Writings document examples of brotherly love in ophthalmology

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This collection of documents demonstrates the love and admiration that these distinguished individuals, all of whom are highly respected in the history of ophthalmology, have held for one another.

Our Ophthalmic Heritage By Morton F. Goldberg, MD, and David L. Knox, MD

Extraordinary professional achievement is sometimes characterized by intensely warm and supportive interpersonal relationships. Such relationships can involve internationally recognized ophthalmic luminaries, as revealed in the following letters and obituaries.

These writings represent examples of brotherhood in medicine and science. In mutually felt platonic love, the donor and the recipient inspire each other in spiritual and intellectual, rather than in physical, ways. These revealing documents demonstrate the love and admiration that these distinguished individuals, all of whom are highly respected in the history of ophthalmology, have held for one another.

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In 1958, Frederick Verhoeff, MD, then 84 years of age, and professor of ophthalmic research at Harvard University, wrote his friend, Alan C. Woods, MD, director of the Wilmer Eye Institute at Johns Hopkins University, on the occasion of Dr. Woods’ 70th birthday. Here is his previously unpublished letter (Figure 1):

                                                                                              November 29, 1958

Dear Alan,

Gout, the decrepitudes of old age, and the refusal of my better half to permit the trip, prevent me from attending the dinner in honor of your seventieth birthday. I regret this exceedingly because you richly deserve this honor as you have the many others you have received. My regret is heightened by the fact that I feel under obligations to you. For you have praised me more highly, more often, and more publicly than has anyone else alive or dead, and I know you are responsible for my receiving two honors that I value highly. Since you always mean what you say, I am sure that I rank high in your estimation, as you do in mine. Unfortunately for the world, my opinion is not always general opinion, but I am sure that in this instance general opinion accords with my estimation of you even if it does not with your estimation of me.

Our careers have been similar in many respects, but I shall not compare them because comparisons are notoriously odious. However, I cannot refrain from pointing out that as regards physical beauty there is, of course, no comparison between us, and as regards physical prowess I am sure that if we had ever engaged in combat on the tennis courts I should have emerged the victor. As to physical afflictions, I have not yet undergone a cataract operation as you have twice bravely done, but you have not suffered the terrific pains of gout and those of a dislocated lumbar disc, as I have repeatedly had to do.

When, many years ago, I first became aware of your existence I was interested in you for three reasons. First, because of your research work which was attracting wide attention, second, because we were both Hopkins graduates, and a Hopkins graduate who became an ophthalmologist was then still a rare bird, and third, because I knew your father and greatly admired him. I met him often in Baltimore in 1899 and 1900, when you were a mere child and I was a beginner in ophthalmology, and soon discovered that he had a profound knowledge of this subject. He was very kind to me and gave me much encouragement. Afterwards I met him at many meetings of the A.O.S. and was greatly pleased when he was elected president of this society in 1919. He would have been delighted to have known that his son Alan was to receive the same honor thirty-six years later.

Now on your seventieth birthday after the completion of your active services to hospital and medical school, you have many things to give you satisfaction. You know that everywhere these services have been recognized as outstanding. You are now free from your former vexatious responsibilities and obligations. You, your associates and former pupils constitute a mutual admiration society. Whenever you meet, you greet each/other with pleasure. You are always welcome at your old haunts. You have the pleasure of having a successor whom you greatly esteem, and who greatly esteems you and always extends to you a warm reception. There are many other things you can contemplate with satisfaction, such as the numerous honors you have received.

You have the intellectual qualities I most admire; intellectual honesty and generosity, logical thought, perseverance against odds, courage to express your convictions even when they are unconventional, a researcher’s spirit uninfluenced by thoughts of personal gain, and a sense of humor that is delightful to all.

Alan, as the years have gone by I have grown to admire you more and more, and, I am almost too bashful to say, have also grown to love you.

                                                                                                         Affectionately,                                                                                                        (signed) Fred

In 1956, the same Professor Alan Woods published an obituary about Jonas Friedenwald, MD, a distinguished ophthalmologist at the Wilmer Eye Institute in Baltimore.¹ Dr. Friedenwald had been responsible for much of the knowledge at that time that was related to tonometry, eye pathology, and aqueous humor dynamics. Dr. Woods described him as a “many-faceted genius” . . . an ophthalmologist, physicist, pathologist, physiologist, and chemist.

Woods said that Friedenwald “possessed the sterling qualities of sincerity and tolerance, and these were responsible for the fact that he never excited jealousy or envy in his colleagues when honors were conferred on him. Rather, there was rejoicing that a man so loved should receive just recognition . . . he was not only my loyal friend, but also my faithful advisor, my colleague and my counselor. During this long association, my respect and my love for him grew. . . . I think of him as a great scientist, a true investigator, a splendid teacher, an inspiration to his pupils and his colleagues, and, above all, as a dearly loved friend.”

                                                                 In 1958, Derrick Vail, MD, editor of the American Journal of Ophthalmology and former chairman of ophthalmology at Northwestern University Medical School, published a paean of praise about Sir Stewart Duke-Elder, Director of Research at the Institute of Ophthalmology in London and Surgeon-Oculist to the Kings and Queen of England, on the occasion of Sir Stewart’s 60th birthday. Sir Stewart was the author of the most influential multi-volume textbook in the history of ophthalmology.² Dr. Vail was 60, himself, and described the two of them as “united in age, in war, in work, and in friendship” (unpublished inscription in a privately bound volume). Dr. Vail’s publication³ reads, in part, as follows:

I have tried to give here some idea of the two Stewart Duke-Elders, the scientist and the man, both of them modest and straightforward, but surprisingly different, for the one, judged from his writings, gives the impression of being very old, articulate, lucid, infinitely wise and learned; the other is youthful, exuberant, a delightful companion, far from austere; hospitable, generous, cosmopolitan, democratic, friendly, intellectual, earthy; a person with whom you get on a first-name basis, no matter what language you speak, straight away. We love both of him.

Sir Stewart replied in a handwritten letter (Figure 2), which is published here for the first time, as follows:

             My dear Derrick,

Some men are so full, so rich that they give themselves wholly at each time of meeting. Each time you take leave of them, you feel it is of no importance whether the parting is forever. They come to you brimming over and leave you full to overflowing. They live in a universe without boundaries; and they do not die because all the time they have lived not in life but in eternity.

                        My very dear Derrick - you are one of these very few.

                                                            (signed) Stewart

In 2013, Torsten Wiesel, MD, then 89, wrote a eulogy in the form of a letter to David Hubel, MD, his long-term collaborator⁴. Drs. Wiesel and Hubel had jointly received the Nobel Prize in 1981 for their research on ocular dominance columns in the brain. Dr. Hubel died in September 2013 at age 87. Torsten Wiesel’s memorial letter, typed near Thanksgiving 2013, reads as follows (Figure 3):

I am writing these words not to say farewell but to point out that you will always remain in my heart and mind as one of the best things that ever happened to me. Even more amazing is that our 20 years working together happened completely by chance. As you well remember, your move to the department of physiology at Hopkins medical school in 1958 was delayed because of lab renovations. Vernon Mountcastle asked Stephen Kuffler at the Wilmer Institute in ophthalmology, where I was a postdoc., if you could be with his group for a year. Steve was delighted, and the three of us met. None of us would have guessed how much that lunch meeting would change everything for us, as you and I over many cups of coffee that day began to carve out our future scientific course.

For inexperienced me, having just arrived from Sweden, you were as if a gift from heaven coming with your famous tungsten microelectrode, which you had successfully used to record single visual neurons in the awake cat, made possible by elegant chambers machined on your lathe and mounted on the animal’s head (a method subsequently copied by colleagues from all over the world). Of course, more than all these technical and inventive skills, you came with a brilliant and creative mind.

Our real bonding was probably established while still at Hopkins when at dawn we would go down through dark tunnels to the animal quarters to pick up a cat or monkey to be anesthetized and later prepared for the experiment. You often liked to tell the story when a spider monkey, to our amazement, skillfully used its long tail to pull the syringe with the anesthetic out of my hand as I tried to make the injection in its abdomen. You were also amused when in late night experiments I resorted to speaking Swedish.

These often more than 24-hour experiments were indeed tiring, but the long hours gave us time to learn to know each other well and above all explore ideas for future experiments and approaches. We were lucky to, over and over again, get exciting leads from our experiments, which in turn led to new questions and answers. Looking back on the years at Hopkins and Harvard, when experiments felt like great adventures with you rushing down the corridors screaming “come and look at this amazing cortical cell responding only to contour of a given orientation,” and again when we found binocular cells, and discovered the columnar organization of the visual cortex. We no doubt will always treasure those days and moments, to which nothing can ever match. You must agree that those were the “golden days.” You used to say that it was like rolling yarn into a big, beautiful ball.

Your ability to write so eloquently is without question that of a true master. This is in part due to your love of the English language – the Fowler and other books on writing were always on your desk. You will remember the press conference after the announcement of the Nobel prize, when I emphasized that from the very beginning your writing was critical for the understanding and acceptance of our papers.

You were always the messenger, and your talks and lectures about our work are still famous for their clarity and brilliance. I must have heard your presentations of our work countless times, and I still enjoyed them time after time.

You also had an amazing talent and passion to communicate not only about our work but the many other wonders of nature. You may remember when we visited a small sea resort outside Tokyo in the seventies, when 20 or so students came around, and you completely charmed them by speaking English and some broken Japanese. Actually, after a fierce effort you became proficient enough to give a lecture in Japanese. Your passion for engaging with young students kept you, yourself youthful. Many Harvard college students over the years have had the joy to listen and talk with you about science and many other interests.

For so many years, we experienced the absolute wonder and excitement of discovering something that nobody else knew. Now, we must leave it to the next generation, to probe into the secrets of nature yet to be revealed.

Looking back on our years together, you will always remain my much admired and beloved scientific brother.

Thank you,

(signed) Torsten N. Wiesel

Verhoeff’s letter to Woods was the result of two able, effective men having interacted in and for American ophthalmology for over forty years. Despite strong and sometimes ascerbic public utterances about all manner of things, their academic experience, authority, leadership and contributions to knowledge were their personally bonding forces.

Dr. Woods’ comments about Dr. Friedenwald are particularly poignant inasmuch as Woods was known to be a crusty individual, not given to public expressions of sentiment or emotion.

Derrick Vail’s comments about Sir Stewart Duke-Elder and his reply are expressions of respect, admiration and affection between two internationally famous ophthalmologists. They met intermittently during World War II and at numerous multinational gatherings. Duke-Elder, who was authoritative and prestigious, and Vail, who was a prominent editor and intellectual leader, admired the merits of each other’s work and thoroughly enjoyed each other’s company.

The length and depth of Torsten Wiesel’s memorial letter to David Hubel is rich in fact and nuance. The two men were research colleagues for more than 20 years and co-Nobel Prize winners. In his later years, Wiesel became a scientific leader, president of the Rockefeller Institute, and a global human rights advocate. Throughout his letter are beautiful memories of Hubel, an able, innovative, and stimulating young man who had original scientific ideas and who had guided peers and younger colleagues with no shred of hunger for personal power. Both men shared their scientific curiosity, their desire for new knowledge, and their affection for each other.

Thinking about these documents has heightened our awareness of other teams of collaboration in science and medicine: Watson and Crick, Banting and Best, Curie and Curie, Penfield and Jasper, Cogan and Kuwabara, Ryan and Smith, Posner and Schlossman, Blalock and Taussig, along with others. In many instances, intense and affectionate persona l relationships favorably influenced their combined intellectual and clinical output.

Our hope in presenting this collection of documents expressing personal emotions is that more of these special relationships will surface and will be published, giving to the world and young scientists evidence of how clinical and research colleagues can work, think, and love, with production of new and useful information for the betterment of all.

References

1.     Woods AC. Jonas S. Friedenwald: In Memoriam. The Bulletin of the Johns Hopkins Hospital. 99:23-28, 1956.

2.     Duke-Elder S., System of Ophthalmology. 15 vols. St. Louis, c.v. Mosby, 1958-1976.

3.     Vail D. Am J Ophthalmol. 1958; 45;10.

4.     Wiesel TN. Letter to David Hubel. Physiol. News. 2014;94;46-47. Reprinted with the permission of the author and of the journal.

Morton F. Goldberg, MD, is the Joseph Green Professor of Ophthalmology and former director, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

David L. Knox, MD, is associate professor of ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

Norman B. Medow, FACS, editor of the Our Ophthalmic Heritage, reviewed this column. He is director, pediatric ophthalmology and strabismus, Montefiore Hospital Medical Center, and professor of ophthalmology and pediatrics, Albert Einstein College of Medicine, Bronx, NY. He did not indicate a financial interest in the subject matter.