs and symptoms described by Hippocrates. Although many of the diseases described by Hippocrates have disap- peared or metamorphosed into new forms, trauma remains immutable, the same today as it was at the time of Hippocrates.
Carl HIRSCH
1913–1973
Carl Hirsch exerted a major influence on the course of orthopedic teaching and practice in the United States. The results of this influence will be felt by subsequent generations of orthopedic sur- geons in much the same way that the influence of Erdheim, transmitted through Willis Campbell and Dallas Phemister, was felt by their students and subsequently by present-day practitioners and residents. Erdheim’s field was pathology. Carl Hirsch’s was biomechanics. The current empha- sis on biomechanics as an important basic science in orthopedics can be traced to his influence and teaching.
His interest in the application of engineering to orthopedic research and practice was stimulated by his work on chondromalacia of the patella, in which he performed mechanical tests on the prop- erties of patellar cartilage. This work was pub- lished in 1943. His attention was then directed to problems of the back, and while he was Associ- ate Professor in the Department of Orthopedic Surgery at the Karolinska Institute in Stockholm, he performed further investigative work. He held three Chairs in Sweden: Uppsala, 1955–1960;
Göteborg, 1960–1969; and Stockholm, 1969 until his death. His biomechanics laboratory was expanded with each move.
In 1957, the first American research fellow
began work in Professor Hirsch’s biomechanics
laboratory. Thereafter, each year one or two
research fellows from the United States and other
parts of the world spent a year or two in the bio-
mechanics laboratory under his direction, per- forming research and learning the application of engineering principles to orthopedic surgery. In Sweden, it is common for a physician aspiring to an academic position to perform research and then to write a thesis to attain the advanced degree of Med Dr. After the thesis has been written and submitted to the university, the candidate must defend the work publicly before a panel of three experts. The thesis, if it is related to orthopedics, is then usually published as a supplement to
Acta Orthopedica Scandinavica. The influence ofa medical educator on the next generation of medical educators in Sweden can thus be meas- ured quite accurately. During the period from 1960 to 1973, 40 doctoral theses were produced under the direction of Carl Hirsch, seven by American surgeons. In addition, many other orthopedic surgeons spent shorter periods of time in his biomechanics laboratory.
Carl Hirsch was a frequent visitor to the United States and was usually to be found at the annual meeting of the American Academy of Orthopedic Surgeons and at many of the postgraduate courses given throughout the United States. He was an entertaining and informative lecturer, who took a new and provocative look at many old prob- lems, such as low-back pain and osteotomy of the hip.
An academic career requires a nice balance between patient care, research, and education. It is rare to find capabilities in all three areas com- bined in one man. Carl Hirsch possessed these capabilities. He was an excellent physician and surgeon. He was particularly skilled in surgery of the spine. In the area of research, the 40 doctoral theses attest to his ability as a researcher and research director. He established an excellent biomechanics laboratory, which has served as a model for many others throughout the world. He had the ability to pose a problem to a person and then gently to lead, push, and encourage that person to completion of the work. In the area of medical education, he played an important role in Sweden, acting as an advisor to the Swedish gov- ernment in the field of orthopedic surgery and rehabilitation. He was a corresponding member of the American Orthopedic Association and an honorary member of the American Academy of Orthopedic Surgeons, the Shriners, and the Israeli Orthopedic Association. He was also a member of the French, British, and Swiss Associations, and was active in the Société Internationale de Chirurgie Orthopédique et de Traumatologie.
Carl Hirsch was known to all by his Swedish nickname, “Calle.” His home was a haven for exchange fellows from overseas and for all visit- ing orthopedic surgeons. It was a rare visitor to his clinic in Uppsala, Göteborg, or Stockholm who was not brought to the Hirsch’s home, which was filled with modern Swedish paintings and sculpture, for a typical Swedish meal. These activities were presided over by his first wife, Anna, who died in 1969. She was a woman of great warmth, and through her hospitality she did much to make the families of the research fellows from overseas feel at home and comfortable in a new environment.
Carl had a great facility for making friends, which made it easy for his students to develop a close relationship with him. This relationship greatly facilitated the work. In 1971, the Carl Hirsch Föreningen, a society of former American research alumni, was founded to honor Carl and to promote American–Swedish cooperation. Carl Hirsch died on June 19, 1973, at the age of 60.
He was survived by his second wife, Anna Bjork, and three children: George, a resident in surgery, Monica, and Jon, a resident in oral surgery.
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