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Edwin Salzman, 82; surgeon shared fight with Parkinson’s

EDWIN SALZMAN EDWIN SALZMAN
By Bryan Marquard
Globe Staff / November 2, 2011

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In the mid-1970s, Dr. Edwin Salzman noticed what he thought was just a lingering ache in his right arm.

“I was a vascular surgeon, operating in a hospital affiliated with Harvard Medical School,’’ he wrote two decades later in the New England Journal of Medicine. “For me to have a stiff arm was a nuisance.’’

No mere annoyance, the soreness was diagnosed as Parkinson’s disease, immediately ending Dr. Salzman’s days in the operating room.

Turning full attention to the scientific research that had always been his parallel career, he helped pioneer using aspirin to lower the risk of blood clots forming in the leg veins of surgery patients, which can cause a fatal pulmonary embolism.

Dr. Salzman, a professor of surgery emeritus at Harvard Medical School, died of complications of Parkinson’s disease Oct. 3 at Beth Israel Deaconess Medical Center, in a room not far from his old office. He was 82 and had been in Cambridge since the mid-1980s, after trading Weston for urban living.

“All these years, surgery had been my life, my identity,’’ he wrote in “Living with Parkinson’s Disease,’’ a New England Journal of Medicine editorial published in 1996. “Could I find the same satisfaction in some other activity?’’

Only 47 when diagnosed, Dr. Salzman found his answer in the laboratory and on the page.

“When I met him, he said, ‘You have to understand, I’m a scientist, but I’m also a cutting surgeon,’ ’’ said Dr. Patrick Clagett, the recently retired chief of vascular surgery at the University of Texas Southwestern Medical Center in Dallas. Clagett studied with Dr. Salzman years ago and considered him a mentor.

After the diagnosis made surgery no longer an option, Dr. Salzman spent a dozen years working part-time as deputy editor of the New England Journal of Medicine.

“When he would go over a paper, it would come back sort of recognizable,’’ Clagett said with a chuckle. “He could take what I’d say in three paragraphs and put it into three sentences, and I was an English major.’’

Dr. Salzman had even more impact with paragraphs he wrote. The journal editorial recounting his experience with Parkinson’s became a teaching tool for physicians and a guide for patients.

“It’s hard to exaggerate the impact that the editorial had,’’ said his son Jim of Durham, N.C. “It’s extremely unusual for a doctor to be so open about living with a disease.’’

In the editorial, Dr. Salzman mixed science with pointed descriptions of how “trivial events of daily life’’ became monumental challenges.

“Nothing is easy in Parkinson’s disease,’’ he wrote. “There is no feature of any task that is not potentially out of control. A cuff link refuses to find its way into a tuxedo shirt cuff. My wife is out of town, and I miss the annual dinner. I am unable to stuff change from a $5 bill into my wallet, and the patrons in line behind the cash register fume. Bow ties won’t tie, and shoelaces won’t lace. In Parkinson’s disease, one must expect the unexpected.’’

Born in St. Louis, he was the older of two children and grew up in Springfield, Ill., where his father was a general practitioner with an obstetrics practice.

While his father was in the military during World War II, his family lived with relatives in Mobile, Ala., where he went to high school before returning to St. Louis to attend Washington University.

Finishing undergraduate work in three years, he went to Washington University School of Medicine, graduating first in his class in 1953.

Dr. Salzman moved to Boston for a surgical residency at Massachusetts General Hospital, and was among the institution’s first Jewish chief residents and attending surgeons, his family said.

During the demanding days of residency, he met Nancy Lurie on a blind date.

They married in 1954 and moved to Ohio, where he spent two years at Wright-Patterson Air Force Base assisting in research to develop the G-suit, which pilots wear to prevent blackouts during hard acceleration.

Returning to Mass. General, Dr. Salzman trained as a surgeon and studied blood clots, including a two-year stint in England. He switched to Beth Israel in the mid-1960s.

Along with the findings in the 1970s about aspirin, he made significant contributions to research involving the blood thinner heparin and other methods that prevent postoperative pulmonary embolism.

“He was a strong and effective national advocate at the National Institutes of Health and the American Heart Association for the prevention of postoperative pulmonary embolism, and this saved many lives,’’ Clagett said.

Dr. Salzman’s research, he added, “also found that heparin, in unusual circumstances, paradoxically led to potentially dangerous fatal clots.’’ The research showed heparin could activate platelets, those cells in the blood that promote blood clotting.

“That early work led to the development of new, more specific heparin blood thinners that avoided those complications,’’ Clagett said. “And that work continues today in the development of new, specific inhibitors for blood clotting.’’

Those who knew Dr. Salzman would not necessarily hear about those accomplishments from him, however.

“I had no idea until I was much older just how important he was in the medical field,’’ his son said. “I never heard him brag about himself. He was very much a Midwesterner.’’

In addition to his wife and son, Dr. Salzman leaves two other sons, Andy of Tel Aviv and David of Chevy Chase, Md.; a sister, Linda Levy of San Antonio; and seven grandchildren.

A memorial service will be held at 1:30 p.m. Dec. 18 in Temple Shalom in Newton.

Dr. Frank LoGerfo, a professor of surgery at Harvard Medical School and a former chairman of surgery at Beth Israel Deaconess Medical Center, praised Dr. Salzman as a physician “known as much for science as for surgery,’’ and for something far more personal.

“In the face of illness,’’ LoGerfo said, Dr. Salzman and his family “were an inspiring example of the finest qualities to which humans aspire.’’

In 35 years since the diagnosis of Parkinson’s, Jim Salzman said, “I only heard him complain about it twice . . . when he was having trouble buttoning his shirt. It was alien to him to engage in self-pity.’’