Ephraim P. Engleman, MD: Maestro of Rheumatology

Dr. Ephraim P. Engleman

UCSF's longest tenured professor, Ephraim P. Engleman, MD, didn't always think he was destined for a career in medicine. Considered a violin prodigy, he worked his way through Stanford in the 1930s by playing in a movie and vaudeville orchestra.

"If talking movies hadn't come, I would have stayed in show business," says Engleman, 97, with a laugh. "But this whole concept of what I was doing in the theater was going to be gone. So with the advice of my parents, we decided I would go to medical school."

After medical school, he interviewed for a fellowship at Massachusetts General with Walter Bauer, MD, often considered the founder of academic rheumatology. Bauer invited him to accompany him on rounds, where they encountered a patient with a musical heart murmur, in which the heart emits a musical tone.

Gifted with perfect pitch, Engleman knew the tone was a half-step above concert A, the note to which orchestras tune their instruments. "Not being very shy, I said I could predict the phonocardiogram would show approximately 500 vibrations," says Engleman. When the lab results proved him right, Bauer told him, "We don't need an interview. You've got the job."

Engleman went on to a remarkable career in rheumatology. In the mid-1940s, he opened a thriving private practice as the Bay Area's only formally trained rheumatologist. He came to UCSF in 1947 as a clinical instructor in medicine, and has been here ever since.

In more than six decades in the field, Engleman has seen incredible progress. "When I was in training, the only modes of treatment were bed rest, large doses of aspirin — as many as 20 tablets a day — and physical therapy," says Engleman. The advent of cortisone was the first breakthrough, more recently followed by biologic drugs, which interfere at the molecular level with the development of arthritis. Orthopedic surgery for joint replacement has been another giant step forward.

Working with Rosalind Russell
In the mid-1970s, Engleman led the National Commission on Arthritis, a Congressionally mandated task force convened to address the woeful lack of arthritis research and education. One of the commission's members was actress Rosalind Russell, known for her performances in His Girl Friday and Auntie Mame. Russell had developed rheumatoid arthritis, and was one of the first people to give a public face to the disease and lobby Washington for more resources.

"We had public hearings throughout the country, and when it was generally known she was on our commission, it was standing room only," says Engleman. "She was a very brave, articulate lady, though by this time she had to use a wheelchair frequently." Among other achievements, the Commission's work resulted in the creation of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, now part of the National Institutes of Health, and special research centers for arthritis.

After Russell's death in 1976, Congress established the Rosalind Russell Medical Research Center for Arthritis, and selected UCSF to house it. Engleman was named as its founding director, a role he continues to this day. Over the years, the Center has raised more than $50 million for arthritis research at UCSF, helping it become one of the top two arthritis research centers in the country and train more than 120 research fellows.

As president of the International League Against Rheumatism, Engleman led a movement to recognize the importance of rheumatic diseases in China, resulting in the founding of the Chinese Rheumatism Association. He also served as president and co-founder of the Association of Clinical Faculty, an organization founded in the early 1970s to improve relations between full-time faculty and community physicians who teach at UCSF.

"I think Eph has a global, national and local influence in the field of rheumatology, and many people view him as one of the fathers of the subspecialty," says Arthur Weiss, MD, PhD, chief of the division of rheumatology and Ephraim P. Engleman Distinguished Professor. "A lot of the funding that has come to the Center has come through Eph's personal connections. He has a lot of loyalty from his patients, and his love of music puts him in touch with a lot of people in a unique way. The happiest I ever see him is when he's hamming it up in front of an audience."

"He leads by example," says Paula Gambs, board chair of the Rosalind Russell Center. "He has a twinkle in his eye, and a joie de vivre that's extraordinary at any age, let alone when you're well into your 90s."

The Show Goes On
Among his many honors, last year Engleman received the Gold Medal from Columbia University College of Physicians and Surgeons. He is also a recipient of the Presidential Gold Medal from the American College of Rheumatology and UCSF's Medal of Honor, the institution's highest honor.

For 60 years, Engleman has also been a member of the Family Club, a prestigious social club. Engleman writes musical biographies of composers like George Gershwin and Jerome Kern; these are performed in the club's outdoor theater, whose Engleman Stage was recently named in his honor.

"I used to recommend retirement to my patients many years ago," Engleman says with a laugh. "More recently, I think it's terrible. I think it's very important to keep active."

"When I was in training, the only modes of treatment were bed rest, large doses of aspirin and physical therapy."
--- Dr. Ephraim P. Engleman

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