Staffing

Gunnar Sebardt remembers the Department of Medicine at Umeå Hospital, as it appeared when he first came there as a consultant in 1947. Up till then, there had been only one consultant at the department, Sven Ekvall, M.D., who was also Head of the Department.

Sven Ekvall had been running the department since 1932. In 1947, he was in charge of 150 hospital beds in addition to the 60 beds for rheumatic patients. The workload had become such that he had to look for a qualified colleague. Gunnar Sebardt was recruited from Stockholm, where he had been trained as an internist at the St Erik Hospital, then a leading teaching hospital.

When Gunnar Sebardt had joined the department there were a total of five doctors (two consultants and three junior physicians). In total, there were 20 doctors at the hospital. Gunnar Sebardt got the responsibility for 70 beds in medical wards and 30 beds in the rheumatological wards.

The economic conditions were less than favourable. The salary was low but incomes from the outpatient clinics on Wednesdays and Saturdays were additional. It meant, however, that the working week did not end until 4 o’clock in the afternoon on Saturdays. Additional income also came from an appointment as a battalion physician at the regiment I20, were Gunnar Sebardt worked between 7 and 9 o’clock in the mornings before medical rounds started at the hospital.

In-hospital patient care

When Gunnar Sebardt came to Umeå, Lycksele Hospital had not been established. Severely ill patients therefore had to travel up to 400 km to Umeå to get to their nearest hospital. Less severely ill patients were treated by mostly well-educated and skilful primary care physicians at local health care centres.

Some disorders that Gunnar Sebardt had not encountered during his Stockholm years were present among the Umeå patients. Subjects with acute intermittent porphyria were admitted to hospital when acute attacks appeared (this genetic disorder had been mapped by Jan Waldenström in the 1930’s). Nephropathia endemica ("vole fever") was fairly common in Västerbotten County also at that time.

Research and education

One of the consultants, Gunnar Jungner, was in laboratory medicine. Gunnar Sebardt and Gunnar Jungner started experiments to cultivate bone marrow cells for transplantation in patients with aplastic anaemia. They never succeeded to get cells to survive for more than just a few days.

Gunnar Sebardt also evaluated gold treatment, standard therapy for rheumatoid arthritis at that time. In a large series of patients, he showed that, although a temporary relief of symptoms often occurred, the long-term prognosis was worse for those that received gold therapy compared with those who did not receive this treatment (this was long, long before modern gold preparations where available). Gold therapy was replaced by the new salazopyrine treatment in Umeå patients.

An education and discussion club at the hospital, The Colloquium, was started by Kurt Kaijser, Head of the Department of Pediatrics. The Colloquium convened for two hours every Saturday. The clinics took turns to present interesting cases. Kurt Kaijser himself contributed with remarkable cases and remarkable diagnoses to the extent that his colloquia were called "Kaijser’s curio cabinet".

The last colloquium of the year included a dinner and a comic theatre performance with doctors and their wifes as actors.

The origins of a new university

During the early 1950’s, two members of parliament were strong proponents of Umeå and its hospital. Per Gordon Lundgren was a conservative and Head of the Department of Ophthalmology, and Gösta Skoglund was a social democrat who later became Minister of Communications. Together with other enthusiasts, they fought (in competition with Härnösand) and succeeded to get to Umeå the so called "5th exemplar", a compulsory library copy of all printed material in Sweden, in addition to the copies received by the four universities that were established in Sweden at that time. This then formed the basis for the development of a new university in Umeå, starting with the establishment of a School of Dentistry in 1956. Gunnar Sebardt was then the acting hospital librarian and he got a task of unpacking and sorting all the printing concerning medical subjects.

Gunnar Sebardt had a reputation for swift work and memorable teaching among younger colleges. For example, he emphasized the significance of punctum quintum, in Germany also called Erb´s point, the precordial area in the third intercostal space to the left of the sternum. In this area, most heart murmurs can be heard by experienced physicians. The fifth point thus provides the logical starting point for heart auscultation (cf. 1, 2).

Translated and intepreted by Prof Kjell Asplund, Dept Int Med, Univ Hosp, SE-901 85 Umeå, Sweden

1. Moll K-J, Moll M. Anatomie. Ed 13, p. 379. Germany.
2. Bates B. A guide to physical examination and history taking. Ed. 4, p. 261-52. Lippincott, New York 1987.

Updated oktober 09, 2000