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J. Franz Buschke, M.D. August 24, 1902 – June 2, 1983
036cL3016%413.00 + .lo Copyright 0 Pergmon Press Ltd.
IN. J Radiaion Oncology Bid. Ph.ys., Vol. 10. pp. 3-4 Printed in the U.S.A. All rights rcsawd.
e In Memoriam
J. Franz Buschke, M.D. August 24, 1902 - June 2, 1983 “One of the living dinosaurs of radiotherapy.“’ his M.D. from the University of Berlin (1927). He served his internship at the Westend Krankenhaus and then trained in internal medicine (1927 to 1932) in both Vienna and Berlin. He had become interested in radiology because of his interest in gastrointestinal diseases. He moved to Zurich in 1933 where he worked under Hans Schintz. In 1934, he went to Paris where he was associated with Coutard and other members of the Paris school of Radiotherapy. Also in 1934, he moved to the Michael Reese Hospital in Chicago and in 1938 became a member of the staff of the Chicago Tumor Institute under the direction of Dr. Max Cutler. In 1938 this group split up to form a major nucleus of the nacent specialty of radiation therapy in the United States. Buschke and Simeon T. Cantril went to the Swedish Hospital in Seattle where Buschke remained until 1956. In 1957, Franz Buschke became Professor and Director of Radiation Oncology at the University of California in San Francisco where he remained until his retirement in 1970. Until his death he was an Emeritus Professor at U.C.S.F., recalled to active duty between 1970 and 1976. These dry facts do not adequately describe Franz Buschke. He was serious, old fashioned, human and humorous. We all remember some of his quotations such as “mustard is for hot dogs” in referring to early attempts at chemotherapy. He often referred to the comparison of an optimist to a pessimist with a saying “to the optimist the schnapps bottle is always half full but to the pessimist it is always half empty”. He probably tended to be more of a pessimist than an optimist himself and he was always certainly a realist about the potential for benefit to the particular cancer patient. His gymnasium background was unique and not seen in these modem days. He was a true old world educated man with a strong background in music, literature and art as well as science. He was an accomplished violist and enjoyed playing with his family. He became a major influence in the lives of all of us who were privileged to work with him because of his broad education, intelligence and wit.
Franz Buschke was honored by his peers in radiation oncology as an outstanding contributor to the development of this important clinical and basic science. These honors included Presidency of the American Society of Therapeutic Radiologists, the Gold Medal of the ASTR, and the Janeway Medal of the Radium Society. He was honored by U.C.S.F. with the annual Franz Buschke Lectureship. Far beyond these documented honors, however, Franz Buschke was loved and respected by his colleagues and students for many many more reasons. As we mourn his death it is appropriate to look at the man, the physician, the teacher and the scientist as seen from the viewpoint of his students and colleagues.
The Physician
“God is an internist.” This was one of Dr. Buschke’s favorite sayings and exemplified his philosophy with its strong basis in internal medicine. He was a fully trained
The Man
Following a classic gymnasium education in Berlin, Franz Buschke, after attending both Berlin and Freiburg, received ‘This quotation from Dr. Buschke appears on the Buschke lectureship plaque at U.C.S.F.
3
4
Radiation Oncology 0 Biology 0 Physics
internist who then trained in diagnostic radiology and then in radiation oncology. He demanded of himself, his colleagues and his students only the absolute best for the patient. All of the information needed for a proper diagnosis and treatment prescription had to be available. He personally reviewed the microscopic slides, the X-ray films, the physical findings, the cytoscopy and the operation as indicated in a particular patient. Second-hand knowledge of reports was not enough to satisfy his standards for proper patient care. He was an excellent pathologist and diagnostic radiologist as well as radiation oncologist. To Dr. Buschke each patient was a special and unique individual for whom the best must be done. The best did not necessarily mean radiotherapy but meant giving them what was likely to be most helpful for their problem. ‘‘Primum nun nocere” was one of his favorite descriptions of the approach that must be taken to the patient in oncology. He was an adamant foe of poor medicine and kept a voluminous black book record of patients he has seen whose care had been severely mismanaged. Analysis of failures and mistakes was as important to him as the analysis of successes in avoiding future mistakes and learning those facts needed to improve treatment. Using these basic tenets, Dr. Buschke helped pioneer the new discipline of radiation oncology, and we recognize that what he was is what we would all like to be in terms of the well-rounded oncologist. He introduced megavoltage radiotherapy at Swedish Hospital and pioneered its use in to the modem era. In spite of his pioneering of high energy machines, such as 1 MeV, Cobalt 60, and Betatron, he maintained his focus on the patient and on radiation oncology as a clinical, not technical, specialty. He was often amused by our over zealous or fancy techniques and always emphasized that it was the disease that would decide the outcome in the end. “You can’t force it” was a saying of his often used in this situation when one was trying to cure the incurable. His involvement with and treatment of the patient, attention to detail and a broad background was brought to all of us who were his students and to the specialty as a whole. His work ethic was “the day begins at 8 and never ends”. The Teacher “I am perfectly willing to let you make your own mis-
takes.” This was a favorite remark of Dr. Buschke’s in referring to his willingness to let his residents try new techniques or repeat old techniques which he himself felt would be unsuccessful, but which he felt one had to try on one’s own before learning what was and was not useful. He
January 1984, Volume 10. Number 1
was an excellent teacher in the classical sense. He taught by example, by scarification and by excellent lectures. ‘His knowledge and extensive clinical experience was strengthened by his true affection for the student and love of teaching. As a resident, medical student, or junior faculty member he allowed you to grow, experiment and yet come back to him as needed for further wisdom based on experience. Teaching was the area he enjoyed most of all those areas related to clinical oncology. The Scientist
“Statistics are like a bikini, what they reveal is interesting, what they hide is essential.” This quote exemplifies Franz Buschke’s skepticism about much published literature and his analytic approach to a review of the work of others as well as his own work. He was a very critical, analytical clinical scientist who pioneered supervoltage radiotherapy and in particularly the treatment of bladder, esophageal and gynecologic cancers. Pituitary tumors and head and neck carcinomas were another major interest of his and he was one of the early developers of combined preoperative irradiation and surgery along with Maurice Galante. Franz Buschke’s publications, including an early text on cancer with Max Cutler, his book with S. T. Cantril and Robert Parker on supervoltage radiotherapy and the three volumes on progress in radiotherapy still remain valuable reference works. He leaves these legacies as well as a large number of scientific papers permanently behind him in literature. Personal Remembrances
There have been two major professors in my own life, both were German-born and trained in the gymnasium tradition, both were Jewish and both were complete human beings. The first was my mentor and German teacher at Dickinson College and the second was Dr. Franz Buschke. He replaced the father that had died while I was in medical school and guided me through my residency, junior faculty position and the beginning of my tenure as Chairman of the Department. The transition from his leadership to mine was smooth, his help was always there but he was never domineering and never tried to turn back the clock. As a physician, oncologist, and as a person I owe much more than I can summarize here briefly to this man, his philosophy and his guidance. Dr. Buschke unfortunately is no longer living but he never was a dinosaur. His beliefs, training and approach to medicine and life are as valid today as when he began his career in the much different world of the 1920’s.
Theodore L. Phillips, June, 1983
M.D.
IN. J Radiaion Oncology Bid. Ph.ys., Vol. 10. pp. 3-4 Printed in the U.S.A. All rights rcsawd.
e In Memoriam
J. Franz Buschke, M.D. August 24, 1902 - June 2, 1983 “One of the living dinosaurs of radiotherapy.“’ his M.D. from the University of Berlin (1927). He served his internship at the Westend Krankenhaus and then trained in internal medicine (1927 to 1932) in both Vienna and Berlin. He had become interested in radiology because of his interest in gastrointestinal diseases. He moved to Zurich in 1933 where he worked under Hans Schintz. In 1934, he went to Paris where he was associated with Coutard and other members of the Paris school of Radiotherapy. Also in 1934, he moved to the Michael Reese Hospital in Chicago and in 1938 became a member of the staff of the Chicago Tumor Institute under the direction of Dr. Max Cutler. In 1938 this group split up to form a major nucleus of the nacent specialty of radiation therapy in the United States. Buschke and Simeon T. Cantril went to the Swedish Hospital in Seattle where Buschke remained until 1956. In 1957, Franz Buschke became Professor and Director of Radiation Oncology at the University of California in San Francisco where he remained until his retirement in 1970. Until his death he was an Emeritus Professor at U.C.S.F., recalled to active duty between 1970 and 1976. These dry facts do not adequately describe Franz Buschke. He was serious, old fashioned, human and humorous. We all remember some of his quotations such as “mustard is for hot dogs” in referring to early attempts at chemotherapy. He often referred to the comparison of an optimist to a pessimist with a saying “to the optimist the schnapps bottle is always half full but to the pessimist it is always half empty”. He probably tended to be more of a pessimist than an optimist himself and he was always certainly a realist about the potential for benefit to the particular cancer patient. His gymnasium background was unique and not seen in these modem days. He was a true old world educated man with a strong background in music, literature and art as well as science. He was an accomplished violist and enjoyed playing with his family. He became a major influence in the lives of all of us who were privileged to work with him because of his broad education, intelligence and wit.
Franz Buschke was honored by his peers in radiation oncology as an outstanding contributor to the development of this important clinical and basic science. These honors included Presidency of the American Society of Therapeutic Radiologists, the Gold Medal of the ASTR, and the Janeway Medal of the Radium Society. He was honored by U.C.S.F. with the annual Franz Buschke Lectureship. Far beyond these documented honors, however, Franz Buschke was loved and respected by his colleagues and students for many many more reasons. As we mourn his death it is appropriate to look at the man, the physician, the teacher and the scientist as seen from the viewpoint of his students and colleagues.
The Physician
“God is an internist.” This was one of Dr. Buschke’s favorite sayings and exemplified his philosophy with its strong basis in internal medicine. He was a fully trained
The Man
Following a classic gymnasium education in Berlin, Franz Buschke, after attending both Berlin and Freiburg, received ‘This quotation from Dr. Buschke appears on the Buschke lectureship plaque at U.C.S.F.
3
4
Radiation Oncology 0 Biology 0 Physics
internist who then trained in diagnostic radiology and then in radiation oncology. He demanded of himself, his colleagues and his students only the absolute best for the patient. All of the information needed for a proper diagnosis and treatment prescription had to be available. He personally reviewed the microscopic slides, the X-ray films, the physical findings, the cytoscopy and the operation as indicated in a particular patient. Second-hand knowledge of reports was not enough to satisfy his standards for proper patient care. He was an excellent pathologist and diagnostic radiologist as well as radiation oncologist. To Dr. Buschke each patient was a special and unique individual for whom the best must be done. The best did not necessarily mean radiotherapy but meant giving them what was likely to be most helpful for their problem. ‘‘Primum nun nocere” was one of his favorite descriptions of the approach that must be taken to the patient in oncology. He was an adamant foe of poor medicine and kept a voluminous black book record of patients he has seen whose care had been severely mismanaged. Analysis of failures and mistakes was as important to him as the analysis of successes in avoiding future mistakes and learning those facts needed to improve treatment. Using these basic tenets, Dr. Buschke helped pioneer the new discipline of radiation oncology, and we recognize that what he was is what we would all like to be in terms of the well-rounded oncologist. He introduced megavoltage radiotherapy at Swedish Hospital and pioneered its use in to the modem era. In spite of his pioneering of high energy machines, such as 1 MeV, Cobalt 60, and Betatron, he maintained his focus on the patient and on radiation oncology as a clinical, not technical, specialty. He was often amused by our over zealous or fancy techniques and always emphasized that it was the disease that would decide the outcome in the end. “You can’t force it” was a saying of his often used in this situation when one was trying to cure the incurable. His involvement with and treatment of the patient, attention to detail and a broad background was brought to all of us who were his students and to the specialty as a whole. His work ethic was “the day begins at 8 and never ends”. The Teacher “I am perfectly willing to let you make your own mis-
takes.” This was a favorite remark of Dr. Buschke’s in referring to his willingness to let his residents try new techniques or repeat old techniques which he himself felt would be unsuccessful, but which he felt one had to try on one’s own before learning what was and was not useful. He
January 1984, Volume 10. Number 1
was an excellent teacher in the classical sense. He taught by example, by scarification and by excellent lectures. ‘His knowledge and extensive clinical experience was strengthened by his true affection for the student and love of teaching. As a resident, medical student, or junior faculty member he allowed you to grow, experiment and yet come back to him as needed for further wisdom based on experience. Teaching was the area he enjoyed most of all those areas related to clinical oncology. The Scientist
“Statistics are like a bikini, what they reveal is interesting, what they hide is essential.” This quote exemplifies Franz Buschke’s skepticism about much published literature and his analytic approach to a review of the work of others as well as his own work. He was a very critical, analytical clinical scientist who pioneered supervoltage radiotherapy and in particularly the treatment of bladder, esophageal and gynecologic cancers. Pituitary tumors and head and neck carcinomas were another major interest of his and he was one of the early developers of combined preoperative irradiation and surgery along with Maurice Galante. Franz Buschke’s publications, including an early text on cancer with Max Cutler, his book with S. T. Cantril and Robert Parker on supervoltage radiotherapy and the three volumes on progress in radiotherapy still remain valuable reference works. He leaves these legacies as well as a large number of scientific papers permanently behind him in literature. Personal Remembrances
There have been two major professors in my own life, both were German-born and trained in the gymnasium tradition, both were Jewish and both were complete human beings. The first was my mentor and German teacher at Dickinson College and the second was Dr. Franz Buschke. He replaced the father that had died while I was in medical school and guided me through my residency, junior faculty position and the beginning of my tenure as Chairman of the Department. The transition from his leadership to mine was smooth, his help was always there but he was never domineering and never tried to turn back the clock. As a physician, oncologist, and as a person I owe much more than I can summarize here briefly to this man, his philosophy and his guidance. Dr. Buschke unfortunately is no longer living but he never was a dinosaur. His beliefs, training and approach to medicine and life are as valid today as when he began his career in the much different world of the 1920’s.
Theodore L. Phillips, June, 1983
M.D.