Lucien B. Guze, Medicine: Los Angeles
One of the finest teachers of internal medicine in his generation was taken from us when Lucien Benjamin Guze died of sudden cardiac arrest on March 14, 1985 at the age of 57.
Lu was born in 1928 in New York, attended New York University and George Washington School of Medicine, from which he received his M.D. degree at the age of 23. He did his core residency in internal medicine at Grady and Barnes Hospitals and then spent two pivotal years as a fellow in infectious diseases under Paul Beeson at Yale. There is little question that Beeson became and remained his “unreachable star” throughout a career of research and teaching that emulated many of the accomplishments of his mentor.
Lu moved to Los Angeles in 1957 and remained there for the rest of his life, rising to the rank of professor of medicine in residence at the UCLA School of Medicine by 1968. He was a member of the staff of Wadsworth VA Hospital (now VA Medical Center West Los Angeles, Wadsworth Division) throughout these 28 years, first as a clinical investigator and then, from 1959, as chief of staff for research. Under his stimulus and guidance, the research program at Wadsworth rose to great size and eminence. He was a powerful force toward strengthening the VA-UCLA relationship, a goal he worked for throughout his career. While still based at Wadsworth, he became chief of the Division of Infectious Diseases at Harbor General Hospital (now Harbor-UCLA Medical Center) in 1967 and continued in that position until 1981. Although only half-time at it, his brilliance as a teacher and as a judge of others led to the creation of a new program of great distinction at Harbor.
Lu was revered, to a degree that few teachers are, by students, residents and fellows. His one-month elective in infectious diseases for fourth-year medical students was, by a wide margin, the most popular elective program available at UCLA. He received the award as the best teacher in the school from no less than five graduating classes (and equalled Sherman Mellinkoff's
― 117 ―record of three years consecutively). He exhibited extraordinary breadth and depth of knowledge; he instinctively practiced and taught the art of medicine; and, above all, he identified with students. He was less of a teacher than a stimulator of learning. He created excitement without a trace of arrogance or condescension. He did important things for students without a shadow of self-importance.
The wider medical world recognized Lu Guze for his scientific contributions. His most important line of work was in experimental pyelonephritis. His group developed the first experimental model imitating the human disease; it was initiated by bacterial infection alone, without trauma, foreign materials, obstruction or ischemia of the kidneys. It was characterized by persistence of an inflammatory process even after all bacteria had been eliminated. The rat model was used for a wide range of studies demonstrating, among other things, that protoplasts were not pathogenetically important, that a mononuclear infiltrate far outlasted the bacterial infection, that there were many evidences of the presence of a renal immunologic reaction, and that serum of the pyelonephritic rat could not transfer the inflammatory process to another animal but parobiosis could (suggesting a cellular mode of transmission). In a similar model in mice, susceptibility to developing chronic pyelonephritis was shown to be influenced by H-2 haplotype, suggesting dependence on an immune-response gene linked to the major histocompatibility locus.
Guze and his collaborators worked notably in several other areas: with Harwick, he described mycoplasma arthritis in mice; with Yoshikawa, high-performance liquid chromatography to measure antibiotics in serum; with Edwards, the classic description of Candida ophthalmitis; and, with Chow, defined the role of anaerobic microorganisms in pelvic inflammatory disease.
Lu Guze received appropriate recognition for his scholarly accomplishments. In addition to the many teaching awards, he was singled out by the V.A. for the Administrator of Veterans Affairs' commendation in 1965 and the William S. Middleton Award for outstanding achievement in medical research later the same year. In 1967, he received the Arthur S. Flemming Award honoring the 10 outstanding young men in the Federal Government.
Throughout a life filled with accomplishments, Lu Guze remained unassuming. When problems arose, he would always say, “Let's have a chat over a cup of coffee.” Somehow, the problems usually dissolved in the coffee. He was inspirational and humanistic. As a friend, he was warm, considerate, gracious and protective. Lu also had courage. During the last 12 years of his life, his mettle was tested, first by a tragic and protracted illness of his first wife, Patty, and then by his own heart disease. He responded to both with understanding and hope.
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Lu Guze was a brilliant and scholarly man who left an indelible mark on the field of infectious diseases, on three major academic medical centers and on his many friends throughout the United States.
Lawrence Freedman David Solomon