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May 27, 2009
May 27, 2009
Colleagues and friends of Joseph B. Kirsner, MD, PhD, a member of the faculty at the University of Chicago Medical Center since 1935, will celebrate the prospect of his turning 100 at a special event, Friday, May 29, sponsored by the American Gastroenterological Association's Foundation for Digestive Health and Nutrition.
The ceremony, from 6:30 to 8:30 pm at the Intercontinental Hotel, 505 North Michigan Avenue in Chicago, is part of Digestive Disease Week (DDW), the "largest and most prestigious meeting in the world for the GI professional." Although Kirsner was born September 21, 1909, the celebration was scheduled to coincide with DDW, meeting this year in Chicago from May 29 to June 3.
Kirsner has helped transform his specialty of gastroenterology from an art--in his words, "speculative, impressionistic, anecdotal, almost mystical at times"--into a science. He has won every award in the field, except one, for which he is not eligible: the American Digestive Health Foundation's Joseph B. Kirsner Award.
The author of more than 750 scientific papers and almost 20 books, including six editions of his textbook on Inflammatory Bowel Diseases, which is by itself more than 800 pages, Kirsner has become the subject of a new book. GI Joe: The Life and Career of Dr. Joseph B. Kirsner, (available through the Chicago Distribution Center, (773) 702-7000, or at Amazon.com) is a 305-page biography of Kirsner, authored by gastroenterologist James L. Franklin, MD, who trained with Kirsner.
"The life and career of Joseph B. Kirsner serves as an inspiration to all physicians," said Franklin. Although long known as a pioneer in the field for his work on immunology and genetics and as one of the first to show the increased risk of colon cancer in patients with ulcerative colitis, "he has always retained his personal warmth and openness with colleagues and is beloved by the institution he has served for over and seven decades," wrote Franklin.
Kirsner, the Louis Block Distinguished Service Professor of Medicine at the University of Chicago, built this career from humble origins. The son of Russian immigrants, he held multiple jobs throughout his school years and worked his way through a six-year program at Tufts University that combined college and medical school.
As a student when the stock market crashed in 1929, "my thought was to go through medical school as quickly as possible and start earning a living," he recalled. Kirsner graduated near the top of his class and came to Chicago in 1934 to begin an internship at Woodlawn Hospital at a salary of $25 a month.
He began attending lectures at the Medical Center, and was impressed by the late Walter Palmer, MD, PhD, who in 1927 had established the first academic gastroenterology unit in the United States. Intrigued with academic medicine, Kirsner applied for a position. In 1935, when a faculty member left unexpectedly, he was invited to join the staff as "assistant in medicine."
His early research involved the study of peptic ulcers and the effects of antacids on stomach-acid secretion and body chemistry. It led to one of the most unusual and productive doctor-patient relationships in history. A penniless, homeless, young man known to gastroenterologists as Edwin R., enrolled in one of Kirsner's research studies. Edwin badly needed treatment. He also needed a job and a place to live, so Kirsner kept him hospitalized for an entire year as a research subject and trained him as a technician.
"It would be difficult to gain approval for such an arrangement today," Kirsner acknowledges, even though none of the experiments posed any threat, "but it was acceptable to him, and he helped me start some of my research. Everybody was happy."
In the late 1930s, Kirsner turned his attention to the inflammatory bowel diseases: ulcerative colitis and Crohn's disease. Working initially with Palmer, Kirsner developed new methods to manage IBD patients. In the 1940s, his studies demonstrating the unanticipated levels of protein loss in patients with even mild IBD placed new emphasis on the importance of nutrition. He developed animal models of IBD, demonstrated the influence of immunology and genetics, and recognized the increased risk of colon cancer in patients with IBD.
During World War II, Kirsner served as an Army doctor in Europe, where he was called to consult on the difficult issue of re-feeding those who had nearly starved in the Nazi concentration camps. Soon after VE Day, he was shipped off to the Pacific Theater, where he advised on the rehabilitation of more prisoners of war, including a group being held captive in Nagasaki in August 1945 when the second atomic bomb obliterated much of the city.
In addition to his own research, Kirsner made such projects possible for others, raising funds for gastrointestinal studies nationwide. In 1962, a collection of his grateful patients joined in by forming the Gastro-Intestinal Research Foundation, which has provided enormous support for gastrointestinal research at the University, including $2 million for the University's 17,000-square-foot Joseph B. Kirsner Center for the Study of Digestive Diseases.
Everyone at DDW should feel "at least slightly indebted to Kirsner," said Stephen Hanauer, MD, section chief of gastroenterology at the University of Chicago. He helped found the American Society for Gastrointestinal Endoscopy, the American Association for the Study of Liver Diseases, and the American Gastroenterological Association, among others.
And he did all this while focusing most of his attention on taking care of patients, one at a time. "Dr Kirsner taught me to be a doctor's doctor," said Hanauer. "Never was a patient too difficult nor would he ever lose patience in caring for an individual."
Early on, Kirsner was recognized "locally and nationally," according to Franklin, "for his successful and compassionate care of patients. The love and devotion his patients felt for him was celebrated and admired." Although he no longer sees patients, they still call him for advice. The key to this lasting connection, says Kirsner, is "competence with compassion."
He has little tolerance for doctors who lack this compassion, no matter how competent. "After nearly 70 years in the practice of medicine," Kirsner wrote in a 2002 essay for JAMA, "I cannot condone the diminished sensitivity of physicians to patients, recalling that as candidates for medical school they had professed the strong motivation 'to help sick people'."
As competent and compassionate as ever, Kirsner no longer has the energy that enabled him to continue to put in 12-hour days for weeks on end. "Every now and then I think about my age and I get very tired," jokes Kirsner. The problem with turning 100, he says, is "having an active mind trapped in a body that's just too old."
He looks forward to the downtown bash during DDW and perhaps a smaller, quieter celebration on his actual birthday. He looks forward even more to his 101st birthday, which he plans to spend, "in my office, catching up on the literature."