On September 9, 2005, Dr. William F. (Bill) Balistreri was honored with a Symposium and Festschrift. Dr. Balistreri is highly deserving of this honor because of his life-long contributions to pediatrics as a clinician educator and to the nascent subspecialty of pediatric gastroenterology and hepatology, which he helped establish. He has had a distinguished career as a clinician-teacher (Fig. 1) at Cincinnati Children's Hospital Medical Center (CCHMC) and served as director of Pediatric Gastroenterology, Hepatology and Nutrition for a quarter century before stepping down earlier in 2005.
Dr. Balistreri is a native of Geneva, NY, and earned his MD from the State University of New York at Buffalo. He completed an internship and residency in Pediatrics and fellowship with Dr. William K. Schubert in Pediatric Gastroenterology and Nutrition at CCHMC. During this time, Dr. Balistreri cared for a patient with intractable diarrhea whom he suspected had a defect in the enterohepatic circulation of bile and he eventually determined that this patient had primary bile acid malabsorption. Collaboration with Dr. Alan Hofmann led to a 1-year research fellowship at the Mayo Clinic to learn more about bile acids. We now know this as translational research!
After a tour in the Navy and a faculty position at the Children's Hospital of Philadelphia, Dr. Balistreri returned to the University of Cincinnati and CCHMC in 1978. In 1980, he became director of the Division of Pediatric Gastroenterology and Nutrition, (now Gastroenterology, Hepatology and Nutrition) a position he held for 25 years. Over that time, the Division trained approximately 50 fellows, many of whom are now prominent pediatric gastroenterologists. Currently, 3 former trainees are chairs of departments of pediatrics, 12 are division directors or clinical division directors and at least 9 are full professors of pediatrics. In 1984, Dr. Balistreri was named the Dorothy M. M. Kersten Professor of Pediatrics.
Dr. Balistreri has encouraged and inspired his colleagues and trainees to bring the bedside to the bench and the bench back to the bedside. The manuscripts in this Festschrift are clear evidence of this. He has also made sentinel observations of his own. For example, in addition to the first description of a congenital defect in ileal bile acid transport, Dr. Balistreri was the first to describe reductase deficiency, a specific inborn error of bile acid metabolism and the use of bile acid replacement therapy as treatment for this otherwise fatal disease. He was among the first to describe the use of a specific bile acid as a therapeutic agent in children with intrahepatic cholestasis; this is now an accepted form of therapy for these diseases. Dr. Balistreri helped to unravel the E-Ferol mystery, a local cause of toxic liver failure in newborns that made national news in 1985-1986. In addition, Dr. Balistreri helped to elucidate the concept of physiological cholestasis and to pioneer the use of serum bile acid measurements in the diagnosis of liver disease. Along with Frederick Suchy, John Noseworthy and Frederick Ryckman, he established liver transplantation in Cincinnati as a treatment modality for children with liver disease and continues to serve as Medical Director of the Pediatric Liver Care Center.
As an ambassador for the University of Cincinnati College of Medicine and CCHMC, Dr. Balistreri has been invited to give more than 400 lectures (including dozens of named lectureships) throughout the world. In addition to his lectures, he has authored over 400 manuscripts, books or book chapters and has received dozens of honors and awards. Among the most important awards he has received are the Shwachman Award of NASPGHAN, the Andrew Sass-Kortsak Award of the Canadian Liver Foundation/Canadian Association for the Study of Liver, the Murray Davidson Award of the American Academy of Pediatrics, the Ohio Outstanding Pediatrician of the Year Award (given by the American Academy of Pediatrics), the University of Cincinnati Faculty Achievement Award, the Distinguished Alumnus Award of the SUNY at Buffalo, the Honored Alumnus Award of the Mayo Clinic and the Founder's Award of the Cincinnati Pediatric Society. He has received the Mead Johnson Excellence in teaching award at CCHMC 3 times in the last 6 years.
Dr. Balistreri has been an innovator in pediatric gastroenterology and hepatology. His efforts have been predominantly directed toward life-long learning. In 1980, he organized the first midwest pediatric gastroenterology club (Gut Club) meeting to help promote collegiality and discussion among the pioneers of pediatric gastroenterology. In 1982, he served as cochair of the first Ross-NASPGHAN Conference on Pediatric GI and helped to formulate the first Mead Johnson-NASPGHAN conference in 1983. Both of these national conferences continue today as part of the integrated educational curriculum for fellow trainees in pediatric gastroenterology. In 1984, he cochaired the first Mead-Johnson Neonatal GI Nutrition Symposium and he has continued to organize this annual conference. Dr. Balistreri has regularly codirected his highly successful and prototypic Aspen summer conferences in pediatric GI and hepatology since 1985. In all of these diverse conferences, Dr. Balistreri has left his mark because of his ability to connect with the audience and to provide insight into pediatrics and pediatric hepatology.
In 1985, Dr. Balistreri organized the postgraduate course at the first NASPGHAN-European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) joint meeting in New York. This meeting, which was planned during his term as President of NASPGHAN, paved the way for subsequent NASPGHAN-ESPGHAN joint meetings, the annual NASPGHAN post-graduate course and eventually the First World Congress of Pediatric Gastroenterology held in 2000 (where he was again asked to organize the postgraduate course). This venue has been a model of subspecialty collaboration for advancing the health of children. In addition to his organizational roles for continuing medical education (CME), he is also in high demand as a postgraduate course speaker. Having reviewed the CME evaluations for NASPGHAN, I can attest to the fact that in nearly all the courses in which he has spoken, he has received the highest marks for best speaker! In addition to these important roles in which he has served NASPGHAN by promoting education and research in pediatric gastroenterology, Dr. Balistreri has now taken on the role of President of the Children's Digestive Health and Nutrition Foundation (CDHNF) and is working to advance the educational and research agenda of this organization.
Dr. Balistreri has not only contributed to the literature, but he has also helped to foster education and educational policy by developing new initiatives in print and by his several roles as journal editor. Dr. Balistreri coauthored one of the first texts of pediatric hepatology-a book resulting from his Aspen summer conference in 1987. He also coauthored and eventually authored several revisions of the definitive, tome-like chapter on pediatric hepatology in Schiff text of hepatology. Most recently, he coedited the preeminent text in Pediatric Hepatology with 2 of his former trainees, Ronald Sokol and Frederick Suchy. He served as an associate editor and reviewer for numerous specialty journals. In 1991, Dr. Balistreri became the first NASPGHAN editor of the Journal of Pediatric Gastroenterology and Nutrition (JPGN). Under his leadership, JPGN became the official journal of NASPGHAN-ESPGHAN and the voice of pediatric gastroenterology, hepatology and nutrition. In part because of his talent and his success with JPGN, Dr. Balistreri subsequently assumed the prestigious position of editor of the Journal of Pediatrics in 1996. He continues in this capacity today and has used the Journal as a positive voice for educational policy initiatives by the American Board of Pediatrics (ABP), the Federation of Pediatric Subspecialty Organizations, and the American Society of Pediatric Department Chairs.
Dr. Balistreri elevated the stature of pediatric hepatology within the specialty of hepatology by his long-standing participation in the American Association for the Study of Liver Diseases (AASLD). He assumed the presidency of this organization in November 1999 and he was the first pediatrician to do so. He has also served in a number of capacities for certifying boards including longstanding service on the executive committee of the ABP and prior service on the sub-board in Pediatric Gastroenterology. He was instrumental in helping to craft the current fellowship training criteria and rules for maintenance of certification at the ABP. He currently serves as Associate Chair of Pediatrics for Fellowship Training at CCHMC.
Despite all of his national and international accolades, it seems to me that his greatest contribution has been his teaching at CCHMC either in a conference room or at the bedside. His talks and his engaging Socratic approach have spawned the phrase "Cincinnati style" because so many of his trainees have learned to teach better from his role model. Thus, it was with great pleasure that more than 140 friends, colleagues and family members gathered in Cincinnati to hear the papers in this Festschrift and to honor him and his family. First and foremost, Dr. Balistreri is not only a respected clinician and master educator, but he is also a devoted father, grandfather and husband and all of his accomplishments would not have been possible without the love and support of his family, in particular his wife, Rebecca Balistreri. These attributes were also noted by Charlie Luken, Mayor of the City of Cincinnati who proclaimed September 9, 2005 as "Dr. William F. Balistreri" Day in Cincinnati.