Madame Suzanne Schiff-Wertheimer.
Madame Schiff-Wertheimer; Louis Paufique, professor of ophthalmology at Lyons, France; Gabrielle Sourdille, professor of ophthalmology at Nantes, France; Louis Guillaumat, ophthalmologist at Quinze-Vingts. Quinze-Vingts Hospital, Paris, France. Photo taken circa 1950.
Decoration of Madame Schiff-Wertheimer for her heroism during World War II.
Madame Schiff-Wertheimer as a grandmother.
Ravin JG. Suzanne Schiff-Wertheimer, MD, as a Role Model. Arch Ophthalmol. 2001;119(12):1845-1848. doi:10.1001/archopht.119.12.1845
The recent increase in the number of women in ophthalmology has been accompanied by a historical interest in female physicians as role models. Important questions arise in this search: How did these women achieve their positions? What obstacles did they have to overcome? How did their families, colleagues, and patients perceive them? What were their contributions to the field? One means of understanding how these concerns have been resolved successfully is to examine the career of an individual who performed particluarly well.
In France, Suzanne Schiff-Wertheimer, MD (1895-1958) (Figure 1, Figure 2, Figure 3, and Figure 4 stands out.1- 5 She is remembered as a brilliant, charming ophthalmologist who was a pioneer in modern techniques of retinal detachment repair. She was a native of Lyons, the third most populous city in France. Her family was bourgeois, but certainly not wealthy. During the early years of the 20th century, the number of women entering medicine in France and the United States was a small fraction of that seen today. In 1910, for example, there were only 707 women enrolled in all the medical schools in the United States, and 802 in France.6 Suzanne was fortunate that her family encouraged her toward a career in medicine. Her father practiced medicine in a working-class district. Her mother supported her scholastic interests, but died when Suzanne was 15 years old. Both parents gave their children a sense of charity and social justice — feelings they retained and acted on throughout their lives. Suzanne and her older brother, Pierre, both became physicians. Pierre Wertheimer, MD (1892-1982), was an esteemed professor of neurosurgery at the Lyons Faculté de Médecine and the author of more than 500 publications.7,8
An intelligent and industrious student, Suzanne excelled in school but did not go directly into medicine following her secondary education. Instead, she followed a more traditional path for women, becoming a nurse. As an orphan during World War I, she departed the war-ravaged country of France for neutral Switzerland and worked in the ophthalmology service of the University of Geneva. Her female role model there was Madame Gourfein-Welt, an ophthalmologist who was also the wife of the head of the ophthalmology department, Prof David Gourfein. Madame Gourfein-Welt encouraged Suzanne to go to medical school(letter to me from Claire Doz-Schiff, Schiff-Wertheimer's daughter, March 6, 2001). She followed this helpful advice and studied at the Faculté de Médecine, Paris, France. Her highly regarded thesis for the medical degree, "Les Syndromes Hemianopsiques dans le Ramollissement Cerebral" ("Hemianopic Syndromes in Cerebral Softening")9 was published in book form in 1926 and is considered a classic. She achieved very high grades in the rigorous competition for the few available internships at the Paris hospitals, and she performed admirably.
During the early years of her medical training, Suzanne worked with several illustrious physicians who influenced the direction of her career. First, she studied cardiovascular physiology and disease with Henri Vaquez(polycythemia is occasionally referred to as Vaquez disease). This was to prove helpful in her studies of ocular blood vessels. During the 1920s, she was an extern at the Salpêtrière in Paris, a major neurologic center. She worked, with 2 men whose names grace many syndromes, Pierre Marie and Charles Foix. Later, she studied retinal circulation at the Quinze-Vingts Hospital (Paris) with 2 highly respected ophthalmologists, Paul Bailliart(1877-1969) and Jacques Mawas (1885-1976). Bailliart, chief of the ophthalmological service and director of the medical unit, invented the ophthalmodynamometer. Mawas was the chief pathologist at Quinze-Vingts before moving to the Rothschild Hospital. Drawn to both ophthalmology and neurology, she chose to specialize in the eye.
In 1925, Suzanne married the highly respected and frequently published psychoanalyst, Paul Schiff, MD (1890-1947).10,11 After marriage, she became Madame Schiff-Wertheimer. Her decision to take on a combined name was personal and professional, not legalistic. The primary reason for the hyphenated name was that she had published articles before marriage using the name Wertheimer, and she wanted readers to be able to connect these publications to her after her marriage. Her mentor at Geneva had followed the same custom, as had a number of other women who were physicians in Paris. Before the 1920s, the general custom was to use only the husband's last name. During the next few decades, the custom was to add the maiden name, but in second position. It was an improvement, but in case of divorce, the woman was deprived of a clear bibliography, which remained alphabetized by the former husband's name. (Today, French professional women may choose to be known by their maiden names or hyphenate their last names by adding the husband's name in second position.) Their only child, a daughter named Claire, was born in 1929. (Like her mother, Claire adopted a hyphenated last name after her own marriage, becoming Claire Doz-Schiff. She did so at the request of her thesis director, who had been a friend of her father. She has retired from previous careers as a professor of philosophy at a lycée and a psychologist at a pediatric psychology center.)
During the 1930s, being a full-time physician and a parent was not an easy task. As for most bourgeois families of that era, the family had full-time help. Occasionally there was time for the 2 physicians, Schiff-Wertheimer and Schiff, to collaborate on an article in the medical literature.12
Paul Schiff was an important pioneer of psychoanalysis in France. Unfortunately, his career was severely interrupted by World War II. His life was threatened several times, but he emerged from the war as a true hero. He served as a military physician with the French army, and after the fall of France, with the Free French Forces. Sadly, Schiff died suddenly the day that Suzanne was honored by being named a chevalier of the French Legion of Honor. A decade later, she was promoted to the rank of officer of the Legion of Honor.
Her entire career in ophthalmology was spent at the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, the oldest eye hospital in the world. The Quinze-Vingts was founded by King Louis IX in the 13th century as a hospice for individuals who were blinded during the Crusades. The name Quinze-Vingts translates as "15 20," meaning "15 times 20," for the original 300 blind individuals. Medieval Frenchmen counted by 20s. Today, the Quinze-Vingts and the Rothschild Foundation are the only institutions in Paris devoted solely to ophthalmology.
Madame Schiff-Wertheimer achieved the rank of chef de service at the Quinze-Vingts through a concours (a highly competitive examination) and held this title from 1934 until the time of her death in 1958. Soon after being named chef de service, Madame Schiff-Wertheimer decided to follow the advice of her colleagues Bailliart and Mawas to learn the new technique of retinal detachment repair that was developed by Jules Gonin, MD (1870-1935), in Lausanne, Switzerland.13 Gonin died near this time, but Suzanne was able to learn Gonin's technique from his pupil, Professor Marc Amsler (1891-1980). She and Amsler got along well, traded visits to each other's clinics, and coauthored an important work about retinal detachment.14 The results of retinal detachment operations performed at the Quinze-Vingts were comparable to those of the innovator.15 She soon became known as la grande specialiste of this field in France.
How was Madame Schiff-Wertheimer so successful? She was technically skillful and academically brilliant; an articulate speaker, writer, and teacher; and she was sincerely devoted to her patients. Her policy of always leaving the individual with a sense of hope, even in the direst circumstance, was very appealing. People flocked to her from all over France and from many foreign countries. Patients, students, and referring physicians appreciated her warm-hearted, sensitive approach. She carried herself with a charming Gaulish flair, yet maintained a certain professional distance. Her manner had developed naturally since childhood, having been reared by unpretentious, hard-working people who were rich in spirit if not in tangible goods. She projected the warm, nurturing quality expected of a woman of that time, as well as professional competence.
Madame Schiff-Wertheimer had no taste for official recognition. She preferred to participate in patient care, medical education, and stimulating conversation. In the grand French tradition of women holding salons at home, she would entertain interesting company. Her circle of friends included physicians, artists, philosophers, historians, businessmen, and politicians from France and abroad.
The darkest days of World War II and the Nazi occupation of Paris from 1940 to 1944 were severe trials for Madame Schiff-Wertheimer. Her husband was away with the army, and later, the Gaullist forces. Despite the great risks from her Jewish heritage, under the Nazis, she remained in the French capital throughout the occupation and was part of the Resistance movement. Although she was officially banned from practicing medicine by the Nazis, she continued to consult clandestinely and to perform surgery as secretly as possible. All levels of the staff at the Quinze-Vingts protected her. There are anecdotes still told about her at the Quinze-Vingts that sound like movie scripts. She narrowly missed being arrested by the Gestapo at her home. When they came after her again at the hospital, she had enough warning to hide as a patient in bed with both eyes patched. On still another occasion the hospital staff kept the Gestapo out of the sterile operating area while she was operating.
One of Madame Schiff-Wertheimer's trainees, Jacques Jonqueres, MD, described meeting her in 1942 in his unpublished memoirs. By day he was a surgical intern in Lyons, and by night, a physician-in-chief of a division of the secret army of the Loire. His superior and grand patron by day was Professor Pierre Wertheimer, Suzanne's brother. Jonqueres was given a secret mission that required a trip to Paris. Wertheimer asked him to take some cigarettes to Suzanne, who missed them dearly. He was able to find her at the Quinze-Vingts, although she was not forewarned and had no idea why he had come to see her. Trembling, she asked anxiously, "What do you want of me, Captain?" "Quite simply, here," Dr Jonqueres replied, giving her 3 cartons. Totally flabbergasted and relieved, she was struck speechless. A long conversation followed. She advised him to forget surgery as she felt ophthalmology was more attractive. She would accept him on her service since she needed an assistant who had some surgical training. Two months later, he was working at the Quinze-Vingts. He liked to joke that he was uncertain if the change in direction of his career was a chance effect of war due to the friendship of his former professor, or the pronounced taste for tobacco of his future patron.
Madame Schiff-Wertheimer was a prolific author of books,9,12,14- 18 chapters, and journal articles on a wide range of topics within ophthalmology. Her writing is notable for its precision and clarity. Her early work is dominated by vascular and neuro-ophthalmologic themes. The later work concentrates on the retina, especially the technique, results, and complications of retinal detachment surgery. The Annales d'Oculistique and the Archives d'Ophtalmologie contain abstracts of nearly 100 of her case reports.
Suzanne Schiff-Wertheimer remains a role model for all ophthalmologists, male and female.
Accepted for publication March 30, 2001.
The assistance of Philippe Lanthony, MD, Denise Godde-Jolly, Edouard Mawas, MD, Claire Doz-Schiff, Pamela Sieving, and Reva Hurtes is gratefully acknowledged.
Corresponding author: James G. Ravin, MD, 3000 Regency Ct, Toledo, OH 43623 (e-mail: email@example.com).