Appreciation For Peter Scheuer By Jay H. Lefkowitch M.d.

Appreciation For Peter Scheuer By Jay H. Lefkowitch M.d.

When I was 14 and growing up in New York, I remember Saturday afternoons sitting in front of the radio listening to live matinee broadcasts from the Metropolitan Opera. The announcer would come on: “This is Milton Cross welcoming you to today’s performance of Johann Strauss’s ‘Die Fleidermaus’ in an English translation by Ruth and Thomas Martin”. Or weeks later, “This is Milton Cross welcoming you to this afternoon’s performance of Mozart’s ‘Cosi Fan Tutte’ with an English libretto by Ruth and Thomas Martin”. Well, Ruth and Thomas Martin were Peter’s cousins, which only proves that the gene for music was well represented in the Scheuer family’s genetic material. I could never have predicted that only 14 years later I would come to London for a fellowship year to study with Peter.

Peter’s life was very much like a prism—taking in light and dispersing it in a multitude of colours. A man of medicine, a music man; a family man, a computer enthusiast; a cook, a photographer; a writer and literary man, a world traveler. Peter’s life was a balance between rationalism and transcendence—the former taken up in both his academic life and his daily life—and the latter in his love of music, the sublime Mozart and the ‘cello.

What Peter taught me was the value of Pragmatism, Organization and Clarity, precepts that he brought to every academic endeavour, from the medical student lecture to postgraduate seminars on liver disease, to seven editions of his textbook Liver Biopsy Interpretation, which was the only textbook on this specialty when it was first published in 1968 and remains the standard bench textbook used by pathologists worldwide.

What Peter brought to liver pathology was an uncommon and penetrating clarity into what we see down the microscope. He wrote on every area in liver disease. But one of Peter’s greatest interests was in developing a modern—and simple—system for the microscopic classification of chronic hepatitis, the liver disease afflicting millions of people infected with the hepatitis B or C viruses. The “Scheuer score” as it has come to be known, is a major indicator of the prognosis. When you consider that thousands of individuals with chronic hepatitis B or C worldwide will have their management adjusted based on the Scheuer method, Peter’s impact is self-evident.

Peter’s renown has circulated in many and varied quarters. On a visit to New York City in the mid-1990’s, I got tickets for us to see a new play by and starring Lynn Redgrave, “Shakespeare For My Father”, about her father Sir Michael Redgrave, which I thought he would enjoy. Celebrities had turned up that evening and in the foyer before it started, I saw Sally Ann Howes (she had succeeded Julie Andrews in “My Fair Lady” on Broadway and her father, Bobby Howes, was a well known entertainer here). Sally Ann is a good friend who knew about my background and training. We went up to her and I said “I’d like to introduce Peter Scheuer from London”, and she looked up brightly and said “oh my, this is your Professor!”

It was a fantastic time at the Royal Free Hospital with Peter. In his lab in 1978 he kept a map of the world with coloured stick-pins inserted where each of his visitors had come from. Some came for a week, others for 6 months, some for a year or more. Every continent was included. So many of his trainees have gone on to head liver pathology units and to be productive investigators in liver disease.

Of his colleagues at the Royal Free Hospital, of course the times with Professor Dame Sheila Sherlock were a halcyon period of unprecedented productivity and investigative activity. The weekly biopsy conferences Peter prepared were a guaranteed showcase for the latest visiting liver dignitary brought by Sheila, and lively discussions were guaranteed. Neil McIntyre took the helm after Sheila and, along with Peter, shares a very special interest in the distinguished history of the Royal Free. Of Peter’s junior colleagues, Andy Burroughs, Geoff Dusheiko, James Dooley and so many others were ready sources of new ideas and directions. James, in fact, was critical in Peter’s health care in this last period. And somewhat behind-the-scenes, though always hailed by Peter (at least when he told me about each event) were the people who made things work: Paul Bates and Francis Moll in the Pathology Museum; Linda Boxer and John Difford in the laboratory; and Jackie Lewin in Electron Microscopy.

We must also speak of the Gnomes, the close group of predominantly European hepatologists (at least in the beginning), with whom Peter met at annual meetings (now approaching 40 years) around which one had to plan one’s diary carefully. Roddy MacSween, Valeer Desmet, the late Hans Popper and Kamal Ishak, Peter Anthony, Alastair Burt, Bernard Portmann and other colleagues who made such meetings so memorable.

On Liver Biopsy Interpretation: Being asked to co-author the 5th edition of this book in 1994 was a huge honour for me, and a huge responsibility to keep up the standard that Peter had set. Who could imagine that being a co-author of the past three editions could have been such a uniformly warm and motivating experience. “You write it the way you want” was his advice on the chapters I was assigned. I should point out the astounding fact that for the latest edition which came out last Fall, Peter unilaterally took up the task of digitally re-photographing in colour some 30% of the images that were still in black and white. Peter generated near-perfect digital images from the exact same glass microscopic slides, very often the exact same field marked by a black ink dot, first taken in 1968. At the American Liver Meeting in Dallas in 2000, which coincided with the publication of the 6th Edition of Liver Biopsy Interpretation, a book-signing was organized and you can imagine Peter’s delight when the queue stretched to the door, with doctors from Peru, Beijing and all over Europe waiting for his signature.

Finally, returning to music, Peter took up mastery of the ‘cello with full force in 1992 on his retirement and the regular chamber music events at the Scheuer’s became memorable occasions. Mozart was Peter’s ideal, “Figaro” his favourite opera, and I think he even took pleasure in my Columbia University affiliation because it was at Columbia that Lorenzo Da Ponte, Mozart’s librettist for the three great operas, became Professor of Italian in his later years.

In closing, there are two musical anecdotes worth sharing with you. In the 1980’s, as part of a Columbia meeting on liver disease that I hosted, the invited faculty were taken out on the first evening. The speakers were the “greats” of liver disease and included Peter, Dame Sheila, Hans Popper, Kamal Ishak, Hy Zimmerman and Gene Schiff, among others. Half the group went to “Phantom Of The Opera”. Peter, Sheila, Hy, Hans and I went to the Metropolitan Opera for Mozart’s “Abduction from the Seraglio”. I can tell you that Peter sat raptly on the edge of his seat as the soprano negotiated her high-flying coloratura arias, while in the seat next to him…Sheila slept.

And in Boston, in 2003, as a celebration for Peter’s 75th birthday, a string quartet with players from the Boston Symphony Orchestra presented a short performance evening of Borodin, Beethoven and Haydn. During the Haydn quartet, the cellist gave over his instrument to Peter for the slow movement, and amongst these professionals from the BSO Peter blended in imperceptibly…I might add, using his his own score from London which he had just happened to bring with him to the Liver Meeting.

In a brief autobiography that Peter penned in 2004, he wrote amusingly that for the young European liver doctor, to really “make it” in the world of hepatology, you had to obtain the degree of B.T.A. (Been To America). I think that we would all have to agree that the degree Peter actually received was the B.T.T.W.: Been To The World.

Added on: 5th April 2006


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British Liver Trust

The British Liver Trust is Britain\'s only national liver disease charity for adults, existing to improve the lives of people suffering from liver disease.