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Jeghers Medical Index

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Early Life

Harold Joseph Jeghers was born in Jersey City, New Jersey on September 26, 1904. The family moved to upstate New York, where his father was an owner of several different businesses in the communities of Saugeties and Rosendale. He worked for his father during vacations and for a full year following graduation from high school. During this interval, he was keenly interested in sports and amateur radio, successfully building and operating a "ham" station in the early days of radio.

Rensselaer Polytechnic Institute

His interest in mechanical and electrical concepts led to his application and acceptance at Rensselaer Polytechnic Institute, Troy, New York, for the study of electrical engineering. During his sophomore year he came under the influence of an ingenious Englishman, Professor Archie Bray, who had been recruited to Rensselaer to organize a newly established program in premedical education. Under Dr. Bray's direction and close personal contact, Harold Jeghers was persuaded to change his major during his junior year. Ultimately, he became one of two students who received the school's first Bachelor of Science in Biology in 1928.

By graduation, Harold Jeghers was determined to become a physician. His father, with great sagacity, gave him an articulated skeleton as his graduation gift. He was encouraged to spend the summer before medical school living and working in a local hospital as a laboratory technician. The medical staff at this institution, and particularly the chief of pathology, was responsible for providing this future master clinician with a remarkable insight into what lay ahead.

Case Western Reserve University School of Medicine

In 1928, he entered Case Western Reserve University School of Medicine, Cleveland, Ohio. His unique undergraduate experiences provided the stimulus and discipline for a firm foundation in medical education. During his freshman summer, he was awarded a Crile scholarship in research which resulted in the publication of a scientific paper.[1] Dr. Jeghers demonstrated in his early years of education an academic inclination.

While at University Hospitals, Cleveland, Ohio, Dr. Jeghers was assigned as a clinical clerk to Thomas Spies, M.D. a Fellow in Medicine. Dr. Spies was then actively engaged in unraveling the mystery of pellagra.

Dr. Blankenhorn, Professor of Clinical Medicine, greatly influenced Harold Jeghers to become a medical internist. Prior to his medical clerkship, Harold Jeghers had considered becoming a pathologist. Drs. Spies and Blankenhorn encouraged him to read medical journals, to search the medical literature for possible diseases for patients he was treating and to make use of the medical library in these endeavors.


Internship at Boston City Hospital

Dr. Spies imparted to Harold Jeghers the importance of obtaining the best internship possible. He urged him to compete for the university affiliated internships available in Boston. Following approximately one week of oral and written examinations given during April of his senior year, Dr. Jeghers was accepted to the Boston University Medical Service at Boston City Hospital for an eighteen month internship.

At that time, most seniors selected a single year of rotating internship and entered medical practice. Few became specialists. Specialization and certifying boards in internal medicine had not yet developed. While awaiting the start of his internship, he spent five months from August-December 1932 as resident physician for the Mahoning County Tuberculosis Sanatorium, Youngstown, Ohio. In this period he wanted to learn as much as possible about various presentations of tuberculosis.

Dr. Jeghers arrived in Boston in December of 1932 and was became one of the first interns on the newly formed Fifth Medical Service at Boston City Hospital, Boston, Massachusetts. Beginning assignments were in the clinical laboratory, outpatient service, and emergency room. Progressive assignments included the position of senior intern, associate house officer and house officer. These opportunities in medical training were sought by medical school graduates from throughout the nation.

Research Fellowship at Evans Memorial Institute for Clinical Research

Dr. John Foley, Boston City Hospital, encouraged Dr. Jeghers to complete a one year research fellowship at the Evans Memorial Institute for Clinical Research which was affiliated with Boston University. Their collaboration

resulted in a publication on Weil's Disease.[see below] The Evans Memorial Institute had a small research ward for patients needing special studies. Resident and research fellows received much individual attention and excellent experience. The talents and hard work of Dr. Harold Jeghers captured the attention of the hospital staff and medical faculty alike. In 1936, he was appointed to the faculty of Boston University and to a full-time teaching position at the Boston City Hospital.

Faculty Appointment at Boston University

In those days, Boston City Hospital was affiliated with three medical schools: Boston University, Harvard, and Tufts and provided a dynamic environment for quality patient care, creative clinical research, and medical education.During this period, Dr. Jeghers was the only paid full-time teacher at Boston City Hospital. He found the city of Boston a superb place to observe how other medical schools and their affiliated hospitals carried out research, teaching, and quality patient care. He astutely observed that while hundreds of doctors in the city were interested in clinical research, relatively few were interested in the application of research to medical pedagogy.

During this period, Dr. Jeghers was the only paid full-time teacher at Boston City Hospital.He found the city of Boston a superb place to observe how other medical schools.

He found the city of Boston a superb place to observe how other medical schools and their affiliated hospitals carried out research, teaching, and quality patient care. He astutely observed that while hundreds of doctors in the city were interested in clinical research, relatively few were interested in the application of research to medical pedagogy.

By that time, Dr. Jeghers had firmly adopted the custom of cutting articles from medical journals, stapling them together. What motivated this activity was the opportunity to utilize this collection in improving clinical teaching demonstrating the Samuel Johnson's proverb: “Knowledge is of two kinds: we know a subject ourselves, or we know where we can find information upon it.”

In Dr. Jeghers opinion, the teaching of medical students the ways of proper examination of patients was a way of life. He ultimately gave up the idea of private medical practice and dedicated his career to academic medicine. His conviction to pursuing medical education led him to a career in academic medicine.

In the years that followed, Dr. Jeghers in his customary long white coat became a familiar figure at Boston City Hospital. An avid and tireless reader, his familiarity with the medical literature became encyclopedic. He possessed a natural talent for communicating and applying relevant information at the bedside and conference room. He rapidly rose to the rank of Associate Professor of Medicine in 1942. In that same year he was appointed Physician-in-Chief of the service on which ten years earlier he had served as intern. Dr. Jeghers is well remembered by the many physicians and students who received their training at Boston City Hospital. He is best remembered for his teaching and his commitment to self-education.

Dr. Jeghers' identification of the Peutz-Jeghers Syndrome

In 1939, while on the Fifth Medical Service of the Boston City Hospital, Dr. Jeghers observed a 14 year old school girl with an unusual medical problem.

"A distinctive type of melanin pigmentation of the oral mucosa, lips and digits with intestinal polyposis. Twice in 1933 she had been operated upon at another hospital for intussusception and intestinal obstruction. On the second occasion a portion of the ileum was resected. Polyps of the stomach, ileum and sigmoid were found at that time."[1]

The recognition of a second patient with the same clinical pattern led to the suspicion that this was a specific syndrome and not a chance occurrence. A preliminary report of these two cases prompted efforts to identify others and suggested a genetic explanation. In 1949, Drs. Jeghers, McKusick and Katz published these findings in the New England Journal of Medicine in December.

The paper cited a 1921 publication [2] in the Dutch literature by Dr. Johannes Peutz, a pediatrician from Westeinde Hospital in the Hague, described a family with similar intestinal polyposis and oral-cutaneous pigmentation. Through correspondence with Dr. Peutz the American authors obtained followup on this Dutch family. The New England Journal of Medicine article described this disease complex as a gene-linked disorder. It is now called Peutz-Jeghers Syndrome.

Georgetown University School of Medicine

In the spring of 1946, Dr. Jeghers accepted the appointment as Professor of Medicine and Director of the Department of Medicine at the Georgetown University School of Medicine. The decision to recruit Dr. Jeghers was supported by an influential and respected member of Georgetown University, Father David V. McCauley. Dr. Jeghers became the first full-time salaried member of the academic faculty.

The administration and clinical faculty were very willing to explore with Dr. Jeghers the development of a Department of Internal Medicine that utilized many teaching innovations, including subspecialty divisions. Few medical schools at that time had recognized subspecialties. In the decade that followed, Georgetown University School of Medicine, significantly enhanced its reputation as a medical center with exceptional teaching and research. Dr. Jeghers' contributions to medical education led to his appointment as a consultant at Walter Reed Army Medical Center, Washington, D.C. and at the National Naval Medical Center, Betheseda, Maryland.

In furthering improvements in medical education Dr. Jeghers proposed a plan through which medical educators could be installed as Directors of Medical Education at community hospitals. Several surrounding Catholic community hospitals lacking affiliation with university centers became interested in his plan in order to attrack hightly qualified medical interns and residents.

Georgetown medical faculty participated in medical lectures, ward rounds and other teaching activities which made this educational approach quite attrative to the community hospital. The "Georgetown Plan" of medical education was adopted by Mercy Hospital in Buffalo, New York; St. Mary's Hospital in Rochester, New York; and St. Vincent Hospital in Worcester, Massachusetts.

Seton Hall College of Medicine and Dentistry

The development of a new medical school in Jersey City in association with Seton Hall University offered a unique and challenging opportunity for Dr. Jeghers. In August 1956, he left Georgetown University School of Medicine and accepted the position as Professor of Medicine and Director of the Department of Medicine at Seton Hall College. In accepting this position he returned to the city of his birth. He held the position for ten years. While at Seton Hall, Dr. Jeghers was awarded the Laetare Medal, an honor given to American Catholics for outstanding professionalism exhibiting Christian virtues.

St. Vincent Hospital

In 1966 Dr. Jeghers accepted the position of Medical Director at St. Vincent Hospital, Worcester, Massachusetts which he held until 1978. Here he continued to make important contributions to medical education and quality patient care. He was instrumental in recruiting full-time medical subspecialists. Dr. Stanley Olson, the first provost and dean of the Northeast Ohio Medical University (NEOMED), Rootstown, Ohio, considered St. Vincent Hospital to be an academic model for postgraduate education. NEOMED's clinical and basic science instructors from Akron, Canton, and Youngstown, Ohio visited St. Vincent Hospital and were impressed with Dr. Jeghers' leadership and approach to medical training. These visitors saw Dr. Jeghers' medical index as key to his approach.

Jeghers Medical Index

In 1976 Dr. Jeghers became a consultant for the Cleveland Health Sciences Library, Case Western Reserve University, Cleveland, Ohio, Subsequent to this appointment he accepted a position at the Office of Medical Education, Research and Curriculum Development at NEOMED with the rank of professor. In 1980, a consortium consisting of the Cleveland Health Sciences Library, St. Elizabeth Hospital Youngstown, and NEOMED was formed to bring Dr. Jeghers collection of medical journal articles to St. Elizabeth Health Center. The consortium was formed by Mr. Cheshier, Dr. E.J. Wheeler, Associate Dean for Academic Affairs at NEOMED, Dr. Leonard P. Caccamo, Chairman of the Board of Trustees at NEOMED, and Sister Consolata Kline, of St. Elizabeth Health Center. In September 1980, the collection of medical journal articles arrived at St. Elizabeth Health Center and was formerly named the Harold Jeghers Medical Index.
Throughout his latter years, Dr. Jeghers visited and participated in medical teaching at the Youngstown State University, Youngstown, Ohio campus of NEOMED. He visited the Youngstown area three or four times yearly, for periods as long as four to six weeks. His efforts were focused on maintaining the Jeghers Medical Index. He treasured his collection of medical articles which he had gathered over many years as a medical educator.

Dr. Jeghers' curriculum vitae is available for viewing, see below.