Jan Waldenström was the grand old man of Swedish internal medicine, internationally known and respected. Few are privileged to have their names attached to a medical condition, but doctors all over the world know Waldenström’s disease, a special type of blood disorder with an often protracted course and varying symptomatology.
Jan Waldenström was the fourth generation in a distinguished family of doctors. His greatgrandfather was a general practitioner in the most northerly part of Sweden, responsible for a district almost the entire size of Sweden north of the polar circle. His grandfather became an internist in Uppsala where he was appointed professor of medicine. His father was a well known orthopaedic surgeon and professor at the Karolinska Institute in Stockholm. Three of Jan Waldenström’s sons, Johan, Anders and Erik, have followed him as the fifth generation in medicine.
Jan Waldenström had a classical education. He spoke fluent English, French and German, and was versed in classical music and well read in literature. He was a skilled botanist. I remember how on a scientific cruise round the world we arrived in Tahiti and were driven round the island by a woman chauffeur. She was amazed when Jan told her to stop and, running out into the rain, he climbed the roadside verge where he had spotted a rare flower he hadn’t seen for a long time.
Jan Waldenström grew up and went to school in Stockholm but studied medicine in Uppsala. He defended his thesis in medicine in 1937 and was appointed associate professor of theoretical medicine. His full professorship followed ten years later. In 1950 he moved to the University of Lund and the Malmö General Hospital where he acted as full professor of internal medicine and chairman of the department of medicine until his formal retirement 22 years later. During his later active years he was instrumental in establishing oncology as a new medical speciality in Sweden. Even in old age he continued a private practice in Malmö.
Jan Waldenström realized early in his career the importance of international contacts and in the mid 1930s worked with Hans Fischer in Munich. He continued to have close contacts with leading international internists throughout his life and he survived most of them.
In Munich he studied the substance which gives the red colour to blood, the porphyrins, and continued his work in Sweden by describing the inherited disease acute intermittent porphyria which is common in northern parts of Sweden. At medical conferences he was fond of demonstrating a several meter wide family tree. From symptomatology and death certificates he had been able to trace the disease back through many generations. He was responsible for one of the first real population studies in Sweden when he studied the prevalence of iron deficiency anaemia in the Uppsala region.
Later his scientific interest centred around the study of plasma proteins, a work greatly facilitated in Uppsala where he worked together with two famous Nobel prize laureates, Theo Svedberg and A Tiselius. It was his study of a specific very heavy plasma protein which led to his characterization of the disease macroglobulinaemia, now called Waldenströms disease. The first reports were published in 1944 in Acta medica scandinavica (117:216-247) - a journal he later edited. His follow up articles were published in the same journal forty years after the original publication, giving witness to an unusually long scientific career.
Jan Waldenström later became interested in so-called paraneoplastic phenomenons, the peculiar biological effects produced by various types of malignant tumours. In this context his work on the carcinoid tumour should be mentioned. Together with other researchers and clinicians he gave the first description of its complicated clinical picture and its explanation through the incretion of serotonin.
In spite of his many prominent scientific achievements, Jan Waldenström continued to see and help patients. He used to say that confronted with the problems of an ordinary patient common sense was often more important than science and statistics. ‘Let well alone’ was his advice. Just because something is wrong according to the textbook, it shouldn’t always mean you should interfere, it may not be necessary. He never tired of emphasizing the importance of a humanistic attitude. He liked to say that humanism is the basis of all science and stressed how important it is to listen to what the patient does not say.
Many of Jan Waldenströms important scientific contributions started at the bedside. He brought what he saw and heard from the patient to the laboratory for further studies. During later years he liked to point out that it was often possible to demonstrate how one inherited gene led to one defective molecule which in its turn created one disease.
Jan Waldenström was gifted with a sense of humour. He married twice and had five sons and two daughters. He liked to quote a famous medieval Swede who on his tombstone wanted the inscription: vixit dum vixit laetus - he lived happily as long as he lived. Jan Waldenstrom lived happily, in spite of the fact that his last years were handicapped by a leg fracture which bound him to his chair.
Lars Erik Böttiger