D. Maurice Kreis
Dorothy Hansine Andersen, Superstar
Updated: Feb 4, 2021
At the risk of repeating myself in tiresome fashion: If any woman in medical history is entitled to posthumous recognition by the New York Times as part of the newspaper's "Overlooked" obituary project, it's Dorothy Hansine Andersen (1901-1963).
Andersen discovered and named cystic fibrosis (CF), the second most common life-shortening genetic disorder. Before she published her findings in 1938, CF was just another mysterious reason why some babies died before making it to toddlerhood. Today there are hundreds of thousands of people around the globe who are surviving and thriving with CF. Every single one of them owes their life to this indomitable and courageous Columbia University pathologist.
I am thinking of Andersen today (February 3) because it's National Women Physicians Day, which prompted my friends at the Cystic Fibrosis Foundation to tweet this out:
It's odd that the CFF did not describe Andersen as the person who first identified and named cystic fibrosis, characterizing her instead simply as the author of the "first comprehensive medical report" on the disease. In my respectful opinion, this is a true statement about Andersen but does not give her the full credit she deserves.
One of the best things about the recently published magnum opus about cystic fibrosis, Breath from Salt by the award-winning science journalist Bijal Trivedi, is how well the book takes account of what Andersen did and the adversity she had to overcome in order to do it.
Trivedi certainly makes clear that Andersen was not the first physician or scientist to notice the disease we now refer to as cystic fibrosis. As Breath from Salt recounts, there were credible medical findings dating as far back as 1826 in France that suggested the existence of a disease that caused blockages in the pancreatic ducts that prevented digestive enzymes from being effective. Margret Hilda Harper, a famous Australian physician and contemporary of Andersen's, published an article in 1930 that speculated about a connection, based on autopsies of babies, between fibrotic pancreases and damaged lungs. At Harvard Medical School, Kenneth Blackfan, Simeon Burt Wolbach, and Charles D. May -- the latter then the world's leading expert on childhood nutritional disorders -- were groping their way toward the key insights in the 1930s. Jacob Greenberg of Yale University and Chicago-based neonatologist Arthur Parmalee were on the trail as well. To some degree or another, all of these researchers had been saddled with the mistaken belief that what they were observing was somehow related to celiac disease.
Andersen knew about the work of these doctors and researchers -- indeed, she worked hard over a period of three years to scrounge up their reports because what she was observing in her own pathology lab did not make sense to her. Celiac disease did not cut it as a credible explanation for her findings.
So it was that on August 1, 1938, the American Journal of Diseases of Children published Dorothy Hansine Andersen's article "Cystic Fibrosis of the Pancreas and Its Relation to Celiac Disease: A Clinical and Pathologic Study." Andersen nailed it.
Specifically, her 1938 article drew, for the first time, a connection between pancreatic cysts and troubles in the lungs and digestive system. She insisted that what she had observed was not celiac, however similar some of the symptoms were. And Andersen named the disease: cystic fibrosis of the pancreas. You don't have to take my word for any of the above; all of this information comes from 17 through 33 of Trivedi's book and the accompanying endnotes.
Therefore, with all due respect to the meticulous and intellectually honest truth-tellers at the Cystic Fibrosis Foundation, to state that Dorothy Hansine Anderson is simply the person who "wrote the first comprehensive medical report on cystic fibrosis" does not give this great medical hero the respect to which she is entitled.
This is important. It's not just that people who achieve significant scientific and medical breakthroughs deserve acknowledgement and honors for their work. Dorothy Hansine Andersen is a paradigm example of a woman who confronted the endemic sexism of her era, fought back, and won. She ended up in the pathology lab because her aspirations of becoming a surgeon were thwarted in light of her gender.
A native of Asheville, North Carolina, Andersen lost her father when she was just 13, at which point she and her mother relocated to St. Johnsbury, Vermont. Andersen took care of her mother, who was not in good health, graduated from the St. Johnsbury Academy, and matriculated at Mount Holyoke College in Massachusetts. While Andersen was at Mount Holyoke, her mother passed away as well.
Nevertheless, Andersen persisted. She graduated from Mount Holyoke, pursued her medical studies at Johns Hopkins, worked as a researcher for that school's first woman professor, and became a doctor herself in 1926. By 1935, she had a PhD and had accepted a job as a pathologist at what was then known as Babies Hospital, part of Columbia University. Again, you don't have to take my word for this; just read page 19 of Breath from Salt.
When Andersen died in 1963 -- in the bitterest of bitter ironies, she was a chain smoker who owed her death from lung cancer to the tobacco companies -- the newspaper of record in the home town of Columbia University, the New York Times, took no notice. To its credit, the Times has for the past several years included an "Overlooked" section on its obituary page, intended to pay tribute to noteworthy people whose deaths it had previously ignored over the years since its founding in 1851.
Alexander Graham Bell, Thomas Edison, the Wright Brothers, Jonas Salk, James Watson and Francis Crick, Francis Collins and Lap-Chee Tsui -- all are examples of noteworthy men whose achievements are solidly enshrined in the annals of history even though none labored alone and others surely contributed to the breakthroughs with which they are credited. (Collins and Tsui share credit for discovering the CF gene in 1989.) There are no asterisks next to their names and, likewise, there should not be one next to the name of Dorothy Hansine Andersen. Let's get that straight now, as the day when CF stands for "cured forever" grows ever closer.
Meanwhile, the picture of Andersen shared by the Cystic Fibrosis Foundation in its tweet is ubiquitous in CF circles. Those of us with a connection to the disease should not rest until we see the picture in the New York Times.