Guido Majno, M.D., 1922–2010

Dr. Guido Majno, Professor Emeritus of the University of Massachusetts School of Medicine, Worcester, MA, and one the leading pathologists of his generation, died in Geneva, Switzerland, on May 27, 2010, at the age of 88 years. A remarkable and rewarding life came quietly to an end, and the international pathology community lost one of its most revered members. He is survived by his wife Dr. Isabelle Joris-Majno, daughter Corinna B. Kaufman, two sons Lorenzo C. Majno and Luca E. Majno, and six grandchildren. Primo Levi, another great Italian intellectual, wrote once “that a funeral oration is a necessary but sad affair.” The same holds true for In Memoriam pieces, and thus, although I was saddened by the news that reached me from Geneva in May, I was also honored to be asked to write this article. There are few “Greats” in our profession who inspired me more. Actually, I always wanted “to be like Guido when I grow up”—give lectures in his inimitable style and write books following his example. Above all I felt, like Guido, that our sacred duty was to transmit to the youngsters in the medical school benches our love for pathology as a study of mechanisms of disease and also to imbue them with our belief that we are all descendants of Hippocrates and Morgagni, Rokitansky and Virchow, and many others on whose shoulders we are all standing. Parenthetically, I should also add that I shared his pet peeve, voiced in a 1982 interview, “that there is a lack of pathology training for graduate students in medical science.”1 Dr. Majno was born in Milan, Italy, where he also received his medical degree in 1947. Initially his intentions were to become a surgeon, and thus he joined the surgery department in Geneva. A temporary sojourn in the local pathology department, where he went at the advice of his surgery professor to gain additional experience in basic sciences, redirected his career to pathology. Having completed his pathology training in Geneva, he moved to Boston where he eventually became an associate professor of pathology at Harvard. During a critical interlude, he spent two years at the Rockefeller Institute working with the future 1974 Nobel prizewinner Dr. George Palade. At Rockefeller he learned to use the electron microscope and developed a life long interest in the cellular and vascular basis of inflammation. The next few years at Harvard were most productive, and he made numerous discoveries, basically laying down the foundations of our current understanding of inflammation and wound healing. In 1968 he was invited by his Swiss colleagues to head the Department of Pathology in Geneva, where he stayed for 5 years. During his “second Geneva years,” he worked on wound healing and described myofibroblasts, defining their role in the contraction of granulation tissue. He also worked on the early changes in myocardial infarctions and described “wavy fibers.” In 1973 he accepted the position of Professor and Chairman, Department of Pathology, University of Massachusetts Medical School, Worcester, MA, a position that he held until 1995, when he retired as Chairman, but continued teaching as Professor and later as Professor Emeritus. Guido Majno devoted his life to pathology as the scientific foundation of medicine. Even though he had an encyclopedic knowledge of medicine, and by nature he was a polymath, he decided early in his career to concentrate on inflammation as one of the body’s crucial responses to injury. Morphology was the basis of his studies, but he emphasized understanding mechanisms and the clinical significance of the processes that occur in the tissues. He was instrumental in defining some of the biological key concepts of inflammation, such as vascular leakage during inflammation, vascular responses to histamine and serotonin, changes in intercellular junctions, cell migration, and contraction of wounds. Dr. Majno and his associates defined myofibroblasts and the role of these hybrid cells in wound healing and contraction (Reviewed in2). His most influential review article on inflammation3 summarized some of his own research and provided future investigators with an overview of the entire field. Cell death intrigued him, especially in myocardial and cerebral infarcts, and of course he loved to discuss apoptosis. His review article on apoptosis4 is yet another classic piece of scholarship; it has been cited more than 1950 times. Overall his opus includes more than 175 papers, many of them fundamental basic science contributions to pathology. This article would be incomplete without mentioning the two most important books written by Guido Majno. The first one, which earned him the moniker “raconteur of medical lore,”1 is entitled The Healing Hand. Man and Wound in the Ancient World.5 Full of stories and anecdotes, it is one of those classics that must be read and enjoyed and then reread from time to time to be fully appreciated. It covers the scientific and popular history of inflammation and wound healing, presenting it in a popular yet sophisticated manner. The second is the textbook of general pathology for medical and graduate students, which he wrote with his wife Isabelle Joris,6 revised in 2004.7 In my mind, this is the most inspirational textbook of pathology I have ever read, and I simply do not believe that anybody could write a better one. It received the American Medical Writers Association Award (Physician category) in 1997, proving that a textbook could be scientifically sound and still readable at the same time. Guido received many other awards. In my preparation for this article, I decided not to list them all and instead asked his widow Dr. Isabelle Joris-Majno to tell me which ones he cherished the most. I am glad to report that the Gold-Headed Cane (awarded by the American Association of Pathology (ASIP) in 1989) had a special significance for him; it stood at the entrance of his office at his home in Worcester, MA, and then next to his armchair in Geneva. Being a Maude E. Abbott lecturer for the US-Canadian Academy of Pathology in 1991 was also very important to him. Dr. Edward H. Kass was a great friend, and it was a great honor for Guido to give the first Edward H. Kass Memorial Lecture for the Infectious Diseases Society of America in 1990. Guido enjoyed receiving his almost “yearly” teaching awards from students at UMass. He was a Member of the American Academy of Arts and Sciences, and in 1995 he became Corresponding Member of the Swiss Academy of Medical Sciences. The Guido Majno Chair in Dermatopathology was established at Boston University in his honor by his former colleague and collaborator Dr. Jag Bhawan. In the preface to his book The Healing Hand, Dr. Majno wrote that his approach to the study of diseases was not only scientific but historical. “I have tried to find answers within the perspective of time.” History and time will be the final judges of all of us, but I am sure that they will be very kind to this humble but erudite humanist and pathologist. I for one will never forget him.