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Mary Anne Guggenheim, MD

Mary Anne Guggenheim

Dr. Guggenheim was born in LaGrande, Oregon in 1935. She completed her undergraduate education at Oregon’s Willamette University in 1957, majoring in chemistry. She completed a year of graduate education in biochemistry at the University of Wisconsin in 1957. The research in which she participated, concerning the mechanisms of action of vasopressin, resulted in three important publications. Despite such a promising start for a laboratory career, the strong allure of a career in medicine took hold of her. Guggenheim entered the Harvard Medical School in 1960. Initially uncertain as to which area of medicine she might pursue, she almost immediately fell under the intellectual spell of two recently arrived neuroscientists. She listened with rapt attention as David Hubel and Torstan Wiesel described what they were learning about the visual system development, plasticity and functional mechanisms of the ocular dominance columns of the occipital cortex. A few years later the same dynamic pair would have the same effect on Peter Camfield.

Dr. Guggenheim’s fascination with neurology and neuroscience was further stimulated by neurologist, Simeon Locke, who taught the second-year basic neurosciences course. Encounters with two other distinguished clinician-scientists during her third year clinical rotations decisively shaped her future. Derek Denny-Brown’s bedside flair, his demand for precision and excellence, impressed her, as had Locke with the pleasure of engaging cleverly in neurological localization and formulation. But it was her encounter with the similarly gifted but far more humane and personable neurologist/neuroscientist, Phil Dodge that cemented an irrevocable bond with neurology. As happened with so many others before and after, she was enthralled by the particular quality of Dodge’s enthusiasm  and subtle capacity to summon excellence from those he encountered, and the desire he inspired to contribute to the advancement of neuroscience and the welfare of children. She recognized in Dodge the very model upon which she wished to base her future career.

Between 1964 and 1966 Guggenheim trained in pediatrics at Case Western Reserve School of Medicine. If she had any doubts about child neurology, these were put to rest by her encounters with Emma Plank and Bob Eiben at the Cleveland Metropolitan Hospital. “Nuchi” Plank was a student of Maria Montessori, who helped Dr. Guggenheim to appreciate and to understand the fears that were experienced by children and parents during hospitalizations. She also explained the grieving process experienced by children and adults and suggested ways in which a caring physician might help them. Guggenheim was to maintain a lifelong interest in doing whatever it took to similarly promote the welfare of children. Dr. Eiben had more than a decade of experience as an infectious disease specialist at the Cleveland City Hospital for Contagious Diseases before he had travelled to Seattle to become one of the earliest formally trained child neurologists. Guggenheim appreciated his fund of knowledge, diagnostic abilities, and skillful management of the physical needs of children. But she was also impressed with the skillful and humane ways Dr. Eiben supported children and families from the early severe anxiety at diagnosis of poliomyelitis through the successive stages of supportive care, therapy, and varying degrees of recuperation, and the caring manner with which he tended to permanent residual motor disabilities.

Dr. Eiben’s mentorship prompted Dr. Guggenheim to undertake a two-year fellowship in neurovirology at the NIH-NCI. Her work there concerned the regulation of interferon production and the mechanisms of interferon activity. This resulted in three important and influential first-authored papers, the first of which appeared in Science. In 1968 Dr. Guggenheim returned to work with Phil Dodge at his new training program at St. Louis Children’s Hospital. During her two years there she particularly enjoyed a stimulating and mutually supportive relationship with fellow- trainee Darryl DeVivo. Her training experiences resulted in co-authorship of four original publications; the most highly cited concerned toxic extrapyramidal injury (cited 38 times) and vaccine-related polio (cited 29 times). A third training year, emphasizing neuropathology, was completed at the University of Colorado, whereupon she accepted an assistant professorship at Colorado, supported in part by an NIH/NINDS grant supporting research designed to examine the clinical usefulness of interferon as a treatment for various childhood neurologic illnesses.

Dr. Guggenheim rapidly advanced through the academic ranks at Colorado. Within three years of her initial appointment she was named Vice-Chair of the Pediatric Department. This appointment and her designation as Program Director of the pediatrics training program were based on her particular talents as organizer, advocate, role model, and her enthusiasm and excellence as bedside educator. With her considerable store of practical knowledge and her skillful approach to sorting out the history and examination of children, she was renowned as an excellent diagnostician and healer of a particular disease manifestation. She was widely respected as a role model physician, advocating and exemplifying the more general role of physician as supporter, educator, and comforter of patients and their families. She emphasized as well the importance of understanding the neuroscientific basis for clinical observations. Her work at Colorado over twelve years resulted in a total of twenty original reports, all achieving strikingly high numbers of citations (mean 45, range 15-155). Many concerned metabolic illnesses and particularly vitamin-E deficiency, including her first-authored sentinel paper on treatment with alpha-tocopherol, (her most cited paper). She also coauthored four important early contributions to the understanding of the timing and antecedents of neonatal intracranial hemorrhage and an early CT paper on the spectrum of schizencephaly.

Dr. Guggenheim joined the CNS during the organization’s infancy, discovering there another quite important influence on her career: Isabelle Rapin. Dr. Rapin’s ideas, presented at CNS meetings, helped Dr. Guggenheim to develop her understanding of behavioral neurology and learning disorders. In 1979 Dr. Guggenheim undertook the arduous task of organizing and sponsoring a very memorable early meeting of the CNS, at Keystone, Colorado. While most attendees were permitted to enjoy the awesome beauty and peacefulness of the surroundings, Dr. Guggenheim was, with her usual calm competence, dealing with transportation snags, sudden illnesses of major speakers, and other troublesome circumstances. In 1979 she was elected to a four-year term on the Executive Committee of the CNS, though her tenure in that post was abbreviated when she became the only person ever elected President of the CNS on the basis of a floor nomination placed during the annual business meeting (by David Stumpf).

Dr. Guggenheim’s academic success was achieved while fulfilling her role as wife of a husband with his own academic medical career and the raising of two children. In addition to her other obligations she undertook leadership positions tackling a financial crisis at the medical school and rectifying the appointment and promotions rules. Finding herself stretched ever thinner, she recruited as her own replacement as head for the Section of Child Neurology, David Stumpf, whom she regarded as the most promising and energetic recent child neurology trainee to be found. In 1975, Dr. Guggenheim initiated child neurology care in Montana, Wyoming, and Idaho by staffing three outreach clinics. In addition to the excellent effect this had on the quality of neurologic care, it afforded Dr. Guggenheim the opportunity to pursue one of her greatest passions, fly fishing. Over time she found it increasingly frustrating to return to Denver from “God’s country.” She resigned her active positions at Colorado in 1983 and moved to Helena to join John Opitz at the Shodair Hospital. She continued to maintain a circuit of outreach clinics and an equally challenging circuit of working rainbow, brown, and cutthroat “fishing holes.”

Never one to avoid responsibility (to say the least), Dr. Guggenheim continued to apply her considerable leadership skills to the needs and interests of children: Board of Directors of Blue-Cross/Blue Shield of Montana; Consultant for the important innovation of the Vaccine Injury Compensation Program of the DHHS; Professional Advisor to the Epilepsy Foundation (Board of Directors 1993-98); Advisory Committee of Children’s Special Services of Montana (Chair 1996- 2004); Advisory Committee, Montana Child and Family Support Services; Chair of the Montana Committee for review of the Newborn Screening Program; and member of the Montana Board of Medical Examiners. She directed a Montana Conference on Autism in 1994 and served one term as a member of the Montana State Legislature. She is on the Board of the Montana Conservation Voters. She has published several more papers and four excellent book chapters. All this after “retiring” from practice in 1995 in order to devote her attention to her custom hand- made furniture business, founded in 1995, together with her partner, Jan Donaldson. It should not be doubted that she has also devoted herself richly to the lives of her two children and three grandchildren.