Prof. Dr. med. habil. Georg Merrem (1908-1971)--a historical vignette.

Abstract

Skrzypczak J. Prof . Dr. med. habil. Georg Merrem (1908–1971)... Zentralbl Neurochir 2008; 69: 207 – 209 September 21 st 2008 is the 100 th anniversary of Georg Merrem ’ s birthday. He was born in K ö nigsberg in Eastern Prussia, now Kaliningrad, the son of the high ranking military physician Dr. Karl Merrem. He grew up with three siblings, went to school in Danzig (now Gdansk) and later to the “ Gymnasium ” in Berlin, fi nishing that with the school leaving examination (Abitur) in 1927. Whereas both his brothers went into law, Georg followed the path of his father and started his medical studies 1927 in T ü bingen, soon to change to Berlin in 1928. Among his teachers and professors were famous people like Bier, Sauerbruch, von Bergmann, Stoeckel, R ö ssle and others. He fi nished his studies with the fi nal state examination in 1932 with “ very good ” success. His initial work as a junior doctor was done at the Hedwigs-Krankenhaus and later on the deciding period of his education took place in the Augusta-Hospital in which Fedor Krause was working. The successors of Krause were Emil Heymann and Carl Max Behrend. This was the time of the fi rst contact to neurosurgery, an event which fascinated him from then on. 1933 Merrem fi nished his dissertation with the title “ The treatment of multiple sclerosis with Germanin (Bayer 205) ” supervised by Emil Heymann. Georg Merrem married the ophthalmologist Dr. Anni Hagedorn, which might explain his later interest for neuroophthalmology. When Merrem was drafted to do his military service in August 1939 he already had two children: Gisela and Bernd. His daughter Gisela, the oldest of his children later married the surgeon and neurosurgeon Dr. Wolf-Eberhard Goldhahn. In 1938 Merrem had received the degree of “ specialist for surgery ” , supplemented with a note “ special knowledge in neurosurgery ” . At the begin of the war Merrem was referred to a medical unit very soon specialising in the treatment of injuries of the brain, spinal cord and peripheral nerves. This brain surgical group was led by Wilhelm T ö nnis (serving in the airforce) and Herbert Peiper (serving in the army). T ö nnis certainly had the largest infl uence on Merrem ’ s activity in military surgery. Merrem was made the leader of a brain surgery group in fi eld hospitals which consisted of one chief, three surgeons, two neurologists, one ophthalmologist, maxillofacial surgeon, otologist and pathologist each. One administrative assistant, two nurses, 57 military medical personnel and 35 drivers were also attached to such a unit. After the war Herbert Peiper tried to convince Merrem to come to him in the city of Mainz where he had in the meantime become the Chairman of the Department of Surgery at the university. This, however, failed due to the lack of money on the side of the hospital. Finally, Merrem was off ered a senior position at the surgical hospital in Dresden-Johannstadt by Dozent Dr. Sprung who was then the director of the surgical department. He agreed and started his work in June 1947 as “ Oberarzt ” and deputy to Doz. Sprung. The general surgical part of his work (500 beds) did not leave him any possibility to work in the neurosurgical fi eld. Thus, at this time he only had the choice to give up neurosurgery or to fi nd a more suitable working place. Having kept up his contacts to T ö nnis, Peiper and other neurosurgeons, he learned that the then Director of the University Department of Neurology and neuroscientist Prof. Richard Arwed Pfeifer wanted to create a department of neurosurgery in Leipzig. This way neurosurgery became a section within the Department of Neurology. Working conditions however, were diffi cult. For example since there was no elevator, patients needed to be carried by hand one fl ight of stairs up and down on the way to the operating theatre. In the era before the introduction of intubation anaesthesia all surgical interventions even in infants were done in local anaesthesia with the occasional use of barbiturates. Today this may appear unbelievable and it certainly is not necessary to discuss details of the problems arising from this constellation. In 1950 Merrem submitted his thesis for the “ Habilitation ” on “ Die Chirurgie des Ventrikelsystems als Ergebnis histopathologischer Beobachtung und neurochirurgischer Erfahrungen (Surgery of the ventricular system and the result of histopathological considerations and neurosurgical experiences) ” to the medical faculty. The reviewers of his thesis were professors Uebermuth, Buzello and R. A. Pfeifer. Until 1950 Merrem was the only neurosurgeon in that hospital. From October 1950 onward soon the facilities at the department no longer could keep up with the requirements brought about by the patient load. 1952 the department moved to another facility at Johannisallee 34. This house had been until 1932 the private hospital of the famous surgeon and late Chairman of the University Department Erwin Payr. Neurosurgery separated fi nally from the Department of Neurology and became an independent university hospital department, for many years to be the only one in East Germany. H.-GNiebeling helped Merrem with his organisational talent to which the hospital in Leipzig owes a lot. The department developed quickly to a respected specialised unit. Many neurosurgeons, many of them later chairpersons themselves, were disciples of Merrem: Weickmann, Niebeling, H ü bner, Krumbholz, Fried, Dietrich, Goldhahn, Skrzypczak, Kretschmer and Sch ö che. On top of that numerous neurologists and orthopaedic surgeons collected experience in the neurosurgical discipline working in this department frequently for several years. Merrem took great care to teach his neurosurgical fellows and co-workers a subtle neurological technique, because neurology had an important place in diagnostics. After all, this was the time when CT scan and MRI were unknown. Angiography and pneumoencephalography or vertriculography besides the EEG were the only diagnostic procedures available. For that reason careful history taking and exact neurological examination were of great value. Prof. Dr. med. habil. Georg Merrem (1908 – 1971) – A Historical Vignette