the evolution of modern pediatrics as a specialty in iran
the evolution of modern pediatrics as a specialty in iran
the evolution of modern pediatrics as a specialty in iran
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Arch Iranian Med 2004; 7(3): 239 – 242<br />
THE EVOLUTION OF MODERN PEDIATRICS AS A SPECIALTY<br />
IN IRAN<br />
“Many <strong>of</strong> <strong>the</strong> th<strong>in</strong>gs can wait<br />
A child cannot<br />
To him, we cannot answer tomorrow<br />
His name is today”<br />
Gabriela Mistral<br />
Today<br />
The <strong>evolution</strong> <strong>of</strong> <strong>modern</strong> pediatric education<br />
started <strong>in</strong> Iran s<strong>in</strong>ce <strong>the</strong> late Dr. Mohammad<br />
Gharib returned home from France <strong>in</strong> 1939. His<br />
drive and enthusi<strong>as</strong>m were <strong>in</strong>strumental <strong>in</strong><br />
establish<strong>in</strong>g <strong>pediatrics</strong> <strong>as</strong> a separate discipl<strong>in</strong>e <strong>in</strong><br />
Iran. He w<strong>as</strong> <strong>the</strong> first physician <strong>in</strong> <strong>the</strong> country to<br />
occupy an <strong>of</strong>ficial teach<strong>in</strong>g post <strong>in</strong> child care and<br />
to practice pediatric medic<strong>in</strong>e. Dr. Gharib w<strong>as</strong> <strong>the</strong><br />
first pr<strong>of</strong>essor at Tehran University School <strong>of</strong><br />
Medic<strong>in</strong>e who had been tra<strong>in</strong>ed by renowned<br />
French scientists, and who successfully adapted<br />
Parisian teach<strong>in</strong>g programs to Iranian needs.<br />
Formerly, <strong>pediatrics</strong> <strong>as</strong> an <strong>in</strong>dependent <strong>specialty</strong><br />
did not exist <strong>in</strong> Europe and North America. In <strong>the</strong><br />
United States, a corner <strong>of</strong> department <strong>of</strong> <strong>in</strong>ternal<br />
medic<strong>in</strong>e w<strong>as</strong> occupied by <strong>the</strong> pediatric patients,<br />
and <strong>the</strong>se patients were managed by general<br />
practitioners (GPs) and <strong>in</strong>ternists. In France,<br />
pediatric and adult patients were also admitted to<br />
<strong>the</strong> same departments, and occ<strong>as</strong>ionally a separate<br />
room (unit) w<strong>as</strong> considered for <strong>the</strong> pediatric<br />
patients. In France, medical students could attend<br />
<strong>the</strong> lectures given by <strong>the</strong> respective teachers <strong>in</strong><br />
different departments (especially <strong>in</strong> <strong>the</strong><br />
departments <strong>of</strong> <strong>pediatrics</strong>/<strong>in</strong>ternal medic<strong>in</strong>e). They<br />
Authors affiliations: The Academy <strong>of</strong> Medical Sciences <strong>of</strong> I.R.<br />
Iran, Tehran, Iran.<br />
•Correspond<strong>in</strong>g author and repr<strong>in</strong>ts: Reza Gharib, MD, The<br />
Academy <strong>of</strong> Medical Sciences <strong>of</strong> I.R. Iran, Tehran, Iran.<br />
Tel: +98-21-2522553, Fax: +98-21-2522125<br />
History <strong>of</strong> Contemporary<br />
Medic<strong>in</strong>e <strong>in</strong> Iran<br />
Reza Gharib MD • , Sohrab Najaf-Tomaraei MD<br />
could exam<strong>in</strong>e <strong>the</strong> patients, but <strong>the</strong> “<strong>in</strong>terns”, who<br />
were more experienced, were directly <strong>in</strong> charge <strong>of</strong><br />
<strong>the</strong> respective departments. For this re<strong>as</strong>on, to<br />
become an <strong>in</strong>tern <strong>in</strong> <strong>the</strong> medical schools <strong>of</strong> France<br />
w<strong>as</strong> a great honor. The <strong>in</strong>ternship period w<strong>as</strong> not<br />
limited only to <strong>the</strong> l<strong>as</strong>t year <strong>of</strong> medical tra<strong>in</strong><strong>in</strong>g, but<br />
comprised <strong>the</strong> l<strong>as</strong>t three years <strong>of</strong> tra<strong>in</strong><strong>in</strong>g period.<br />
For this re<strong>as</strong>on, <strong>the</strong> <strong>in</strong>ternship period provided a lot<br />
<strong>of</strong> experience for <strong>the</strong> students and <strong>the</strong>refore, this<br />
period w<strong>as</strong> very important to <strong>the</strong>m. The entrance<br />
exam<strong>in</strong>ation for selection <strong>of</strong> <strong>the</strong> <strong>in</strong>terns for<br />
hospitals <strong>in</strong> Paris w<strong>as</strong> considered one <strong>of</strong> <strong>the</strong> most<br />
difficult and extremely important tests for <strong>the</strong><br />
students. The importance <strong>of</strong> <strong>in</strong>ternship period w<strong>as</strong><br />
so immense that, it once led to <strong>in</strong>terpellation <strong>of</strong> <strong>the</strong><br />
members <strong>of</strong> <strong>the</strong> French parliament and <strong>the</strong>refore,<br />
<strong>the</strong> rul<strong>in</strong>g government w<strong>as</strong> about to fall. The<br />
<strong>in</strong>terns were directly <strong>in</strong> charge <strong>of</strong> <strong>the</strong> patients and<br />
had <strong>the</strong> responsibility for <strong>the</strong>ir management. Thus,<br />
to succeed <strong>in</strong> <strong>the</strong> <strong>in</strong>ternship exam<strong>in</strong>ation w<strong>as</strong> a<br />
great honor and achievement for <strong>the</strong> students.<br />
The earliest group <strong>of</strong> Iranian students who<br />
became <strong>in</strong>terns <strong>in</strong> France <strong>in</strong>cluded Dr. Yahya Adl,<br />
Dr. Mohammad Gharib, Dr. Ali Vakili, and a few<br />
o<strong>the</strong>r talented students whose description is out <strong>of</strong><br />
<strong>the</strong> scope <strong>of</strong> this paper. The <strong>in</strong>terns <strong>of</strong> hospitals <strong>in</strong><br />
Paris responsible for cl<strong>in</strong>ical exam<strong>in</strong>ation and<br />
treatment <strong>of</strong> <strong>the</strong> admitted patients could show more<br />
<strong>in</strong>terest <strong>in</strong> one or two specialties and work <strong>in</strong> those<br />
departments. Dr. Gharib w<strong>as</strong> more <strong>in</strong>terested <strong>in</strong> <strong>the</strong><br />
fields <strong>of</strong> <strong>pediatrics</strong> and dermatology. Dr. Gharib<br />
had been extensively tra<strong>in</strong>ed <strong>in</strong> France and had<br />
championed <strong>the</strong> transplantation <strong>of</strong> <strong>the</strong> French<br />
university system to <strong>the</strong> Iranian system.<br />
The Iranian government <strong>in</strong>vited one <strong>of</strong> <strong>the</strong><br />
renowned French physicians, Dr. Oberlen, to<br />
establish a school <strong>of</strong> medic<strong>in</strong>e <strong>in</strong> Tehran<br />
Archives <strong>of</strong> Iranian Medic<strong>in</strong>e, Volume 7, Number 3, July 2004 239
University that could tra<strong>in</strong> medical students more<br />
scientifically and appropriately. Dr. Oberlen, who<br />
well knew <strong>the</strong> Iranian medical graduates (from<br />
France), gave <strong>the</strong>m <strong>the</strong> responsibility <strong>of</strong> different<br />
departments. For example, Pr<strong>of</strong>essor Yahya Adl<br />
w<strong>as</strong> appo<strong>in</strong>ted <strong>as</strong> <strong>the</strong> head <strong>of</strong> <strong>the</strong> Department <strong>of</strong><br />
Surgery; Dr. Sadegh-Pirooz Azizi, Dr. Farzad, Dr.<br />
Manouchehr Eghbal, Dr. Mahdi Azar, and Dr. Ali<br />
Vakili (<strong>as</strong> a <strong>the</strong>ory teacher) were <strong>in</strong> charge <strong>of</strong> <strong>the</strong><br />
Department <strong>of</strong> Internal Medic<strong>in</strong>e; and <strong>the</strong><br />
responsibility <strong>of</strong> <strong>the</strong> Department <strong>of</strong> Pediatrics w<strong>as</strong><br />
given to Dr. Gharib. The primary nucleus <strong>of</strong><br />
pediatric education by Dr. Gharib w<strong>as</strong> formed at<br />
Razi Hospital affiliated to Tehran University. Dr.<br />
Gharib can be recognized <strong>as</strong> <strong>the</strong> first person to<br />
establish a scientific b<strong>as</strong>e for <strong>pediatrics</strong> <strong>in</strong> Iran. He<br />
w<strong>as</strong> a great teacher and enthusi<strong>as</strong>t <strong>of</strong> pediatric<br />
studies. Dr. Gharib radiated enormous enthusi<strong>as</strong>m<br />
<strong>in</strong> promot<strong>in</strong>g and development <strong>of</strong> <strong>pediatrics</strong>. The<br />
heads <strong>of</strong> o<strong>the</strong>r departments at Razi Hospital were<br />
Dr. Azar (Internal Medic<strong>in</strong>e), Dr. Maleki<br />
(Dermatology), Dr. Eghbal (Infectious Dise<strong>as</strong>es),<br />
Dr. Hanjen (Surgery), and Dr. Kar (Pathology).<br />
The full-time schedule for <strong>the</strong> academic staff <strong>of</strong><br />
medical schools w<strong>as</strong> not considered at that time.<br />
Perhaps, it w<strong>as</strong> also followed <strong>in</strong> o<strong>the</strong>r countries<br />
(because medical education w<strong>as</strong> <strong>in</strong> <strong>the</strong> form <strong>of</strong><br />
cl<strong>in</strong>ical [bedside] teach<strong>in</strong>g). The subject <strong>of</strong><br />
research w<strong>as</strong> not so scientific <strong>as</strong> it is seen<br />
nowadays. Perhaps, it followed <strong>the</strong> same order <strong>as</strong><br />
<strong>in</strong> o<strong>the</strong>r universities throughout <strong>the</strong> world.<br />
Scientific research <strong>in</strong> <strong>the</strong> follow<strong>in</strong>g years got much<br />
importance and became widespread.<br />
Dr. Gharib w<strong>as</strong> a great observer who had an<br />
enormous capacity for improvisation <strong>in</strong> his cl<strong>in</strong>ical<br />
presentations. From <strong>the</strong> beg<strong>in</strong>n<strong>in</strong>g <strong>of</strong> his academic<br />
activities <strong>in</strong> <strong>the</strong> Department <strong>of</strong> Pediatrics <strong>of</strong> Razi<br />
Hospital, Dr. Gharib planned a special tra<strong>in</strong><strong>in</strong>g<br />
program for some <strong>of</strong> <strong>the</strong> medical graduates<br />
(<strong>as</strong>sistants). While work<strong>in</strong>g <strong>in</strong> different<br />
departments, <strong>the</strong> abilities <strong>of</strong> <strong>the</strong>se students were<br />
observed and <strong>as</strong>sessed by Dr. Gharib, and <strong>the</strong>y<br />
were <strong>the</strong>n selected <strong>as</strong> <strong>as</strong>sistants. I (<strong>the</strong> first author)<br />
remember Dr. Gharib emph<strong>as</strong>iz<strong>in</strong>g that Dr.<br />
Mokhtarzadeh (<strong>the</strong> future pediatric <strong>as</strong>sistant) and<br />
Dr. Hadavi (<strong>the</strong> future <strong>as</strong>sistant <strong>in</strong> <strong>in</strong>ternal<br />
medic<strong>in</strong>e) were <strong>the</strong> honors <strong>of</strong> Tehran University<br />
School <strong>of</strong> Medic<strong>in</strong>e. Therefore, he selected Dr.<br />
Mokhtarzadeh and appo<strong>in</strong>ted him <strong>as</strong> pediatric<br />
<strong>as</strong>sistant. The next group <strong>of</strong> <strong>as</strong>sistants at that time<br />
<strong>in</strong>cluded Dr. Ahmad Ghaane-B<strong>as</strong>iri, Dr. H<strong>as</strong>san<br />
Zamani, Dr. Nek<strong>of</strong>ar, and Dr. Morteza<br />
M<strong>as</strong>hayekhi.<br />
240<br />
Archives <strong>of</strong> Iranian Medic<strong>in</strong>e, Volume 7, Number 3, July 2004<br />
Modern <strong>pediatrics</strong> <strong>in</strong> Iran<br />
There were two systems <strong>of</strong> select<strong>in</strong>g <strong>the</strong><br />
<strong>as</strong>sistants <strong>in</strong> different departments <strong>of</strong> <strong>the</strong> Medical<br />
School. Some <strong>of</strong> <strong>the</strong>m, after p<strong>as</strong>s<strong>in</strong>g <strong>the</strong><br />
competitive exam<strong>in</strong>ation and present<strong>in</strong>g a paper <strong>in</strong><br />
a scientific conference, were selected <strong>as</strong> “<strong>of</strong>ficial<br />
<strong>as</strong>sistants”. The o<strong>the</strong>rs, after p<strong>as</strong>s<strong>in</strong>g <strong>the</strong> entrance<br />
exam<strong>in</strong>ation, were appo<strong>in</strong>ted <strong>as</strong> “un<strong>of</strong>ficial<br />
<strong>as</strong>sistants”, and after gett<strong>in</strong>g <strong>the</strong> postgraduate<br />
(specialist) degree, had to leave <strong>the</strong> system (School<br />
<strong>of</strong> Medic<strong>in</strong>e) and do private practice. The first<br />
group (<strong>of</strong>ficial <strong>as</strong>sistants) could take <strong>the</strong><br />
responsibility <strong>of</strong> a primary health center after<br />
completion <strong>of</strong> <strong>the</strong> <strong>as</strong>sistantship period and p<strong>as</strong>s<strong>in</strong>g<br />
ano<strong>the</strong>r competitive exam<strong>in</strong>ation. After work<strong>in</strong>g<br />
for 3 to 4 years <strong>in</strong> a health center, and <strong>in</strong> c<strong>as</strong>e <strong>of</strong><br />
hav<strong>in</strong>g a vacancy <strong>in</strong> <strong>the</strong> post <strong>of</strong> “Associate<br />
Pr<strong>of</strong>essor”, <strong>the</strong>y could attend <strong>the</strong> competitive<br />
exam<strong>in</strong>ation for that position. The prerequisite for<br />
becom<strong>in</strong>g an <strong>as</strong>sociate pr<strong>of</strong>essor, <strong>in</strong> addition to<br />
completion <strong>of</strong> <strong>the</strong> postgraduate period, w<strong>as</strong> to<br />
attend an exam<strong>in</strong>ation and presentation <strong>of</strong> a<br />
scientific paper <strong>in</strong> a conference (<strong>in</strong> presence <strong>of</strong> <strong>the</strong><br />
teachers <strong>as</strong> well <strong>as</strong> <strong>the</strong> students). The first <strong>as</strong>sociate<br />
pr<strong>of</strong>essor <strong>in</strong> <strong>the</strong> Department <strong>of</strong> Pediatrics w<strong>as</strong> Dr.<br />
Mokhtarzadeh.<br />
The work<strong>in</strong>g schedule <strong>of</strong> Dr. Gharib, when he<br />
w<strong>as</strong> younger, consisted <strong>of</strong> daily rounds <strong>in</strong> <strong>the</strong><br />
Department <strong>of</strong> Pediatrics start<strong>in</strong>g from 7:30 am<br />
and l<strong>as</strong>t<strong>in</strong>g up to 1:00 pm. This period <strong>of</strong> time<br />
<strong>in</strong>cluded listen<strong>in</strong>g to <strong>the</strong> c<strong>as</strong>e histories and<br />
exam<strong>in</strong>ation <strong>of</strong> <strong>the</strong> newly admitted patients,<br />
follow<strong>in</strong>g <strong>the</strong> progress <strong>of</strong> <strong>the</strong> old patients, and<br />
attend<strong>in</strong>g <strong>the</strong> weekly scientific conferences <strong>of</strong> <strong>the</strong><br />
department (presented ei<strong>the</strong>r by himself or one <strong>of</strong><br />
<strong>the</strong> students). He w<strong>as</strong> <strong>in</strong> agreement with <strong>the</strong> fulltime<br />
system <strong>of</strong> work<strong>in</strong>g <strong>of</strong> <strong>the</strong> academic staff. He<br />
admired and encouraged scientific researches, but<br />
did not give priority to b<strong>as</strong>ic researches because he<br />
believed that major focus <strong>of</strong> <strong>the</strong> pediatricians at<br />
that time should be on <strong>the</strong> treatment <strong>of</strong> <strong>in</strong>fectious<br />
dise<strong>as</strong>es and decre<strong>as</strong><strong>in</strong>g mortality and morbidity <strong>of</strong><br />
diph<strong>the</strong>ria, g<strong>as</strong>troenteritis, and malnutrition. When<br />
we say that <strong>pediatrics</strong> more than any o<strong>the</strong>r branch<br />
<strong>of</strong> medic<strong>in</strong>e is directed towards preventive<br />
medic<strong>in</strong>e, we must feel grateful to Dr. Gharib for<br />
hav<strong>in</strong>g directed <strong>pediatrics</strong> <strong>in</strong> Iran <strong>in</strong> this way. He<br />
caused <strong>pediatrics</strong> to become a dynamic and rapidly<br />
expand<strong>in</strong>g subject <strong>in</strong> Iran.<br />
Before <strong>the</strong> era <strong>of</strong> <strong>modern</strong> pediatric practice<br />
taught and promoted by Dr. Gharib and graduates<br />
<strong>of</strong> his tra<strong>in</strong><strong>in</strong>g program, treatment <strong>of</strong> all patients,<br />
adult <strong>as</strong> well <strong>as</strong> children, w<strong>as</strong> carried out by GPs,<br />
nonphysicians, or herbal medic<strong>in</strong>e shopkeepers.
The diagnosis and screen<strong>in</strong>g <strong>of</strong> some <strong>of</strong> dise<strong>as</strong>es,<br />
<strong>in</strong> <strong>the</strong> beg<strong>in</strong>n<strong>in</strong>g, depended on <strong>the</strong> diagnostic<br />
ability and experience <strong>of</strong> <strong>the</strong> physician. However,<br />
some <strong>of</strong> dise<strong>as</strong>es, nowadays, can be diagnosed on<br />
screen<strong>in</strong>g “at cellular (molecular) level”, for<br />
example Down’s syndrome, cystic fibrosis,<br />
coagulopathies, and <strong>the</strong> detailed diagnosis <strong>of</strong><br />
<strong>in</strong>fectious dise<strong>as</strong>es. It should be realized and<br />
agreed that <strong>in</strong> different subspecialties <strong>of</strong> <strong>pediatrics</strong>,<br />
<strong>as</strong> far <strong>as</strong> <strong>the</strong> diagnosis (on <strong>the</strong> b<strong>as</strong>is <strong>of</strong> cl<strong>in</strong>ical<br />
methods) and surgical treatment (both curative and<br />
palliative) are concerned, congenital heart dise<strong>as</strong>es<br />
have had <strong>the</strong> best development. It should be<br />
po<strong>in</strong>ted out that perhaps, <strong>as</strong> far <strong>as</strong> <strong>the</strong> genetics and<br />
application <strong>of</strong> <strong>the</strong> newer technologies (used <strong>in</strong> <strong>the</strong><br />
most <strong>modern</strong> and well-equipped centers<br />
throughout <strong>the</strong> world) are concerned, <strong>pediatrics</strong> h<strong>as</strong><br />
utilized <strong>the</strong> m<strong>in</strong>imum.<br />
Today, one <strong>of</strong> <strong>the</strong> great challenges <strong>of</strong> <strong>pediatrics</strong><br />
<strong>in</strong> Iran is to decide whe<strong>the</strong>r <strong>the</strong> art, empathy, and<br />
concern for all children that have characterized this<br />
discipl<strong>in</strong>e over <strong>the</strong> l<strong>as</strong>t 65 years can be preserved<br />
<strong>as</strong> technologies become ever more complex and<br />
<strong>the</strong> body <strong>of</strong> scientific knowledge becomes ever<br />
larger.<br />
“From <strong>in</strong>ability to let well alone; from too<br />
much zeal for <strong>the</strong> new and contempt for what is<br />
old; from putt<strong>in</strong>g knowledge before wisdom,<br />
science before art, and cleverness before<br />
common sense; from treat<strong>in</strong>g patients <strong>as</strong> c<strong>as</strong>es;<br />
Figure 1. Physicians <strong>in</strong> <strong>the</strong> Gharib family.<br />
R. Gharib, S. Najaf-Tomaraei<br />
and from mak<strong>in</strong>g <strong>the</strong> cure <strong>of</strong> <strong>the</strong> dise<strong>as</strong>e more<br />
grievous than <strong>the</strong> endurance <strong>of</strong> <strong>the</strong> same, Good<br />
Lord, deliver us”.<br />
Sir Robert Hutchison<br />
The life history <strong>of</strong> Pr<strong>of</strong>essor Mohammad<br />
Gharib, <strong>the</strong> fa<strong>the</strong>r <strong>of</strong> Iranian <strong>pediatrics</strong> 1<br />
“Great men are very rare. They are worth<br />
know<strong>in</strong>g. They give impulse and stimulus to<br />
lesser men. They make <strong>the</strong> world more<br />
worthwhile for o<strong>the</strong>rs to live <strong>in</strong> because <strong>of</strong> <strong>the</strong>ir<br />
presence <strong>in</strong> it”.<br />
“Graham Lusk”<br />
Dr. Mohammad Gharib w<strong>as</strong> born <strong>in</strong> a noble and<br />
religious family <strong>in</strong> Tehran <strong>in</strong> 1910. His fa<strong>the</strong>r, <strong>the</strong><br />
late Ali-Asghar Gharib, w<strong>as</strong> from Garakan, a city<br />
<strong>in</strong> Center <strong>of</strong> Iran <strong>in</strong> Markazi Prov<strong>in</strong>ce. His primary<br />
school<strong>in</strong>g w<strong>as</strong> <strong>in</strong> Siroos School, and he completed<br />
his secondary school<strong>in</strong>g <strong>in</strong> Dar-ol Fonoun.<br />
In 1928, he went to France with <strong>the</strong> first group<br />
<strong>of</strong> Iranian students, and cont<strong>in</strong>ued his studies <strong>in</strong> <strong>the</strong><br />
field <strong>of</strong> medic<strong>in</strong>e <strong>in</strong> one <strong>of</strong> <strong>the</strong> best medical<br />
centers, supervised by famous scientists. In France,<br />
<strong>the</strong> young physician’s enthusi<strong>as</strong>m helped him p<strong>as</strong>s<br />
<strong>the</strong> <strong>in</strong>ternship exam<strong>in</strong>ation at Paris. This started <strong>the</strong><br />
academic carrier <strong>of</strong> Dr. Gharib. His subsequent<br />
flair <strong>in</strong> <strong>the</strong> general <strong>as</strong>pects <strong>of</strong> childhood dise<strong>as</strong>es<br />
Archives <strong>of</strong> Iranian Medic<strong>in</strong>e, Volume 7, Number 3, July 2004 241
w<strong>as</strong> due, <strong>in</strong> no small me<strong>as</strong>ure, to his hav<strong>in</strong>g<br />
received his pediatric tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Paris supervised<br />
by renowned physicians and scientists. He<br />
completed his <strong>the</strong>sis, <strong>the</strong> apnea <strong>of</strong> prematurity,<br />
successfully and returned home (Iran) <strong>in</strong> 1939.<br />
In 1939, he got married to Miss Zahra Gharib,<br />
<strong>the</strong> daughter <strong>of</strong> <strong>the</strong> late Aghamirza-Abdolazim-<br />
Khan Gharib, and <strong>the</strong> results <strong>of</strong> this marriage were<br />
two sons and two daughters. His sons are now<br />
physicians. Figure 1 shows <strong>the</strong> physicians <strong>in</strong><br />
Gharib family.<br />
Upon his return from France, Dr. Gharib<br />
became a staff member <strong>of</strong> <strong>the</strong> Department <strong>of</strong><br />
Pediatrics at Razi Hospital affiliated to Tehran<br />
University School <strong>of</strong> Medic<strong>in</strong>e. Dr. Gharib w<strong>as</strong><br />
<strong>in</strong>ternationally known for his v<strong>as</strong>t knowledge <strong>of</strong><br />
general <strong>pediatrics</strong>. He w<strong>as</strong> <strong>the</strong> Chairman <strong>of</strong> <strong>the</strong><br />
Departments <strong>of</strong> Pediatrics at Razi Hospital, Hezar<br />
Takht-e-Khabi Hospital (now called Imam<br />
Khome<strong>in</strong>i Hospital), and Children’s Medical<br />
Center. These departments ga<strong>in</strong>ed much fame<br />
throughout Iran and <strong>the</strong> Middle E<strong>as</strong>t region for<br />
<strong>the</strong>ir work <strong>in</strong> <strong>pediatrics</strong>. After completion <strong>of</strong> <strong>the</strong><br />
build<strong>in</strong>g <strong>of</strong> Children’s Medical Center <strong>in</strong> 1968 (Dr.<br />
Gharib and <strong>the</strong> late Dr. H<strong>as</strong>san Ahari were among<br />
<strong>the</strong> pioneers who established <strong>the</strong> Children’s<br />
Medical Center), he cont<strong>in</strong>ued his research and<br />
teach<strong>in</strong>g <strong>in</strong> this center. Dr. Gharib can be<br />
recognized <strong>as</strong> <strong>the</strong> one who first established a<br />
scientific b<strong>as</strong>e for <strong>pediatrics</strong> <strong>in</strong> Iran, and dur<strong>in</strong>g <strong>the</strong><br />
next half a century he built and directed <strong>the</strong> first<br />
<strong>modern</strong>, scientific, and full-time pediatric<br />
department <strong>in</strong> Iran. In 1941, he published his book<br />
entitled “Dise<strong>as</strong>es <strong>of</strong> Children”, <strong>the</strong> first known<br />
textbook <strong>of</strong> <strong>pediatrics</strong> written by an Iranian author.<br />
In 1946, <strong>the</strong> new edition <strong>of</strong> his book w<strong>as</strong><br />
published. With <strong>the</strong> late Dr. H<strong>as</strong>san Ahari, he<br />
wrote a book <strong>in</strong> two volumes entitled “The<br />
Problems <strong>in</strong> Pediatrics” which is still worth<br />
read<strong>in</strong>g.<br />
He w<strong>as</strong> <strong>the</strong> founder <strong>of</strong> <strong>the</strong> Iranian Society <strong>of</strong><br />
Pediatrics and for many years w<strong>as</strong> <strong>the</strong> chairman <strong>of</strong><br />
this society. He w<strong>as</strong> one <strong>of</strong> <strong>the</strong> em<strong>in</strong>ent<br />
pediatricians <strong>in</strong> <strong>the</strong> International Society <strong>of</strong><br />
Pediatrics, and w<strong>as</strong> once elected <strong>as</strong> a member <strong>of</strong><br />
this society.<br />
The l<strong>as</strong>t years <strong>of</strong> his life were <strong>the</strong> best teach<strong>in</strong>g<br />
cl<strong>as</strong>ses for his students. Even <strong>the</strong> deadly dise<strong>as</strong>e,<br />
cancer, for a man who knew everyth<strong>in</strong>g about it,<br />
could not prevent him from fur<strong>the</strong>r teach<strong>in</strong>g,<br />
exam<strong>in</strong>ation <strong>of</strong> <strong>the</strong> patients, and help<strong>in</strong>g <strong>the</strong> poor<br />
and underprivileged people. He eventually<br />
succumbed to cancer at <strong>the</strong> age <strong>of</strong> 65.<br />
242<br />
Archives <strong>of</strong> Iranian Medic<strong>in</strong>e, Volume 7, Number 3, July 2004<br />
Modern <strong>pediatrics</strong> <strong>in</strong> Iran<br />
He only missed a few days <strong>of</strong> his life from<br />
pediatric teach<strong>in</strong>g and discussion. Dr. Gharib w<strong>as</strong> a<br />
pioneer. He w<strong>as</strong> a man <strong>of</strong> em<strong>in</strong>ent personality. He<br />
had great <strong>in</strong>fluence <strong>in</strong> rais<strong>in</strong>g <strong>the</strong> level <strong>of</strong> pediatric<br />
medic<strong>in</strong>e particularly at Tehran University School<br />
<strong>of</strong> Medic<strong>in</strong>e. His methods were also adopted by<br />
many <strong>of</strong> his followers, <strong>as</strong> gradually returned from<br />
<strong>the</strong>ir European and North American tra<strong>in</strong><strong>in</strong>g<br />
periods. The success <strong>of</strong> his disciples, for example<br />
Dr. Siadati, Dr. Khatami, Dr. Farhoodi, Dr.<br />
Bodaghi, and o<strong>the</strong>r pediatricians <strong>in</strong> private practice<br />
helped <strong>the</strong> discipl<strong>in</strong>e get more attractive and<br />
popular. His goals were an excellent service to<br />
society, a propitious field for pediatric teach<strong>in</strong>g,<br />
and a fertile environment for research on <strong>the</strong><br />
dise<strong>as</strong>es <strong>of</strong> childhood. Dur<strong>in</strong>g <strong>the</strong> middle and l<strong>as</strong>t<br />
third <strong>of</strong> <strong>the</strong> 20 th century, almost all pediatricians <strong>in</strong><br />
Iran could trace <strong>the</strong>ir tra<strong>in</strong><strong>in</strong>g and mentorship to<br />
Dr. Gharib. His scientific achievements were so<br />
extensive that <strong>the</strong>y cannot be summarized here. Dr.<br />
Gharib w<strong>as</strong> not only a physician but a philosopher<br />
and a man <strong>of</strong> extremely deep feel<strong>in</strong>gs -a complete<br />
physician.<br />
With deep regrets, <strong>the</strong> Iranian Society <strong>of</strong><br />
Pediatrics w<strong>as</strong> <strong>in</strong>formed <strong>of</strong> <strong>the</strong> death <strong>of</strong> Dr. Gharib<br />
on 20 th January 1975. He w<strong>as</strong> a giant <strong>in</strong> <strong>the</strong> field <strong>of</strong><br />
<strong>pediatrics</strong>, and his contributions hold a significant<br />
place <strong>in</strong> <strong>the</strong> history <strong>of</strong> <strong>pediatrics</strong> <strong>in</strong> Iran. It w<strong>as</strong> a<br />
loss to Iranian <strong>pediatrics</strong>. Dr. Gharib h<strong>as</strong> p<strong>as</strong>sed to<br />
<strong>the</strong> next generation <strong>the</strong> sense <strong>of</strong> commitment to<br />
scientific approach and social concerns that are <strong>the</strong><br />
hallmarks <strong>of</strong> <strong>pediatrics</strong>.<br />
Dr. Gharib w<strong>as</strong> a great man dedicated to<br />
healthy development <strong>of</strong> children. We, <strong>in</strong> <strong>the</strong><br />
Iranian Society <strong>of</strong> Pediatrics, will miss his sage<br />
advice. We always remember him. May his sole<br />
rest <strong>in</strong> peace.<br />
“The physician must never forget that<br />
medical art h<strong>as</strong> a higher range and aim than <strong>the</strong><br />
prescription <strong>of</strong> drugs or even <strong>of</strong> food and<br />
hygienic means, and when nei<strong>the</strong>r <strong>of</strong> <strong>the</strong>se<br />
avails, it is still no small portion <strong>of</strong> his art to rid<br />
his patient’s path <strong>of</strong>f thorns if he cannot make it<br />
bloom with roses”.<br />
Alfred Stille<br />
Reference<br />
1 Annual Congress <strong>of</strong> <strong>the</strong> Iranian Society <strong>of</strong> Pediatrics and<br />
<strong>the</strong> 25 th Memorial Congress <strong>of</strong> Pr<strong>of</strong>essor Mohammad<br />
Gharib (Abstracts). April 2004: 18 – 20.