In Memoriam - Andreas Flach

Andreas Flach was an important contributor to German pediatric surgery and, in particular, to pediatric urology. I first met him 1965 when I still was a medical student. He was a surgical senior house officer at the University Hospital of Tübingen. His interest in surgery of children and his surgical talent were already evident but he still intended to gain more experience in neonatal surgery. Therefore he spent some time with Max Grob, former head of the Department of Pediatric Surgery at the University of Zürich.

In 1969 he became Head of the Department of Pediatric Surgery of the University of Tübingen, the department that he had founded between 1962 und 1969 together with his clinical training teacher and academic mentor Hofrat Professor Dr. Walter Dick. In 1972 the position of Professor for Pediatric Surgery was established within this clinical department and Andreas Flach was the first to hold this chair.

In the following years he became an important clinical and academic leader in his field. His research was mainly focussed on questions concerning urodynamics in vesico-ureteral reflux (H. Mildenberger and P. Reifferscheid), pathogenesis of the funnel chest (H. Geisbe), embryology, pathogenesis and treatment modalities in extrahepatic bile duct atresia (P. Schweizer), surgery of hepatoblastoma (P. Schweizer) and short bowel syndrome (R. Bähr and U. Hofmann).

From 1978 to 1980 he was President of the German Society of Pediatric Surgery. In 2006 his dedication was recognized by the award of the “Fritz-Rehbein-Medaille”, the highest honour of the German Society of Pediatric Surgery.

In 1986 he retired. His serious illness and his patient suffering during the last two years came to an end early in the morning of Monday, October 30, 2006.

As an academic teacher he allowed his students much scientific freedom. He definitely expected scientific excellence from his young staff members but never put pressure on them. The term: “Publish or perish” was repugnant to him, but when he saw scientific interest or even curiosity in a young colleague he supported his activities with critical benevolence, efficiently and constructively. With this mental attitude he inspired confidence. In spite of this open-mindedness he did not share his leadership with others. He kept all threads in his own coordinating hands, but we - his medical team - hardly felt this. In the discussions that he liked to hold late in the evening, his understanding of the needs of a successful clinical science team became evident. Again and again he said: “A teaching hospital's efficiency results from each individual member's efficiency”. In order to be efficient he developed an alert sense for opportunities, picked up ideas and sorted them out critically. At the same time he had an acute sense of how to realize ideas, overcome obstacles, and he urged patience and reliability.

His personal concern was characterized by an intensive commitment for his patients, above all to their personality, in accordance with his belief that of the three commitments of an academic medical teacher - i.e., patient care, teaching and research - the first of these has to have priority over the other two.

Three talents made him an outstanding physician: his deep human sympathy with his patient's grief and their parent's sorrow, his attentiveness and his circumspection ready to help everyone. He also persistently demonstrated how to restrict diagnostic measures to a useful and reasonable degree in order not to burden the patient unduly. In this respect he also taught us to accept the limits of medicine. When I was still a junior staff member he said with regard to an inoperative liver tumour that I desperately wanted to remove completely: “Keep in mind that our medical work may be dangerous, strenuous and that it may be an ordeal, but that our work leads us to a better understanding of the tragedy of man's existence and can contribute to a better way of dealing with human grief.”

If I had to characterize Andreas Flach in two sentences I would say: “He was an authority without being authoritarian and he placed the personality of his patients in the centre of his considerations and his medical work. With this ideal attitude he unobtrusively influenced our social behaviour and our self-appreciation.”

Our time together will not fade in my memory. He left a life-long impression on me. His clinical and academic work will not be forgotten. We will remember him with deep respect.