Maxwell Myer Wintrobe: Influential Teacher in the Field of Hematology
Published on: November 01, 2007
Dr. Kushner is the Maxwell M. Wintrobe Distinguished Professor of Medicine at the University of Utah School of Medicine.
Maxwell M. Wintrobe became a hematologist before the discipline of hematology existed. In 1925, he received his medical degree from the University of Manitoba in Winnipeg, Canada, where he graduated first in the class. Following his internship and a medical-biochemistry fellowship at the University of Manitoba, he accepted a faculty position at the Medical School at Tulane University in New Orleans. At the time, Chief of Medicine John Musser, Jr., MD, was an editor of the Tice Practice of Medicine. He asked Dr. Wintrobe to write the section on "Diseases of the Blood." This request set the stage for Dr. Wintrobe to enter an extremely productive research career in hematology. While at Tulane, he developed the now-famous Wintrobe Hematocrit Tube. He realized that there were no published, reliable, normal blood values to use in clinical practice. He was the first to document statistically normal values in adults and children. An important part of this effort was the derivation of the red blood cell indices that remain in wide use. From these indices, Dr. Wintrobe classified anemia morphologically as microcytic, normocytic, or macrocytic, a classification that has been in continued use ever since. Dr. Wintrobe earned a PhD at Tulane (His thesis title was The Erythrocyte in Man.) and became intensely interested in the nutritional requirements necessary for effective erythropoiesis. His PhD work formed the basis of later studies establishing the role of pyridoxine as a cofactor for aminolevulinic acid synthase and for studies defining the important roles of iron and copper in the development of the red cell.
Dr. Wintrobe was recruited to the faculty at Johns Hopkins University School of Medicine in 1930 and remained there for 13 years. While there, he continued to be a productive investigator. He correctly recognized the Mendelian mode of transmission of Cooley’s anemia and described the phenotype of thalassemia minor. He was the first to characterize the nature of cryoglobulins and did pioneering studies establishing clinical phenotypes and laboratory abnormalities in a wide variety of hematologic disorders. While at Johns Hopkins, he published the first edition of Clinical Hematology. This was a single-authored, exhaustively and meticulously referenced 792-page textbook. For the first six editions of Clinical Hematology, Dr. Wintrobe remained the sole author and it was not until the 7th Edition that five of his former fellows were appointed as co-editors.
In 1943, Dr. Wintrobe left Johns Hopkins to become the University of Utah’s first Chair of Medicine at the newly formed four-year medical school. He recruited a small but outstanding faculty including his long-term partner in research, Dr. George Cartwright. Dr. Wintrobe did important studies on the effects of nitrogen mustard, folate antagonists, and adrenocorticosteroids on the hematopoietic system. He was one of the first to recognize the potential of chloramphenicol to produce aplastic anemia. He and Dr. Cartwright were the first to characterize the anemia of chronic inflammation and demonstrate the associated abnormalities of iron metabolism. He was awarded the first extramural grant funded by the NIH for the study of muscular dystrophy and inherited disorders of the blood. He established one of the country’s earliest hematology training programs, a program from which more than 80 percent of the fellows trained went on to develop careers in medical schools and research institutes around the world. He demanded much of his trainees, but never more than he demanded of himself. He was firm but fair and praised only those whose performance was exceptional. His unwavering commitment to excellence made him intolerant of mediocrity. He never wasted a moment at work, but he knew how to relax. He was an avid skier and established a tradition of skiing at Alta with the fellows and faculty on Wednesday afternoons. All who skied on Wednesdays were expected to work a full day on Saturdays. He appreciated the fine arts, especially music. He enjoyed playing the violin and often participated in evenings of chamber music with fellows and faculty. Musical skills were considered a positive attribute in fellowship candidates and probably tipped the balance for many.
Dr. Wintrobe served as President of the American Society of Hematology in 1972. He also served as President of the Association of American Physicians and the Association of Professors of Medicine. In 1973, he was elected to the National Academy of Sciences and the University of Utah named him Distinguished Professor of Internal Medicine, the highest academic rank achievable in the School of Medicine. He died of heart failure in 1986 at the age of 85, ending six decades of outstanding clinical research and teaching.
Dr. Wintrobe had no mentors and no formal scientific training in hematology; his work was responsible for establishing hematology as a subspecialty. His textbook, Clinical Hematology, remains one of the most authoritative in the field. He had a favorable and profound influence on countless medical students, residents, and hematology fellows, as they have in turn had on their students. This was, perhaps, his most profound and enduring contribution to the field.
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