This entry is a result of some "over the OR table talk". While operating the other day I asked my medical students and residents if they knew who Albert Schweitzer was and what he was famous for doing. To my shock, none of them knew. So I am posting a brief bio of Schweiter here; mostly to remind me to keep telling others about him.

Born on January 14, 1875 in a country village in Alsace (then part of Germany; later part of France), Albert Schweitzer was the son of a Lutheran pastor. A little-known fact is that Jean Paul Sartre was Schweitzer's cousin. Because of the difference in their ages, Sartre referred to him always as "Uncle Al."

From an early age he showed a passion and talent for playing the organ, and was accepted as a pupil by some of Europe's finest professionals. He later went on to become the world's leading expert on organ building. In 1893, Albert Schweitzer began his studies at the University of Strasbourg, receiving a Doctorate in Philosophy in 1899; his studies also took him to the Sorbonne and the University of Berlin. Later that year he was appointed to the pastoral staff of St. Nicholai's Church in Strasbourg. In 1900 he obtained an advanced degree in theology, and within the next two years was appointed principal of St. Thomas College in Strasbourg, Curate at St. Nicholai, and to the faculty in both theology and philosophy at University of Strasbourg. Along the way, Dr. Schweitzer published several books on theology, including the most famous, The Quest for the Historical Jesus, as well as books on Kant, perhaps the definitive biography of Bach, books on organ building, and others.

Schweitzer had always felt a strong yearning towards direct service to humanity. In 1904, he came by chance upon an article in the Paris Missionary Society's publication indicating their urgent need for physicians in the French colony of Gabon. [The following and all subsequent quotes are from Schweitzer: A Biography (1971), written by George Marshall and David Poling (published by and available from The Albert Schweitzer Fellowship)]:
"Of all the hundreds of young men and women who read this piece, none could have been more affected than Albert Schweitzer. When he had finished the article, he put the magazine aside and quietly began his work. But his search was over. He saw his time and place; his future, his life, took clear shape... Schweitzer reached the point of view that atonement for the wrongs that the Christian -- the white man -- had done to underdeveloped peoples -- the black man -- was in itself a justification for missions. The following Sunday the sermon he preached included these words: 'And now, when you speak about missions, let this be your message: We must make atonement for all the terrible crimes we read of in the newspapers. We must make atonement for the still worse ones, which we do not read about in the papers, crimes that are shrouded in the silence of the jungle night.'... Later he wrote, 'Our institutions are a failure because the spirit of barbarism is at work in them... Our society has also ceased to allow to all men, as such, a human value and a human dignity; many sections of the human race have become merely raw material and property in human form.'

"The first major moves began on October 13, 1905, when he posted some letters to his parents and certain close friends, informing them that at the beginning of the winter term he would enroll as a medical student. His destination was to be Africa. His profession would not be music or philosophy or theology, but the practice of medicine... The reason he desired to study medicine he explained as the desire 'to work with my hands... For years I have been giving myself out in words' but 'this new form of activity' would not be merely talking about 'the religion of love, but actually putting it into practice.'

"Shock, puzzlement, and alarm were the first responses to those letters. The faculty of St. Thomas was stunned. The administration officers felt that he had made a serious mistake in his decision and expressed their disapproval. Friends around Europe could not accept it either and wrote him of their immediate, strenuous objections. ...Schweitzer's father could only express disappointment. The family suggested that the whole enterprise was foolish. They could not conceive that he could bury his life and his talent in the jungle while there were others who could easily take the Congo assignment... A lady friend told him that he could do much more for the Africans by lecturing on the need for medical assistance... What irritated Schweitzer more than anything else was the unexpected shallowness and conservatism of so many Christian friends and acquaintances... Schweitzer was to remember the struggles and the letters of protest and scolding... Only Helene Bresslau [at the time, a close friend] understood and supported him... When Schweitzer arrived at the medical school administrative office, he created a sensation. He recalled the occasion with these words, 'When I went to Professor Fehling, at that time dean of the medical faculty, to give my name as a student, he would have liked best to hand me over to his colleague in the psychiatric department.'"

Despite all the resistance and protestations he encountered, in January 1905, at the age of 30, Albert Schweitzer began his studies in medicine, receiving his degree with a specialization in tropical medicine and surgery at the age of 38. What he had not anticipated was that, even though Dr. Schweitzer had rearranged his life to meet the most urgent need expressed by The Paris Missionary Society, they turned him down! On the basis of his theological views, Albert Schweitzer, minister and now physician, was rejected by the Society on the grounds that "it would only intensify their problem by encouraging intellectuals and freethinkers who could only disrupt the mission enterprise and confuse the natives with their theological improvisations... They were not about to sponsor Schweitzer and open the floodgates to other liberals and radicals." Today, we would characterize the Paris Missionary's view of Albert Schweitzer as a person who was "politically incorrect!"

Yet, as Marshall and Poling have characterized it, "he was learning that controversy could not destroy him. Delay him, yes, but not defeat him... He would return to the Paris Missionary Society not as a beggar soliciting support but as a self-sufficient doctor offering his professional services. They, not he, as he saw it, would have a chance to redeem themselves; there would be another confrontation with the Society." Helene Bresslau, by now Dr. Schweitzer's wife and a trained nurse, "eagerly joined her husband in a program of fund-raising to supply a hospital and underwrite the expenses for its first two years. They compiled lists of friends who might help... And if they could successfully raise the money, they could tell the Society that it would cost them nothing... Their list of names expanded... For eight years he had studied and prepared for his journey. He had resigned from his academic posts, canceled long-term concert and lecture contracts and was totally dependent on a small band of friends for help. Only their love, support and encouragement made it possible for him to go forward... 'Thus,' he later wrote, 'on the understanding that I would avoid everything that could cause offense to the missionaries and their converts in their belief, my offer was accepted with the result that one member of the Committee sent his resignation.'"

In March 1913, Dr. and Mrs. Schweitzer left for Africa to build the hospital at Lambaréné in the French Congo, now Gabon. They began their health care delivery in a chicken coop, and gradually added new buildings, so the hospital now treats thousands of patients.

The rest of Schweitzer's life experiences and history have literally filled many volumes. One year after their arrival at Lambaréné, World War I broke out. Because of their German citizenship, the Schweitzers were enemy aliens in the French colony. From the first prisoner of war camp in the Pyrenees, they were taken to a camp in St. Remy. Here, Schweitzer had odd feelings of déjà vu, feeling as though "he knew the room from some past experience. He could not lay his finger upon his strange sense of acquaintance and intimacy with the room, and began to wonder if he was losing his mind... Then awoke one night, the mystery solved: a Van Gogh picture glowed in his mind's eye... he remembered the Van Gogh drawing of which he had vaguely been thinking and recalled that the tortured artist had once been confined for a mental breakdown in the south of France. Upon inquiry in the morning, he learned that the building had previously served as a mental institution and was indeed the very same building where Van Gogh had spent four miserable, hopeless months before his suicide."

In 1918, Albert and Helen returned to Alsace, where their daughter Rhena was born on January 14, 1919. In 1920, he was invited to give a lecture in Sweden and there he described how, while being rowed up the Ogowe River from Lambaréné, his search for an expression of his philosophy was answered: "There flashed upon my mind the phrase Reverence for Life." "Man's ethics must not end with man, but should extend to the universe. He must regain the consciousness of the great chain of life from which he cannot be separated. He must understand that all creation has its value... Life should only be negated when it is for a higher value and purpose -- not merely in selfish or thoughtless actions. What then results for man is not only a deepening of relationships, but a widening of relationships."

But when he returned to Africa in 1924, Helene Bresslau Schweitzer and Rhena stayed behind in Europe. Helene, to her sorrow, was not well enough to accompany her husband. However, they corresponded frequently. Rhena saw little of her father during her childhood, but when her own children were grown, Rhena acquired technical lab skills and left for Africa to serve with her father. Dr. Schweitzer asked her to take over the role of Administrator of the hospital after his death, and when he passed away at the age of 90, Rhena did fill that role for many years. Subsequently she married an American doctor volunteering at the hospital, Dr. David Miller, and lived with him in rural Georgia until his death in 1997. She remains active in and devoted to the interests of her father, and, among other projects, prepared for publication the numerous letters exchanged by her parents during the ten years prior to their marriage in 1912.

Dr. Schweitzer's fame became increasingly widespread over the years, and many journalists and other curious people flocked to Lambaréné to see him in action. But even -- perhaps especially -- here his ingenious individuality asserted itself. Dr. Schweitzer was frequently known to say that "everyone must find his own Lambaréné." He formulated what he lived in the words, "My life is my argument." In 1953, at the age of 78, Dr. Schweitzer was honored for his humanitarian work with the Nobel Peace Prize for the year 1952. After he received the prize, although all his life he had avoided becoming engaged in politics, Dr. Schweitzer was profoundly disturbed by the development of nuclear weapons following the bombing of Hiroshima/Nagasaki. Thus, with the urging of many friends, he studied the issue and in 1957 he issued a worldwide public appeal, "A Declaration of Conscience." Schweitzer published this with two subsequent appeals in 1958 in his book, Peace or Atomic War?, which remains as relevant and compelling today as it was 34 years ago, given the proliferation of nuclear weapons since that time.

One perhaps little-known aspect of Dr. Schweitzer's personality was his sense of humor. To cite just two examples of many: Once, in the middle of a banquet in his honor, Dr. Schweitzer was being pestered to the point of harassment by a journalist who simply did not understand the philosophy of Reverence for Life and repeatedly demanded that Dr. Schweitzer elaborate it for him. "Finally he said, 'Reverence for Life means all life. I am a life. I am hungry. You should respect my right to eat.' With that, he excused himself and returned to the banquet." The second example deals with a very common faux pas which it may surprise you to learn that Dr. Schweitzer was well aware of. "He reported... that once he was traveling on a train in America when two girls came up to him and asked: 'Dr. Einstein, will you give us your autograph?' 'I did not want to disappoint them,' he said, 'so I signed their autograph book: Albert Einstein, by his friend Albert Schweitzer.'"

Physician, lover of animals, minister, scholarly theologian, environmentalist (Rachel Carson dedicated her seminal work Silent Spring to him), musician and musical scholar, anti-nuclear activist, philosopher, husband, father, friend -- these are the many facets of Dr. Albert Schweitzer. Today, although in some quarters history is already painting him as a controversial figure, and several different "ism's" are being attributed to him, one fact remains immutable: In the words of his friend Albert Einstein, Schweitzer "did not preach and did not warn and did not dream that his example would be an ideal and comfort to innumerable people. He simply acted out of inner necessity."

Albert Schweitzer died in Lambaréné several months after his 90th birthday the 4. September 1965.


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© Association Internationale de l'Oeuvre du Docteur Albert Schweitzer de Lambaréné (AISL)

Well, This is another entry in the Joy of Surgery Blog.
This note will focus on my thoughts about medical students and career choices. I will once again repeat my oft given advice to students.
"Life is too short to do something you don't like."
"In choosing a field of specialization in medicine, the wrong choice will make it the shortest life you can imagine."
The trigger for this entry is an article passed out at our departmental leadership meeting. The article is entitled "How medical students define surgical mentors"; appeared in The American Journal of Surgery 187 (2004) 698-701. The survey research was done at University of Utah.
I guess the first thing that struck me about the article was the authors declarative statement under methods = "No definition of the term [mentor] was provided so the definition was open to student interpretation." From my perspective this almost renders surgical mentorship equivalent to pornography. "I can't define pornography, but I know it when I see it." Probably the most often quoted comment ever by a Justice. The next most interesting comment was that 84 of 98 students were able to identify at least 1 attending mentor. So what we have here my friends is a class of third yaer medical students in which more than 15% of the students could not or would not identify 1 attending surgeon. In reflecting on this statement of the inability of medical students to name an attending, I am reminded of how often over the years I have had individuals approach me at medical meetings, charity events, social or political occasions, even airports, and address me by name and then go on to identify themselves as someone who was a third year clerk on surgery under my tuteledge. The majority of the time they did not go into the field of surgery yet they clearly remembered me. I suppose I have considered this remembrance of me as an attending in surgery to students most striking when reported to me second hand. My youngest son, a tennis pro at a famous Southern tennis resort on more than more than one occasion informed me that he had students in his tennis university stroke and drill classes who had been students at a medical school where they were third year clerks and remembered me. So now I am pondering the difficult question - was I a positive or megative role model? Guess I would have to do a survey to find out. Now for the question of relevancy - do I really want to know? Not really, because the survey would have no impact on the fact that I love surgery. So. Looking for comments here. JTE.