Charles A. Janeway, Pediatrician to the World’s Children (review)

In his lifetime, Charles A. Janeway was perhaps the most prominent pediatrician in the world. Yet today, a quarter century after Janeway’s death, few would recognize his name. To correct this, Drs. Robert Haggerty and Frederick Lovejoy, two former Janeway trainees and prominent pediatricians in their own right, wrote this biography.

Charles A. Janeway was fourth in a line of distinguished physicians. After attending Milton Academy, Yale University, Cornell, and Johns Hopkins Medical Schools, Janeway trained in internal medicine at Boston City Hospital, then at Hopkins. Early on, through his work with Drs. Chester Keefer and Hans Zinsser, Janeway cultivated an interest in infectious diseases and immunology. With the advent of World War II, he became involved in studies of the use of serum albumin in the treatment of shock (and later, nephrotic syndrome), and eventually in the fractionation of the globulin components of blood, leading to the discovery of agammaglobulinemia and other immune deficiency disorders. During the war years, Janeway was asked to develop an infectious disease research and treatment unit at Boston Children’s Hospital. In 1946, Janeway was appointed Chief of Pediatrics at the hospital, and given an endowed pediatrics professorship at Harvard Medical School, positions he was to hold for twenty-nine years.

Almost immediately, Janeway developed the pediatric subspecialties at Boston Children’s through the recruitment of individuals interested in applying biomedical research techniques to solve problems of child health. At the same time, he encouraged the development of academic primary care pediatrics, adolescent medicine, child development, and psychiatry, in addition to family medicine. Although he was keenly interested in basic research, Janeway was passionate about excellence in clinical care, and prompt, courteous service to patients and referring physicians.

Of all Janeway’s accomplishments during the course of his career, the authors consider his teaching to have been his major tour de force (279). Janeway’s style was always to have the patient present, to demonstrate the art of communication and physical examination, then to outline the problem on a blackboard, using the Socratic Method to guide his students to a diagnosis. In addition to his bedside teaching, Janeway spent much effort in the continuing education of practicing physicians. Over time, he expanded the focus of his teaching to include lectures on disease prevention and medical education.

Much of Janeway’s career was devoted to outreach. He was known for sending his graduates to other institutions, where they would develop academic pediatric programs on the Harvard/Children’s Hospital model. Janeway’s concern, though, was not limited to the needs of American medicine. From very early in his life, Janeway had developed a world view, and in the aftermath of World War II, he became passionate about the peace movement, and in assembling a global community of pediatricians. He regularly trained physicians from overseas, including many from developing nations. He was deeply involved with the International Pediatric Association, serving on its executive board and executive committee, traveling extensively around the world teaching and forging alliances with local pediatricians. During extended sabbaticals, Janeway spent time in residence in Madras India, working to improve pediatric health care. Additionally, he was instrumental in developing a teaching hospital in Shiraz, Iran, and a medical school in the Cameroons, the latter to train physicians competent in providing rural health care.

Charles Janeway received many prestigious awards and lectureships. Perhaps most notably, the pediatric hospital at St. Johns, Newfoundland was named “The Dr. Charles A. Janeway Child Health Centre.” Sadly, not long after he retired, Janeway was diagnosed with Waldenstrom’s macroglobulinemia, which took his life almost six years later. A full-page obituary in the Boston Globe quoted a colleague who said about Janeway, “His word was as good as anything in the world. He never did a dishonest thing in his life. He was a rare individual. A decent, compassionate man of total integrity. A model for...