Soon after the BCMJ published the article “Russell Palmer: Forgotten champion” in November 2010, I was contacted by the prestigious journal Hemodialysis International saying they would be interested in publishing the article, but they politely pointed out that it may have contained two errors.
The first error suggested was related to my claim that Russell Palmer’s hemodialysis in September 1947 at Shaughnessy Hospital[1] was the first successful treatment in North America using Dr Willem Kolff’s original equipment. Hemodialysis International suggested that a team in New York had preceded him by a few months.
The literature, however, shows that both the New York team and Palmer had used this equipment earlier with technical success, but Palmer was the first to do so with clinical success in that a patient otherwise doomed survived; the first such survival in New York was in January, 1948.[2]
A minor footnote of interest is that whereas Kolff gave his equipment to New York, and to several other centres, Palmer had it built in Vancouver from the blueprint Kolff gave him in 1945.[3] It is true that there were only a few months between the two successes--but just as the Olympian winning gold in the 100 meter dash does so by a fraction of a second, it is he who is commemorated, and we should honor Russell Palmer likewise.
The second error suggested related to my assertion that Palmer initiated the world’s first unassisted home peritoneal dialysis in January, 1964.[4] The record shows a team in Seattle did send patients to do home peritoneal dialysis, but not until May 1964 in which a nurse would provide initial support and “. . . the physician visited the home to do the (peritoneal) punctures for each dialysis . . . .”[5] Hence these dialyses, unlike Palmer’s, were assisted by health care professionals.
Palmer’s earlier success resulted from the semi-permanent indwelling peritoneal tube he had developed with Wayne Quinton and first used in September, 1963 in a patient, a nurse, who subsequently went home to dialyse in January, 1964.[6] It was not until 1967 that the Seattle team, under the leadership of Dr Henry Tenckhoff, having modified and improved on Palmer’s tube, were able to send patients home unassisted as Palmer had done.[7] Thus Palmer again lead the field.
Shortly after the original article appeared in the BCMJ, a woman with a family history of polycystic kidney disease contacted me to say Dr Russell Palmer had taught her father to do home peritoneal dialysis in 1964; she produced a copy of the now-defunct Vancouver Times newspaper dated 5 February 1965 showing her father doing peritoneal dialysis at home with the familiar two bottles hanging at his side (see the Figure).
In the text the patient is quoted as saying the peritoneal tube was placed at St Paul’s Hospital in May, 1964 and that he went home to carry out the procedure in December of that year.
He dialysed himself at home assisted only by family, and despite the early complications to be expected with this novel procedure, was able to continue working with his son as a gold panner until October 1967, when he was killed in a road accident while driving himself to work in pelting rain. Tragic though this was it suggests the impressive level of rehabilitation he attained before it happened after nearly 3 years on unassisted home peritoneal dialysis.
These points were graciously accepted and Hemodialysis International published the original article with the BCMJ’s permission in their October, 2011 edition, together with a short piece they asked that I write, entitled Reflections on Russell Palmer.[8]
British Columbians can be proud that the first-ever unattended home peritoneal dialyses worldwide were initiated by our own Dr Russell Palmer, firstly the nurse who returned to work part time while dialysing herself at home in January 1964, and secondly the intrepid gold panner recorded here; both were instructed in the art of home peritoneal dialysis by Dr Russell Palmer and his team at St Paul’s Hospital in Vancouver.
--Angus Rae, MB, FRCPC, FRCP(UK), FACP
Clinical Professor Emeritus of Medicine, University of British Columbia
References
1. Palmer RA, Rutherford PS. Kidney substitutes in uraemia: The use of Kolff’s dialyser in two cases. Can Med Assoc J 1949;60:261-266.
2. Fishman AP, Kroop IG, Leiter HE, et al. Experiences with the Kolff artificial kidney. Am J Med 1949;7:15-34.
3. Rae A. Russell Palmer: Forgotten champion. BC Med J 2010;52:466-469.
4. Palmer RA, McDonnell CE. Prolonged peritoneal dialysis for chronic renal failure in patients over 50 years of age. Can Med Assoc J 1968;98:344-349.
5. Tenckhoff H, Shilipeter G, Boen ST. One years’ experience with home peritoneal dialysis. Trans Am Soc Artif Int Organs 1965;11:11-17.
6. Palmer RA, Quinton WE, Gray JE. Prolonged peritoneal dialysis for chronic renal failure. Lancet 1964;1:700-702.
7. Tenckhoff H, Schecter H. A bacteriologically safe peritoneal access device. Trans Am Soc Artif Intern Organs 1968;14:181-186.
8. Rae A. Reflections on Russell Palmer. Hemodial Int 2011;15:441-443.
Related content
January/February 2012
BC first: Hemodialysis
November 2010
Russell Palmer: Forgotten champion
