In Honour of Professor Emeritus Dr. Paul Schweizer

“The healthy ones don't need a doctor but the sick ones do.” This was the maxim of Prof. Dr. Paul Schweizer, M. D. (Fig. [1]), who directed all his efforts in his 36 years as a doctor towards improving the care of sick children.

Fig. 1 Prof. Emeritus Dr. Paul Schweizer.

Prof. Schweizer was born on February 22, 1937 in Sauggart/Biberach. Prior to his medical career he worked as a school teacher. After graduating from school in 1956 he began to study philosophy, psychology and pedagogics at the Pädagogische Hochschule in Weingarten, graduating in 1958. From 1958 to 1961 he worked as a teacher to earn money to enter medical school where he started as a student in 1961. Two days after his graduation on 27 July 1966 he completed his thesis on the effect of X-rays on immunological pathways and white blood count. His thesis was supervised by Prof. Dr. Bock and Prof. Dr. Kallée. After his two years as a resident at the hospital of Tettnang he received the final “approbation” as a doctor in Germany. During his specialist training in general surgery, traumatology and paediatric surgery his teachers were Prof. Max Grob in Zurich, as well as Hofrat Prof. Walter Dick, Prof. Leo Koslowski and Prof. Andreas Flach in Tübingen. Paul Schweizer finished his training in general surgery on October 31, 1974 and worked as a senior physician and assistant professor from 1974 to 1980 at the Department of Paediatric Surgery of the University of Tübingen under Prof. A. Flach. Prof. Andreas Flach was the first head of the Department of Paediatric Surgery in Tübingen, which was first established in May 1971 and was the second department of paediatric surgery at universities to be established in Germany.

The intolerable experience of losing children suffering from inborn malformations of the biliary system led to new scientific investigations and clinical studies into the aetiology, pathogenesis and morphology of the development of the biliary system and its malformations. Paul Schweizer's scientific work during his first years as a resident and young assistant physician on biliary atresia led to his habilitation in which he presented a new operative technique for draining bile in biliary atresia. Professor Schweizer received the venia legendi for general surgery and paediatric surgery on June 20, 1974.

Professor Schweizer's scientific interest in anorectal, oesophageal surgery, and the resection of liver tumours prompted him to visit and work with well-known paediatric surgeons abroad such as Prof. Parks at the St. Paul's Hospital and Prof. Spitz at the Children's Hospital Great Ormond Street in London.

Professor Schweizer was designated extraordinary professor of general and paediatric surgery on July 11, 1979 and appointed head of paediatric surgery at the “Kinderkrankenhaus auf der Bult” in Hannover in 1980. On April 1, 1987 he was offered a professorship at the Department of Paediatric Surgery in Tübingen.

In 1987 he visited the Université Catholique de Louvain Cliniques Universitaires Saint-Luc in Brussels as a guest professor, where he specialised in paediatric liver transplants, and in 1989 he again spent some time at the Children's Hospital Great Ormond Street in London where he focused on liver tumour surgery.

Professor Schweizer made many important contributions to research, covering such subjects as the staging of liver neoplasms, the surgical approach to bilateral Wilms' tumours, the operative treatment of biliary rhabdomyosarcomas, methodical and analytical tests for the culture of human hepatoblastoma and neuroblastoma cells, the inhibition of ras-oncogene membrane binding in neuroblastoma cells and the inhibition of neuroblastoma proliferation in culture.

He wrote two monographs (Biliary Atresia, 1984; Hepatobilary Surgery in Childhood, 1990) as well as 19 book chapters on paediatric hepatology, gastroenterology, traumatology and oncology. He held 128 lectures at international conferences and performed over 32 000 operative procedures, including 5000 paediatric urological operations. The combination of this extremely rich practical experience and his scientific interest led to the development of four new and internationally acknowledged operative techniques: an extended hepato-porto-enterostomy for the treatment of biliary atresia, an anatomically guided papillotomy to remove incarcerated papillary concrements in children, a modified pull-through Duhamel's procedure and a modified anterior anorectoplasty.

As a resident and later as an assistant physician Professor Schweizer initiated and established the fields of thoracic paediatric surgery and paediatric traumatology at the University Hospital in Tübingen.

During his 30 years as a practising paediatric surgeon, the morbidity and mortality of many diseases in paediatric surgery, especially of inborn malformations, were drastically reduced. Thus, when Prof. Schweizer began his surgical training, nearly all children suffering from oesophageal atresia died; today the lethality for this malformation is less than 1 %. Similar progress was achieved for necrotising enterocolitis and defects of the abdominal wall (omphalocele and gastroschisis). In the last 20 years all children suffering from meningomyelocele, obstructive uropathy excluding urethral valves and isolated uni- or bilateral vesicoureteral reflux could be preserved from end-stage renal failure and dialysis. The percentage of children with urethral valves was reduced from 35 % to 8 %. This rapid progress in the surgical treatment of critically ill children was mostly achieved by the unremitting efforts of our teachers. Professor Schweizer, an internationally recognised and competent expert, was one of them. In addition to his scientific curiosity, his credo was always to gather patient-oriented knowledge and to incorporate it directly into his clinical routine.

In addition to his extensive medical work, Professor Schweizer was always a proponent of academic teaching. He has been dean of the Faculty of Medicine since 1999 and will continue in this function after his retirement. Professor Schweizer developed and introduced the “Studienplan 2000”, a reformed medical curriculum for the next generation of medical students. Due to his efforts a “Centre of Competence” for didactics in Medical Schools of the Federal State of Baden-Württemberg was recently established in Tübingen.

Since 1976 Professor Schweizer has been a member of several faculty committees, including the ethics committee and the studies committee. From 1994 - 1998 he was a member of the presidential committee of the German Society of Surgery and since 1990 of the presidential committee of the German Society of Paediatric Surgery. In his function as a paediatric surgeon and as an active member of several international therapeutic study protocols (CWS-92, CWS-96, SIOP) in the field of paediatric oncology he had a decisive influence on the modalities of therapeutic options.

In his function as a physician, a professor, and a teacher as well as a scientist Professor Schweizer actively promoted the development of paediatric surgery internationally. He represents the type of physician who looks beyond his particular speciality in order to integrate it into other, more general fields. In addition to its specialist areas, the Department of Paediatric Surgery in Tübingen also offers a wide spectrum which not many paediatric surgical clinics in Germany can match.

We would like to wish Professor Schweizer all the best and a fulfilled life with plenty of health and happiness for all his activities in this new chapter of his life.

H.-W. Hacker, Tübingen