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Biographical entry Ger, Ralph (1921 - 2012)

MRCS and FRCS 1953; MB BCh Cape Town 1942; MD; FRCS Edin 1953; FCS South Africa 1954; FACS.

Born
20 February 1921
Cape Town, South Africa
Died
6 April 2012
USA
Occupation
Anatomist and General surgeon

Details

Ralph Ger was a clinical anatomist and innovative surgeon, who spent most of his working life in New York at the Albert Einstein College of Medicine. He emigrated from South Africa during the period of apartheid, and obtained much of his surgical training in the United Kingdom after war service in the South African Medical Corps.

Born on 20 February 1921, he was brought up in a modest home in a working class neighbourhood of Cape Town. His father, Morris Ger, emigrated as a young man from Lithuania. In his adopted country he worked first as a butcher and then as a meat inspector. He married Mary (née Shattenstein), who was born in Glasgow, the daughter of Lithuanian immigrants. Ralph had an older brother, Lazarus, who became an accountant and, a younger sister, Zelda.

Ralph went to the local school and matriculated at the age of 15, during which time he also received teaching in the synagogue. Subject to bullying, his undoubted scholastic ability, a natural flair in sports and his considerable height countered the verbal abuse and stone throwing he experienced on his way to school. He had visions of becoming a veterinary surgeon, but at the time the only centre for this was at the University of Pretoria, where the tuition was in Afrikaans and not in English. Ralph turned to medicine. Entering the University of Cape Town, he graduated at the early age of 21 in 1942. From 1938 he was appointed as a student demonstrator in the department of anatomy. At university he excelled in many sports: he enjoyed playing soccer in the Cape Town league, and was excellent at tennis and table tennis. For most of his adult life Ralph was a keen golfer. Indeed, his retirement present was a new set of golf clubs.

He obtained his licence from the South African Medical Council on completion of house appointments at Grey's Hospital, Pietermaritzburg. In 1944, Ralph joined the South African Medical Corps as a lieutenant and was posted to a military hospital as a medical officer on the tuberculosis ward. He was then ordered to board the Liberty ship Nirvana, a well-worn vessel built in the USA and billed as a 'mule ship', capable of only a few knots and used to transport mules from South Africa to Karachi for use in the Burma campaign. Ralph was responsible for the welfare of the crew and the muleteers, although at times he was called on to help the ship's 'vet' relieve large bowel obstructions by dis-impaction of solid faeces.

He returned to South Africa when peace was declared and was posted to the medical division at Springfield Hospital, Natal, before being discharged in 1946 with the rank of captain. Ralph continued to demonstrate anatomy for a further year in Cape Town, but decided on a career in surgery rather than pure anatomy. In pursuit of this he decided to continue his training in the United Kingdom, as did so many South African, Australian and New Zealand doctors, and became a postgraduate student at the Royal College of Surgeons in London. Anatomy held no terrors for him and he passed the primary FRCS in 1948, before going to the Walton Hospital, Liverpool, as a junior registrar in surgery. At the time large numbers of post-war trainees were competing for posts in the UK, but family circumstances dictated that Ralph should return to South Africa, where he spent a year as a resident at the Somerset Hospital, Cape Town. Returning again to the UK, Ralph registered as a postgraduate student at the Royal College of Surgeons in Edinburgh to prepare himself for the final FRCS examination.

He obtained posts as a registrar in the UK, firstly at the Wingfield-Morris Hospital in Oxford in orthopaedics (in 1952) and then at St Catherine's Hospital in Birkenhead during 1953. Study did not come easily as the posts were very busy, and sleep deprivation almost drove him to a nervous breakdown. A short-lived early marriage failed, and this did not help his health. It was in Liverpool that he worked for a superb teacher with a great knowledge of basic sciences, Alfred Mark Abrahams, and during this period he passed the final FRCS, first in Edinburgh and then in London. The Abrahams were very hospitable and Ralph met their three-year-old son, Peter, who was later to become a doctor and is now an anatomist. Little did Ralph know that he and Peter would later be co-authors of Essentials of clinical anatomy (London, Pitman, 1986). Ralph's final posts in the UK were at St Peter's Hospital, Chertsey, and St Thomas' Hospital throughout 1954, as a senior registrar in general surgery and urology.

When he returned to South Africa he went to Baragwanath Hospital, University of Witwatersrand, Johannesburg, for over a year in 1955. This well-known trauma centre was very busy and his future wife, Dorrit, was working there as an occupational therapist.

Dorrit Neumann was the only child of Jacques Neumann and Charlotte Neumann née Silberberg. Jacques was born in Würzburg, Germany, and graduated from the University of Hamburg and built up a successful practice there as a consultant physician. In 1937 Dorrit's parents emigrated to Johannesburg in order to escape the horrors of Nazi persecution. Jacques Neumann repeated three years of medical training in order to practice in South Africa as a general practitioner. It is believed that Charlotte Neumann's family all died in the Holocaust: she herself died when her only daughter, Dorrit, was 11.

Ralph Ger spotted this tall and attractive occupational therapist on the hospital tennis courts and, having tracked Dorrit down to the appropriate department, invited her out for a meal - the beginning of a long courtship. They married in 1958 in Johannesburg, by which time Ralph had an increasing private practice as a surgeon in Cape Town, whilst still retaining a strong interest in anatomy as a lecturer in the medical school. He had other appointments between 1958 and 1966, as a consultant in surgery at Cape Town University Medical School and was attending surgeon at Groote Schuur Hospital. He was also an examiner in basic sciences for the College of Physicians, Surgeons and Gynaecologists of South Africa, and became the director of programmes in anatomy to the college.

He was also appointed to the staff of Somerset Hospital, a non-white institution. As he wrote in an unpublished memoir: 'This appointment brought joy to my heart, because I was able to do something to improve the situation that had arisen in a country where the civil rights of the majority of the population were non-existent. I always had mixed feelings of living in a racist community, but the apartheid government was reaching new lows. I met a man who belonged to a Christian organisation and who was trying to ameliorate the conditions under which the blacks lived, and I arranged a weekly clinic for those who needed surgery, driving them to hospital where I could treat them.'

Some university students became militant on the problem of apartheid, and one of their number recognised that their actions might lead to situations needing medical care. Ralph agreed to treat them, irrespective of the cause of their problems.

One night the security police visited the Ger home and, after a thorough search, took Ralph to prison, where he was interrogated throughout the night. He was released in the morning, only to find that the student who had asked for medical support had had his accommodation ransacked by the police several days earlier. The police had found an address book incriminating Ralph Ger as the movement's medical attendant. The very next day, following his release, the front page of an Afrikaans newspaper pictured Ralph as the 'movement's doctor'. His hard-earned hospital appointments were immediately terminated by order of the government.

Emigration for Ralph and Dorrit and their three children seemed the only option. He turned to a South African friend, 'Effie' Ephron, who was working at New York's Albert Einstein College of Medicine and had also trained in the UK. Following his advice, Ralph travelled to the USA and was successful at an interview for a post at the Lincoln Hospital, managed by the Albert Einstein College of Medicine. So began a long association with the Albert Einstein, after sad farewells to friends and relations in South Africa.

Ralph and Dorrit settled in Great Neck, New York. Their three children all attended local schools and had successful careers. Their daughter Amanda married Jerry Gitilitz after studying early childhood education. Their son, Michael, studied mechanical engineering and now works for Oracle. Kevin, the youngest, studied aeronautical engineering and works for Jetstar airlines in Australia.

Ralph Ger's long association with the Albert Einstein College of Medicine encompassed a 10-year post as assistant professor of surgery from 1966. He soon became chief of surgery at the Jack D Weiler Hospital on the campus of the medical college. Happily Ralph had access to the dissecting room and, by 1968, Ralph and his colleague 'Effie' Ephron had reshaped the anatomy course with an emphasis on clinical anatomy.

Ralph left the faculty of the Albert Einstein College of Medicine in 1986 to become chair of the department of surgery at Winthrop University Hospital on Long Island, but he continued his commitment to the Einstein anatomy courses for another 20 years, as a popular, witty lecturer. He gave his last lecture in 2009, at the age of 88, on the abdominal wall and hernias. So popular was his teaching that he received many awards. Using a blackboard, coloured chalks and very few projected slides, he was able to make his subject come alive and easily remembered. He was a logical choice as director of courses on operative surgery.

Ralph played a major role in the creation of the American Association of Clinical Anatomists (AACA) in 1983. He first went to the 1982 Liverpool meeting of the British Association of Clinical Anatomists (BACA). He was also pleased to find at national meetings that many American surgeons shared his concerns and vision for teaching relevant clinical anatomy. He became president of AACA after Ollie Beahrs of the Mayo Clinic and Robert A Chase of Stanford University, California, and was the driving force for the publication of the transactions of AACA meetings, first in American Surgeon. Later he and Ray Scothorne, Regius Professor of Anatomy at Glasgow University, became the first editors of Clinical Anatomy, a joint publication of AACA and BACA.

Many innovations in his surgical practice were based on sound anatomical principles, and were the source of numerous publications and scientific presentations. Ralph was one of the first to perform laparoscopic hernia repair: he was a pioneer in the use of muscle transposition to aid healing of chronic ulcers in many areas of the body, including sacral sores, lower limbs and feet.

Ralph and Dorrit were gracious and warm hosts and friends. Guests were met with Ralph's winning smile. He was very knowledgeable when golf tournaments were televised, and any spare moments on his way back from hospital duties were spent at a driving range at his country club. Wimbledon fortnight was compulsive viewing in the Ger household. They were also fond of theatre, visiting Stratford-upon-Avon for performances of the bard's works.

Ralph Ger died on 6 April 2012. He was survived by Dorrit, his children, Amanda, Michael and Kevin, and his grandchildren, Jason, Andrew and Alexa,

N Alan Green

Sources used to compile this entry: [Information from Dorrit Ger; Todd R Olson; Peter Abrahams; 'The American Association of Clinical Anatomists from 1983-2003: Reflections of a founding member' Ger R. Clin Anat, 2004, 17:451-3; 'The teaching of anatomy. Report of a conference held at the Royal College of Surgeons of England on 26th May 1976' Coupland RE, Tresidder GC, Green NA. Ann R Coll Surg Engl, 1976 Nov;58(6):434-9].

The Royal College of Surgeons of England