 | Dr. Gerhard Giebisch |
Dr. Gerhard Giebisch had a difficult time early in his career choosing between the large, smooth, mysterious liver and the twin powerhouses, the kidneys.
The kidneys prevailed.
"The liver was my first love," says Giebisch, now Sterling Professor Emeritus of Cellular and Molecular Physiology. "With the kidney you could measure what went in and what came out. You also could see the kidney tubules. With the liver, everything was hidden inside."
Giebisch has spent his entire career examining how the kidney functions at the micro level. "His work is largely responsible for the field's current understanding of the cellular and molecular mechanisms underlying regulation of renal potassium excretion," says Dr. Peter Aronson, the C.N.H. Long Professor of Internal Medicine and professor of physiology.
"There are thousands and thousands of substances that the kidney controls," explains Giebisch. "The kidney is not a sieve; it is a control organ. It is one of the most complex control organs we have because it responds to minute changes in the blood's composition."
"If you eat a hamburger, you eat a certain amount of salt in it. The precise amount of salt in that hamburger must be excreted over a period of time, otherwise you would swell," he says. "How does the kidney sense that you ate one hamburger or two hamburgers or half a hamburger? The kidney must be precisely informed and regulate appropriately to the changes in salt input.
"You can't live without a kidney," he adds. "Three weeks without a kidney and you're dead. If the brain stops, you fall asleep; muscles relax. But if the kidney fails, all of these other organs perish. The kidney is the master chemical director of the show."
Giebisch settled on what would become his life's work as a renal physiologist after reading a seminal book on the subject, Homer Smith's "Porter Lectures," and later Smith's "The Kidney." It was Smith who made renal clearance techniques the major tool for understanding how the kidney handles various substances, Giebisch says. He recalls that -- as an impoverished medical student in his native city of Vienna -- he wrote to Smith and asked for a free copy of his book, which Smith graciously sent to him. Giebisch went on to receive the Homer Smith Award of the American Society of Nephrology in 1971. It's just one of numerous awards he has garnered in his career, including the Johannes Muller Medal of the German Physiological Society in 1980, election to the American Academy of Arts and Sciences in 1983, election to the National Academy of Sciences in 1984, and five honorary doctorates.
Another influence on the Yale scholar during his early years in medical training was the treatise "Modern Methods for Studying Renal Function" by Swiss internist Otto Spühler, who later invited Giebisch to work in his laboratory as a three-month visiting fellow. It was while Giebisch was in Zürich that he became acquainted with the rapidly expanding modern renal methodologies in the United States.
Not only was renal research more advanced in the United States, says Giebisch, medical training was also very different. Instead of attending the kind of small classes found in U.S. schools, he was one of 1,800 freshmen in his medical school in Vienna. Everyone with a high school diploma in Austria is accepted to medical school, he notes, and the number of first-year students still hovers around 1,000.
"Medical school training was five years," Giebisch says. "There were no written exams, only a few oral ordeals. There were few, if any, modern books, and you faced a fairly bleak future."
Despite the lack of personal attention, Giebisch says, he had several inspiring teachers who succeeded in making their students feel that basic science was exciting and important. One professor in particular, Franz V. Brücke, was instrumental in Giebisch's decision to become a physiologist, he says.
In 1951, Giebisch decided to come to the United States, and, with the help of an American friend of his father's, he was accepted as a rotating intern at Milwaukee Hospital. He also married the friend's daughter, Ilse Riebeth, and they will celebrate their 53rd wedding anniversary in December.
During his internship he applied for postdoctoral training in renal physiology at several institutions and decided on Cornell University Medical College, now Weill College of Medicine of Cornell University, where he worked from 1952 to 1968 with Robert Pitts, a leading renal physiologist at the time. Pitts had already made fundamental contributions by pioneering studies on the organization of the respiratory center before doing seminal work in acid base regulation by the kidney.
After about three years, Pitts allowed Giebisch to pursue his own research interest -- the effect of hormones on kidney function, particularly adrenal hormones. Giebisch left for one six-month period to learn tubule micropuncture from Phyllis Bott at Women's College of Medicine in Philadelphia and took another one-year sabbatical to study with Silvio Weidmann in Bern, where Giebisch learned voltage clamp methods to expand his electrophysiological background.
In 1968 Giebisch received an offer to become chair of the Department of Physiology at Yale, which was strong in transport physiology and nephrology. He was chair for five years before stepping down to pursue his research full time. By this point, he was fascinated with potassium since it involved filtration, reabsorption, secretion and excretion. The late Dr. Robert Berliner, former dean of the medical school, had established the basic overall principles of potassium handling and became both a mentor and friend.
While learning the process of tubule micropuncture with Bott, Giebisch happened across a paper by Paul Müller, a biophysicist who described an ultramicro-flame photometer permitting him to measure sodium and potassium on Ranvier nodes of single mammalian nerve fibers. Müller helped Giebisch build a new and improved version of the device, and Giebisch's flame photometer later was adopted by several labs, including the Max Planck Institut in Frankfurt.
The field of kidney research has evolved over the years from the heyday of the clearance method to studying the transport process in single cells, says the Yale professor. "We now can also clone specific transporters, take a transporter out, look at it
When Giebisch retired last year, his research achievements were recognized in a symposium at the Anlyan Research Center that drew colleagues from around the globe. This fall, he helped organize another international conference, this one held in Switzerland honoring the achievements of his Yale colleague Robert Berliner.
Were he entering the field today, Giebisch says, he might become very interested in transplant rejection or how diabetes destroys the kidneys. Another process that intrigues him is how, once diseased, the kidney turns on itself, beginning a relentless march toward its own annihilation.
For now, Giebisch is easing into retirement, finding time at last to read the classics, attend the opera, travel and indulge a life-long interest in photography. He also has more time for his wife as well as his two adult children and four grandchildren, who live nearby.
The Yale researcher's daily presence is missed in the department, says Aronson, a longtime colleague. "Dr. Giebisch is widely respected for his integrity, modesty and generosity. He has earned the universal respect, admiration and affection of his colleagues and friends."
When not driving a used Porsche he bought from his car mechanic, Giebisch is often planning a hiking adventure. An avid mountain climber, he spent years exploring the Dolomites with some Swiss colleagues who are also mountain climbers. He says he finds the variations in the topography -- the glacial contrast between rock and ice, the vegetation and the clouds -- to be beautiful and arresting.
"Things from the top look very good," he laughs. "And in the evening, after having hiked the whole day, to look up at the mountains is like looking at art. It is very satisfying."
-- By Jacqueline Weaver
T H I S
Doctor's career spent researching
body's 'master chemical director'
and express it in isolation," Giebisch says. "Or we can use genetically modified animals, deleting one of the critical potassium transporters."
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