Special Feature: Obituary
Daniel Alagille, the eminent French pediatric hepatologist who gave his name to the Alagille Syndrome died November 8, 2005 of complication of heart surgery. He leaves a profound imprint on the subspecialty that he fathered, on countless colleagues, trainees and health professionals, and on pediatric medicine.
Born in Paris in 1925, Alagille trained at Hôpital St-Vincent-de-Paul with Professor Lelong where he began his academic career. Shortly, after being appointed Professeur agrégé in 1963, he established, at Bicêtre Hospital, his world famous Pediatric Hepatology, Unit, which he directed until his retirement in 1990. Professor Alagille transformed Bicêtre from an obscure suburban hospital into a first class teaching hospital and into the Faculté de Médecine Paris Sud. He was its founder and first dean.
Professor Alagille was Editor-in-Chief of Archives Françaises de Pédiatrie for more than 25 years and was a member the Editorial Board of the Journal of Pediatric Gastroenterology and Nutrition, as well as of Pediatric Research. He authored more than 500 original articles, and in 1978 with his former trainee and closest associate, Michel Odièvre, produced the text Maladies du Foie et des Voies Biliaires chez l'Enfant in close collaboration with 11 members of his team of clinicians and researchers. Translated into six languages, it was the first textbook of liver disease in children. In the words of one of us (RG) who wrote the preface, it represented a very personal view of pediatric hepatology. In fact, it was largely a compendium of research performed in his INSERM Unit and of a large clinical experience gathered from studying and managing with care and attention to every detail an exceptionally rich case material recruited from all over Europe and North Africa in a 35 bed inpatient unit and in a large outpatient facility dedicated to pediatric liver disease.
First a médecin d'enfants, Professor Alagille had a holistic approach to children whom be loved dearly. One of his favorite sayings went like this: “a physician who attends to adults does not need to love his patients, while a pediatrician cannot care for his patients without loving them.” Conscious of the impact of chronic diseases on children's lives, he created la Maison de l'Enfance. An entire floor of the hospital was converted into a living space dedicated to play and school where children forgot that they lived in a hospital. When one of us (CCR) was on sabbatical at Bicêtre, a youngster on the phone with a friend was overheard saying: “Come to my place. I live in my doctor's home.”
Alagille was convinced that the psychologic and physical well being of families played a central role in the healing process. Four years after launching, in 1986, his liver transplantation program, which has more than 500 transplants to its credit, he created la Maison des Parents, a first in Europe. Professor Alagille always insisted on maintaining a close line of communication with parents, and taught his trainees “to know what to say” (savoir dire). Some of us remember him remonstrating residents who dared meet and talk with parents in a corridor instead of in the interview rooms set aside for this purpose.
As a mentor (recalls FA), Professor Alagille taught by precept; he did not so much impart facts, skills and technique. One learned by careful attention to the mentor, his thinking, his insights, his kindness, and his commitment to excellence. He influenced careers by infecting trainees et al. with rigor and a passion for le plus beau métier du monde (the best trade in the world) and with his love for children.