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Andrzej Szczeklik
Tomasz Zurek
Obituary
Andrzej Szczeklik Physician, immunologist, and expert on aspirin-sensitive asthma. Born on July 29, 1938, in Krakow, Poland, he died on Feb 3, 2012, in Krakow, aged 73 years. Holistic is a much abused word, particularly in the context of medicine where it has too often been commandeered by practitioners whose understanding of the body in health and disease is little short of antithetical to science. No such charge could be laid against Andrzej Szczeklik, a physician whose scientific credentials included career-long interests in the nature of aspirin-sensitive asthma and in the role of prostacyclins and other members of the eicosanoid chemical family. But while his days were spent in the lab and the clinic, his off-duty thoughts strayed into the philosophical, cultural, historical, and even mythological aspects of the business of doctoring. One manifestation of these intellectual excursions was a book, Catharthis, in which he aimed to set his scientific medicine in a broader landscape. Szczeklik was a man whose approach to medicine really did merit the description holistic. Although his father was a professor of medicine, it was by no means certain that Szczeklik would follow in the paternal footsteps. He was tempted to pursue literature; other studies earned him a place in the Polish Academy of Music. But it was medicine that finally won. His medical and scientific training was completed at the Universities of Cracow and Wroclaw, and in 1972 he became the head of the allergy clinic at the latter institution. In 1990, he moved to Cracow’s Jagiellonian University School of Medicine as professor of medicine. He 1698
also spent time at the University of North Carolina and the Karolinska Institute, and worked in the UK with Sir John Vane, co-winner of the 1982 Nobel Prize in Physiology or Medicine for studies on the prostaglandins. Szczeklik’s key scientific contributions were in the fields of cardiovascular and pulmonary disease, allergy and asthma. Professor Ewa Nizankowska-Mogilnicka, also of Jagiellonian University School of Medicine, first met him when she was still a student and went on to become a research collaborator and friend. “He put forward the hypothesis that bronchospasm after aspirin was not an allergic response but a pharmacological one”, she says. His hypothesis was that aspirin precipitates asthma attacks through the inhibition of cyclo-oxygenase (COX 1), an enzyme involved in the metabolism of eicosanoids. That was in 1975. He went on to show that the bronchi of patients with aspirin-induced asthma show undue amounts of leukotriene C4 synthase, the result of a genetic predisposition that accounts for the susceptibility, work that was published in The Lancet. Klaus Rabe, professor of medicine at the University of Kiel, first met Szczeklik more than two decades ago: “If I think of aspirin-sensitive asthma and eicosanoids”, he says, “I immediately think of Andrzej Szczeklik.” Although this aspect of aspirin was Szczeklik’s longest running preoccupation, it was not his only interest. Szczeklik and his colleagues explored the value of prostacyclins in treating pulmonary hypertension and unstable angina. Besides working with Vane he had also spent time in the UK with the cardiovascular physician John Martin, then based in Sheffield. “It was they who really stimulated his interest in cardiovascular disease”, says Stephen Holgate, professor of immunopharmacology at the University of Southampton who got to know Szczeklik over 20 years. “The work was about understanding the balance between thromboxane production causing thrombosis and prostacyclin generation preventing it.” Szczeklik’s concern for his patients extended beyond their physical wellbeing. With the fall of communism, he decided his department needed a piano. Through the director of the music school where he’d studied he found one, which happened to be white. He or visiting performers would give informal concerts for patients on the piano, says Nizankowska-Mogilnicka. She was captivated by his intelligence. So was Rabe. “Szczeklik was a thinker. A person who was never loud—a good listener. He would let you finish your sentence and not interrupt. He always had something to say, but he would think before he spoke.” Poland’s communist era government took a more jaundiced view of Szczeklik’s democratic principles, at one point bringing about his demotion. Holgate thinks the government would have been happy for him to leave the country. But he stayed, and argued his case. Szczeklik leaves his wife Marysia, two sons, and a daughter.
Geoff Watts www.thelancet.com Vol 379 May 5, 2012
Obituary
Andrzej Szczeklik Physician, immunologist, and expert on aspirin-sensitive asthma. Born on July 29, 1938, in Krakow, Poland, he died on Feb 3, 2012, in Krakow, aged 73 years. Holistic is a much abused word, particularly in the context of medicine where it has too often been commandeered by practitioners whose understanding of the body in health and disease is little short of antithetical to science. No such charge could be laid against Andrzej Szczeklik, a physician whose scientific credentials included career-long interests in the nature of aspirin-sensitive asthma and in the role of prostacyclins and other members of the eicosanoid chemical family. But while his days were spent in the lab and the clinic, his off-duty thoughts strayed into the philosophical, cultural, historical, and even mythological aspects of the business of doctoring. One manifestation of these intellectual excursions was a book, Catharthis, in which he aimed to set his scientific medicine in a broader landscape. Szczeklik was a man whose approach to medicine really did merit the description holistic. Although his father was a professor of medicine, it was by no means certain that Szczeklik would follow in the paternal footsteps. He was tempted to pursue literature; other studies earned him a place in the Polish Academy of Music. But it was medicine that finally won. His medical and scientific training was completed at the Universities of Cracow and Wroclaw, and in 1972 he became the head of the allergy clinic at the latter institution. In 1990, he moved to Cracow’s Jagiellonian University School of Medicine as professor of medicine. He 1698
also spent time at the University of North Carolina and the Karolinska Institute, and worked in the UK with Sir John Vane, co-winner of the 1982 Nobel Prize in Physiology or Medicine for studies on the prostaglandins. Szczeklik’s key scientific contributions were in the fields of cardiovascular and pulmonary disease, allergy and asthma. Professor Ewa Nizankowska-Mogilnicka, also of Jagiellonian University School of Medicine, first met him when she was still a student and went on to become a research collaborator and friend. “He put forward the hypothesis that bronchospasm after aspirin was not an allergic response but a pharmacological one”, she says. His hypothesis was that aspirin precipitates asthma attacks through the inhibition of cyclo-oxygenase (COX 1), an enzyme involved in the metabolism of eicosanoids. That was in 1975. He went on to show that the bronchi of patients with aspirin-induced asthma show undue amounts of leukotriene C4 synthase, the result of a genetic predisposition that accounts for the susceptibility, work that was published in The Lancet. Klaus Rabe, professor of medicine at the University of Kiel, first met Szczeklik more than two decades ago: “If I think of aspirin-sensitive asthma and eicosanoids”, he says, “I immediately think of Andrzej Szczeklik.” Although this aspect of aspirin was Szczeklik’s longest running preoccupation, it was not his only interest. Szczeklik and his colleagues explored the value of prostacyclins in treating pulmonary hypertension and unstable angina. Besides working with Vane he had also spent time in the UK with the cardiovascular physician John Martin, then based in Sheffield. “It was they who really stimulated his interest in cardiovascular disease”, says Stephen Holgate, professor of immunopharmacology at the University of Southampton who got to know Szczeklik over 20 years. “The work was about understanding the balance between thromboxane production causing thrombosis and prostacyclin generation preventing it.” Szczeklik’s concern for his patients extended beyond their physical wellbeing. With the fall of communism, he decided his department needed a piano. Through the director of the music school where he’d studied he found one, which happened to be white. He or visiting performers would give informal concerts for patients on the piano, says Nizankowska-Mogilnicka. She was captivated by his intelligence. So was Rabe. “Szczeklik was a thinker. A person who was never loud—a good listener. He would let you finish your sentence and not interrupt. He always had something to say, but he would think before he spoke.” Poland’s communist era government took a more jaundiced view of Szczeklik’s democratic principles, at one point bringing about his demotion. Holgate thinks the government would have been happy for him to leave the country. But he stayed, and argued his case. Szczeklik leaves his wife Marysia, two sons, and a daughter.
Geoff Watts www.thelancet.com Vol 379 May 5, 2012