Dr. Bortrum
02/08/2019
Pittsburgh and Starzl
CHAPTER 100 Pittsburgh and the Liver
When last we met, I was engrossed in the travels of the Hew Horizons spacecraft which was in the process of passing a small rock way out beyond Pluto. New Horizons had already given us superb pictures of that demoted planet. The small rock is Ultima Thule and I was wondering if it was going to turn out to be a peanut or two smaller rocks orbiting close to each other. Turns out NASA is calling it a snowman, formed when two spherical objects bumped into each other and stuck together. I just looked at a photo put out by NASA a few days ago and it's a lumpy snowman with what look like craters. It seems the snowman is about the size of Washington, DC and is believed to have formed very early, like in the first one percent of the life of our solar system. Thus it has preserved what the stuff of which our planets formed looked like billions of years ago. More data and even clearer pictures of the snowman will be forthcoming as data are expected to be streaming from New Horizons until late in 2020!
Speaking of things sticking together, you may have noticed that this is Chapter 100 in this series of Bortrum columns. Long time readers will know that I posted hundreds more columns prior to starting to label them with chapter numbers. Back in the day, I was writing one column every week and was getting reimbursed a modest sum of money per column by our StocksandNews editor, Brian Trumbore. Then he stopped paying me and I said I might write a column now and then. Well, it's been 100 months and I've managed to turn out something every month since then, pro bono. Given that I am now 91 and in the sunset of my tenure on this planet, I've been mulling over whether I should make a serious attempt to write my book. Doesn't everyone think he or she should write a book?
Well, what do you know? I decided to look back in the archives and have found that my memory at 91 is not good. I did not start numbering these columns as chapters after my last paid column posted 12/31/2009 but for some time after that was posting columns every couple of weeks or so. In August of 2010, I posed the same question as in the preceding paragraph - should I start writing a book? The answer then was yes and I indeed started to write it on this site, labeling my columns with chapter numbers. I actually wrote a lot more than I remembered about my life before the chapters went back to being just columns about science or whatever I deemed interesting at the time.
One of the key chapters of my life was my 4 years spent at in graduate school at the University of Pittsburgh. A couple of weeks ago at our Old Guard meeting Pittsburgh came up in the conversation and I mentioned what a great environment it was around the campus when I was there. The centerpiece of the University is the very impressive 42-story Cathedral of Learning (see Wikipedia for a picture and description of this renown structure). Essentially across the street was Forbes Field, where I spent hundreds of hours watching the Pirates with Ralph Kiner just coming up playing against the likes of Jackie Robinson. A block or so away in the opposite direction was the Syria Mosque, where I experienced my first symphony concert, by the Pittsburgh Symphony under Fritz Reiner. A couple blocks in another direction were the Carnegie Library and the Mellon Institute, where I saw and heard my first Nobel Laureate, Linus Pauling, give a talk. Pitt Stadium was not only the locale for the Pitt football games but in the summer it was home to the Civic Light Opera, where I became acquainted with Sigmund Romberg's music.
Well, after our Old Guard meeting I got home and found in the mail the Winter 2019 edition of PITT, the alumni magazine. On the cover was a picture of some of thousands of students linked, arms around each other, on the lawn of the Cathedral of Learning with the words "STRONGER THAN HATE" The occasion was a tribute and memorial to the victims of the mass murder of 11 individuals and wounding of 6 at the Tree of Life synagogue in the Squirrel Hill section of Pittsburgh. I have a fond memory of Squirrel Hill, where we played softball when I was at Pitt. I still remember my over-the-shoulder catch of a fly ball in one of those games. It ranks with my sinking of an over-the-shoulder shot from the corner in a fraternity basketball game at Dickinson college or my sinking of a 60-foot putt on the first hole of the Old Course at St. Andrews in Scotland. Sorry to get distracted like this but long time readers will know that I take any opportunity to bring up my sporting achievements such as my hole-in-one. Incidentally, I think it was on a golf course in Squirrel Hill that I first made an attempt to play golf, just for a few holes.
I can usually count on an issue of PITT to have an interesting article or more on a scientific subject, often of a medical nature. This time I was taken by a picture of a new bronze statue of Thomas Starzl seated on a bench near The Cathedral of Learning. Starzl, who died in 2017, was a surgeon who changed the face of transplant surgery with his innovations that resulted in the largest and busiest transplant center in the world being in Pittsburgh. He performed the first successful human liver transplant and went on to do fundamental work on various aspects of transplantation, notably on immunologic drugs such as cyclosporine. He directed the first operation involving a simultaneous heart and lung transplant, in six-year-old Stormie Jones. Stormie lived to be 13 years old, which might not sound impressive but she was really in bad shape before the operation. Her LDL cholesterol level was 988! After the transplant surgery it dropped to 184. The liver plays a significant role in cholesterol. Before the operation she had had two heart attacks; hence the rationale for the heart transplant.
On Wikipedia I found mention that Starzl was noted by the Institute of Scientific Information as being a, or even the most cited author. I happen to be familiar with ISI, having been asked by ISI to write a brief commentary on a paper I published that was heavily cited. ISI terms heavily cited papers Citation Classics. Wondering if Starzl had also written any such commentary, I found that ISI has a list of such commentaries arranged alphabetically by authors' last names. After confirming that mine was on the list I found that Starzl had written commentaries on two of his publications, one of them a book.
In one commentary, he describes how the first attempts at liver transplantation were performed at the University of Colorado in Denver, my birthplace, in 1963. Over the next 16 years, 170 patients were transplanted with only 56 surviving more than a year. A similar program was underway in Britain under the direction of Roy Calne and with similar results. In 1979, Calne and his team reported using a new drug, cyclosporine, in 34 organ transplants, including 2 liver transplants. By substituting cyclosporine for one of the drugs used in their 2- or 3-drug cocktails, Starzl's team logged 11 out of 12 liver recipients surviving more than a year. By 1980-1981 Starzl and his team were at Pitt and things were moving quickly, with close cooperation in sharing data with Calne and his British team. The Surgeon General C. Everitt Koop, was made aware of the results and by 1983 liver transplantation was designated a "service" procedure, which Starzl said started a stampede to start new liver transplant centers.
I liked the following quote from Starzl's commentary: "Honors and awards resulted, but these meant little compared to the satisfaction of seeing a population of well patients grow who only one generation previously were consigned to early death, and of watching the burgeoning careers of physicians and surgeons who had trained in our programs. . When I stopped clinical work, I wrote their story in a book called The Puzzle People. The book also described a mutually supportive professional relationship with Calne and his British team, which might be emulated by those who become so competitive that they erode the respect and affection that should come naturally between companions in a common cause." We could use some of this in today's political climate.
Well, I was going to end with the above but I noticed that I had spelled Calne Caine when I hadn't copied the above quote electronically. To check, I Googled Calne and found he's Sir Roy Calne. I also found a very laudatory piece on him on The Thomas Starzl Web site that I assume Starzl wrote before he died.
OK, I thought I was finished but had to go to the bathroom, where I do most of my serious reading, and there was the February issue of National Geographic and an article on ketchup. Ketchup and Heinz. Where was Heinz born? Pittsburgh. What building did I forget to mention that is located on the Pitt campus? Heinz Memorial Chapel. I'll leave it to you to go to Wikipedia if you're interested. I may write about ketchup next month.
Next column on or about March 1, hopefully.
Allen F. Bortrum
