Alfred Fishman, MD: an appreciation

On Friday morning, as I was getting off a plane in Raleigh-Durham, I received a note from Carol Vreim (via Dr. Steve Kawut) that Dr. Al Fishman had died in Philadelphia at 92 years of age.

It was appropriate that the note came from Dr. Vreim, who in the early 1980's worked with Dr. Fishman and others in developing the NHLBI pulmonary hypertension registry which formed a cornerstone for much of the research over the following two decades. Dr. Fishman argued that registry into existence.

Put simply, Dr. Fishman was one of the early builders of the field of pulmonary hypertension.  His work made much of today's progress possible.

Here is what three of his colleagues have written...

The modern era in pulmonary hypertension began with the NIH Registry of Primary Pulmonary Hypertension in the early 1980’s that defined the disease accurately and began to base therapy on scientific study. Many of us in the field and in PHA started our clinical careers through work on this registry.

Al Fishman began his career in the pulmonary circulation in the 1940’s as a fellow with Cournand and Richards, who won the Nobel Prize for their work defining the physiology and diseases of the pulmonary circulation through right heart catheterization. Al Fishman was a major reason for the initiation and success of the NIH registry and for developing this second generation of PH researchers and doctors. We  owe him a great debt as we stand on his shoulders and are grateful for his vision.

John H. Newman, MD
Elsa S. Hanigan Professor of Pulmonary Medicine

Vanderbilt University School of Medicine
Chair, PHA Scientific Leadership Council

Al was the grandfather of PH. To me, that says it all. His insight and dedication to the field is why we have been so successful over the past 6 decades in studying the pulmonary circulation, which had to occur before we could even attempt to develop treatments for PH. I will always be indebted to what Al has taught me, that is, how to think and expand our dreams, exploring far beyond the horizon. He truly was a legend in his own time and will remain a great figure in the field of PH. 

Robyn Barst, MD

Professor of Medicine Emerita

Columbia University School of Medicine
Past Chair, PHA Scientific Leadership Council

The sadness of this news is buffered by the recognition that he led such a productive and gratifying life, and did it in a way that was inspiring to many, including me.  He will certainly be missed.  It seemed poignant and meaningful that the news reached many of us as we were at the REVEAL Registry Investigators Meeting in Boston, hopefully carrying on one of the many threads of his career in trying to further understand PAH by means of a national database

Michael McGoon, MD

Professor of Medicine

Mayo Clinic School of Medicine

Past Chair, PHA Scientific Leadership Council

Judy Simpson and her husband Ed who were among PHA's founders added this...

Dr. Fishman was an important person in the early days of UPAPH. [PHA's original name was United Patients Association for Pulmonary Hypertension.] 

Dr. Walker Long, with Burroughs Wellcome at the time, told us that if we could get Dr. Fishman involved other physicians interested in pulmonary hypertension would join in. How right he was!

Dr. Fishman was our keynote speaker at the First International Pulmonary Hypertension Conference in Stone Mountain, Georgia, in 1994. As many of you will remember this was the largest gathering to that date of physicians interested in pulmonary hypertension.

Dr. Fishman encouraged PHA and offered helpful suggestions to us along the way. We owe him a great debt of gratitude.

I had the pleasure of spending time with Dr. Fishman at many of the PHA International and American Thoracic Conferences and, like the Simpsons, appreciated his understanding and support of PHA's efforts.   When we were a small organization, he gave us encouragement and credibility.  As we grew, he continued to share his wisdom and knowledge.

In 2004 in Miami, Dr. Fishman delivered his last plenary session lecture at a PHA International Conference.  It was titled One Hundred Years of Pulmonary Hemodynamics. Typical of who he was, he wanted the lecture to provide understanding of progress to patients..and it did.

Thank you, Dr. Fishman, for all you did to make this a vibrant field with growing hope for patients. 

Your contributions were immeasurable.  Your legacy continues.


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Dr. Fishman wrote over 250 papers during his career. I thought you might like to read one written in 2003 and titled, Primary Pulmonary Arterial Hypertension: A Look Back.

For the many who have already asked whether PHA will establish a tribute fund for Dr. Fishman, that is being discussed and we hope to make an announcement shortly.

Carol Vreim...

Today is Carol Vreim's last day at PHA...

She certainly been been a tremendous asset to PHA as a part-time employee for the past several years but her life and work have been intertwined with the PH community since the 1970's.

In 1973, a group of physicians with an early interest in PH met under the auspices of the World Health Organization. Their goal was to review the current state of knowledge on Primary PH (later described as idiopathic PH).  Following that review, they proposed the establishment of a multicenter collaborative study. This led to the historic and invaluable NHLBI PPH registry which enrolled 187 U.S. patients  from 1981 to 1985. Carol was in charge of that registry.  It was this information that framed much of the research that took place over the next two decades.  It also helped to develop a network of physicians who built this little known field into today's vibrant and active medical community.

Carol also was a catch point for patients during a period of great isolation.  They would call her desk at the National Heart Lung and Blood Institute and she would put them in touch with each other and, as PHA came into existence, with PHA leaders.  As a trustee of the Dauna Leigh Bauer Foundation, she kept Dauna's legacy alive, through early Foundation gifts that helped PHA establish itself in the early days.

After Dr. Vreim's retirement as Deputy Director of the Lung Division at NHLBI, we were honored to have her talents at PHA.

Thank you Dr. Vreim.  Good luck in your move to Pennsylvania. Have no doubt that we'll miss you and that we'll stay in touch!