July-August 2008, Volume 5, Issue 4
William Dameshek: Compassionate Clinician and Gifted Teacher
Published on: July 01, 2008
Dr. Schwartz is a Deputy Editor of the New England Journal of Medicine.
William Dameshek (1900-1969) was the preeminent American clinical
hematologist of his time. A polymath, his interests ranged from
diseases of the blood to pre-Columbian statuettes. He was a lead
investigator in the first-known multi-institutional trial of
chemotherapy (nitrogen mustard for Hodgkin lymphoma). Dr. Dameshek
pioneered in the treatment of immune thrombocytopenia with
corticosteroids, introduced antimetabolite therapy for autoimmune
diseases, developed the concepts of the myeloproliferative and
lymphoproliferative disorders, and proposed that CLL is the result of a
gradual accumulation of lymphocytes. He was the founder ofBlood, an architect of the American Society of Hematology, and an organizer of the International Society of Hematology (ISH).
Dr. Dameshek was named Ze'ev at his birth in Voronezh, Russia, and,
at the age of three, was brought to the United States by his parents,
who settled in Medford, MA, and renamed him William. An exceptional
student at Boston's English High School (the oldest public high school
in America), he went to Harvard College, and in 1923 he graduated from
Harvard Medical School and married Rose (Ruddy) Thurman.
During his internship at Boston City Hospital, he worked with Dr.
Ralph Larrabee, a Tufts professor who had established a "Blood
Laboratory" in the basement of the hospital. Dr. Dameshek's first
research paper was titled "The reticulated blood cells — their clinical
significance." Dr. Dameshek was also drawn to hematology by George
Minot, director of the Thorndike Memorial Laboratory of the hospital,
who in 1925 was treating pernicious anemia — then a fatal disease —
with raw liver. In 1939, Dr. Dameshek established the Blood Research
Laboratory at what was to become the New England Medical Center (now
Tufts Medical Center). There he did the work that brought him
Dr. Dameshek was a gifted teacher. He ran the most popular course
(hematology) for medical students at Tufts University School of
Medicine; his Saturday morning hematology Grand Rounds at the New
England Medical Center were legendary. He trained more than 100
hematologists from 20 countries. Former trainees still remember walking
rounds with Dr. Dameshek — 20 fellows and students trailing the master
through the hospital. Dr. Dameshek knew better than any of us how to
take a history, perform a physical examination, and interpret a blood
smear. In the hallway, after leaving the patient, he would quiz,
cajole, and tease the fellows but never embarrass, and never parade his
knowledge. He could effortlessly admit, "I don't know." ("We'll vote,"
he'd say about a difficult problem or decision.) Above all, he was
deeply empathetic with patients for whom there were few effective
treatments. He never denied them hope, never seemed rushed, never
failed to touch them.
Dr. Dameshek was not a laboratory investigator. He was a busy
clinician who took the time to think deeply about his patients and
their diseases. He was tireless. He wrote five books and more than 350
articles and editorials. He would arrive in his office on Monday
morning with a bundle of lined white paper on which he had, over the
weekend, written in characteristic green ink his latest thoughts on
PNH, CLL, or myelodysplasia. On some Mondays, he would arrive bursting
with a wonderful new idea about the origin of lymphomas, or the
relation between PNH and aplastic anemia, or why immune
thrombocytopenia develops in systemic lupus erythematosus. Soon after
we (puppies) had yelped our objections to the latest idea, it would
appear as an editorial in Blood.
Dr. Dameshek demanded from us fellows his own level of enthusiasm,
commitment, and effort. It wasn't easy to emulate the boss. On Friday,
October 4, 1957, the day the Sputnik satellite went into orbit, we
received a memorable lecture on our deficiencies. Later, he apologized
even though we knew that he meant every word.
Patients came from everywhere to seek Dr. Dameshek's counsel.
Luminaries arrived regularly. He collected art, lived in a beautiful
house in Brookline, loved music (Serge Koussevitzky was his patient),
and entertained grandly thanks to Ruddy. Dressed by Louis, Boston's
high-end haberdasher, Dr. Dameshek cut a stylish figure. He was, from
outward appearances, the antithesis of the staid, underpaid Boston
academic. He would brush off petty jealousies with a shrug. His
favorite response to the critics was, "Every knock is a boost."
Dr. Dameshek had an extraordinary influence on the development of
hematology in America. He used his intelligence, independence, and
influence in ways that benefited not only hematologists but also
patients. His legacy is unique.
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