Lifetime Achievement Award: Dr. Gerald W. Friedland

CNN's "Voice of the Millennium" in 1999. He was featured on CNN because in the last few pages of their book, Drs. Friedland and Friedman state that they believe the future cure of mental health disorders, such as schizophrenia and manic-depressive disorder, will be one of the next great discoveries. Due to their interest in research for mental health disorders, former first lady Rosalyn Carter as well as Tipper Gore also appeared on CNN's "Voice of the Millennium," along with Dr. Friedland. In addition, Medicine's 10 Greatest Discoveries was featured on the History Channel's "Mavericks, Miracles and Medicine" in 2003. This past year, Dr. Friedland was invited by the Friends of the Cape Medical Museum to give a talk on his book at the Cape Medical Museum in South Africa, which features exhibits from the history of medicine in the Western Cape.

As the son of a radiologist, Dr. Friedland's deep interest in medical discoveries began at an early age and he eventually chose radiology as a career, despite the admonitions of his father that he become a dermatologist. After graduating from Pretoria University Medical School in South Africa, Dr. Friedland completed a three-year residency in internal medicine, which consisted of one year in cardiology (1959-60) and gastroenterology (1960-61). After passing his exams in internal medicine and gastroenterology, Dr. Friedland became a Member of the Royal College of Physicians of Edinburgh (MRCPE) in 1961 and began his residency in radiology at Glasgow University in 1962. He was senior research resident in radiology in 1964, funded by the British Medical Research Council at Cambridge University. After receiving his Diploma in Medical Radio-Diagnosis (DMRD) from the Royal College of Physicians of London and the Royal College of Surgeons of England as well as becoming a Fellow of the Royal College of Radiologists (FRCR), Dr. Friedland worked for two years at the Great Ormond Street Hospital for Sick Children, where he became experienced in gastrointestinal radiology, uroradiology, and pediatric radiology.

Well aware of Stanford's outstanding reputation, Dr. Friedland began considering a radiologic career in the United States. His wife's severe mold allergies, precipitated by living in the old houses in England, also provided impetus for his career move. When he contacted Stanford to inquire about job possibilities, he was surprised to learn that Stanford Professor of Radiology Leslie Zatz was in London. "In lieu of an interview, Dr. Zatz spent one week following me around and observing me at the Great Ormond Street Hospital for Sick Children," Dr. Friedland remarked. "At the end of the week, he offered me a position at Stanford, so I came to Palo Alto and began as an assistant professor of radiology in 1967."

Within a few years, he was promoted to associate professor of radiology and completed important work in embryology. While on a six-month sabbatical at the Carnegie Institute of Embryology at the University of California, Davis, Dr. Friedland discovered that the descriptions of embryology in the textbooks were based on the embryos available at the Carnegie Institute in the early 1900s. He examined the most recent embryos at the Carnegie Institute and found that the literature did not contain any descriptions of these more recently acquired embryos, which were at a much earlier stage of embryonic life. As a result of his research, he coauthored "The Staged Sequential Development of the Anus and Rectum in Human Embryos and Fetuses," which was published in the Journal of Pediatric Surgery in 1974 (9(5):755-769). Because of his innovative research, Dr. Friedland received the 1974 Cum Laude Award, along with Dr. de Vries, from the Radiological Society of North America (RSNA) in the Basic Science Division for his exhibit entitled "Ano-Rectal, Spinal and Urinary Tract Malformation: Their Embryologic Basis."

Despite his success at Stanford and great admiration for our Department, Dr. Friedland left Palo Alto in 1975 to become professor of radiology and chair of the division of diagnostic radiology at Bowman Gray School of Medicine at Wake Forest University in Winston-Salem, North Carolina. While Bowman Gray was a great learning experience, Dr. Friedland missed his colleagues at Stanford as well as the California culture.

After three years in the South, Dr. Friedland returned to Stanford and became a professor of radiology in 1978 at the Palo Alto Veteran's Administration Hospital (VA), where Dr. Zatz was chief of radiology. Dr. Friedland conducted some of his greatest research achievements of his career at the VA. In the late 1970s, he settled an age-old debate surrounding four theories about the anatomy of the lower esophagus. Some thought that the esophagus had no sphincter; or, that the sphincter was at the top end of the esophagus; or, that the sphincter was at the bottom end; or, that the sphincter was very long and extended across most of the esophagus. To test these theories, Dr. Friedland dissected the esophagus during autopsy; distended it with formalin until it became fixed; drained the formalin and filled the esophagus with barium; and then X-rayed it. He found that all four theories about the appearance of the esophagus were really just descriptions of four different phases of the esophagus caused by the contraction and relaxation of muscles. He published his ground-breaking research, "Progress in Radiology: Historical Review of the Changing Concepts of the Lower Esophageal Anatomy: 430 B.C.-1977" in the American Journal of Roentgenology in 1978 (131(3):373-388), and he received letters from as far away as Czechoslovakia congratulating him on his discovery.

A few years later, he also completed important work in sonography that greatly improved the lives of spinal cord injury patients at the Palo Alto VA Hospital, who were receiving high doses of radiation because they needed X-ray examinations of their bladder and urethra every six months. Along with Drs. Shapeero and Perkash, Dr. Friedland developed a new sonographic technique to produce images of the bladder and urethra that were equivalent to those produced by X-rays, but were acquired without any exposure to radiation. They published their research entitled "Transrectal Sonographic Voiding Cystourethrography: Studies in Neuromuscular Dysfunction" in the American Journal of Roentgenology in 1983 (141(1):83-90). He and his colleagues were awarded first prize from the American Institute of Ultrasound in Medicine for their exhibit, "The Sonographic Voiding Cystourethrogram," which was based on their work.

Dr. Friedland's research has infused his pedagogy. Along with Drs. Filly, Gross, Kempson, Korobkin, Thurber, and Walter, he was the first to produce a reference text based on his uroradiological research, Uroradiology: An Integrated Approach (1983), which was organized by symptom, rather than by disease or diagnosis. He recently visited the Urology Museum in Lithicum, Maryland, where, to his surprise, this book was displayed. The Museum curator asked Dr. Friedland to sign the book, while informing him that the urologists who organized the Urology Museum considered Uroradiology: An Integrated Approach to be the greatest uroradiological book of the twentieth century. Dr. Friedland's pedagogical talents extended into the classroom, where he received the Excellence in Teaching Award by the diagnostic radiology residents in 1998 and an award for excellence in resident education in 1992. While he was working at the VA Hospital, Dr. Friedland was asked to speak about his research on two separate occasions in Italy, first in Florence and then in Verona. In recognition of his contributions to medicine and science, the Gerald W. Friedland Learning Center was established at the Palo Alto VA Hospital Diagnostic Radiology Section in 2004.

After succeeding Dr. Leslie Zatz in 1989, Dr. Friedland served as chief of the radiology service until his retirement in 1992. Recently, he completed cardiac patient interviews for a book called Heart Attack: Advice for Patients by Patients. Dr. Friedland also continues to teach, and, for four hours each week during the spring quarter, he and Dr. Charles Prober, professor of pediatrics at Stanford, teach a course based on Medicine's 10 Greatest Discoveries to premedical students. In addition, he and his wife, Dr. Miriam Friedland, enjoy visiting their two daughters. Their younger daughter, who lives in Bethesda, Maryland, with her husband and three daughters, is a professor of pediatrics at the National Children's Hospital in Washington, D.C. Their older daughter does marketing consulting in Albuquerque, New Mexico.

On June 17th, Dr. Friedland will be giving a talk at the Stanford Department of Radiology based on his book Medicine's 10 Greatest Discoveries, charting the innovations that were integral to the creation of modern medicine.