This is a fascinating medical story involving JFK, which brings back memories of

my personal, dear to my heart, precious experiences in my early professional career.

JFK was diagnosed to have Addison's disease at age 30 and was treated by implanting

DOCA, a mineralocorticosteroid, a precursor to aldosterone,  the only available drug, then

later cortisone was added as it became available, then developed hypothyroidism, requiring thyroid hormone.

It turned out he had hereditary autoimmune polyendocrinopathy.

In 1966 when I was a first year medical resident, I published my first paper on Addison's disease,

report of a case I managed so that I did a thorough going literature review on the subject.

In July of 1970 I took oral internal medicine board exam at Harvard Med School

after having passed the written exam of the Internal Medicine Board in 1969.

The two examiners were from Peter Bent Brigham,

Chief of endocrinology and Chief of Infectious Disease, Dr. Thomas and Dr. Weinstein.

I was given two patients and 45 minutes for each patient for H&P.

I had to come up with diagnosis, treatment, etc. and answer all the questions by the examiner 

for another 45 minutes for each patient. 

The first patient had some 300 healed incisions on his body and his both ears were ossified ("stature's ears")

This patient had Addison's disease and survived it for years by having DOCA

implanted under the skin.

The only way to administer DOCA was to make  about 2 inch incisions 

and implant DOCA pellets.

That is why the patient had some 300 cuts on his body. The scars were everywhere.

The stature's ears is called "Thorn's ear" named after Dr. Thorn, chief of medicine

at Peter Bent Brigham who described it. Thanks to my case report I wrote in 1966,

I was able to come up with correct diagnosis.

The patient told me afterwards that the three candidates ahead of me failed. 

The funny thing about the Thorn's ears is that you cannot bend the ears or earlobes.

They are like stones. Because of lack of adrenal hormones and mineralocortosteroids,

ear cartilages developed calcium deposits and become stones like kidney stones.

The second case was cardiac case, aortic valvular stenosis and angina, which I easily handled.

This experience was one of highlights in my early professional career.

What is autoimmune polyendocrine syndrome?

"Autoimmune polyendocrine syndrome is a rare, inherited disease in which the immune system mistakenly attacks many of the body’s tissues and organs. The mucous membranes and adrenal and parathyroid glands are commonly affected, though other tissues and organs may become involved as well.

The disease prevents the damaged glands from producing the hormones needed to adequately regulate some body functions. This can create a life-threatening condition if allowed to progress untreated.

Some signs of autoimmune polyendocrine disorder may appear in infancy and others may not show up until adolescence. The syndrome is slightly more likely to affect girls and is mostly limited to certain ethnic groups. These include Fins, Sardinians, and Iranian Jews. Less frequent clustering has been reported from northern Italy, northern Britain, Norway and Germany. Only about 500 cases of autoimmune polyendocrine disorder have been reported worldwide."

I knew John F Kennedy had Addison's disease but I didn't know it was by such unusual autoimmune syndrome I never heard before. Indeed I spent quite an amount of time since my medical school days with special interests to the endocrine disease and further my first NIH grant soon after I started the transplant surgery program at Georgetown Univ was the project of parathyroid hormone so that I still keep special interests in the endocrine surgery and have been involved to MEA-I & MEA-II through years till I left Georgetown U to move to George Washington U.

Anyhow it was a nice surprise to learn you also have a special interests in the endocrinology as well!

Indeed, during the senior year of med school, I made a great debt to Prof. 민헌기 to start to have special interests to the endocrinology so that I ordered Danowski's Clinical Endocrinology (1st ed- 1962) through 범문사 to study more and continued further under David Hume who started his career as an endocrine surgery at Harvard before he committed to the transplant surgery- he wrote the endocrine surgery chapters for many surgery textbooks-. So I got excited to know you also committed to this endocrinology field!

BB Lee

Thank you, Professor, sharing your story involving the field of endocrinology.

As for me, early on in med school I chose internal medicine over surgery and

dedicated myself in deepening and broadening my knowledge in basic sciences 

which helped my career in USA.

Cardiovascular diseases accounted for at least 50% of internal medicine patients then

so that it was rather natural thing for me to choose the field where the action was.

In Feb of 1972 I was able to pass the old fashion 2 day oral Cardiology Board examination 

before ten examiners at Texas Heart Institute, Houston.

There were only less than ten board certified cardiologists

in the entire state of Michigan then, which helped me launch my career in Cardiology

in Detroit Metro, being welcomed at multiple hospitals affiliated with Wayne State University 

School of Medicine.

I was invited to join clinical faculty as assistant professor by Dr. Arnold Weissler,

Chief of Medicine and Cardiology, Wayne State University School of Medicine,

a pioneer in the field of non-invasive Cardiology,

who was one of the two chief examiners at my Board Exam.

Soon I got to know 이형모 선배님, Virginia,

through heart transplant referral matters as we once discussed on this homepage.

Dr. HM is a real 'born surgeon' with talents we don't see often -perhaps Dr. 민병철 in Korea as well!- so that Dr. Hume took maximum advantage on HM. Indeed, HM was the fixer for Hume who himself was not such terrific surgeon technically like HM or Mel Williams, and always remained standby to be ready to take over Hume's case to complete. He never complained or bragged and always was humble! HM was such gentleman with integrity that he remained the idol for every one who went through MCV training and became legendary. I miss him dearly!!!

So, you don't miss Detroit and Michigan since you moved to California after these many years, leaving all the friends and colleagues? I would have been chickened out!

BB Lee

Thank you, Professor, for letting us know more about the great surgeon,

Dr. HM Lee.

Of course, I miss Michigan and old friends there.

It wasn't easy and took only 5 years to make the permanent move.

My wife and I had to do it to be near our three children and five grandchildren.

We have enough friends here as well and are glad we made that move before Pandemic.