The Other Flexner

Abraham Flexner, the author of a report that re-structured American medical education, and his brother Simon, who headed up the Rockefeller Institute for Medical Research, were two of the most influential men of their day. But they owed their success to some degree to their older brother Jacob.

Jacob Flexner

Jacob Flexner

Their father, Morris, lost his haberdashery business in Louisville, Ky., in the Panic of 1873. Jacob, an intelligent young man who hoped to be a doctor, was forced to go to work immediately to help support the family. He became a pharmacist, as close as he could get to his dream, and eventually owned his own store, according to an account by Ward O. Griffen MD in The Annals of Surgery.

The eldest of seven boys and two girls, Jacob employed Simon, a slacker in his teens, in his store, and he gave Abraham $1,000 to go to Johns Hopkins University, where an acquaintance had gone.

“Upon that choice my whole subsequent career and those of others of our family have depended," Abraham Flexner wrote years later in his autobiography.

Jacob "was throughout his life a person of quick and remarkable intelligence, and he must have realized that we were all destined to humble careers unless at the first opportunity a break was made," Abraham Flexner wrote.

Jacob Flexner was a Louisville pharmacist, but he too played a role in the birth story.

Simon Flexner

After Simon Flexner dropped out of the sixth grade in Louisville, Ky., in the 1870s, his father, Morris, arranged a tour for him of the town jail, warning that if he didn't straighten out, that was where he would wind up.

But after Simon, the fourth of nine children, nearly died of typhoid fever at the age of 16, he found his passion — infectious diseases.

Simon Flexner

Simon Flexner

Flexner went to work as an apprentice in his brother Jacob's pharmacy, where he learned to use a microscope. Doctors he knew from the store gave him tissue samples for his self-directed studies in histology, the study of microscopic structures in tissues, and pathology.

At 26, he earned his medical degree from the two-year program at the University of Louisville. His younger brother Abraham, a recent graduate of  Johns Hopkins University, arranged for Simon to study pathology there under William Henry Welch, who was helping to bring the scientific method to American medicine.

Flexner became a microbe hunter extraordinaire, helping to suss out the causes of meningitis among Maryland coal miners, bubonic plague in San Francisco's Chinatown, and a common dysentery that is now known as Flexner's bacillus. He also played a critical role in the conquest of polio.

In 1902, Flexner became the head of the new Rockefeller Institute for Medical Research, and this is where the birth story intersects his own. Flexner assembled an amazing team of scientists that included Alexis Carrel, Peyton Rous and Karl Langsteiner who, among other achievements, brought blood transfusion to reality.

The Flexner Report

The so-called "Flexner Report," issued in 1910, was a game-changer in American medical education.

Previously, a man — or woman — could become a physician by sitting through a winter's worth of lectures at a "medical school," which might be some doctor's parlor. Only the more rigorous schools survived after 1910 — all the women's medical schools and most of those that accepted minority candidates closed.

Abraham Flexner

Candidates had to qualify for the schools that remained, and they spent years, not months, learning the craft, which began to include hands-on training with patients. All these innovations impacted the birth story.

Abraham Flexner, who wrote the report for the Carnegie Foundation, was primarily an educator. He got his start with a private laboratory school he founded in his native Louisville, Ky., after graduation from Johns Hopkins University, and wrote a book in 1908, The American College, that brought him national attention.

Flexner was deeply involved in re-structuring the nation's medical schools in the years leading up to World War I. Later, he was the first director of the Institute for Advanced Study, a colossally influential "think tank," founded in 1930 in Princeton, N.J., by Newark retailer Louis Bamberger and his sister Caroline Bamberger Fuld.

At the IAS, Flexner saw opportunity in the political clouds gathering over Europe, recruiting scientists like John von Newmann and Kurt Godel. And, Flexner personally wrote the letter that brought Albert Einstein to the United States in 1933.