Franz Joseph Ingelfinger

Background

Ingelfinger was born on August 20, 1910 in Dresden, Germany, the only child of Joseph Ingelfinger, an assistant professor of bacteriology at the University of Göttingen, and Eleanor Holden, an American teacher. His parents had met during one of his mother's trips to Europe; the family immigrated to Boston in 1922.

Education

Ingelfinger attended Phillips Andover Academy, then received his B. A. in English in 1932 from Yale, where he played on the football team.

The country was in the midst of the Great Depression, and jobs in the financial world were scarce, so his senior year Ingelfinger decided to take the science courses he needed to enter medical school. He graduated with an M. D. from the Harvard School of Medicine in 1936.

Career

Ingelfinger became an American citizen in 1931. Unsurprisingly, then, he decided to specialize in gastroenterology, an uncommon field in the 1930's. In Philadelphia he worked with T. Grier Miller and William Osler Abbot, who designed the intestinal tube, and became interested in studying the properties of the intestine's motility (motions and contractions) and absorption.

Only four years after receiving his M. D. , Ingelfinger was appointed chief of gastroenterology at Boston University Medical School's Evans Memorial Hospital, where he began a twenty-seven year career as a researcher and teacher. In 1961, Ingelfinger became chief of the Boston University Medical Services at Boston City Hospital. Over the next six years, he transformed it into a leading center of teaching.

He began a third career in 1967 as editor of the New England Journal of Medicine. Over a ten-year period, he boosted the journal's circulation from about 100, 000 to 170, 000, and the number of articles submitted for publication increased 140 percent. While Ingelfinger was editor of the New England Journal of Medicine, Lewis Thomas wrote a regular column for it, "Notes of a Biology Watcher, " which eventually became the National Book Award winner The Lives of a Cell (1974). Ingelfinger also published Norman Cousins's controversial account of how he overcame a collagen disease by taking high doses of vitamin C, laughing a lot, and avoiding doctors and hospitals. Cousins later expanded the article into the best-selling book Anatomy of an Illness (1979).

During his editorship, Ingelfinger devised the hotly debated "Ingelfinger Rule, " which requires that any material published in the Journal not have been published previously. The rule became a standard practice for other medical journals and, as a result, researchers have become less willing to talk to reporters or show them work. "The Finger, " as he was known among colleagues, stepped down from his editorship in 1977.

Two years earlier, he had, ironically, diagnosed himself as having cancer of the esophagus. An operation in 1975 removed part of his digestive tract. He continued to lead an active life despite subsequent radiation and chemotherapy treatments, but eventually his deteriorating physical condition forced him to retire. Ingelfinger said he had "few regrets" about his life.

He died in Boston.

Achievements

• Franz Joseph Ingelfinger was among the first to transform gastroenterology from a descriptive discipline into a quantifiable science. He trained fifty-seven researchers, or "Fingerlings, " as they were called; most became leaders in academic medicine around the world. Ingelfinger's laboratory made fundamental contributions to the understanding of the human digestive system. Ingelfinger and his team used intraluminal manometry to observe intestinal motility. They devised the mecholyl test and perfusion techniques to investigate intestinal absorption, examined blood flow through the liver to determine its role in various diseases. Ingelfinger felt his most important contribution was the documentation of the megaloblastic anemia that can follow a complete gastrectomy. He also served as Editor of the New England Journal of Medicine (NEJM) for ten years. Ingelfinger's editorship encouraged innovation and provoked controversy. In 1979 he was presented the George Kober Medal of the Association of American Physicians, given to leaders in academic medicine, research and teaching. The Ingelfinger rule is named after him.

Works

More photos

• book

  • Dorland's Medical Dictionary

    (Data on the fundamentals of medical etymology prefaces ex...)

  • Gastrointestinal Disease (Pathophysiology, Diagnosis, Management, Two-Volume Set)

    (A two-volume set encompassing 119 chapters. The first edi...)

  • Controversy in Internal Medicine

Views

Ingelfinger liked to teach by the Socratic method, in which he asked questions in a way that induced students to find the answers for themselves. Known as "the Boss" among his trainees, he inspired both fear and respect.

Ingelfinger had some unconventional views regarding medicine and the doctor-patient relationship. He felt patients expected too much of physicians and needed to realize that doctors could not cure everything. He advocated two forms of preventive medicine: old-fashioned self-discipline and keeping oneself informed. On the other hand, he said, "Doctors fail to appreciate how patients feel. They take too much for granted, don't realize how little the patient understands, how much the patient needs to be talked to. " He was against patients' "shopping" around or switching from doctor to doctor. But he also felt a doctor should "take time to explain his impressions and recommendations to the patient (in) terms that the patient can understand (and) language that is distinctly non-authoritarian. "

Quotations: "Don't do what everybody else is doing" was Ingelfinger's motto.

Personality

Tall, thin, bald, with rounded shoulders and an authoritarian manner, Ingelfinger arrived at work at 7:15 in the morning and left at 6 in the evening. "We work Saturdays, " he told trainees, but they ended up working Sundays and holidays as well. "Demanding, humbling, but always stimulating" was the way one trainee described his experience under Ingelfinger. Devoid of pomp or egotism, Ingelfinger spoke his mind, and when he did not know something, he simply said, "I don't know. " When aggravated, however, he had the curious habit of chewing on his tie or shirtsleeve to vent his frustration. Ingelfinger was fiercely competitive, and hated to come in second.

He often experimented on himself and would put tubes through his nose and mouth in order to study the physiology of the esophagus, stomach, and intestines.

As the editor, he loved debate and lively correspondences in the letters-to-the-editor section. He insisted on strict scientific review and evaluation of articles submitted. Using his background as a college English major, he expected articles to be written in lucid, readable, and, if possible, entertaining prose. He focused on issues of medical ethics, and did not hesitate to publish antiestablishment views of medicine.

Interests

• At the annual picnic at his summer home in Ipswich, Massachussets, he would organize a football game among the trainees, select the most athletic ones for his team and, according to one trainee, leave "a pathetic aggregation of obese, lame, nearsighted residents to serve as the loyal, but impotent, opposition. " Ingelfinger would play two positions at once, quarterback and running back, so that he almost always had the ball.
  
  He continued his hobbies of gardening, watercolor painting, and music after he retired.

Connections

Ingelfinger had married Sarah Shurcliff on August 23, 1941; they had two children.

Father:

Joseph Ingelfinger

Mother:

Eleanor Holden

Spouse:

Sarah Shurcliff

coworker:

T. Grier Miller

coworker:

William Osler Abbot