Alexis Carrel

In 1894, Marie Francois Sadi Carnot, the president of France, was stabbed by a would-be assassin in Lyons. By today's standards, the wound was not severe; however, the knife severed the portal vein in his abdomen. Carnot bled to death because up to that point, no one had figured out how to repair blood vessels.

Alexis Carrel
Alexis Carrel

One man undertook to change that, Alexis Carrel, a student in Lyons who was appalled by Carnot's death, in his hometown, while a number of physicians stood by and watched.

But consider the problem — repairing a tiny, elastic, living tube, part of a network of tubes of different sizes and functions, so that it would retain its ability to channel many gallons of blood every day, birth to death, without a hitch.

The story is that Carrel — Dr. Carrel by 1900 — studied with Marie-Anne Leroudier, one of the most proficient needlewomen in Lyons (her work was exhibited at the Columbian Exposition in Chicago in 1893), learning to make minute, uniform stitches. He developed a triangular system that allowed him to rapidly close up a vein or artery end-to-end without having the stitches adhere to the opposite wall, ushering in the birth of vascular surgery.

Carrel came to the University of Chicago in 1904, where his prodigious 21 months' work as an assistant to G. N. Stewart at the Hull Laboratory laid the groundwork for transplantation surgery. That work was the basis for Carrel's becoming the first scientist working in the United States to win the Nobel Prize for medicine, in 1912. Carrel soon moved on to the Rockefeller Institute for Medical Research in New York.

(Carrel's collaborator at the U. of C., Charles Claude Guthrie, was miffed that he was not included in the Nobel Prize. Guthrie possibly lost points with the Nobel committee for his subsequent experiments in St. Louis with head transplants.)

Carrel was a complicated man, compassion and curiosity mixed up with arrogance and resentment. He was a eugenicist — that is, he subscribed to the false science of "perfecting" the human race by eliminating traits judged to be inferior — and he was also an enthusiastic believer in the miracle cures at the shrine at Lourdes. At the time of his death in 1944, in Paris, he was working on a project for the collaborationist Vichy government.

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.