Editor-in-Chief: Janusz Ostrowski IAHN Bulletin is the official E-Newsletter of the International Association for the History of Nephrology
INTRODUCTION Dear Friends, It has been three years now since the IAHN Bulletin was established. It has been delivered into your hands every six months, and here we come with the somewhat delayed release of the 6th issue. As we are still struggling with the lingering pandemic, with some countries experiencing its fourth wave, congresses and conferences on nephrology are held in an on-line manner. As good as it gets, it is still a far cry from a direct, face-to-face exchange. The emotions involved are not the same. As it is, the wide availability of vaccines has not yet been coined into an ultimate success in the combat with the disease. This, which I find difficult to grasp, is down to the fact that the number of those ready to be vaccinated is highly insufficient, as if they failed to understand that this is the only way to beat the pandemic. Anyway, it has occurred to me that limited contact possibilities require a more streamlined, modified format of the Bulletin to suit the situation. This is the task that should be taken on by the founding body of the Bulletin, i.e. the IAHN Council. This issue features articles by both well-known authors, including Natale De Santo and Garabed Eknoyan, and new ones like Maria Kalientzidou from Greece. You will also find brief notes about some honorary members of the Polish Society of Nephrology and meritorious individuals for the Society who sadly passed away in the first half of the year. I wish you a successful second part of the holidays and a quick return to the pre-pandemic reality. Janusz Ostrowski
No. 6, June 2021
Janusz Ostrowski Professor, Centre of Postgraduate Medical Education, Warsaw, Poland
Board of the International Association for the History of Nephrology Iwannis Stefanidis – President Janusz Ostrowski – Past President Ayse Balat – President Elect Vincenzo Savica – Treasurer Councillors:
Maria Kalientzidou Biagio Ricciardi Davide Viggiano Achmet Aciduman   Sylvie Opatrna        Przemysław Rutkowski
Introduction Philosophical thinking is often in demand during human life because it offers answers to the question of a rational and ethically justifiable decision under conditions of uncertainty and ignorance. Social epistemology plays a role here, as does decision theory, and, especially, risk ethics. When medical and philosophical communities meet they should not focus on abstract disputes with little-to-no applicability to the outside world. Risk ethics during crises of kidney diseases and healthcare services needs a philosophy in real time and risk-ethical thinking with a deadline, whereas theoretical philosophy acts without time limits. Shaped by the life skills of a medical community, philosophy can help to develop a special feeling for the ability of a whole society to endure what is unavailable in health crises. Philosophical practice can claim to treat sick societal behaviors. Anybody in a healthcare system could seek advice from philosophical practitioners, but in doing so be considered as a guest rather than a patient or client. Philosophical practice is neither looking for the best of possible worlds, nor for easy solutions. Philosophy offers for caregivers in all disciplines a cognitive process which has no blind spots. Although unintended, complacency is inevitably increasing with time in people belonging for longer periods to institutions and associations such as healthcare service systems. Philosophy consists in knowledge that abstains from tunnel vision and from inefficient communication. In philosophical practice, terms that may be qualified as pathological in the medical field are not excluded from discourses and are re-thought from the tradition of philosophy. The implications of complexity, systems thinking and philosophy for pediatricians. In our recent article [1], we wrote that natural sciences are based on inductive thinking, which involves reductionism and uses the concept of a single fact that can explain the whole (Figure 1). The humanities and social sciences offer the use of deductive thinking, which means starting from a hypothesis and then singling out facts that can be extrapolated from the view of the whole in order to explain the individual parts. This pathway starts by grasping the idea from complex systems thinking and it is completed if the suggested single fact fits into the concept of the whole. For example, a patient with unclear complex symptoms and signs suggesting a multi-system disorder can be diagnosed by molecular biology, biochemistry and genetics, using cross pathway analyses (Table 1). These methods can provide the proof of concepts being based on mono-causal or multi-factorial correlations. Cross pathway thinking will inevitably identify the complexity of nephrology [2-4] requiring complex systems thinking of nephrologists as well as of retired scientists and of young and developing researchers who all together could create an endless loop of thoughts, discourses and activities across borders under the umbrella of ISN, ERA/EDTA, IPNA, EAPE.
Jochen Ehrich Children's Hospital, Hannover Medical School, Hannover, Germany
Natale G. De Santo, MD Emeritus Professor, University of Campania Luigi Vanvitelli, Naples, Italy
Complexity of nephrology Complexity in nephrology does not only include complicated patients and severe kidney diseases. There are many factors contributing to complexity in nephrology such as medical technology, diagnostic algorithms and therapeutic guidelines, competition of nephrologists, ethics of research, teaching and training in nephrology. Nephrologists play a key role in ethical committees when dealing with transplantation, futility and palliative care. Shortage of time is severely affecting every day work and research of pediatric nephrologists. Last but not least, academic freedom is a right and although documented in the constitutions of university, it has to be maintained and prevented from unnecessary limitations. Medical technology Medical means not only the use of technical tools, but also the way of dealing with problems. Technology has become "a form of methodology of human interaction with reality” [5]. Technology is, therefore, not a thing that exists, but it is a "mental access to the consciousness of the world", thus, a particular form of thinking [5]. The question is, what kind of thinking does technology entail? This is where philosophy begins to play an important role. Gaining control over people, their achievements and machines is the claim of technology. This also involves quality control, control over the medical world—including nature and disease—and over doctors’ self-control, which may end in their self-exploitation. The technically induced idea of a fundamentally predictable world, therefore, is the result of a reduction in complexity that has been incorporated into technical methodology from the beginning [5]. This is done by establishing algorithms that are nothing more than an abstraction of reality. But every situation opens up a variety of possibilities that cannot all be grasped by algorithms, because every situation is too complex. The endeavor to find a technical solution inevitably reduces this complexity. Furthermore, standardization leads to regulation of human behavior, e.g. subordination to technically prescribed regularity. Moreover, in the alliance with technical thinking, scientific thinking threatens to become an automated, schematic handling of vital challenges that exclude life’s reality. The fact that technology tends to self-boost inevitably escalates these challenges to the next technical level of increase. This threatens to become an automatism which the individual person can no longer mentally follow, but must follow in order to maintain the connection to new developments [5]. Ultimately, the medical professions also threaten to lose sight of their mental dimensions and their ethical world, e.g. CRISPR/CAS and trans-humanist visions of a “new man” for those who can afford it. Technology after the COVID-21 syndemic “We can remember that Heidegger thought that technology would drive the world to a mere resource to be used. Indeed, we are still humans after the first and second wave of Covid-19 pandemic. Technology has given us distance teaching, smart work, online psychotherapies, medical and business consults, links with the world, including concert and theatre halls, and sport events We were and are humans since there is technology. For Heidegger “technology “is not a human activity, but develops beyond human control”; is “the highest danger”, risking us only seeing the world through technological thinking We are endangered, but probably the dangers may be less than the benefits (6). We live in a society of great changes (R.Baldwin, Globotics Upheaval: Globalisation, Robotics and the Future of Work 2019) driven by automation and globalisation” that have to do with 800 million jobs in the human cloud and will cause job displacements. Ours is a world of telemigrants who sit in a country and work in the offices of another country, of remote work and robots that make work in presence less important and keep migrants in their countries and will reshape the world and will have effects on white collars and will probably reduce their incomes and life-styles. However we have to use of both brain and heart. The “happy end” can be achieved. Being “humane is an advantage not a handicap”. Remote work, telemigrants and white-collar robots may be domesticated. However, we must bear in mind that “old rules will not count” and the “future does not set appointments”. Luckily enough, robots lack the “humane empathy”, so they are not invincible since they work only on the already known. We and our children may protect ourselves by selecting jobs done by huge groups of people, working together in well-defined places (by definition work in presence). We have the capability to determine the height and pace of transformation (6). Role of philosophers be in taming the risks of medical-information-education-communication-business technology Automatisms, routine, stereotypes and standards are facilitated by artificial intelligence and must be balanced with humanity, empathy and improvisation, an act of creative and innovative performing, without being unprepared for the unforeseen or unforeseeable. We must avoid a world of alienation when humanity moves into the second plan of medical care. The triangle of communication between patients, their families and health professionals must not be subjected to a fourth party, the computer and its algorithms or the robot. Philosophers could become pillars of strength when things go wrong in nephrology. In fact, decision-making in nephrology can be a huge challenge, and nephrologists may well worry about what happens when they have to make decisions in difficult situations. Many questions inevitably arise and need to be discussed in the team—which may include a philosopher. The essential questions will be: How quickly does pre-planning go stale and the needs arise to refresh it? Is there a lack of essential needs, logistics and supplies? How do we deal with professional incidents, disobedience, shortages, complacency and clientelism? What about the lack of confidence and cooperation of patients and their families, including non-adherence to therapy? The role of philosophers in supporting academic freedom of nephrologists Never have there been more scientific congresses than today. Nor have there been ever more scientific journals than today and more publications. Never have infrastructure, logistics, funding, communication and cooperation been better than today. Academic freedom in departments of nephrology at university hospitals enables nephrologists to engage in controversial research and critical inquiry concerning complex healthcare. It creates a scientific atmosphere to advance human knowledge in health sciences and health services, thus, protecting the health and well-being of people. Academic freedom is the right of academic staff members to teach undergraduates and train postgraduates. Academic freedom includes the right of nephrologists to practice research and publish the obtained findings regardless of prevailing opinion or institutional doctrine. It includes the freedom of nephrologists to express their critical opinion about their workplace. It also includes the freedom of academic nephrologists to become active members of national and international academic organisations. Last but not least, it includes mechanisms that sustain security of appointment and income of nephrologists. Conclusions If medicine refuses to have anything to do with philosophy, nephrologists would follow a narrowed and specialized way of thinking without being aware of the nature of this way of thinking. Our article points out several risks of a strict separation of scientific insight and sensory experience in kidney healthcare service systems. We conclude that complex systems thinking could become an extra tool in kidney care and renal research by respecting the multiple interactions of socioeconomic, cultural and environmental factors involved in kidney diseases. When patients and their nephrologists feel unsafe they must change their inner philosophy to change the way they see the world. Philosophers could become advisors or even pillars of strength when these feelings are at risk to go wrong. References 1. Ehrich J, Manemann J, Tasic V, DeSanto NG. The implications of complexity, systems thinking and philosophy for pediatricians. Ital J Pediatr 2021; 47:76-80. doi: 10.1186/s13052-021-01031-6. 2. De Santo NG (2019) Nephrology a discipline evolving into complexity: between complex systems and philosophy. J Nephrol 2019; 3: 1- 4. https://doi.org/10.1007/s40620-019- 00674-3 3. De Santo NG. Nephrology between reductionism and complex systems: the role of philosophy – Review of evidence and opinion. Eur J Molec Clin Med 2019; 7: 35–45. 4. De Santo NG. Nephrology: a prototype of a discipline evolving into complexity. The border with philosophy. Arch Hellenic Med 2020; 37(Suppl 2):80-84 5. Maio G (2019) Medizin gefangen im Stückwerkdenken. Zur Bedeutsamkeit der Philosophie für einen reflektierten Umgang mit Technik. Zeitschr Med Ethik 65:115-128. 6. De Santo NG. From the Needs and Wants of Children and Old-Olds to Technology Bull Eur Assoc Profs Emer 2021; 2(2): 23-24.
Figure 1.
Table 1.   Cross pathway analyses using the omics cascade  and the scientific ladder. The  - omics cascade The scientific ladder 1. genomics 1. basic science 2. transcriptomics 2. translational science 3. proteomics 3. clinical science 4. metabolomics 4. public health science
5. I have learned a new way to keep busy with all the free time that retirement and the lockdown provide: It is just as easy, or may be just as difficult, to take 3 hours to do what can be done in 30 minutes. Actually, when you take longer doing something you get a greater sense of accomplishment once you are done with it. An age old wisdom is that people who become good at this, usually end up claiming that there is not enough time to do everything! My wiser mother used to call it plain old ‘laziness’. 6. Speaking of the apathy of laziness, the monotony of life that comes with the lockdown presented a major challenge halfway through the year. The easy downhill path of letting things slip by from then on was increasingly tempting. I had to make a concerted effort to put a stop to it by restoring some order to the otherwise daily dulling routine of ‘eat, s**t, sleep, repeat’. I have since resumed my rituals of waking up early, exercising, shaving, showering and getting dressed every day as if I am going to work, and then finding something to do. By the end of the day though, I sometimes still question its futility but refuse to let it get me off track again. 7. As for waking up early, I continue heading to my computer and do my best at maintaining some level of intellectual productivity. But, finishing a manuscript is taking longer and longer, the number of times I end up revising a paragraph greater and greater, and the time I spent just staring at the computer screen more and more drawn-out. But I continue to forge ahead and plan to do so as long as I can. 8. I am increasingly aware of becoming forgetful. Never having been one of good memory that does not really bother me now. Hence, my New Year resolution: Apply this expanded skill of mine to forgetting the horrible year that 2020 has been. And now, with 2020 behind me in a few months I will be 86 years old. The oldest I have ever been but also the youngest I will ever be again. I still don’t understand why people complain about getting old, it does come with inconveniences but sure beats the alternative. Bravura and bragging aside, the realities of old age are increasingly in my thoughts. As I dwell on them, I find solace in the wisdom of Khalil Gibran, with whose poem on Fear I would like to conclude my missive: It is said that before entering the sea a river trembles with fear She looks back at the path she has travelled, from the peaks of the mountains, the long winding road crossing forests and villages. And in front of her, she sees an ocean so vast, that to enter there seems nothing more than to disappear forever. But there is no other way. The river can not go back. Nobody can go back. To go back is impossible in existence. The river needs to take the risk of entering the ocean because only then will fear disappear, because that’s where the river will know it’s not about disappearing into the ocean, but of becoming the ocean.
“Sweet are the uses of adversity…”(1) William Shakespeare Introduction Undoubtedly, the most dramatic and preeminent chapter of 2020 is the outbreak of a global pandemic of a novel Coronavirus (CoV-19) commonly known as COVID-19. Pathogens have profoundly influenced our evolution, causing epidemics that wiped out a significant number of our ancestors and contributed to the shaping of our history. Influenza pandemics have struck about three times every century since the 1500s, or roughly every 10-50 years. In the 20th century, there were 3 influenza pandemics which were named ”Spanish flu” in1918-1919, “Asian flu” in 1957-1958, and “Hong Kong flu” in 1968-1969 each of them harmed human life and economic development(2). Innovation The current pandemic opens its box and gives its woes to humanity, leaving as a last resort the hope for innovation. A new cut in society, in science, in religion, in art and the environment. Innovation in society-public health-politics Very few phenomena throughout human history have shaped our societies and cultures the way outbreaks of infectious diseases have. Outbreaks of disease often function as “great revealers,” of social problems that have gone unaddressed(3).
Maria Kalientzidou Renal Unit /Nephrology Department General Hospital of Kavala, Greece
The Black Death of the 1300s was devastating and wiped out up to 60% of the population in Europe and it was responsible for changing the economic and social structure of Europe and the creation of a middle class. Killing almost half of its population, led to labour shortages.The remaining workers were able to claim better pay the fair value of agricultural land declined and effectively ending the system of serfdom(3,4). In England, the Crown passed legislation in this regard the tensions created by which would eventually lead to the Peasant Revolt of 1381(5). During the colonization of America, completely new diseases such as smallpox, yellow fever and plague were part of the exchange between the old continent and America. New World slavery is a legacy of lack of immunity of the indigenous population, making Africans suitable for enslaving and this was a decisive factor in the whole history of the settlement of the Americas and also Australia and New Zealand. Yellow fever plays a huge geopolitical role in reorienting the balance of power among the great powers of the period. We see the emergence of the United States as a very significant regional power to eventually becoming a global power. In 1798, President John Adams stated the need for stricter quarantines enforced nationwide in the event of epidemics. Adams also signed the Act for the Relief of Sick and Disabled Seamen, which mainly set up hospitals at ports across the country to care for sick seamen. But the institution's function expanded to eventually become what is now the Public Health Service(6). Cholera was a disease of the Industrial Revolution that thrived on social tension and helped also to create it. It gave rise to enormous social tensions because it was clearly a class disease(7). The 1832 cholera epidemic was a social and political turning point in the rise of modern public health. The 1918 flu pandemic, also (inaccurately) called the “Spanish flu,” wiped out some 20 to 50 million people worldwide. Disproportionately killed more men than women, leading to a worker shortage, and allowed women to enter the workforce, even in jobs that were traditionally held by men, such as manufacturing. Soon women were asking for equal pay and not long after for voting rights. So the Spanish Flu changed women’s role in society and helped pass the 19thAmendment to the U.S. Constitution in 1920. It gave women “a job” but also “a step” for new ideas - paved the way for women's emancipation.This pandemic marshalled in a new era of public health. Public health started to look more like it does today, based on the practice of epidemiology—the study of patterns, causes and effects in disease. In the 1920s, many governments embraced new concepts of preventive medicine and socialized medicine. Russia, France, Germany and the U.K., among others, put centralized healthcare systems in place, while the United States adopted employer-based insurance plans. Massive public health crises tend to generate overall improvements to patient care, often in small ways that are easy to overlook. For instance, hospital beds changed over time from wood to metal for improved sanitation. The concept of social distancing has also influenced residential building designs. After the 1918 pandemic, public health officials recognized that closely packed urban housing was contributing to the spread of disease. Subsequent legislation addressed the issue. In the 1930s, Franklin D. Roosevelt’s New Deal required all apartments to have fire escapes, main hallways that were three feet wide, and separate bathrooms. Health is a "globalized" task led by international organizations whose leaders have a "global" concept about the issue of health. The International Sanitary Conferences (ISC), which began in 1851, aimed to prevent the spread of infectious disease. From the late 19th century through World War II, the ISC, oversaw the international response to, the spread of three diseases—plague, cholera, and yellow fever—until those responsibilities were transferred to what we now know as the World Health Organization. Since 2005, WHO regulations have established protocols and criteria for national health system readiness and also for what constitutes a "public health emergency of international concern," or PHEIC. Religion Once the pandemics were considered as a “Divine punishment for sins. The development of philosophy and science has seized man from the world "of divine rage and punishment " leading him to understand his relationship with his natural environment. The epidemic of the Black Death challenged man’s relationship with God. “How could it be that an event of this kind could occur with a wise, all- knowing and omniscient divinity?” The most significant impact of the Black Death was perhaps the weakening of the Catholic Church which would never regain the power and influence it had enjoyed before the outbreak of the plague(4). The Protestant Reformation in the 16th century would further weaken the Church. The Antonine plague that occurred in the Roman Empire affected ancient Roman traditions, leading to a renewal of spirituality and religiousness, creating the conditions for the spreading of new religions, including Christianity. During the Justinian plague as the nomadic Arab tribes, moving through sparsely populated areas and practising a form of protective isolation, were setting a stage for the rapid expansion of Islam(8). Arts(9) Plagues and pandemics have often been the most profound and shocking events for the people who experienced them, and the collective expression of this shock has often been through culture. The case of the Black Death stirs the problems of mortality and sudden death. Artists responded to this. One sees great attention to themes of the suddenness of death, that is, the danse macabre, where everyone is swept away. The cult of religiosity going across Europe and had a transformative effect on the iconography of European art. The medieval author Giovanni Boccaccio set his masterwork The Decameron (1351) in the midst of the 1348 bubonic plague, which the author witnessed firsthand in his city of Florence. In Shakespeare’s case, is that “plagues may have caused plays”. He was twice quarantined during two separate outbreaks of the bubonic plague. During this time he wrote Venus and Adonis, and The Rape of Lucrece, King Lear, Macbeth, and Antony & Cleopatra. British author Daniel Defoe and the Italian writer Alessandro Manzoni wrote historical novels based on the 17-century plague pandemic that swept through Europe. The Plague written, by Albert Camus, composed three years after an outbreak of bubonic plague in Algeria. The 1918 influenza crisis sparked some of the most important literary works of the early 20 century, including T.S. Eliot’s Wasteland, William Butler Yeats’ The Second Coming, and Virginia Woolf’s Mrs Dalloway. And the AIDS pandemic of the 1980s produced artists (pop art) such as David Wojnarowicz, Therese Frare and Keith Haring. Tuberculosis in the nineteenth century was considered as the a disease of the élite, of the artist, of the beautiful glorified operatic heroines. Artists like Toulouse-Lautrec painting of an anorexic-looking woman who’s putting rice powder on her face so that she’ll look pale like the tuberculosis people. Social distancing has even had an impact on fashion.Crinoline within women’s dresses provided much needed distancing from men but it also helped women to avoid contracting a fatal disease. Environment The global outbreak of coronavirus disease is affecting every part of human lives, including the physical world. The taken measures to control spread have significant effects on the environment by compiling the recently published data from research articles, NASA (National Aeronautics and Space Administration), US Geological Survey (USGS) and ESA (European Space Agency). These data reveal changes in deforestation, snowpack reflectivity, water quality, air and noise pollution atmospheric aerosols and many other barometers of environmental health(10,11)). Unfortunately, all researchers estimate that these positive environmental effects of the pandemic are not expected to last long. If humanity returns to its pre- pandemic environmentally destructive habits, the observed improvements will be reversed. Science Science has always been an ally of humanity in its struggles against crises. Pandemics were a challenge for scientists, a trigger and a research opportunity. At the time of the Black, Death doctors were allowed to perform autopsies to help determine the cause of death and managed to learn a lot about human anatomy. Among the most notable plague doctors of their time were Nostradamus, Paracelsus, and Ambrois Pare. The first known quarantine(8) was enacted in Ragusa (City-state of Dubrovnik) in 1377, where all arrivals had to spend 30 days on a nearby island of Lokrum before entering the city. This period of 30 days (trentine) was later extended to 40 days (quarenta giorni or quarantine). In 1665, Isaac Newton, a 24-year-old student from Cambridge, was among those forced to leave campus and isolate himself to his childhood home. During this time away (year of wonders) he discovered differential and integral calculus, formulated a theory of universal gravitation and optics(12). The Boston Smallpox epidemic of 1721 led to the first innovations that gave us vaccines. Edward Jenner developed the world’s first vaccine in 1798. This practice took the mortality rate from 14% to 2%. Just 200 years later the Spanish Flu spread across the world, and the public health knowledge that was gained from it eventually led to the first influenza vaccine just a couple of decades later. During the current pandemic, there was an improvement of "scientific communication and collaboration " within the scientific community and engaged in the radical sharing of data, materials, and ideas to fight the virus. In a matter of weeks, scientists openly shared samples, sequenced the SARS-CoV-2 virus, shared proteins associated with it, developed diagnostics, put vaccines into clinical trials, and began work repurposing old drugs to fight the disease. There was a movement from proprietary science in which we patent everything to open science(13). Humanity has never made such progress in a year, for any disease as in the case of Covid 19. Technology has a key role in controlling and reducing the by offering "innovative" tools to manage it. Throughout the COVID-19 pandemic, digital technologies have been used creatively to solve coronavirus-related problems in many parts of the world. The use of sophisticated technologies such as 5G, robotics, Internet of Things, Artificial Intelligence, drones, self-driving cars have been extremely helpful. Additionally, online training programs, e- Universities, and distance learning methods such as massive open online courses have opened unprecedented educational opportunities. The widespread use of devices embedding satellite navigation GIS (geographic information systems) ensure safety in public spaces, and better manage critical infrastructure in times of crisis we are living in(14,15). Epilogue It is a trying time for all of us, as our lives are upended and our routines are disrupted due to the pandemic. But global health crises have also sparked progress in culture and society, changing lives for the better. They can bring out and highlight the difference between individual self-interest and social responsibility as we have already witnessed in the time of the pandemic Covid-19. So a big question arises if we all are ready for learning anything from the history of the recent pandemic. References: 1. William Shakespeare. As you like it. Act 2. Scene1 2. W.Qiu; S. Rutherford; A. Mao; C. Chu. The Pandemic and its Impacts. Vol 9–10 (2016–2017) | ISSN 2161-6590 (online) DOI 10.5195/hcs.2017.221 | http://hcs.pitt.edu. 3. Walter Scheidel. The Great Leveler: Violence and the History of Inequality from the Stone Age to the Twenty-First Century. Published:Sep 18, 2018 4. Frank M. Snowden. Epidemics and Society: From the Black Death to the Present. Yale University Press,2019. 5. Lizzie Wade. From Black Death to fatal flu, past pandemics show why people on the margins suffer most.Science, May. 14, 2020. 6. Glenn McDonald. 5 Advances That Followed Pandemics.History JUL 15, 2020. 7. Alexandre White. How pandemics shape society. Hub staff report, Apr 9, 2020. 8. Damir Huremović. Brief History of Pandemics (Pandemics Throughout History). Psychiatry of Pandemics. 2019 May 16 : 7–35. 9. Isaac Chotiner. How Pandemics Change History. March 3, 2020. 10. Tanjena Rumea and S.M. Didar-Ul Islamb . Environmental effects of COVID-19 pandemic and potential strategies of sustainability. Heliyon. 2020 Sep; 6(9): e04965. 11. What we can learn from the Coronavirus crisis with satellite data. Euricy 25 March 2020. 12. How Isaac Newton Turned Isolation From the Great Plague Into a “Year of Wonders”. Foundation for Economic Education. March 27, 2020. 13. Jeremy de Beer and E. Richard Gold. International Trade, Intellectual Property, and Innovation Policy: Lessons from a Pandemic. 14. Hamza Mudassir. COVID-19 Will Fuel the Next Wave of Innovation. Entepreneur March 16, 2020. 15. Bill Gates..Innovation for Pandemics. N Engl J Med 2018; 378:2057-2060. May 31, 2018.
Garabed Eknoyan Professor at Baylor College of Medicine, Houston, Texas, USA
January 1, 2021 Dear family and friends, 2020 has been a year that is best forgotten. It certainly was not what I had anticipated in my last New Year missive when I reported my retirement on January 1, 2020. It started getting complicated in January with reports from Wuhan, followed by an illness of my older sister in February, and then through no fault of hers things have been getting worse by the week. Rather than lament the varied troubles we all have endured during the pandemic or whine over what could have been, I want to share with you some apolitical lessons I learned over the past year: 1. I am delighted that 2020 is over. Covid vaccines are finally available. I got my first dose on December 29. At least the Covid calamity is likely be over by this time in 2021. 2. The difficulties we’ve all had to cope with notwithstanding, I am grateful that most of us were lucky to get through the year without serious trouble or major indisposition. 3. I feel blessed that everyone I hold dear is still around and aging gracefully. I have dearly missed their hugs, kisses and shared celebrations due to the social isolation imposed by that horrible predator termed Covid-19. 4. I still believe that wine and scotch are divine gifts, but now realize that they were created to be shared. They just do not taste the same and certainly are not near as enjoyable when consumed in isolation.
Zbigniew Fałda MD, PhD (1930-2021) Zbigniew Fałda, MD, PhD was born on April 1, 1930 in the Polish capital city of Warsaw. He studied medicine at the Faculty of Medicine of the Medical Academy in Warsaw, currently known as the Medical University of Warsaw. Having graduated in 1954, Z. Fałda started working at the I Clinic of Internal Medicine at the Medical Academy in Warsaw, initially headed by prof. Andrzej Biernacki, and then prof. Tadeusz Orłowski. He participated in the first haemodialysis session in Warsaw, which happened to be the second one in Poland. He obtained his PhD title in 1973 and then was trained at Nils Alwall’s Clinic of Nephrology in Lund, Sweden, at the Nephrology Clinic in Moscow, Russia, and also with the legendary prof. Belding Scribner in Seattle, USA where he cared for Clyde Schield, the first patient to be included in a chronic haemodialysis programme. He also collaborated with Dr Tenckhoff, one of the pioneers of peritoneal dialysis. While working at Tadeusz Orłowski’s clinic he co-developed new technical solutions in the field of both haemo- and peritoneal dialysis. He was the author of numerous works on renal replacement therapy. It was in 1980 when he was accepted to do a scientific internship at the Hannover Munden Nephrology Centre in West Germany, and then took up permanent employment at the Clinic in Bad Wildungen as the Deputy Head and then Head of the Departments of Nephrology and Dialysis. Although he retired in 2000, he continued to participate in nephrology conferences in Poland in Warsaw, Poznań and Kraków. In 2008, he received the title of "meritorious for Polish nephrology" from the Polish Society of Nephrology. Doctor Zbigniew Fałda died on January 17, 2021 in Bad Wildungen, Germany. He was an exceptional man. His contribution to the development of Polish nephrology, and dialysis treatment in particular, was invaluable. At the same time, he was a friend and Teacher to many of us. Janusz Ostrowski Professor Franciszek Kokot (1929-2021) Professor Franciszek Kokot was born on 24 November1929 in Oleśno Śląskie, Poland. In 1953, he completed his medical education at the Medical Academy in Rokitnica Bytom, currently the Medical University of Silesia in Katowice. Still a student, he worked as a laboratory technician in the Department of General Chemistry, and later as a doctor in the Department of Pharmacology. Then, he started working in the 3 Department of Internal Medicine headed by the famous Polish internist, prof. Kornel Gibiński. In 1965, he became Head of the Division of Nephrology at the Department of Internal Medicine, and in 1975 Head of the Department of Nephrology, which in 1997 was renamed the Department of Nephrology, Endocrinology and Metabolic Disorders. F. Kokot ran the clinic until 2000, when he retired. In 1957, he defended his doctorate followed by habilitation in 1962. Professor Kokot participated in research internships in Geneva and London, which later proved decisive for his scientific interests. In 1982, he became professor of medicine. About 100 of his students have specialised in internal medicine or nephrology. Under his supervision, nearly 80 doctors obtained a doctorate and 30 habilitation, including 6 doctors from Germany. 14 of them later became professors. In 1982-1984 he was the Rector of the Medical University of Silesia. F. Kokot was the author or co-author of over 1000 articles published in reputable medical journals and the author of many books and academic textbooks. Moreover, he translated books of other eminent authors from German and English. His main scientific interests were endocrine disorders in acute and chronic renal failure, primary and secondary arterial hypertension including that following a kidney transplantation, as well as issues related to the renin- angiotensin-aldosterone system. He was one of the co-founders of the Polish Society of Nephrology, of which he was later president for 3 terms. He also actively participated in the work of the ERA-EDTA, where he was a council member three times. At the ERA-EDTA Congress in Paris in 2012, he was among the most eminent nephrologists from Europe, a group called Pioneers in Nephrology, and a member of many other scientific societies. These included the Polish Society of Internal Medicine, International Society of Internal Medicine, and Polish Society of Hypertension. He was also a full member of the Polish Academy of Sciences and the Polish Academy of Arts and Sciences. He received 10 honorary doctorate titles from Polish and foreign universities. He received many state decorations, incl. Knight's Cross and Commander's Cross of the Order of Polonia Restituta, and posthumously received the Order of the White Eagle. Professor Franciszek Kokot died on 24 January 2021 He was an outstanding speaker, teacher, researcher, doctor and for many Polish medical professionals – a living legend. His death is an inconsolable loss for the Polish science. Janusz Ostrowski Andrzej Więcek Doctor of Natural Sciences Sławomir Bautembach (1947-2021) Dr Sławomir Bautembach was born on 26 September 1947 in Gdynia, Poland. In 1971, he graduated from the Faculty of Physics at the Higher School of Pedagogy (now the University of Gdańsk). In 1973 he took on a position at the Department of Physics of the Medical Academy in Gdańsk, currently the Medical University of Gdańsk. In 1981 he defended his doctoral dissertation. During his work at the university, he collaborated with the Clinic of Nephrology, where using bioimpedance, he studied red blood cells in healthy people and those with renal insufficiency. After erythropoietin had been introduced, he studied the changes in red blood cells caused by the drug. In 1987-2005 he was the Administrative Director of the Medical Academy in Gdańsk and during that period he cooperated with the National Nephrology Team in the scope of national procurement of erythropoietin and medical equipment for haemodialysis and peritoneal dialysis. It was within this task that he was involved in developing a distribution system for these products in Poland, thus contributing to the improvement of the condition of dialysed patients. He also contributed to the creation of a model Department of Peritoneal Dialysis at the Clinic of Nephrology in Gdańsk. For many years he was a co-editor of "Report on the Renal Replacement Therapy in Poland". He was also a co-author of chapters in textbooks for doctors and nurses on the subject. He worked as an advisor at the Diaverum company. He participated in many national and international nephrology conferences. In 2008, the Main Board of the Polish Society of Nephrology awarded him with the title of Meritorious for Polish Nephrology. Dr. Sławomir Bautembach died on February 13, 2021 following a long disease. He was an affectionate friend and a helpful man. Janusz Ostrowski Boleslaw Rutkowski
Zbigniew Fałda
Franciszek Kokot
Sławomir Bautembach