“There is no history, only biography.” Ralph Waldo Emerson (1839)
Our interest in the extraordinary life of Rudolf Nissen began soon after we moved to Brooklyn and were told that the surgeon whose technique of fundoplication is used so often in clinical practice worked for more than 10 years in Brooklyn within a short walking distance from our hospital. This amazed us, because we always thought that Nissen was either Swiss or German. If so, we wondered, what was he doing in Brooklyn? We started to search for answers to these questions, and very quickly what began as an attempt to satisfy our curiosity evolved into a lengthy project. Our own protracted move across a few continents into Brooklyn was perhaps an incentive to approach this topic with a touch of personal vein. The effort invested in this work involved a diverse set of sources that may indeed be a part of the story.
Official biography
Only a few hours of searching the Medline and walking the isles of the Cornell Medical Library started to unveil Nissen's complex biography. A cryptic footnote in Bailey and Love's Short Practice of Surgery states: “Rudolf Nissen, contemporary, formerly Professor of Surgery, Istanbul, Turkey, and Basel, Switzerland.”
1
A brief biographic note accompanies Nissen's own article, “Reminiscences: Reflux Esophagitis and Hiatal Hernia.”2
Born in 1896 in Neisse, Germany, his father, Dr Franz Nissen, was a well-known surgeon in Neisse, and his son soon decided to follow in his father's footsteps. Nissen studied medicine at the Universities of Munich, Marburg, and Breslau and then studied pathology under Professor Albert Ludwig Aschoff (1866 to 1942) at the University of Freiburg. In 1921 he became assistant to Professor Ferdinand Sauerbruch (1875 to 1951) at the Surgical Department of the University of Munich. Nissen soon established himself as one of Sauerbruch's brightest pupils and remained with his chief at Munich until 1927, when Sauerbruch moved to the Charite' Hospital and the University of Berlin. Nissen accompanied Sauerbruch to Berlin, where he gradually climbed the academic ladder to become a professor of surgery. In 1933 Nissen was appointed Professor and Head of the Department of Surgery at the University of Istanbul in Turkey. In 1939 Nissen came to the United States and took up a post as a Research Fellow in Surgery at the Massachusetts General Hospital. Two years later he became Attending Surgeon and Chief of the division at the Jewish Hospital in Brooklyn and, subsequently, at the Maimonides Hospital, also in Brooklyn. He spent all the years of World War II in the United States. In 1952 he was appointed Professor of Surgery and Head of the Department of Surgery at the University of Basel in Switzerland, a post he held until he retired as Professor Emeritus in 1967.Henry Ellis, writing in 1992 about “Nissen Fundoplication: Classics in Thoracic Surgery,”
3
states that “Nissen died on Jan. 22, 1981, at the age of 85 years after a long and productive career, much of it devoted to the field of thoracic surgery.” Carcellon and O'Leary4
reproduced an identical biographic version mentioning his other contributions. In his book, A Century of Surgery, Ravitch mentions Nissen briefly, only to attribute to him the first successful pneumonectomy, performed in 1931. Also, in the 1961 History of Thoracic Surgery, Meade refers to Nissen, albeit at greater length, to stress his pivotal role in the evolution of pulmonary resection. In the “World Who's Who in Science,” we learned that Nissen authored more than 30 books, excluding book chapters, and more than 475 articles on thoracic and abdominal surgery.7
Cohen and Graver8
tell us that it was Nissen who, in December 1948 at the Brooklyn Jewish Hospital, operated on Albert Einstein's abdominal aortic aneurysm, wrapping it with cellophane.This is all we could discover in the English-language literature, in addition to brief descriptions of Nissen's contributions to hiatal hernia and gastroesophageal reflux surgery,
10
and Nissen's own historic perspectives on pulmonary surgery.11
, 12
, 13
Turning to German journals, we found brief biographic notes celebrating Nissen's 70th14
, 15
and 75th birthdays16
and announcing his death.Another obituary, in Hungarian, was more informative
18
; only later did we become aware that it must have been based on Nissen's autobiographic book: Light Pages—Dark Pages: Memories of a Surgeon, published in 1969.19
From the Hungarian article we learned that at the age of 20 years (1916), Nissen, a medical student, was conscripted to the German army to serve as a paramedic on the Western Front during World War I. He endured several combat injuries including a damaged lung. We also noted that Nissen married his beautiful and much younger wife Ruth in 1933, just before leaving Berlin for Istanbul.As often occurs during the planning and research phase of many articles, by lucky coincidence an article appeared in the Diseases of the Esophagus in 1996,
20
suggesting, at first glance, that our work has been done by others and any further research would be superfluous. The article, entitled “Rudolph Nissen: Reminiscences 100 Years After His Birth,” is by Professor Dr Liebermann-Meffert, a previous coworker and family friend of Nissen. This superb overview of Nissen's life appeared to be the definitive story of Nissen's life until we read the section “Munich and Berlin 1921-1933: Happy Fruitful Years.” “Early in 1933,” the author wrote, “Nissen was becoming a widely recognized authority in surgery, and on the short list for chairmanship at Cologne. However, an unbelievable personal disaster was in store for him which has to be put into the context of that time in Germany. This was a period of unemployment, inflation, unrest, and great political troubles. Noisy, aggressive unemployed people turning rowdy… .” “The violence and pathos of the times induced in Nissen a sincere disgust with fascism. In early 1932 and 1933 a vehement accumulation of antisemitic incidents and aggression against contemporary “decadent art” and progressive artists and performers took place, particularly in Berlin, all witnessed by Nissen. The assumption of power by the Nazi regime immediately led to the expulsion and prohibition from work of many renowned scientists, writers, musicians, and artists.” In the spring of 1933, we learned from Liebermann-Meffert, Nissen's “spell at Berlin, so full of plans and results of research, was abruptly terminated by Hitler's assumption of power… . Nissen acted upon his aversion to the Nazi regime and tendered his resignation to Sauerbruch.”20
This unusual turn in Nissen's career aroused our curiosity: Nissen, a 36-year-old rising star in German surgery, a protégé of the great Sauerbruch, then perhaps the leading surgeon in Europe, decided to exchange Berlin for Istanbul only because of his disgust with “noisy, unemployed people turning rowdy” or as a sign of solidarity with the “intellectual elite which lost jobs?” His mentor, Sauerbruch, stayed behind and served the Third Reich well, and so did the vast majority of the German and Austrian medical community,
21
, 22
so why did Nissen leave?Fleeing Germany
We began solving this puzzle by contacting Professor Mario E. Rossetti, who worked under Nissen in Basel, and subsequently termed the Nissen fundoplication as the “Nissen-Rossetti procedure.”
10
Rossetti (personal communication) responded, endorsing Libermann-Meffert's biography and not adding more.20
Next we turned to Professor Felix Harder (personal communication), the current director of Nissen's department in Basel, who wrote, “As it happens, we celebrated his (ie, Nissen's) 100th birthday at the end of August 1996, with a much appreciated symposium here in Basel.” Harder enclosed a copy of a lecture delivered during the symposium by Dr Erwin Rotermund from Mainz, entitled “Rudolph Nissen: Bewaehrung im Exil” (Ordeal in Exile). Rotermund writes, “The young Berlin professor, second in command to Ferdinand Sauerbruch at the Charite' Hospital, was instructed in March 1933 to dismiss all the Jewish assistants; he himself was going to be exempt from this fate. Situations similar to this one were taking place in many other clinics in Germany. Nissen took the consequences rapidly. On April 2, 1933, 1 day after the “Pandemonium of the Jewish Boycott,” he wrote to Sauerbruch: “many vile events are happening now, but nothing is worse than the foul insults on my personal honor. I feel personally hurt by a treacherous abuse with which not only the masses, but also professional people and colleagues of mine, fully agree… .” His decision to leave the clinic and Germany is adamant: “I separate myself from a working community which not only helped me constantly increasing my performance … but also gave me the whole meaning of life… .”
Dr Ira M. Rutkow (personal communication), a surgical historian, replied to our inquiry: “Nissen has long proved an elusive individual to the surgical biographers in this country because much of his written work was in German.” Rutkow referred us to Nissen's autobiography,
19
which “unfortunately, has never been translated into English, and I am uncertain as to whether it details his years in the United States.” Nissen's autobiography19
proved to be long out of print, but we eventually located a copy at a medical library in Hamburg. We began to translate it, meanwhile continuing to look for anyone who knew Nissen personally.Dr Robert E. Condon (personal communication) E-mailed us: “Nissen fled the Nazis, first to Turkey (1936). Then, when it appeared that Turkey was not too safe, he came to the United States (1939), first to Boston. Although he ended as a Swiss, he began as a German, and a Jew, which is why he had to be a refugee-surgeon in the United States. I had lunch with Nissen at his home in Riehen, Switzerland, in 1963, when he told me this story.” Professor Martin Allgower (personal communication), who succeeded Nissen in Basel, called after receiving our inquiry. He had no doubts: “Nissen left Germany because his father was Jewish. If he would have remained in Germany he most certainly would have died; not even the great Sauerbruch would have been able to save him!”
Timothy O. Nissen, Architect (personal communication), Nissen's only son, responded to our questions: “My father left Germany because he was disgusted with the developments under the new Nazi regime and, being half Jewish (his mother was Jewish), did not believe that in the long run he would be able to work and practice freely. It is difficult for me to determine how strongly my father considered himself a Jew. He surely did not deny his Jewish heritage, as this quotation from a letter he wrote to the rector of the University of Istanbul documents: “It would be easy for me to free myself from being classified as a Jew. I could point out that I am only partially of Jewish descent. But by doing so I would declare my inherited Jewish heritage as mediocre. But in reality, I am very proud to possess the blood of a race which for thousands of years has definitively enriched the culture of practically all countries in spite of evil physical and spiritual persecutions.” It is not clear whether Nissen, when writing this letter, was already aware that, according to the 1935 Nuremberg Nazi laws, “deemed to be Jews are also people who, owing to their or their parents' conversion, were Christians or if a requisite portion of their ancestry was Jewish.” Tim Nissen continues: “It would be pure conjecture to predict what would have happened to my father had he remained in Germany. The best I can do is to refer you to analogies of what happened to other Jews of prominent intellectual status. It is clear that he did not believe in Sauerbruch's continuous assertions that Nazi aggressiveness toward Jews was a passing phenomenon.”
Sojourn in Istanbul
In a recent communication, “A German Professor of Surgery in Istanbul (1933 to 1939),” Professor E. Goksoy summarizes Nissen's sojourn in Turkey.
24
The acceptance of Nissen, and a large number of leading professional refugees from Germany, in Turkey was part of Kemal Ataturk's (the founder of the Turkish Republic; 1881 to 1938) plan to modernize the Universities of Ankara and Istanbul. As commonly occurs, the lucrative positions of those who were forced from Germany to exile were hastily snatched by greedy locals,21
, 22
whereas opposition arose against the émigré physicians from the threatened Turkish faculty. Be it as it may, the new 37-year-old Professor of Surgery in Istanbul initially enjoyed the challenges of establishing himself a surgical leader in less than ideal circumstances. Nissen was treated as a surgical celebrity and his teachings left a remarkable imprint on the surgical Department in Istanbul until the present day.24
He operated on patients all over Turkey, traveling in military airplanes put to his disposition. Requests for surgical consultation took him to the Soviet Union, Greece, and Egypt. With a Turkish passport, he even succeeded in visiting Germany in 1937, experiencing an atmosphere of fear and mistrust even among “old friends.”19
Although Goksoy did not see any reason for Nissen to leave Turkey other then his declining health,
24
it is clear that Nissen, in 1939, sensed that the worst was still to come; he did not feel secure being in close geographic proximity to his former fatherland. “In the beginning of July 1939,” he wrote, “we leave our nice house on the Bosporus, taking only books and clothes with us. On July 15, we land in New York.”19
Nissen's large medical library, including his writings, was left behind and consumed by a fire in 1940.18
From Turkey to America
Nissen's contact with American surgery began during the 1920s in Munich. Here he met Edward Churchill (1895 to 1972), the leading thoracic surgeon from Boston, who visited Sauerbruch. In his book
19
Nissen recalled the frequent American visitors to Munich, describing with distaste the excessive noise levels they created in the operating room. Gradually, however, Nissen points out, the Americans stopped coming, having less and less to learn in Europe.Nissen first visited the United States in 1937 to attend a meeting of the International College of Surgeons. He recalls, among others, visiting Albert A. Berg (1872 to 1950) in Mount Sinai, N.Y., Edward Churchill in Boston, and Harvey Cushing (1854 to 1934) in New Haven. The latter impressed Nissen the most. He praised Cushing's “no-nonsense” attitude and the doors he would subsequently open to him in Boston and New York.
19
Nissen visited Max Thorek (1880 to 1960) in Chicago; the latter, in his autobiography, A Surgeon's World, wrote: “Somehow he (ie, Nissen) reminds me of a surgical Paganini.” During this visit, Nissen was disappointed with the relatively small size of the American academic surgical departments. He was accustomed to the great German “surgical empires” run by “professor-kings” and therefore doubted whether one could find professional fulfillment in such an environment.19
Nissen in New York
After his emigration to the United States in 1939, Nissen's first stop was Boston, where Edward Churchill arranged for him an unpaid research fellowship position. Churchill hosted the Nissen family in his Boston house while he moved out to his summer home. We do not have any evidence that Nissen produced any research at the Massachusetts General Hospital. What we know is that he improved his English, studied for the licensing examination, and observed the surgical scene in Boston and New York. He was immensely impressed with the high standards of Boston's surgery led by Elliott C. Cutler (1888 to 1947) and Churchill. Conversely, he was not impressed at all with what he saw in New York.
19
After obtaining a license to practice in the states of New York and Massachusetts, he decided to move to the former, which offered, he hoped, better chances to sustain his family as a private practitioner.19
In January 1941 Nissen started a limited private practice in New York. His first gastrectomy earned him $300; this was a lot of money for Nissen, who hitherto was living on gradually dwindling savings.Initially Nissen was not enthusiastic about private practice in New York. The common 50/50 fee splitting with referring physicians, which was a common practice at the time, was an ugly discovery for him; he refused to be a part of such a system and suffered financially. Nissen complained about the large volume of unnecessary or nonindicated surgical procedures in New York City, which in turn produced avoidable morbidity and death.
19
Gradually, Nissen permeated the “system,” becoming in 1941 Chief of the Thoracic Surgical Division, Brooklyn Jewish Hospital, under the chairmanship of William Linder, whom Nissen defined as a “magical personality,” and in 1945 he became the Director of Surgery at Maimonides Hospital in Brooklyn.Significantly, the New York chapter in Nissen's autobiography is called “happy years.”
19
Nissen became a popular surgeon and operated on celebrities who flocked to see the European surgeon. He operated on Albert Einstein's abdominal aortic aneurysm8
and subsequently on Einstein's daughter Margot.19
However, Nissen was not a gossip teller; in his book he laconically remarked, “about Einstein's disease and operation, look at the multiple biographies available about the latter.”19
Becoming a successful New York practitioner, Nissen had privileges in 7 public and private hospitals and owned a summer house in New Hampshire. He lived in Manhattan during his American years; a chauffeured limousine took him from hospital to hospital.That not everything was perfect we do not learn from Nissen himself who was a man of honor and a noncomplainer. The highest academic appointment Nissen obtained in the United States was a modest Assistant Professorship at the Long Island College of Medicine, which later became State University of New York. An interesting echo was received from Dr C. Barber Mueller (personal communication), who sent us his notes concerning the history of pneumonectomy. Mueller wrote that in 1950 Evarts A. Graham (the American surgeon who performed the third successful pneumonectomy) received a letter from Dr Freddy Homburger of Boston indicating that Rudolf Nissen was being considered for the professorship of surgery at the University of Basel, Switzerland, and asked Graham's opinion as to Nissen's qualifications as a surgeon and his professional standing in the United States, particularly in thoracic surgery. Graham's distaste for the International College of Surgeons (to which Nissen belonged) led to an imprudent response to the effect that he had never met Dr Nissen and knew very little of him. He stated that Dr Nissen “does not belong to any of the good surgical societies of this country but he is a member of the International College of Surgeons.” Graham wrote, “the fact that that society is the only one to which Nissen belongs may be significant with regard to his practice. I am not aware of the fact that he is doing any thoracic surgery. If he were doing much and were above criticism he would certainly be a member of the American Association of Thoracic Surgery.” Professor Martin Allgower of Basel told us (personal communication): “Nissen was insulted in the United States; he was not even accepted by the American College of Surgeons.” “Why?” Stated Allgower, “it was not easy to be a German Jew at that time, not even in America… coming to Basel was his final victory!” Francis D. Moore of Boston wrote (personal communication): “Although we have not known each other well, I have followed his work and his career with great interest, and feel that he was one of the leaders in surgery and in this country.” This most probably was not what Nissen sensed around him at that time.
Final station in Basel
Nissen's post–World War II contact with Europe was revived when in 1946 he was offered the surgical chair at the University of Hamburg. Nissen declined, explaining that he could not see himself teaching surgery to a medical community contaminated by ex-Nazis.
19
Previous connections with the “old world” were gradually resumed and in 1949 Nissen delivered his first postwar address in Germany to the Bavarian Surgical Association. In 1951 Nissen was invited to become the Chairman of Surgery at the University of Basel. Nissen hesitated because he and his family were now happy and well settled in New York. He who had had to start all over again so many times was reluctant to move anew. Tim, Nissen's son, wrote (personal communication): “The main reason for leaving the states, I think, was his wish to teach again (as he had done in Germany before the Nazis and also in Turkey), if possible in his mother language. My father was happy to go to a German-speaking country but not Germany itself.” Thus coming to Basel, Nissen returned to a quasi-German culture but away from Germany. This was his end station; subsequently he refused other offers, including the prestigious Billroth Chair of Surgery in Vienna.In Europe Nissen found a disorganized and inferior system of anesthesia and was disturbed by the lack of personal accountability of surgeons, too short working hours, and poor documentation.
19
Nissen tackled many of these problems; he introduced bedside clinical teaching for students, a novelty in Europe, and emphasized a team-interdisciplinary approach. “He brought with him from the United States the concept of modern perioperative care,” says Professor Allgower (personal communication). During the 15 years of chairmanship in Basel, Nissen re-emerged as a major leader in the German-speaking medical world. For more details about those years the reader is referred to the article by Liebermann-Meffert.20
Accomplishments
Nissen's numerous contributions to surgery are beyond the scope of this article, in which we attempted to uncover the man rather than what he did. The fundoplication procedure, however, was not Nissen's only major offering. Under Sauerbruch, Nissen performed and published pioneering work on emphysema,
26
the first lung lobectomy,27
and pneumonectomy. In Istanbul he performed transthoracic resection of the cardia, “plicating” the gastric remnant around the anastomosis29
; observing the long-term lack of reflux esophagitis after this operation, he got the idea for what subsequently became known as the fundoplication procedure. In Brooklyn in 1946 he performed the first transabdominal reduction of a bleeding paraesophageal hernia with gastropexy,10
and in 1949 he reported the first esophagectomy for carcinoma with cervical gastroesophagostomy.4
The first Nissen fundoplication was performed in Basel in 1955.30
A less known innovation by Nissen was the antrum-preserving gastrectomy.31
In addition to the fundoplication, Nissen's eponyms refer to the atypical closure of a “difficult” duodenal stump, ligature of periesophageal varices without esophagotomy, and correction of hypospadias with scrotal skin.20
The Surgical Word Book mentions Nissen's sutures, Nissen's rib spreader, and Nissen's forceps.Interestingly, Nissen published nothing during his years in Brooklyn. Professor Allgower mentions (personal communication) that “Nissen had that great, clear, and careful writing style he inherited from Sauerbruch.” Was Nissen the perfectionist intimidated initially by a foreign language or were other concerns on his mind?
Nissen and Sauerbruch
This essay about Nissen cannot be complete without expanding further on his relationship with Ferdinand Sauerbruch, who was for Nissen what Johannes von Mikulicz-Radecki (1850 to 1905) of Breslau was for him: a molding mentor. For 12 years Nissen slaved under Sauerbruch, who was the father of modern thoracic surgery and perhaps the most remarkable surgeon of the early half of the 20th century; however, his love, admiration, and loyalty to Sauerbruch continued as long as the 2 men lived.
In his autobiography, Nissen dedicated a long chapter to Sauerbruch and referred to him extensively throughout the book.
19
Remarkably, the opposite is not true, and in Sauerbruch's autobiography Nissen is featured very scantily. The chapter, “Under the third Reich,” includes the following: “My registrar, Professor Nissen, was a Jew. In spite of many difficulties, I had tried to keep him, but there was no doubt that his position with us was none too secure. At that time I received an invitation from Turkey. While there, I took the opportunity to recommend Professor Nissen; my word carried weight and before long he was able to move from Berlin to Istanbul. His path then led to New York, where he soon earned a high reputation as a surgeon.”Sauerbruch's easily read, grossly entertaining, and sensational autobiography was published in 1951 in Germany and subsequently, when translated, became a best seller in England and the United States. Conversely, Nissen's autobiography
19
is “heavy” reading, serious, and scholastic; it has never been translated from German and fell into obscurity. Only after reading it did we discover that Sauerbruch's autobiography was not written by Sauerbruch himself. Nissen tells us that a short while after Sauerbuch's death he received a request from a German publisher to write a preface for “Sauerbruch's autobiography.” Nissen agreed on the condition that he would be allowed to examine the manuscript but did not hear further from the publisher. Subsequently, while on a visit in Germany Nissen found out that Sauerbruch was too “senile” during his later years to produce a memoir; consequently, the publisher secured pieces and bits of Sauerbruch's documents and hired a ghost writer to produce the alleged “autobiography.” Nissen talked to the ghost writer himself and tried to convince him not to produce the book but to no avail. Nissen found the book “depressing,” extremely sensational, and full of inaccuracies. “Those of us who knew Sauerbruch's style and accurate writing were convinced that this could not have been his book,” wrote Nissen.19
The differences in the personal traits between Nissen and his beloved mentor were striking: the latter explosive, flamboyant, and talkative; the former “somewhat stiff, impervious to any display of pathos, softly spoken, and never known to raise his voice at work.”
20
In fact, in Munich and Berlin Nissen functioned as a “pacifier,” repeatedly talking his boss into calming down and not harassing his assistants. Close contact between the two continued throughout the years after Nissen's forced exile to Turkey; even during World War II the two exchanged letters through a mutual friend in Switzerland. What Sauerbruch did or, more importantly, did not do during World War II is what made his legacy so controversial. Sauerbruch prospered under the Nazi regime, both professionally and financially. He was nominated Surgeon-General of the armed forces and visited the fronts in that capacity. He was awarded the National Prize of Science by the leading Nazi authorities, with a few of whom he also interacted socially. It may be that later he passively supported General Stauffenberg's anti-Hitler coup d'etat, but his reputation was contaminated by being passive to the atrocities of others. In his book, Doctors of Infamy, Mitscherlich wrote that during a conference of the Academy of Military Medicine in Berlin, Sauerbruch was a discussant on a paper dealing with experimental gas injury on prisoners. None of those who were present, including Sauerbruch, objected to the use of prisoners for experimentation.34
Nissen discussed this issue at length.19
“Only a few hundred medical practitioners performed human experiments but thousands knew about them,” he wrote, explaining the angst to resist that led to passivity. “All what Sauerbruch said at that infamous meeting was ‘surgery is better than sulphamides,'” Nissen explained, going “all the way” to save the reputation of the man now gone he so admired.19
The last meeting between Nissen and Sauerbruch took place in 1948 in Switzerland; 10 years had passed since they had seen each other. Nissen alluded to the early symptoms of Sauerbruch's senility, later to become a subject of a book by Jurgen Thornwald: “I noted spells of memory loss,” wrote Nissen,
19
and “it was impossible to discuss with him surgery on the same level as before.” Nissen's suggestion that Sauerbruch should retire was not accepted. Nissen lamented his adored guru “… the man who most influenced my life, whom I loved like my father…I never saw him again … his spirit shines today and will shine for a long time.”19
Epilog
After retiring from the Basel Chair in 1967, Nissen continued private practice for a few years and then devoted himself to writing. Many of his late articles reflected a surgeon who thought a lot on issues beyond the scalpel: iatrogenic surgical illnesses, the duration of the operation, the surgeon and the internist, the authority of physicians in the hospital, reform in medical education, how much should the patient know, and much more.
24
So, who was Nissen: the man behind the fundoplication? A German surgeon, a Swiss, an American, a Turk, a Jew, or perhaps a surgical giant who was a victim of times and circumstances? Although probably a product of German surgery in its best years, he ceased being German for obvious reasons. He valued the Swiss hospitality that allowed him to return to more familiar surroundings and eventually accepted the Swiss nationality, but this did not make him necessarily a Swiss surgeon. America offered him shelter at the darkest period of his life; he became a US citizen, but neither he nor the American surgical establishment considered Nissen an American surgeon. Was he a Turkish surgeon? Very unlikely. Was he a Jewish surgeon? In all his writings, except perhaps the letter to the Dean in Istanbul, Nissen did not seem to carry the burden of Jewishness. So who was he? Probably the best definition is offered by Allgower (personal communication), who told us: “Nissen was a world citizen ‘Weltbuerger' surgeon!”
We recently visited Nissen's Brooklyn Jewish Hospital; it is called Interfaith Hospital now. Nissen would not have recognized the changed neighborhood. We started this endeavor to discover what brought Nissen to Brooklyn only to stumble upon issues of perhaps greater importance: that of professional identity versus social definition of a person and how to reconcile that professional identity with the need for a cultural identity. However, our main goal in writing this article was to remember this great surgeon and to tell a story that has been partially masqueraded by others.
“It takes a great deal of history to produce a little literature.” Nathaniel Hawthorne (1879)
Acknowledgements
We thank Drs Asher Hirshberg, Jan Christoph Meister, and Ira Rutkow for their critical evaluation of the manuscript and Dr Ramesh Paladugu for his assistance.
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Article info
Publication history
Accepted:
July 14,
1998
Footnotes
☆Surgery 1999;125:347-53.
☆☆Reprint requests: Moshe Schein, MD, Department of Surgery, 506 Sixth St, Brooklyn, NY 11215.
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© 1999 Mosby, Inc. Published by Elsevier Inc.
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