November-December 2008, Volume 5, Issue 6
Clement Finch: A Unique Man at a Unique Time
Published on: November 01, 2008
Dr. Adamson is Clinical Professor at the University of California, San Diego. He is also a past president of ASH.
Clement (Clem) Alfred Finch, MD, was born on July 4, 1915, in
upstate New York. With a father and grandfather who were physicians,
and occasionally joining his father on evening house calls, Dr. Finch
decided to follow in their footsteps. After his second year at the
University of Rochester Medical School, Dr. Finch was offered the
Dean's Fellowship to work with Nobel Prize winner George Whipple — a
pillar at the school. Although Dr. Finch didn't feel he "accomplished
anything [in] particular," his first paper, on hemoglobin regeneration
in dogs that had been bled, was published in theJournal of Experimental Medicine,
which was not bad for a second-year student. Also, in Rochester he came
into contact with Paul Hahn, who was working on iron metabolism, and,
to a lesser extent, Joe Ross, whom Dr. Finch would later join in
Boston. He began to feel that academic life could be fun!
After graduating in 1941, Dr. Finch went to the Brigham in Boston,
where he encountered many of the leaders in American medicine,
including Soma Weiss. In those days, house officers lived in the
hospital, and, if they wanted to get married, they had to ask for
permission! Dr. Finch married after one year. Dr. Weiss said,
"Congratulations, but when you come back, act like you're not married."
Dr. Finch felt that when he was at the Brigham the most important thing
in his life was being a good clinician. The Brigham spirit was one of
viewing each patient as a research subject. Patient loads were light;
inquiry was fostered. There was ample contact with stellar physicians,
such as Eugene Stead and Charlie Janeway.
After his clinical training, Dr. Finch accepted a fellowship with
Joe Ross at Boston University. It was Dr. Ross who really introduced
Dr. Finch to academic medicine, taking him on trips to Washington, DC,
for meetings of the National Research Council (NRC). With Dr. Ross, the
work in iron metabolism and blood preservation began in earnest. Dr.
Finch's contributions to blood preservation are often overlooked, but
it was a very important issue at that time with the nation at war.
At the end of the year, George Thorn brought Dr. Finch back to the
Brigham as Chief Resident, made him director of the nascent hematology
labs, and gave him some lab space of his own. Eventually, Dr. Finch
became responsible for blood transfusion therapy at the Brigham.
This was also a time of gathering for those interested in iron:
Charlie Rath, cousin Stu Finch, Robly Evans, and Don Haskins. The
Finches and Haskins began to look at bleeding as a way to treat
hemochromatosis. Boston was rich in hematology.
By 1948, Dr. Finch felt it was time to go. Having grown up in the
Adirondacks and loving the outdoors, Dr. Finch always thought of moving
to a place with mountains. In 1948, he was invited by Bob Williams, the
new Chair of Medicine in Seattle, to look at a position there. John
Lawrence (from Rochester) tried to recruit Dr. Finch to the UCLA
faculty but Dr. Finch decided on Seattle, where he could build a new
division from scratch in his own vision of an integrated clinical,
teaching, and research-oriented division. LA was smoggy; Seattle was
clean and fresh, according to Dr. Finch. Seattle was a new medical
school; it opened in 1946. With Dr. Finch's spirit of adventure, three
technicians also made the move across the country with him. This was a
testament to Dr. Finch's belief that a core of loyal technicians is key
to a lab's success.
While studies of iron metabolism became the backbone of his
research, the first 10 years in Seattle were also marked by continuing
efforts to increase the storage life of red cells for transfusion.
Ernie Simon and Beverly Gabrio led these efforts and they realized that
as ATP in storage declined over time, red cells became less viable. The
work on blood preservation was carried out in labs at the King County
Blood Bank (now Puget Sound Blood Center). The exposure to the workings
and people who were on the NRC contributed greatly to Dr. Finch's
interest in this particular field.
The work on iron advanced. Dr. Finch's lab established the
principles of red-cell production and internal iron metabolism. This
formed the basis of a physiological classification of anemia and
polycythemia, resulting in the "Red Cell Manual," a book designed for
medical students. The principles remain as valid today as they were 40
years ago and reflect Dr. Finch's abiding interests in physiology and
Much work was done to understand how iron was absorbed and how it
trafficked. This literally set the table for the revolution in
understanding provided by molecular biology. Dr. Finch recognized the
"erythropoietic regulator" and the "iron stores regulator," and
provided the criteria used today to define iron deficiency and
iron-deficient erythropoiesis. Work on iron absorption was valuable in
assisting the World Health Organization to be able to make
recommendations concerning diets in developing countries. Dr. Finch
came to view anemia and iron in the context of the nutritional status
of a population. For his studies on iron, he was elected to the
National Academy of Sciences.
In 1966, Dr. Finch served as the eighth president of ASH. The
clinicians in the society were becoming restive because the annual
meeting program was considered irrelevant to the needs of the
practitioner. From those discussions emerged the format of the annual
meeting as we have it today — the first two days devoted to Education
Sessions, admixed with the programs of the Scientific Committees, and
the very useful ASH Education Book.
Dr. Finch lived life a bit differently. He loved the outdoors and
climbing in the Cascades. He put his skills to the test one day when,
having forgotten his keys, he scaled the outside of the Health Sciences
Building to get into his office. Occasionally, on his forays into the
woods, he would bring back mushrooms — as John Huff, a young faculty
person at Harborview, discovered when he went to take a preparation of
tobacco mosaic virus off the lyophilyzer only to find that Dr. Finch
was drying mushrooms!
At six feet, five inches, Dr. Finch was conspicuous going between
hospitals on his Vespa. In an attempt to carve out more hours for his
science, Dr. Finch worked all night, every other night. The
reduced-sleeping routine lasted for about a week. And, he may be the
only faculty person at the University of Washington targeted by the
Medical Executive Committee, who ruled that hospital rounds were not to
be made wearing lederhosen.
As I look back on my time with Dr. Finch in Seattle, anything was
possible intellectually. There was a wonderful faculty doing truly
meaningful clinical research and a hematology program built on rigor
and collaboration. Not a bad model.
ASH Extends Its Thanks
Drs. Frank Bunn, Marshall Lichtman, and Wendell Rosse graciously agreed to coordinate with The Hematologist
to present the 50th anniversary profiles starting in late 2007 through
the end of our anniversary year. We would like to say thank you to Drs.
Bunn, Lichtman, and Rosse for all their exemplary work. They put forth
their time and effort to give readers the opportunity to learn more
about these extraordinary individuals. Because of the quality and
popularity of these articles, we will be extending this series into
2009. All of the profiles are available online.
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