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Wallace Graham — A Life in Canadian RheumatologyIn this issue of The Journal K.M. Graham, the acclaimed Canadian artist, reminisces about her life during the 3 decades (1930s–1960s) when the specialty of Rheumatology came of age in Canada (Figure 1). As wife of Wallace Graham, one of Canada’s pioneer rheumatologists, she participated in momentous activities in his life that dramatically changed the face of arthritis research and treatment everywhere1. The prewar years for Graham were a time when the general physician/internist took an interest in the rheumatic diseases, but rarely considered restricting clinical practice exclusively to it. However, during the war years special treatment centers for servicemen were established in the United States and Canada2. Post-war these units served as a model for the establishment of a network of academic, rheumatic disease units (RDU) for the population at large throughout Canada3. Soon after the war 3 major scientific discoveries provided a major incentive for further advances. These were the discoveries of the rheumatoid factor and the lupus erythematosus cell, and the introduction of corticosteroids4. With these events came an appreciation that much more could be done for diagnosis and treatment of rheumatic diseases, coupled with the recognition that arthritis was a major health problem demanding more attention.
These discoveries also captured the interest of physicians and researchers who became committed to the investigation and treatment of people with arthritis and rheumatism. Moreover, these seminal advances led to the creation of our medical specialty so that physicians working in our field became known as rheumatologists4. Two wartime friends would come to the fore again with the creation of the Arthritis Foundation in the United States with Holbrook as president, and the Canadian Arthritis and Rheumatism Society (CARS) with Graham as president5. In her memoir K.M. Graham also outlines the role of Lord Horder and the Empire Rheumatism Council in the formation of CARS, and the recruitment of Edward A. Dunlop as its founding managing director. This year is a special one to recall Wallace Graham’s friendship with Philip Hench because it is the 50th anniversary of the Nobel prize in medicine honoring Hench, Kendall, and Reichstein, and the 100th anniversary of the founding of the Nobel prizes. Professor Liljestrand in his Nobel citation about Hench notes “your brilliant investigations in respect of the beneficial effects of pregnancy and jaundice on rheumatoid arthritis have been the starting point for the famous discovery during [the preceding year] that these diseases and some others are favorably influenced by hormones from the adrenal cortex.”6 K.M. Graham was also present for the announcement in 1957 at the 9th International Congress on Rheumatic Diseases of the establishment of The Gairdner Foundation awards for medical scientific achievement7. The awards have been compared to the Nobel prizes since so many recipients of the Gairdner award have later become Nobel laureates8. It is easy to speculate that the pivotal role of Wallace Graham in the establishment of the Gairdner awards was inspired by the Nobel prize awarded to his good friend Philip Hench only a few years earlier. When reporters in Stockholm asked Hench, “How do you go about winning a Nobel prize?” his response was, “by having the right relationships.”8 Likewise Graham’s accomplishments were essentially a product of his having followed through with “the right relationships”. The rheumatological community owes a debt of gratitude to K.M. Graham for informing us in her memoir how Wallace Graham became a leading rheumatologist and how the impact of his work led to better understanding, prevention, and care of arthritis patients at home and abroad. Finally, Charles Godfrey, medical historian, provides us with a broad overview9 that puts K.M. Graham’s personal memoir into its historical context. Duncan A. Gordon, MD,
ACKNOWLEDGMENT We thank Marguerite Hunt and Hugh Smythe for the photograph of K.M. Graham. REFERENCES 1.Graham KM. Origins and early beginnings of the Canadian Arthritis Society and the first rheumatic disease units. 2.Hench PS, Boland EW. The management of chronic arthritis and other rheumatic diseases among soldiers of the United States Army. Ann Intern Med 1946;24:808-25. 3.Ogryzlo MA, Gordon DA, Smythe HA. The rheumatic disease unit concept. Arthritis Rheum 1967;l0:479-85. 4.Smyth CJ, Freyberg RH, McEwen C. History of rheumatology in the United States. Ch. 1 and 2. Atlanta: The Arthritis Foundation; 1985. 5.Robinson HS. The Canadian Rheumatism Association. In: Morley TP, editor. Medical specialty societies of Canada. Toronto: Associated Medical Services; 1991:381-91. 6.Liljestrand G. Nobel prize in physiology or medicine 1950. In: Nobel lectures, physiology or medicine 1942-1962. Sweden; Nobel Foundation; 1999: http://mirror.nobel.ki.se/laureates/medicine-1950-press.html 7.Hulse E, Dirks J. The Gairdner Foundation: a celebration. Toronto: Gairdner Foundation; 1999:4. 8.Hench PS. A reminiscence of certain events before, during and after the discovery of cortisone. Minnesota Medicine 1953;36:705-10. 9.Godfrey CM. In the beginning.... J Rheumatol 2000;27:1599-600. |
