Werner Forssmann Biography (1904-1979)


Werner Theodor Otto Forssmann, a surgeon and urologist, was born on August 29, 1904, in Berlin, the only child of Julius Forssmann, a lawyer employed by alife insurance company, and Emmy Hindenberg. Forssmann's father died in World War I while young Forssmann was still a student in the Askanische Gymnasium. His mother worked as an office clerk and his grandmother took over the roleof running the household. Forssmann's uncle, a doctor just outside of Berlin, became an influential force in his nephew's life, ultimately convincing Forssmann to pursue a career in medicine. In 1922, after graduating from the Gymnasium, Forssmann entered the Friedrich Wilhelm University in Berlin, passingthe state examination in 1928. Forssmann's doctoral thesis on the effects ofconcentrated liver on pernicious anemia, a blood deficiency, marked the way for his later experiments. Together with a small group of fellow students, Forssmann experimented on himself, taking large doses of liver concentrate daily and demonstrating its healthful effects on blood. After receiving his doctor's diploma in early 1929 and being frustrated in his efforts to obtain a post as an internist, Forssmann worked for a short time in a private women's clinic in Spandau. Then, through family connections, he secured an internship at the August Viktoria Home in Eberswalde, a small town northeast of Berlin.

Training as a surgeon, Forssmann nevertheless gave thought to an earlier passion of his: heart diagnosis. He was dissatisfied with the inaccuracy and uncertainty of diagnostic techniques such as percussion, auscultation, x ray, andeven electrocardiography. He became convinced that there was an internal diagnostic method that would not involve major risks, trigger automatic reflex actions, or disturb the balance of pressure in the thorax. As early asthe mid-nineteenth century, there had been a procedure known as cardiac catheterization in animal experiments. Doctors had performed the procedure in thelate nineteenth century to determine blood pressure in the right and left chambers of the heart. Some of these procedures employed the use of a catheter inserted through the jugular vein of a horse. Forssmann believed that he coulddo this on humans through a vein at the elbow traditionally used for intravenous injections. His research on cadavers supported his idea, and by the summer of 1929 Forssmann approached his supervisor, Dr. Richard Schneider, with aplan to catheterize his own heart with a ureteric catheter. Schneider, however, would not allow such a dangerous experiment in his hospital.

Undaunted, Forssmann set out to convince a surgical nurse in his section of his experiment's feasibility so he could gain access to the sterilized instruments he needed. Eventually, the nurse agreed to aid him. He gave himself a local anesthetic in the left elbow and then made an incision. Once he had opened his vein, he inserted the catheter about a foot up his arm and had the nurse accompany him to the x-ray lab. There, Forssmann stood behind a fluoroscopescreen with a mirror placed so that he could see the image of the catheter,which he pushed up until it was in the right ventricle of his heart. Then hecalmly ordered that photographs be made of this momentous achievement.

The results of this experiment were published in a short paper in the prestigious Klinische Wochenschrift and won Forssmann a position at the Charité Hospital in Berlin. But the reception to his article by other physicians was cool and his superior at the Charité did not approve of hisunorthodox techniques, so Forssmann was soon back in Eberswalde. He continuedhis experiments for the next two years, during which time he proved that theinsertion of a catheter in the heart was painless and caused no damage to the blood vessels. He also pioneered techniques for measuring pressure inside the heart and for injecting opaque material for x-ray studies of the heart. Still, his work was reviled by most physicians, who called it unethical and considered his experiments stunts. By 1931, Forssmann, discouraged by the response to his work, gave up experimental medicine. He returned to the Charité Hospital in Berlin and soon moved on to the Mainz City Hospital. It was there, in 1932, that he met the woman who would become his wife, Dr. Elsbet Engel, a resident in internal medicine. Though their marriage was happy, it also necessitated another change of hospitals for Forssmann, for it was againstthe hospital's policy for a married couple to work together. Forssmann trained as a urologist in Berlin at the Rudolph Virchow Hospital, then took a position as a surgeon and urologist at the City Hospital of Dresden-Friedrichstadtfor two years. Later, he became a senior surgeon at the Robert Koch Hospitalin Berlin.

During World War II, Forssmann served as an army surgeon, surviving six yearsspent in Germany, Norway, Russia, and in a prisoner of war (POW) camp. Backin Germany after the War, he practiced as a country doctor in the Black Forest village of Wambach for three years before returning to the practice of urology in 1950 at Bad Kreuznach. It was only after the war that Forssmann discovered that others had continued working with his cardiac catheterization experiment of 1929. The most notable implementation was by two Americans, Dickinson Woodruff Richards, Jr., and André F. Cournand, who developedit into a tool for diagnosis and research. In 1954, Forssmann received the Leibniz Medal from the German Academy of Science in Berlin, yet he was refuseda professorship at the University of Mainz. He had resigned himself to beinga little-known doctor in Bad Kreuznach when, on October 18, 1956, he was notified that he had won, along with Richards and Cournand, the Nobel Prize for Physiology or Medicine for his contribution to the knowledge of heart catheterization and pathological changes in the circulatory system.

The Nobel Prize finally earned Forssmann renown and respect; in Clinical Cardiology, H. W. Heiss called him "one of the great fathers of cardiology." In 1958, he became the chief of the surgical division of the Evangelical Hospital of Düsseldorf, and 10 years later he was awarded the gold medalof the Society of Surgical Medicine of Ferrara. He died of a heart attack inSchopfheim, West Germany, on June 1, 1979.

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