A UCLA doctor is on a quest to free modern medicine from a Nazi-tainted anatomy book

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As Dr. Kalyanam Shivkumar pondered really to hole nan quality heart, he was fixed a gift laced pinch horror.

Shivkumar, a cardiac electrophysiologist known arsenic “Shiv” to friends and co-workers astatine UCLA, was trying to amended understand nan intricate specifications of nerves successful nan chest. He hoped doing truthful mightiness thief him amended treatments for cardiac arrhythmias — aberrant rhythms of nan bosom — that tin beryllium dangerous and moreover deadly.

A Canadian workfellow sent him a group of anatomy books renowned for nan beauty and item of their drawings, but tipped him disconnected that nan “atlas” had an appalling history.

Shivkumar was aghast to study it was nan activity of an ardent Nazi whose Vienna institute had dissected nan bodies of prisoners, galore executed for governmental reasons aft Austria was annexed to Nazi Germany successful 1938.

“Every clip I unfastened up that book,” he said, “my consciousness is revulsion.”

Shivkumar is simply a large thinker, an erudite expert speedy pinch an apt quotation, whose Westwood agency is stacked pinch Sanskrit volumes of nan Mahabharata alongside books related to legendary Bruins hoops coach John Wooden.

Dr. Shumpei Mori sets up a donated bosom to beryllium photographed astatine UCLA.

Dr. Shumpei Mori sets up a donated bosom to beryllium photographed astatine UCLA arsenic portion of nan Amara Yad task to create new, ethically made anatomical images.

(Allen J. Schaben / Los Angeles Times)

As he waded into nan scholarly statement complete utilizing nan tainted atlas, nan expert bristled astatine proceeding others praise its illustrations arsenic “unsurpassable.” Much of nan psyche searching among physicians had revolved astir erstwhile and really to usage it. Shivkumar wanted to put those questions to bed.

“Could we beryllium better?” he asked. “Could we not beryllium making thing that’s wholly untainted?”

That mobility would motorboat Shivkumar connected a quest that has lasted much than a decade and is expected to strengthen for years. He wants to surpass nan anatomical atlas created by Dr. Eduard Pernkopf, a fervent protagonist of nan Nazi authorities whose activity was fueled by nan dormant bodies of its victims.

His passion task astatine nan UCLA Cardiac Arrhythmia Center is called Amara Yad, a mashup of Sanskrit and Hebrew meaning “immortal hand.” The activity has relied connected nan generosity of group who person willed their bodies for usage astatine UCLA, arsenic good arsenic hearts that were donated but could not beryllium utilized for transplant.

So far, Amara Yad has completed 2 volumes focused connected nan anatomy of nan bosom and is enlisting teams astatine different universities for more. The scheme is to draught a freely available, ethically originated roadworthy representation to nan full assemblage that eclipses nan weathered volumes of watercolors from Pernkopf and honors nan Nazis’ victims.

Anatomists person told him, “‘You’re crazy. It’s impossible. How could you ever surpass it?’” Shivkumar said of nan Pernkopf atlas successful a reside past twelvemonth earlier members of nan Heart Rhythm Society.

But “can it beryllium beaten? The reply is yes.”

For decades, nan origins of nan Pernkopf Atlas were chartless to galore who turned to its pages for guidance. Swastikas tucked into signatures of an illustrator were airbrushed retired successful later editions. Its history began to trickle out successful journals successful nan 1980s.

When Dr. Howard Israel yet learned of its roots, he was horrified. Israel, an oral surgeon astatine Columbia University and self-described “very mean American Jew,” told the New York Times he had been relying connected nan book since he was a aesculapian student.

“I felt stupid astatine utilizing nan book,” he told nan newspaper, “that I could perchance person benefited from thing that sounded truthful evil.” He and different expert enlisted nan Holocaust remembrance group Yad Vashem and publicly pushed for nan University of Vienna to analyse whose bodies were depicted successful its pages.

The resulting probe recovered nary grounds that nan anatomy section nether Pernkopf — who had ascended to go dean of nan aesculapian module astatine nan University of Vienna successful 1938 — had received bodies from nan Mauthausen concentration camp, arsenic immoderate had wondered.

But nan institute had been fixed astatine slightest 1,377 bodies of executed people, astir of them sentenced to decease for governmental reasons. Among nan charges that led to their executions: “crimes of resistance” and “high treason.”

Using nan bodies of executed group was “a centuries-old believe successful anatomy,” preferred because anatomists could clip their activity swiftly aft a scheduled death, said Dr. Sabine Hildebrandt, an anatomy pedagogue astatine Harvard Medical School. What was caller nether nan Nazis, she said, was nan sheer number of executions.

The institute “was drowned successful bodies,” and “the root for these bodies was mostly connected pinch nan servants of nan state of repression of nan Nazi regime,” said historian Herwig Czech, a personnel of nan Lancet Commission connected Medicine, Nazism, and nan Holocaust, astatine a caller forum.

By nan clip those findings emerged, nan patient of nan anatomy book had stopped printing it.


Stacks of books connected a support successful an office


A close-up image of a area of an illustration successful a Pernkopf atlas volume. The creator added a swastika to his signature.

1. A stack of volumes of nan Pernkopf atlas connected a support successful Dr. Kalyanam Shivkumar’s UCLA office. 2. Erich Lepier, 1 of nan Pernkopf atlas illustrators, many times included a swastika aft nan cursive R successful his signature. (Allen J. Schaben / Los Angeles Times)

Yet usage of nan atlas persisted. Hildebrandt said that a decade ago, dental students successful her classes “were fundamentally giving each different thumb drives pinch bootlegged copies of nan caput and neck.”

Other anatomical atlases exist, but these illustrations had particularly good details, including of nan nerves extending beyond nan encephalon and spiral cord. One survey of nervus surgeons recovered that 13% of respondents were utilizing nan atlas. Among those who person publicly grappled pinch it is Dr. Susan Mackinnon, a room professor astatine Washington University School of Medicine successful St. Louis known arsenic a pioneer successful nervus regeneration.

“I utilized this textbook for years earlier I knew nan history of it,” she said. “My encephalon is contaminated pinch that. I can’t undo that.”

Mackinnon sought ethical guidance. Rabbi Joseph Polak, a Boston University adjunct adjunct professor of wellness rule who survived nan attraction camps arsenic a child, said 1 dilemma progressive a diligent successful excruciating pain.

Polak recalled that nan diligent had told Mackinnon that “if you can’t find nan nervus to extremity nan pain, past I want my limb amputated.” The rabbi walked done Jewish teachings that applied to nan ethical quandary and conferred pinch different experts, penning a group of recommendations called nan Vienna Protocol.

Among his urgings to doctors: If you usage these drawings, make it clear to patients wherever they came from.

The Third Reich wanted “to extinguish them and to extinguish yet each representation of them,” nan rabbi said of Holocaust victims, speaking astatine a caller forum astir nan atlas. But erstwhile a expert tells patients astir what happened to nan group depicted successful nan drawings, he said, “they’re being called retired of that darkness.”

Mackinnon now keeps nan atlas locked away. In nan uncommon cases she feels she needs to consult it to operate, she tells patients and co-workers astir nan man down it. His firings of Jewish doctors. The grim specifications successful its pages — shorn hair, emaciated bodies — that began to raise suspicions astir its unspeakable origins.

The only logic to usage it, she said, is to prevention personification from misery — and only if “nothing other will thief you.”

Dr. Kalyanam Shivkumar, wearing a laboratory overgarment and sitting down an unfastened laptop computer, gestures arsenic he speaks.

“Could we beryllium better” than Pernkopf? Shivkumar asked. “Could we not beryllium making thing that’s wholly untainted?”

(Allen J. Schaben / Los Angeles Times)

Shivkumar said his extremity is to destruct nan request to consult those pages astatine all. Inside UCLA’s Center for nan Health Sciences successful Westwood, he showed disconnected a donated heart, prepped and fresh for its close-up successful a area of nan laboratory outfitted pinch a achromatic backdrop and superb lights.

A spent bosom usually wilts for illustration a deflated balloon, but this 1 had been pumped pinch chemicals to imitate nan fullness of life. The squad first puts nan organs to usage successful research, past cautiously dissects them for imaging.

Bringing retired a bisected portion of a heart, Dr. Shumpei Mori displayed really its soul architecture could beryllium captured connected camera, threading a catheter done nan organ arsenic a co-worker snaked successful an endoscope.

“The soul building is really good and delicate,” said Mori, a master successful cardiac anatomy who had jumped astatine nan chance to do thing caller successful nan field.

“Even Pernkopf simplified nan anatomy” successful its drawings, Mori said. “What we are doing is much complicated.”

Dr. Shumpei Mori holds a bisected exemplary of a heart.

Dr. Shumpei Mori holds a elaborate exemplary of a heart. “Even Pernkopf simplified nan anatomy,” he said. “What we’re doing is much complicated.”

(Allen J. Schaben / Los Angeles Times)

The camera is acold from their only tool: The squad has generated 3-D images to exemplify nan dimensions of nan soul structures of nan heart; done CT scans to nutrient hand-held models; and utilized blase imaging from a microscope to uncover nan lattice of nerves connecting to nan organ — portion of nan signaling strategy that Shivkumar calls “the net of nan quality body.”

In different lab, Mori cautiously unzipped a container connected a metallic gurney to uncover nan stripped-down interior of a cadaver diligently dissected complete a twelvemonth and a half, its rib cage cracked unfastened for illustration a weighty book. Shivkumar pointed retired nan ray web of nerves stretching up done nan neck. Mori had painted them yellowish by hand.

The quality assemblage mightiness look for illustration well-traveled territory, but arsenic physicians activity to find little invasive ways of healing, specified arsenic attacking a crab pinch ultrasound, Shivkumar said location is “a volcanic desire for this benignant of information.” Snip nan correct nerve, he said, and you tin avert nan request for a bosom transplant.

“Pernkopf ne'er did nerves for illustration this,” he said pinch pride.

Amara Yad is besides an enactment of “moral repair” meant to grant nan victims, said Dr. Barbara Natterson-Horowitz, a UCLA cardiologist and evolutionary biologist who helped support nan project. The Nazi atlases “were for illustration documents of death. The atlases that Shiv is creating are really living, interactive devices to support life.”

When Shivkumar decided to motorboat nan project, he had been inspired by nan words of USC emeritus professor of rheumatology Dr. Richard Panush, who had pushed to group nan atlas speech successful nan room of nan New Jersey aesculapian halfway wherever he had worked, moving it to a show lawsuit that explained its history.

Panush said nan aged atlas should beryllium preserved only arsenic “a awesome of what we should not do, and really we should not behave, and nan benignant of group that we cannot respect.”

Doctors request to cognize that history to understand their ain civilized fallibility, Hildebrandt said. Physicians successful Nazi Germany “still thought they were doing nan correct thing,” she said, moreover arsenic they grounded to spot immoderate group arsenic human.

Rabbi Polak stressed that doctors astatine nan clip “had nan deepest, astir profound respect of nan masses.”

Yet erstwhile nan Nazis took power, “it turned retired that a immense proportionality of them were civilized sleazeballs,” Polak said. “They were nan first to subordinate erstwhile they saw that it could beforehand their careers.”

Model hearts successful different forms and views statement a bookshelf astatine UCLA.

Model hearts statement a bookshelf astatine UCLA. The Amara Yad task is moving pinch different universities to tackle different parts of quality anatomy.

(Allen J. Schaben / Los Angeles Times)

Shivkumar said that beyond making caller devices for physicians, nan Amara Yad task is moving pinch Oxford University to create an accompanying program that will research ethical failures successful medicine. Pernkopf’s anatomy book is only 1 example.

The history of nan atlas “invites nan contemplation of really doctors and aesculapian scientists and anatomists are related to a regime,” said Sari J. Siegel, who heads nan Center for Medicine, Holocaust and Genocide Studies astatine Cedars-Sinai. Thinking astir it underscores that “medicine is political.”

“It can’t beryllium divided from nan larger contexts successful which it exists.”

Shivkumar, calved to a Hindu family successful nan southernmost authorities of India, is utilized to group wondering why he became “possessed” pinch this project. He recalls first learning astir nan Holocaust from a photographer friend of his grandfather, a erstwhile newspaper editor erstwhile imprisoned for sedition against nan British Empire.

He was 11 erstwhile nan photographer showed him images making love to World War II, and it chilled him “to spot that quality beings could beryllium truthful sadistic to different humans.” As a child, his parents had told him they owed nan world because their portion of India was fortunate to beryllium agelong spared from specified conflict.

In Amara Yad, we “get a uncommon opportunity successful history to correct an unbelievably depressing stain that was placed successful our field,” he told nan Heart Rhythm Society.

It irritates him to deliberation of nan abundant resources that a Nazi had astatine manus to do this benignant of work. “Imagine having 5 Shumpeis!” he exclaimed astatine 1 point, gesturing astatine his workfellow who manus painted nan nerves. At UCLA, nan task has piggybacked connected ongoing investigation and relied connected donations. He is hoping to garner $500,000 annually to proceed and grow nan work.

But Shivkumar likes to quote nan Emperor Ashoka connected that point: “To do bully is difficult. One who does bully first does thing difficult to do. ... Truly, it is easy to do evil.”

Source latimes