CARREL OF DISCONTENT

by
Sherwyn Warren, MD

Delivered to The Chicago Literary Club
November 8, 1999

In 1909, Dr. Karl Beck, professor of surgery at the University of Illinois, nominated Dr. Alexis Carrel for the Nobel Prize in Physiology and Medicine for work done at the Hull Laboratory of Physiology of the University of Chicago.

Carrel, a surgeon, born and educated in Lyon, France, first saw Chicago in September, 1904. He described it as: "The big, dirty city. Heart rendering impression is the feverish activity of the crowds, Michigan Avenue, the Lake, the boulevards, the intersections, the terrible noise of the elevated metro; the mud, the dirtiness of the streets, the traffic, the big stores, high buildings, gray sky, dirty clouds, the heat and humidity."

Carrel had left Lyon for Montreal in the spring of 1904, discouraged with his prospects for a surgical career in France and discontented with French medical politics. Pursuing the possibilities of life as a farmer or rancher, on August 10, he undertook a rail journey through western Canada and the United States. Thereby disenchanted with agriculture and husbandry, Carrel decided to stay in the big, dirty city. Two years of encouragement and opportunity at the University of Chicago was pivotal on his path to the Nobel Prize in 1912 and the century's most significant developments in surgery.

Eldest of three children, Alexis was born in Saint Foy les Lyon on June 28, 1873 and baptized Marie Joseph Auguste Carrel Billiard. His father, Alexis Carrel-Billiard, a well to do textile merchant, died when the son was five years old. Marie Joseph Auguste dropped his baptismal names and became known as Alexis Carrel. His devout Catholic mother guided him through a Jesuit education at St. Joseph's Day School and the University of Lyon Faculty of Medicine. After passing his final examinations in 1893, he spent the next two years as an extern at the Red Cross hospital and the Hospital Antiguaille. In 1895, he served his one year of military service in a unit of the mountain troops, the Chausseurs Alpins. His first practical surgical experience was gained in the hospitals of Lyon, principally the Hotel Dieu, between 1896 and 1900. In 1898 he secured an appointment as a prosector, in which capacity he taught anatomy and experimental surgery to students from the university.

On June 24,1894, Sadi Carnot, fourth president of the third French republic, delivered a speech at an exhibition in Lyon. Sadi was extremely popular with the French people. Born in 1837 and educated as an engineer, he was president of the republic during turbulent times, a figure of confidence and stability during the French fiasco involving the Panama Canal, labor agitation and the anarchist movement. He was retained in office despite ten changes of government. Immediately after the speech, Sante Caserio, an Italian anarchist, rushed up to Carnot and stabbed him in the abdomen. The blade lacerated the portal vein. Sadi was operated on, but surgeons had no techniques for repair of a lacerated blood vessel, and he bled to death. National mourning followed; Sadi was buried in the Pantheon, next to his grandfather, Lazare Carnot, who was called the "Organizer of Victory" of the French revolution,

Carrel, a very junior house officer at this time, questioned why there were no techniques for repair of blood vessels. These views, publicly expressed, irritated his superiors; nevertheless, Carrel sought laboratory space where he could try ideas and experiments. He found such space in the laboratory of Marcel Soulier, a professor of therapeutics, whose son was his close friend. There, he worked in complete freedom for many semesters, developing and gaining experience in techniques to suture blood vessels, and reported his results in local medical journals. Meanwhile, he also prepared his doctoral thesis, under Professor Poncet, on cancer of the thyroid. It was favorably received and accepted in 1901. That same year, he took his clinical exam for a position on the surgical staff under Poncet. Wait of Marcel Soulier, a professor of therapeutics, whose son was his close friend. There, he worked in complete freedom for many semesters, developing and gaining experience in techniques to suture blood vessels, and reported his results in local medical journals. Meanwhile, he also prepared his doctoral thesis, under Professor Poncet, on cancer of the thyroid. It was favorably received and accepted in 1901. That same year, he took his clinical exam for a position on the surgical staff under Poncet. Wait of Marcel Soulier, a professor of therapeutics, whose son was his close friend. There, he worked in complete freedom for many semesters, developing and gaining experience in techniques to suture blood vessels, and reported his result.

In May, 1903, Carrel accepted an invitation from the priest in charge of the yearly pilgrimage to Lourdes to travel with the "sick train" and observe the alleged miracle cures first hand. He was attracted by stories of the cures at Lourdes and relished the opportunity, as he later wrote, to "examine the facts objectively, just as a patient is examined at a hospital or an experiment conducted in a laboratory." Most of the so-called cures he attributed to the incredible power of suggestion at a pilgrimage. One patient, however, he could not explain. An eighteen year old girl, Marie Bailly, appeared gravely ill, her abdomen seemingly distended by solid masses with a pocket of fluid beneath her umbilicus. Her legs were swollen, her temperature elevated, her pulse and breathing rapid. Carrel believed she suffered from tuberculosis peritonitis. When she was brought to the women's pool, he thought her too ill to be immersed; he directed that some of the water be sprinkled on her abdomen. In half an hour her respiration became less rapid. Suddenly, her abdomen became flatter. That evening, she was sitting up in bed and eating. Later that year, Marie Bailly entered the religious order of the Daughters of Charity, where she remained until her death in 1937, at age fifty-one.

Carrel reported this inexplicable experience to the medical community in Lyons. His observations were headlined in newspapers throughout France. He was attacked on one hand by the clergy for being skeptical, and on the other by organized medicine for being gullible. One of his professors advised him, "My friend, with your ideas you would do well to give up the surgical examinations; from now on you will never pass."

The advice was prophetic. Carrel took the examination, but lost out again, this time to Rene Leriche, one of his former students, who became a world-renowned professor of surgery, with an interest in vascular surgery; the two retained a lifelong friendship and affection. This rejection discouraged Carrel. Though generally appreciated by his superiors and admired by his colleagues, he felt increasingly constricted by the conservative and provincial Lyonnaise society.

Some months previously, a group of young missionaries, before leaving for northern French Canada, came to ask Alexis to instruct them in emergency surgery. He provided them with several lectures and demonstrations at Hotel Dieu. Impressed by his skill and knowledge, they begged him to accompany them to Canada and share in her treasures. The fantasy of adventure intrigued Carrel. After the incidents at Lourdes and failing his examination, Carrel pondered his future. He sought advice, solace and comfort from his adoring mother, then decided to make a drastic change in his life.

He spent four months in Paris, eschewing the surgical wards, instead attending lectures in history, art and music. He returned to Lyon in March, 1904, and on the sixth of May, left for Canada, "the France of America, a country of adventure, of the future." Almost 31 years old, he bid farewell to his mother, never again to see her alive. Years later, Carrel maintained that at the time of his departure, he planned to renounce medicine completely and take up ranching.

Notwithstanding, instinct or whatever led him to the Hotel Dieu, the largest Catholic hospital in Montreal shortly after his arrival in Canada. He quickly made the acquaintance of two surgeons, brothers Adelston and Francois de Martigny. They had read his scientific reports, and arranged for him to deliver a paper and give a surgical demonstration at the Second Medical Congress of the French Language of North America in Montreal. These caused a sensation. Several surgeons from the United States attended, including Chicagoan Karl Beck. He proposed that Carrel come to Chicago. The Matigny brothers wanted him to remain in Montreal, but could find no suitable facilities for him. Adelston Matigny wrote to a friend at the University of Chicago about Carrel, "He would reflect a certain glory upon the university whose professor had performed such marvelous, almost impossible operations. He does have some income and would not seek a practice." The letter was transmitted to George N. Stewart, head of the department of Physiology at the University of Chicago.

Carrel spent his first two months in Chicago improving his English, exploring the city, giving surgical lectures and meeting prominent local surgeons. In November 1904 he was offered two positions, one at the University of Illinois under Dr. Beck, and another in the Hull Laboratory of Physiology at the University of Chicago under Dr. Stewart.

He accepted the latter position and was assigned to work with Dr. Charles C. Guthrie, who was six years younger and only four years out of medical school. Carrel supplied most of the imagination and energy, and performed most of the experiments, especially since Guthrie was on sabbatical leave for the nine months between February and December 1905. Carrel depended upon Guthrie to help with his writing and speaking, since his English was not yet fluent. In the 22 months between November 1904 and August 1906, they jointly wrote 21 papers.

In April 1905 Carrel was invited by Dr. Harvey Cushing, chairman of its department of surgery, to give a lecture at Johns Hopkins Medical School in Baltimore. This lecture was well attended, enthusiastically received and excerpts were widely reported. Carrel then visited medical institutions in Philadelphia and New York. In the fall of 1905, Cushing and other distinguished surgeons visited the Hull Laboratory, where Carrel demonstrated his pioneering surgical techniques.

Carrel's greatest frustration at Chicago was lack of financial support for his research. He was offered a clinical professorship, but declined because he did not want to have to support his experimental work by clinical practice. He was offered a position at Johns Hopkins and another at the Rockefeller Institute. In May 1906, he wrote to his brother: "I received a letter from the Director of the Rockefeller Institute for Medical Research in New York telling me that I had been named to a post there by the last Assembly of Directors. It was the immediate result of my lecture at Johns Hopkins and my visit to New York. The Rockefeller Institute is, though bigger and richer, similar to the Pasteur Institute in Paris. Besides, everything is absolutely new there because it has only been open for 15 days. I am going to accept immediately although it disgusts me to live in New York. New York is entirely built of high, high buildings and it seems that one is in prison, as in Lyon, for example. I will go there in September."

The Rockefeller Institute for Medical research, incorporated in 1901, was proposed to John D. Rockefeller by his executive director of philanthropy, Frederick T. Gates, a Baptist minister. Gates had recommended Rockefeller's gift of $600,000 to the University of Chicago in 1889 in order to "improve the level of education in the Midwest." In 1897, he concluded that the scientific study of medicine was "woefully neglected." Gates and John D. Rockefeller Jr. persuaded the elder Rockefeller to establish a medical research institute. Simon Flexner, professor of pathology at the University of Pennsylvania, was selected as director in June 1902. In 1905, with a new institute under construction, he met and was so impressed by Carrel that he offered him extensive laboratory space on the top floor of the main building for an Experimental Surgery Department.

Carrel moved to New York and rented a small apartment where he could walk to his laboratory. He was physically rather short, of medium build, balding, with close-cropped hair. He possessed small, piercing eyes, one brown and one blue, not easily noticeable because of thick lenses he wore for myopia. He has been described as intense, not unsociable but distant. He felt rejected by and disdainful of the French medical establishment, characterizing it as "bureaucratic, decadent, too ignorant to plan for the future." These opinions he freely expressed even during his summer vacations in France.

In October 1912, Carrel learned that he had been awarded the Nobel Prize. He was uncertain whether or how he should accept. Each honoree is introduced by a representative of his government. Carrel did not want to be introduced by the French government; he chose instead to be introduced by the American ambassador to Sweden.

The Nobel Prizes are presented by the King of Sweden on December 10, the anniversary of the death of Alfred Nobel, in a solemn ceremony at the Royal Academy of Music. The presentation speech by Professor J. Akerman of the Royal Caroline Institute was a model of diplomacy. This is an abridged version:


"Your Majesty, Your Royal Highnesses, Ladies and Gentlemen. The staff of professors of the Royal Caroline Institute has awarded the Nobel Prize in Physiology or Medicine to Doctor Alexis Carrel of the Rockefeller Institute, New York, for his work on suturing of vessels and transplantation of organs.

"The search has been going on for a long time for methods of closing a wound in the wall of a blood vessel without interrupting the circulation of blood, and, if the vessel were cut in two, of reuniting the edges of the wound so as to restore the circulation. Alexis Carrel was the first person, as a result of work begun some ten or twelve years ago in Lyon, to invent a reliable method of sewing vessels together again. The French doctor, when he made a suture, enlarged the opening using three retaining stitches located at equidistant points which converted the round opening into a triangular one, following which he stitched the walls together again edge to edge with fine silk threaded on to ordinary needles, which were very fine and round.

"This method proved to be reliable and effective insofar as it protects against post-operative hemorrhages and embolisms, but its greatest merit was that it did not produce stricture at the site of suture. From the time of his first publication-in `Lyon Medical' of 1902-Carrel was able to describe attempts at replacing and reconstructing sections of damaged vessels as well as transplantation of whole organs to a different place in the same animal or from one animal to another. In the course of his activities at the Hull Laboratories in Chicago, and at the Rockefeller Institute of New York, he continued to experiment and perfect his method. He showed that suturing the ends of two vessels can be carried out not only on relatively large vessels but also those with a diameter less than that of a match. He succeeded in replacing a section of artery with a vein, he patched up holes in the wall of a vessel. Results proved satisfactory when examined months and years later.

"So that he would always have material at his disposal for repairing sections of vessel, Carrel experimented with the preservation and use of such sections.

"Carrel was able to restore the circulation in complete organs which he had excised, or had replaced with other similar organs removed from another animal. Arteries and veins are sewed to arteries and veins of the organ. The blood will then circulate by its normal routes through the transplanted organ, whose cells-once the circulation is resumed-carry on living and functioning as before. In this way, half the thyroid gland, the spleen, ovaries, one kidney, both kidneys even, could be transplanted from one animal to another or cut out and sewn back in their old place, still surviving and fulfilling the task required of each organ in the body's economy. Carrel also replaced an animal's paw with one taken from another animal, and put an amputated limb back; he saw the limb survive and knit back with the body.

"Many surgeons have already resorted to Carrel's techniques for healing local lesions in vessels. This method has also been used in blood transfusions.

"Carrel further showed that it was possible to divert the circulation in an organ, even in one of the limbs, thus facilitating or reestablishing the flow of blood. Where arteriosclerosis, for example, was obstructing the flow of blood in the leg arteries, reversion of the circulation has been tried, and, in a fair number of cases, it has been possible to avoid, even to cure, the onset of gangrene in the leg.

"On the other hand, the experiments in which Carrel has successfully transplanted whole organs or limbs from one animal to another have not found application in man. For one thing, healthy kidneys, spleens and limbs are hardly ever available to the surgeon, and, for another, the experience we have gained with animals has taught us that organs transplanted from one animal to another usually degenerate in their new owner.

"Doctor Carrel, the Caroline Institute has awarded you this year's Nobel Prize for Medicine for your work on the suture of vessels and organ transplantation. Sir, you have achieved great things.

"The clear, bright intelligence which was the patrimony you received from your country-from France, in whose debt humanity stands for so much that is valuable-was allied to the bold, resolute energy of your adopted country, and these marvelous operations, of which I have just spoken, are the manifest result of this happy collaboration." Carrel was the second individual associated with the University of Chicago to win a Nobel Prize. The first was Albert Michelson, awarded the prize in physics in 1907. Of the 70 Nobel Prizes awarded to individuals associated with the University of Chicago, 11 have been for Physiology or Medicine.
Besides the $40,000 Nobel award, Carrel was honored by the French government with the Legion of Honor in February 1913. His former colleagues in Lyon asked him to deliver a lecture in the great amphitheater of the Faculty of Medicine. President William Howard Taft sent a congratulatory telegram and spoke at a ceremony in his honor. The New York Medical Journal observed, "This is the first time the prize has been given for researches in medicine in this country." At 39, Carrel was the youngest Nobel Prize laureate.

He sailed back to New York almost immediately to resume his work. His routines and habits were strenuous, orderly and disciplined. He stayed aloof from the general life of the Institute. Many colleagues considered him arrogant. His work required asepsis and sterility. He did not like bright light so he painted the walls of his laboratory dark gray, used black linen for his operations and outfitted his assistants in black surgical gowns, masks and caps. This was at a time when white was the usual color, and Carrel wore a distinguishing white, cotton, knitted cap.

Rockefeller Institute allowed for an annual vacation. Carrel spent each summer in France, part of the time at a chateau near Lyon that his mother had purchased in 1901. He also returned each August to Lourdes. There, in 1910, he met Anne Marie Meyrie, a 35-year-old nurse and widow, who was born into an aristocratic family. Alexis and Anne Marie saw each other the next two summers. In 1912, they visited the Carrel family in Lyon and Alexis spoke of marriage. Anne Marie did not like the idea of changing her lifestyle, leaving France and subordinating herself to her husband's career. She demurred a decision at that time, but the two officially became engaged the following summer and made plans for a wedding in December. A civil ceremony was held in Paris December 26, 1913, followed by a religious ceremony at the Church of Saint Pierre du Gros. They sailed for New York the following day. Anne Marie was a complete surprise to Carrel's friends and co-workers in New York; they had no hint of any romantic interest, much less matrimonial plans.

The Carrels rented a home in Garden City. Madam Carrel utilized her nursing skills and became part of the experimental surgery team. In June, 1914, they sailed to France for their annual vacation. They spent July at a chateau owned by Anne Marie's family, in the province of Anjou.

On August 1, 1914, Alexis, still a French citizen, received mobilization orders. World War I broke out in mid August. Carrel was posted to the old Hotel Dieu in Lyon, treating war wounds. Gas gangrene was a serious problem. He tried to persuade local authorities to provide him facilities and assistants for organized experiments to improve treatment. They refused. With the intercession of James Hazen Hyde, an influential American, he obtained an interview with the national inspector general for health services. Carrel was sent to inspect military surgical facilities. He wrote a critical report, recommending uniform standards of treatment and requesting a hospital near the front lines where he could do research. He was allowed to establish a hospital at Compiegne, 12 kilometers from the front lines. Madam Carrel worked as a nurse and administrator. No funds were allotted for research.

Undaunted, Carrel obtained a grant from the Rockefeller Foundation. With Simon Flexner's help, he recruited an outstanding English chemist, Henry Dakin to collaborate with him. Dakin formulated and tested over two hundred antiseptic solutions for wound irrigation. He settled on hypochlorite of soda, modified so that it lost most of its irritating tendency, yet retained its germicidal quality. Meanwhile, Carrel was working out methods of applying this agent to serious wounds. By late spring of 1915, they had developed the Carrel-Dakin technique of wound management.

Carrel promulgated his treatment method to the military authorities. His solution is still a standard for wound irrigation.

The wartime experience affected Carrel. He wrote: "War is something much more frightening and absurd than I had thought. Men die with unequal courage. Women and mothers don't complain. The spectacle that our hospital represents these days is at the same time deplorable and heroic. For a long time I hated to believe the atrocities committed by the Germans in Belgium. Today I am sure that they were committed in a fashion even more barbarous than the wild tribes in Central Africa."

The Carrels returned to New York after the armistice to a hero's welcome. The United States Army awarded Alexis a Distinguished Service Certificate. His Department of Experimental Surgery received additional space and equipment. He plunged into his work with his usual intensity. The Carrels resided in a downtown hotel. Initially, Anne Marie accompanied Alexis on trips to medical meetings, but soon began to spend increasingly more time in France.

In 1922, the Carrels purchased a home on the tiny island of St. Gildas, off the coast of Brittany in France, using Nobel Prize award money. This became their beloved retreat, where they spent most of each summer. Each September, Alexis returned to New York by ship. As Anne Mare spent less and less time in New York, Alexis eventually rented a small penthouse apartment that overlooked Central Park, and where he lived in almost monastic simplicity. His main diversion was dinner with several prominent and intellectual friends. Nights were spent reading, studying, writing and reflecting. To escape the pressures of New York, he periodically withdrew for several days to a rustic hideaway resort.

Carrel's research interests broadened. He developed methods of growing both normal cells and cancer cells in Carrel flasks, a variant of test tubes, and studied the influence of various factors on their growth. In 1912, he had begun culture of cells from a chick embryo heart. He turned this culture line over to Albert H. Eberling, a laboratory assistant, who maintained it for many thousands of generations, until April, 1946, first at the Rockefeller Institute, then at Lederle Laboratories. Carrel's surgical interests extended to preserving organs outside the body, seeking ways to prevent organ rejection and the audacious idea of growing whole organs from single cells. He worked to develop a mechanical perfusion pump to nourish whole organs in an artificial chemical environment.

In 1929, the interests of two prominent people intersected. Charles Lindberg's sister-in-law, Elizabeth Morrow, was left with severe disease of the heart valves after acute rheumatic fever. Lindberg asked her doctor why her heart could not be repaired by surgery. When told that the heart could not be stopped long enough for surgeons to work on it, Lindberg questioned why a mechanical pump could not be used for circulating the blood while the heart was stopped. A physician friend introduced him to Carrel. Lindberg asked to became a volunteer assistant in Carrel's laboratory and work on the perfusion pump. By 1935, the pump was able to keep the thyroid gland of a cat alive for eighteen days. Cells of that gland were then successfully transferred to tissue culture. Time magazine's cover of July 1, 1935 pictured Carrel and Lindberg with their "mechanical heart."

In 1938, Lindberg and Carrel published a book, The Culture of Organs. The Lindberg pump was a popular exhibit at the New York World's Fair in 1939. It was a flop for its intended purpose, extra-corporeal circulation for heart surgery. John Gibbons, of the University of Pennsylvania, first achieved this in 1953. His heart-lung machine was based on completely different mechanical principles.

From the collaboration, the Lindberg and Carrel families developed an enduring friendship. In 1938, the Lindbergs bought the island of Illiec, near St. Gildas, so they could spend summers together. Lindberg described St. Gildas as "a small island. Massive tides, ebbing and flowing through a range of forty feet, now separate it from, now connect it to the mainland. There are times when one can neither walk nor cross by boat. It has a weird, austere and kaleidoscopic beauty."

Carrel enjoyed increasing celebrity. The movie "Frankenstein" with Boris Karloff, based on Mary Shelley's book, was released in 1931 and was a popular success. The public became intrigued with a living scientist who had bold ideas for growing and exchanging human body parts. The popular press publicized Carrel's activities, with such wild imagination as the suspense radio program, "The Beating Heart," about growing artificial organs in the laboratory. He was both flattered and annoyed by the notoriety. His friends encouraged him to write a book for laymen summarizing his knowledge and understanding of biology and humanity.

Carrel spent most of 1933 writing the book in French. The English translation required almost as much attention. Entitled, Man the Unknown, it was a huge success. It sold 900,000 copies, was translated into 19 different languages and was "number one" on the New York Times non-fiction best-seller list for 1936.

Carrel's preface begins: "The author of this book is not a philosopher. He is only a man of science. He spends a large part of his time in a laboratory studying living matter. And another part in the world, watching human beings and trying to understand them. He does not pretend to deal with things that lie outside the field of scientific observation. He has tried to confine all his knowledge of man within the pages of a small book. Before beginning this work the author realized its difficulty, its almost impossibility. He undertook it merely because somebody had to undertake it."

The book lucidly presents biology. Regarding transplantation, Carrel writes: "The individuality of tissues may manifest itself in the following way: Fragments of skin, some supplied by the patient himself and others by a friend or relative, are grafted on the surface of a wound. After a few days, the grafts coming from the patient are adherent to the wound and grow larger, whereas those taken from other people loosen and grow smaller. One rarely finds two individuals so closely alike that they are able to exchange tissues. However, between identical twins, glandular transplantation would doubtless succeed."

The first successful kidney transplant was performed between identical twins by James Murray of Boston in 1954.

Some of Carrel's generalizations clearly do lie "outside the field of scientific observation." Three brief examples:

"Women who have no children are not so well balanced and become more nervous than the others. It is therefore absurd to turn women against maternity. The same intellectual and physical training and the same ambitions should not be given to young girls as to boys."

"Clairvoyance and telepathy are primary datum of scientific observation."

"We must not forget that the most highly civilized races are white. In France, the populations of the north are far superior to those of the Mediterranean shores."

Carrel's reputation muted criticism from the scientific community. Many scientists at the Rockefeller Institute were embarrassed by and critical of opinions and ideas presented in the book, reinforcing their judgements of Carrel as arrogant, bigoted and eccentric. Historian George W. Corner, who wrote The History of the Rockefeller Institution in 1965, described Carrel as "not a profound analyst but rather a superb applied scientist, advancing the progress of biology and surgery much as Thomas Edison advanced the practical use of electricity."

In 1939, Simon Flexner retired as director of the Rockefeller Institute. Herbert Spencer Gasser, who replaced him, did not share Flexner's admiration for Carrel. On July 1, 1939, shortly after he became 65, Carrel's Division of Experimental Surgery was disbanded and his laboratory was closed. Carrel wrote five articles for the Readers Digest. His seminal works on vascular surgery, heart surgery, organ transplantation, tissue culture and cancer chemotherapy already filled the scientific literature.

In July 1939, Alexis and Anne Marie sailed for France. Alexis intended to return to New York in mid-September. World War II broke out September 1. The Carrels remained in France. Alexis wanted to establish an experimental surgical laboratory. On March 22 1940, France accepted armistice terms from Germany. Carrel went to New York May 28 to work on a design for mobile hospitals. Madam Carrel refused to leave St. Gildas.

In February, 1941, Carrel returned to Europe with James Wood Johnson to bring vitamins to children's hospitals in occupied France. They landed in Lisbon and traveled through Spain and France, witnessing dreadful suffering, privation and starvation. Carrel undertook the study of the effects of famine on the population. While in Aix en Provence, he was informed that his wife was ill. He immediately rushed to St. Gildas to nurse her back to health. Numerous letters and telegrams implored him to return to the United States, but Anne Marie refused to leave France, and Alexis refused to leave Anne Marie.

Carrel's sentiments and activities during World War II are controversial. He has been accused of collaboration during the German occupation, but no irrefutable evidence was presented. He was not an isolationist, like his friend Lindberg, who characterized him as, "a deeply patriotic Frenchman, decorated and damned, often by the same people." Although he condemned Nazism, he worked with Nazi occupation officials as well as the French occupation government.

Carrel proposed to the Vichy occupation government, formation of one of his long-held ambitions, an "Institute of Man," which, of course, he would head. Marshal Henri Philippe Petain, head of the government, embraced the proposal. Most medical officers on his staff ridiculed it. Named, "The French Foundation for the Study of Human Problems," it was sanctioned by law in November 1941, and funded with the equivalent of eight million dollars. Carrel assembled a staff of philosophers, psychologists, psychiatrists, architects, political scientists, economists, anthropologists, biologists and physiologists to "Research all practical solutions and proceed with demonstrations with the view of improving the psychological, mental and social conditions of the population."

The foundation, based in Paris, conducted studies in such areas as child development, work-related illnesses, fatigue and work psychology. Madam Carrel conducted experiments in her areas of interest: parapsychology, hypnosis, mental telepathy and extra-sensory perception. Carrel probably tried to avoid political involvement; nevertheless, he dealt with Vichy government officials as well as German occupation officials. Extra food and fuel rations were offered to the Carrels, but they refused special privilege. Both lost weight and their general health declined.

In August 1943, while at St. Gildas, Carrel suffered a heart attack and went into heart failure. Both medical care and food were inadequate and he was rushed by canoe, auto and train to Paris, where he was hospitalized for several weeks. Diligent treatment improved his condition enough so he was able to resume his previous routine. In August 1944, however, he suffered a second, more serious episode. Left too ill to leave his apartment in Paris, he spent most of the time recumbent in a lounge chair.

By then, the Allied armies had liberated France. A new French government had taken over. Valery Radot was appointed minister of health. Carrel had denounced Radot, when the latter was head of the Pasteur Institute. Radot suspended Carrel from the Foundation and set up a "purging" committee to determine the extent of his collaboration. The media denounced Carrel as, "a racist, a Nazi apologist and Nazi eugenicist." Police invaded his home to prevent him from leaving.

On October 18, 1944, a letter from a visitor reported: "I have just been seeing Madam Carrel. Doctor Carrel is down and cannot speak. She believes he will die in two or three days. His heart is so soft you can just feel it. His face is changed."

Alexis Carrel died at 71 years of age on the morning of November 5, 1944. Nine hours later the French radio reported that Dr. Alexis Carrel had fled his home to avoid standing trial for collaborationist activities. Five hours after that announcement, they acknowledged their error and reported his death.

In accordance with his wishes, Alexis Carrel lies buried in the Chapel of St. Yves near his house on St. Gildas. Also in accordance with his wishes, his papers are preserved in the archives of an American university ("because America had given me the opportunity for untrammeled research"), and in an institution administered by Jesuits ("because priests of that religious order had guided my early education"). They are collected in the library of Georgetown University.

Scientist and mystic, in death as in life, discontent and ambivalence have dispersed Alexis Carrel: his ideas and work are in America, but his heart remains in France.

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