visit radiology page [BIDMC RADIOLOGY] One day in November of 1895, a physics professor named Wilhelm Conrad Roentgen was bent over his laboratory table in Wursburg, Germany. He was investigating cathode-ray fluorescence by Note: to see any of passing electricity through tubes filled with the historical photos rarified gas, similar to our fluorescent light below full-size, bulbs. Suddenly he noticed a strange glow click on them. This emanating from a small screen lying nearby on requires that your the table. This was not supposed to be part of Web browser's the experiment! Preferences be configured correctly. Fascinated with the new phenomenon, he These photos are from investigated it day and night for seven weeks. the Beth Israel He saw the outline of the bones in his hand and Deaconess archives then in his wife's hand. Roentgen realized that and are copyrighted a previously unknown "invisible light" was by the hospital. causing the fluorescence and the resultant image (it turned out to be an electromagnetic wave with a very short wavelength). Because "X" is used in mathematics to indicate an unknown quantity, he called the phenomenon an "X-ray." On December 28, 1895, Roentgen wrote up his findings in the Wursburg Physical Medical Society Journal -- and became instantly famous. At a January meeting his "X-ray" was named the "Roentgen Ray." So enthusiastic was the scientific world over this discovery that more than a thousand articles and over fifty books about the "Roentgen Ray" were published in that first year, 1896. Within several years, two French researchers named Pierre and Marie Curie had isolated radium, an element that emits radiation as it decays. This gave further impetus to the medical advances that had begun with Roentgen's discovery. Equipment was rapidly manufactured and installed in major hospitals; surgeons were especially delighted with its ability to reveal the body's secrets. Roentgen himself never tried to patent or benefit financially from his discovery. Boston, with its mixture of science and industry and its many institutions of higher learning, was the city to lead the way in America. Two of the earliest American physicists to confirm Roentgen's work, Professor Amos Dolberg and Professor John Trowbridge, were both centered in Boston, as were many other pioneers. At first, X-rays of patients were performed in the physics labs of MIT; but when the first year of Roentgenology had ended, the City of Boston boasted five X-ray machines being used for medical purposes. ------------------------------------------------- The History of Radiology at Boston's Beth Israel Deaconess Medical Center by Morris Simon, M.D. Toward the end of the 19th century, Boston experienced a large influx of Jewish immigrants who had fled persecution in eastern Europe. They spoke little English, had different social, dietary and religious traditions, and were distrustful of the medical care available at existing Boston hospitals. A group of young Jewish doctors and community leaders met on June 21, 1896 to plan a Jewish hospital for "persons of any creed or nationality." This began in 1902 as the Mount Sinai Hospital Outpatient Department, funded by a federation of charitable organizations. Part-time physicians staffing twenty medical clinics were immediately overwhelmed by patients. Dr. Ariel W. George was appointed the first roentgenologist in 1909. Patients were transferred to his office and the X-ray plates were sent back to the hospital. Pressure for inpatient services was strong but the dispensary was experiencing severe financial difficulties. In May 1916 the hospital was abruptly closed since "the war had made it impossible to raise funds." But the idea of a major hospital had taken root. The Beth Israel Hospital opened its doors within eight months with the majority of the physicians from the Mount Sinai Hospital; its objectives and bylaws virtually identical. One of these physicians was Dr. Samuel A. Robins, a Tufts graduate who had switched from obstetrics to roentgenology after four months of training with Paul F. Butler at the City Hospital. Samuel A. Robins, M.D., Chief of Radiology, 1918-1955 Dr. Robins was appointed roentgenologist at Beth Israel Hospital in 1918. Starting with a portable machine borrowed from his office, he soon installed two x-ray machines in a barn across the road from the hospital. These machines were operated by the color and sound of the gas tubes with much guess work. Patients were brought over on stretchers, bundled up against the weather. Because of wartime conditions, the X-ray department (which was on the ground floor of the nurses' home) did not open until March 1919. At that time the hospital had fifty inpatient beds. In 1922 it was decided that the primary clinical purpose of Beth Israel should be expanded to "stimulate investigation and research," as well as teaching and training of medical students and physicians. Post-graduate training opportunities for Jewish doctors were almost nonexistent in Boston. It was decided to build a new hospital close to the Harvard Medical School. Funds were raised and the new site on Brookline Avenue was purchased. The construction of a series of buildings started in 1924. The first patients were admitted in August 1928. The academic relationship with the medical school began with the full- time appointment of Dr. Herman Blumgart in 1928 as chief of a clinical department of medical research, with teaching responsibilities for medical students. The school catalogue for 1928-1929 includes a description of "an extensive x-ray department" at Beth Israel Hospital. Dr. Blumgart had pioneered the use of a radioactive tracer to study animal and human blood flow, reported in a series of fifteen scientific papers. He was also the first to use radioiodine for the treatment of intractable cardiac disease. He was the first physician named to the Honor Roll of Nuclear Pioneers by the Society of Nuclear Medicine in 1969. Dr. Robins conducted a busy private clinical radiology practice while serving part-time as Chief of Radiology at BIH. He became Professor of Radiology and Chairman of the Radiology course at Tufts Medical School, his alma mater. He also served as president of the New England Roentgen Ray Society, the Greater Boston Medical Society, and the Norfolk District Medical Society. He published about thirty-five papers and book chapters dealing mainly with the genitourinary tract. Dr. Robins attracted a number of strong associates, notably Dr. William S. Altman, Dr. Charles Liebman, and Dr. George White. However his most notable appointment was undoubtedly that of Dr. Felix Fleischner, who became the first full-time radiologist at BIDMC in September 1942. Felix G. Fleischner, M.D., 1942-1960 Born in Vienna in 1893, Felix Fleischner graduated from the University of Vienna Medical School and trained in radiology with a number of the early pioneers including Haudek, Holzknecht, and Kienbach. He then became chief of the roentgen department of the Vienna CS Child's Hospital for six years with professorial rank. He was a scholar, publishing eighty-seven papers in the European radiologic literature before World War II. He was also a renowned lecturer in radiology of the post-graduate courses sponsored by the University of Vienna and the American Medical Association. In 1930 he became Professor and head of radiology of the Second Medical Clinic of the University. As a delegate to the fifth International Congress of Radiology in Chicago in 1937, he met a number of leading American radiologists. Following the annexation of Austria by Hitler, Dr. Fleischner fled to Boston with his family in 1938. He spent two years in the radiology department of the Massachusetts General Hospital and another two years in private practice in Greenfield, Massachusetts. He was offered a position at Beth Israel Hospital in 1942 with appointments at Harvard and Tufts Medical Schools. He started the first formal residency training program in radiology at BIH, and became Professor of Radiology at Harvard in 1952. The Fleischner era was characterized by a strong emphasis on radiologic teaching and research. During his American career he published an additional 165 scientific articles (for a total of 251) and made numerous seminal contributions to the literature of radiologic imaging. He received many honors. Two international symposia, the first on pulmonary embolism and the second on frontiers of chest radiology, were dedicated to him. Dr. Fleischner represented the Harvard Medical School at the 600th anniversary of the University of Vienna in 1965, an ironic twist of history. Dr. Fleischner was an inspirational role model and mentor to many students, residents and professional associates. After retirement from the Beth Israel Hospital in 1960, Dr. Fleischner continued to teach at the Peter Bent Brigham Hospital and the Massachusetts General Hospital until his death in 1969. His finest memorial tribute was the adoption of his name by the Fleischner Society, the prestigious multidisciplinary international society of leading experts in chest disease. Search for a Successor, 1960-1963: Robert Shapiro, M.D. (Director 1962-1963) While the search for a successor continued, Dr. Morris Simon, a senior associate of Dr. Fleischner's, served as Acting Chief. Dr. Robert Shapiro, Professor of Radiology at Yale and Director of the St. Raphael's Hospital Radiology Department was selected as the new Director. He had authored a classic textbook on myelography. He accepted the position in 1962 and initiated negotiations with the medical school and the other Harvard teaching hospitals in an attempt to reorganize, consolidate and strengthen the academic ties between these institutions. However, the decentralized Harvard pattern was deeply entrenched and the talks eventually broke down. As a result, Dr. Shapiro resigned after one year and returned to New Haven. Morris Simon, M.D. 1958 - Present (Director 1963-1970) Dr. Simon graduated from medical school in South Africa in 1948 and after an internship year and starting a surgical residency he decided to become a radiologist. He moved to London in 1950, completed his radiology residency at the London Hospital and then joined the staff of Guys Hospital as a radiology registrar. Guys was the major British referral center for cardiac cathereterization and cardiac surgery, then in its infancy. This provided a great opportunity to correlate the radiologic and hemodynamic findings in these patients, and this became the major focus of his research. Meanwhile, across the Atlantic, Dr. Fleischner had also published some of the early studies in this new field. It was thus an easy decision for Dr. Simon to accept an associate position with the renowned Dr. Fleischner at Beth Israel Hospital in Boston in 1958. This led to a close professional as well as personal relationship between the two families. In 1963 Dr. Simon was offered and accepted the Chief position, at age 37. The challenge was to maintain and build upon the strong academic and clinical legacy of Fleischner. Important staff additions included senior associates Keith Rabinov, Norman Joffe and Brian Leeming. Laboratory investigations of the pulmonary circulation, newer techniques in angiography and clinical radiology, and early applications of computer technology to medical-information processing were the primary interests of the department. The residency program was enlarged to twelve. However, after a few stimulating years, the administrative burdens become increasingly demanding and frustrating, and Dr. Simon requested the appointment of a new Director. Sven Paulin, M.D., Ph.D. 1970 - Present (Director 1970-1993) Dr. Paulin became Chief of Radiology in 1970. His medical school training, radiologic residency and first clinical appointments were all in Sweden. His Ph.D. thesis on coronary arteriography was recognized as a landmark as soon as it was published as a monograph. He was invited to the U.S.A. by Dr. Herbert Abrams and joined him as a fellow at Stanford. He subsequently moved to Boston with Dr. Abrams, who was appointed Chairman at the Peter Bent Brigham Hospital and Harvard Medical School. Dr. Paulin's appointment as Chief at the BIDMC was accompanied by a marked expansion and renovation of the radiology department and research facilities including state-of-the-art angiography equipment and substantial medical and support staff increases. Dr. Simon and other senior radiologists remained on the staff and were joined by Drs. Ferris Hall, Colin McArdle, Robert Edelman, Eric Fossel, John Kleefield and others. The stage was set to incorporate the break-through technologies of the era, particularly echocardiography, body ultrasound, computerized tomography, magnetic resonance imaging, and spectroscopy. Research now focused on the heart and contrast agents though the pulmonary circulation and computer projects continued. Dr. Jean Serur was appointed the first full time head of radiology research and was succeeded by Eric Fossel. MR angiography research was a pioneering effort under Bob Edelman. The residency program was increased to sixteen. The Radiologic Foundation was established. The first satellite imaging center was opened at 1101 Beacon Street. Full Harvard professorships are held by Drs. Paulin, Simon, Hall and Edelman. In 1993 Paulin retired as chairman but continued to serve as a cardiac radiologist. Herbert Y. Kressel, M.D. Chairman 1993 - Present Dr. Kressel assumed the chairmanship of the department of radiology in 1993. His radiologic training was at the University of California, San Francisco. His subsequent national academic stature and administrative experience were achieved at the University of Pennsylvania, where he became the director of the pioneering magnetic resonance imaging division. His appointment once again triggered a major new era of reorganization and expansion of the radiology department. This reflected the changing patterns of health care delivery in the entire country. A new ambulatory center has been built adjacent to the hospital, virtually doubling the size of the radiology department. The new facility opens in January 1996 and will become the main radiology department. The original department is being simultaneously renovated to serve inpatients but will also be used for major outpatient procedures. New magnetic resonance facilities for clinical use and research, and additional spiral CT and ultrasound equipment are being added. Film interpretation, teaching and conference spaces have been expanded. Improved operational efficiency is being provided by new and expanded state-of-the-art digital computerization of patient control and of imaging, as the department evolves cautiously toward a fully digitized system. A substantial increase in support staff as well as medical and nursing staff has been initiated. Closely linked satellite facilities have been opened in Lexington and others are in the planning stage. The residency program has increased to twenty. The clerkships for Harvard students have become extremely popular under the direction of Dr. Gillian Lieberman. Research activity in MRI and Spiral CT as well as interventional angiography and ultrasound have been further invigorated. The radiology department is once again prepared to play a leadership role in medical imaging as we move into the 21st century.