Lives of the fellows

Jan Brod

b.19 May 1912 d.10 February 1985
MD DSc Prague(1937) FRCP(1969)

Jan Brod was born in Novy Jicin, Czechoslovakia. His father was a business manager and his mother, Marta Pachnerova, also came from a family in business. He went to school in the town of his birth and then to Charles University, Prague. After graduation he worked in hospitals in Prague and Vienna. He left Czechoslovakia at the time of the German occupation and held a French government research fellowship in Paris for almost a year. On the invasion of France he volunteered for the Free Czech Army and served in a first aid station caring for wounded civilians in Compiegne near the French front. On the collapse of France he became attached to a Czech field ambulance in Britain, and for a year was seconded as a house physician to the Warneford hospital in Leamington Spa. In 1942 he volunteered for the RAMC and served in Britain, North Africa and Italy with field ambulances, and later as a graded physician in a military hospital. He was mentioned in despatches.

On demobilization Jan became an assistant at the 1st Medical Clinic at Charles University, and spent a year as a Rockefeller fellow under Homer Smith at New York University. In 1951 he joined the Institute of Cardiovascular Research in Prague, becoming its director in 1963. He was the chief initiator of the ‘Manifesto of 2000 words’ in support of Dubcek’s liberalization policy in Czechoslovakia and had to leave Prague when the Russian tanks occupied the country later, in 1968. He was invited as visiting professor to Mainz, and in 1969 accepted the offer of the second chair of medicine at the Hanover Medical School, a position he held until his retirement in 1981.

Brod was a true European; he lectured extensively in many European countries and was conversant with some eight languages, in most of which he was fluent. In 1971 he delivered the Lilly Lecture at the College. He had an international reputation in the fields of nephrology and hypertension. He was a founding member of the International Societies of Nephrology and of Hypertension, and was president of the 2nd International Congress of Nephrology in Prague. He was a member of many medical societies and academies throughout Europe, and in Argentina. In Britain, he was a member of the Medical Research Society and the Renal Association, and shortly before his death was made a fellow of Green College, Oxford, and an honorary member of the British Hypertension Society. In 1961 he received the Purkinje medal of the Czechoslovakian Academy of Science. He wrote several monographs including a momumental work The Kidney, London, Butterworth, c.1973, which was translated into three languages from the original Czech, and over two hundred scientific papers.

Scientifically, his early work was in the field of renal diseases, particularly chronic pyelonephritis, and he will be remembered for introducing the endogenous creatinine clearance test into clinical practice. He progressed to the study of the disturbed homeostasis of water and electrolytes in heart failure and then, in 1954, he turned his attention to the pathogenesis of hypertension, a subject which was to remain his dominant interest right up to the time of his death. At first he was concerned with the autonomic control of blood pressure and the manner in which this is disturbed by external influences in normotensive and hypertensive subjects. With his research team in Prague he demonstrated that the response to the cold pressor test was enhanced in normotensive subjects to a greater extent in those with, than in those without, a family history of hypertension. His researches were extended to the study of the response to mental stress and to a more precise definition of the manner in which flow to various territories was selectively affected. He provided clear evidence that the pattern of haemodynamic response to emotional stress in normal subjects, involving renal and skin vasoconstriction and muscle vasodilatation, was similar to that in unstimulated hypertensive subjects. The peripheral response to such stress in hypertensives was shown to be greater and more protracted than in normotensives. These studies have largely been the stimulus to subsequent research workers in the field and have provided strong support for the existence of a genetic-environmental interaction in the pathogenesis of essential hypertension. With his research group in Hanover he continued his studies of haemodynamic changes in different forms of hypertension. In renal disease he demonstrated an early rise in cardiac output preceding the development of hypertension and possibly attributable to reduced venous distensibility. The rise in output was followed by a return to normal associated with a rise in peripheral resistance in more advanced hypertension. These findings, together with the observation that whereas vascular resistance in muscles is lowered in essential but unchanged in renal hypertension, provided good evidence for a difference in pathogenesis in the early stages of these two forms of hypertension. Brod continued his researches after his retirement and, within a few weeks of his death, he communicated recent original work to a meeting of the Medical Research Society, This was concerned with studies of the response of subjects with and without early renal disease to body fluid volume expansion and led him to the conclusion that renal hypertension was a consequence of altered sodium homeostasis, resulting in an increase of resting blood volume and increased susceptibility to fluid overload. Furthermore, he observed that subjects with early renal disease were unable to adjust to fluid overload and the associated increase in cardiac output by increasing arterial and venous distensibility and in consequence suffered a rise in blood pressure.

Brod was a bedside clinician in the English tradition and his ward rounds in Hanover were a unique experience for his undergraduate students. Many of these rounds were conducted in English and were attended by medical staff from the British Military Hospital in Hanover. He was a deeply caring doctor and taught respect for patients and avoidance of their discomfort. He wrote critically in later years about the substitution of clinical judgement by technology.

Brod regarded England as his second motherland, his beloved Czechoslovakia being barred to him. From the war years he retained a keen interest in the RAMC and it gave him great satisfaction to be made an honorary member of the officers’ mess both in Hanover and Millbank. He had a particular attachment to Leamington Spa from the time he was a house physician there during the war and, shortly before his death acquired a house there in which he planned eventually to retire. He was a staunch supporter of the College, and his record of attendances at meetings would put to shame many a Fellow resident in England.

His very many friends both in Britain and abroad speak of the warmth of his personality and of his unwavering loyalty. He had a quite phenomenal memory and could recall details of encounters with his friends long after they had forgotten. He often seemed more at home in each country he visited than did the natives themselves, and usually knew as much or more than they about their country’s history, topography, architecture, music and art. He was an accomplished pianist and a great lover of music, particularly Czech opera and Wagner. He was an invariable optimist, for had he not escaped in turn from Nazi persecution in Czechoslovakia, from the German Army in France, from the Coventry bombing in 1940, from the sinking of the Windsor Castle in the Mediterranean in 1942, and finally from the Russian communists in 1968. Although he could show anger, he never spoke with malice of anyone. He tended to converse too fast and not infrequently left his audience gasping in pursuit of his wide ranging ideas. He inspired good fellowship among physicians and research workers. Many throughout the world remember with pleasure attending the annual International Nephrological Symposia which he organized in Hanover and at which he created the perfect atmosphere for both the formal and informal exchange of knowledge. A visit to the opera was mandatory and even recalcitrant opera goers on these occasions were converted overnight by Jan’s enthusiastic interpretations of the complexities of the librettos. His private hospitality was unfailingly generous and spontaneous.

A visit by Jan to one’s own department would be an event to be remembered. He would pull out his notebook and record obsessionally the details of the exchanges, making apt comments and suggestions throughout. Thoughts expressed at such visits would be recalled unerringly years later.

Jan Brod married, at the age of 48, Elisabeth Staffenova, known to all as Ula, who had been a medical student of his at Charles University. It was an ideal marriage and gave him support through good times and bad, lifting his spirits and making it possible for him to achieve so much. A touching tribute to her appears in the dedication of his great book on the kidney. They had one son, whom Jan sent to be educated in England and who was an undergraduate at Magdalen College, Oxford, at the time of Jan’s death. Tragedy befell many of his family, for he lost 40 relatives in Nazi concentration camps, including his mother.

Tributes to him were paid at memorial services in both Hanover and Leamington Spa. His ashes were brought from Germany, at his request, to be deposited at Leamington Spa.

JM Ledingham

[, 1985,290,719-720; Lancet, 1985,2,470-471; The Times, 26 Feb 1985; J .Hyperlens., Oct 1985,3(5),527-8]

(Volume VIII, page 53)

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