The Imposed Obscurity of Richard W. Lippman, MD (1916–1959), Revered Renal Researcher and Physician

In 1948, Richard W. Lippman, MD, was appointed to a research position at the Institute for Medical Research at Cedars of Lebanon Hospital in Los Angeles. His grant support came from the Guggenheim Foundation and the US Public Health Service (USPHS). He was also actively involved in seeing referred patients with kidney disease and was the founder of the hospital’s kidney disease clinic, the first of its kind in Southern California. His clinical practice was flourishing, and his research had generated over 50 scientific papers, most in major scientific journals.

Lippman’s research studies included measurements of renal function and their variation in animal models of disease, mechanisms of proteinuria, and the relation of dietary protein intake to kidney size and function, as well as the pathophysiology of nephrotoxic globulin nephritis in rats. Clinical studies included psychologic management of children with GN, surgical management of hypertensive complications of advanced renal disease, abnormal salt and water retention in the nephrotic syndrome, and the relationship of antibiotic therapy to urinary tract infections.

In December of 1951, Lippman learned, to his surprise, that he and two other physician colleagues would not be reappointed to the medical staff of the hospital. He subsequently discovered that the leaders of the County Medical Association had intervened, pressuring hospitals to expel certain individuals. He was clear about assigning responsibility for this outcome by stating on the record: “I want to make it clear that I do not feel the Cedars of Lebanon Hospital is responsible for the position they were forced to assume.”¹ However, Lippman’s USPHS grant funding was soon rejected by the hospital, and research funding became entirely unavailable to him. Only Dr. Harry Goldblatt, Director of the institution’s Research Institute and discoverer of the renal origin of hypertension at Cedars of Lebanon Hospital, supported him and declined to discharge him from his facility or to terminate his research duties.¹

Later, giving testimony to the State of California Hearing on Un-American Activities Committee (HUAC) in 1955,¹ Lippman describes his experience of the event:

At the time of my expulsion, I was engaged in work that had been in progress for many years, which was of considerable significance in my field. It had potential importance to the people of this country. The disease is nephritis which, when it is related to nephrosis, accounts for about 17,000 deaths a year. We did a good deal of work concerning the cause of this disease and its treatment. We felt that we were on the verge of much more important discoveries.

The expulsion happened so rapidly that I was unable to make arrangements to take care of my clinic patients. I was founder of the first clinic of this sort in Southern California and in the Southwest. In a short time, it had received the reputation as a center for people with kidney disease and high blood pressure.

During the “Cold War” between the United States and the Soviet Union that followed World War II, the stigmatization of communists and other radicals considered to be proponents of militant actions, through the use of federal and state legislative investigative committees and the punishment by firing and blacklisting of those identified, comprised a successful political tactic. It spread not only to government employees but to individuals working in the entertainment industry, the professions, labor unions, and the private sector.

Major players in these activities on the federal level included Senator Joseph McCarthy and HUAC. At the state level, the California legislature passed the Levering Act in 1950, which required loyalty oaths from all state employees and made several unsuccessful attempts at passing legislation that would have required lawyers, doctors, and other professionals to take loyalty oaths or lose their right to practice. Hearings were held by HUAC in Los Angeles in 1951, but Dr. Lippman was not called for testimony at that time.²

The reasons for Richard Lippman’s removal from Cedars of Lebanon were initially less obvious for he had yet to make any appearance before HUAC or have his name sullied during a hearing. Lippman became aware, however, that the national and state medical societies regarded him with great animosity, as his personal history of activism stretched back to the early 1940s when he had been a leader in the Association of Internes and Medical Students (AIMS), a medical student group that itself became a Cold War casualty in the early 1950s after an extended attack from the American Medical Association.

Medical activism among American medical students had flourished during the 1930s and 1940s, and chapters of AIMS were widespread across the United States. Many political causes were promoted, public lectures were provided, and the Interne was published with a national circulation. Until its demise, AIMS had advocated for national health insurance, better working conditions in training hospitals, and an end to racial discrimination in hospital and medical school admissions.³

After moving to Los Angeles, Lippman had become active in opposing nuclear testing, and in 1950, he helped research a pamphlet detailing patterns of discrimination in Los Angeles hospitals that specified institutions by name. These activities occurred at a time when the American left and the Communist Party were major propellers of more militant civil rights action.⁴

A remarkable cast of individuals emerged as historical players in this subsequent story. Involved were Thomas Addis, eminent clinician-scientist working on the diagnosis and management of CKD at Stanford University; Harry Goldblatt at Cedars of Lebanon Hospital; Jean Oliver, leading renal anatomic pathologist at State University of New York; and Nobel Laureate Linus Pauling, Chair of the Division of Chemistry and Chemical Engineering at the California Institute of Technology.

After not being reappointed to the medical staff in Los Angeles, Dr. Lippman published a book Urine and the Urinary Sediment in 1952.⁵ In the introduction, he writes: “It was the author’s good fortune to be associated with Dr. Thomas Addis, first as a medical school postgraduate fellow at the Clinic for Renal Diseases of the Stanford University School of Medicine and later as a friend. Dr. Addis believed deeply in the need for unifying theory and practice.”

Having published a series of single-authored papers on kidney function and kidney disease in prestigious journals, in 1948 Lippman entered into collaboration with Dr. Thomas Addis at Stanford University School of Medicine. Addis was a pioneer in the field of nephrology, and his dietary treatment plan at the time was new and revolutionary. He was an advocate for the rights of minorities and the politically oppressed and was involved in the advocacy for national health insurance, which was opposed by the American Medical Association. He made no secret of his sympathies for the Soviet Union and its state socialism and medical system advances, and his political views forced a very strained relationship with Stanford University, which ultimately took away his laboratory.

Addis, who then went on to work with Goldblatt at Cedars of Lebanon Hospital,⁶ died in 1949 following an operation for renal infarction. After Addis’ death, Lippman completed publication of the results of his studies with Addis on the pathophysiologic mechanisms of GN (then known as Bright disease) and a novel dietary treatment of this disorder. In three high-profile articles in 1951, Addis was posthumously named as first author.

One of Dr. Addis’ most notable patients was Linus Pauling, who had developed facial swelling, a 20-pound weight gain, and urinary protein loss of 20 g/d and was diagnosed with Bright disease. The edema cleared after 4 months, and Pauling remained on diet therapy for the next 14 years. Dr. Pauling’s nephritis did not recur, and he lived another 53 years until his death of complications of prostate cancer at age 93.^6,7

It was upon Dr. Addis’ death in 1949 that Pauling transferred his care to Richard Lippman. Pauling was a man of great influence, soon to receive the Nobel Prize in Chemistry in 1954. (His additional Nobel Peace Prize in 1962 made him the only individual ever to win two undivided Nobel Prizes.⁸) He first attempted to intercede on Lippman’s behalf in a letter to the hospital’s Board of Trustees, dated May 29th, 1952. He argued that the board’s action was interfering with medical research, especially on the kidney, in which he outlined details of Lipmann’s experiments. He says: “I myself have a special interest in the physiology of the kidney and the nature and treatment of nephritis. It is my opinion that Dr. Lippman is the outstanding worker in this field of medical research.”⁹ Pauling received no response to his letter.

In the fall of 1953, Lippman moved to New York City, where he had finally located a post at Montefiore Hospital only to discover that it required him to appear before HUAC and take a loyalty oath, which he refused to do, returning then to Los Angeles.

Looking for an influential person to assist Lippman in finding a research position, Pauling wrote to Dr. Charles Best at the University of Toronto on February 4th, 1953. Best, although a medical student at the University of Toronto, worked with Dr. Frederick Banting, Professor J.J.R. Macleod, and Dr. James Collip, leading to the discovery of insulin in 1922. (Banting, Best, and Collip shared the patent for insulin. In 1923, the Nobel Prize Committee honored Banting and Macleod with a Nobel Prize for the discovery of insulin, ignoring Best and Collip. Banting chose to share half of the prize money with Best.)

After describing Lippman’s situation in Los Angeles, Pauling’s letter expressed his doubt that Lippman could get a job in the United States, indicating that it was his belief that Lippman would accept a position carrying a small salary if he were to be permitted to continue his research. He went on to say: “I think that Dr. Lippman is one of the leading research men in the field of kidney function in the world.”¹⁰

Nothing came of Pauling’s approach to Best.

From 1952, Lippman initiated a collaboration with Professor Dan H. Campbell, a colleague and collaborator of Pauling’s at the California Institute of Technology on problems of immunology and protein chemistry, and in 1956, he accepted an appointment there. He engaged in studies on the chemical basis of mental disease, especially mental deficiency, and over a 3-year period, he served as Medical Research Director of the Ford Foundation project in this field. He was strongly attracted to the field of mental diseases, which was new to him, and he was enticed by the possibility that discoveries made through research in this field could contribute significantly to decreasing the amount of human suffering in the world.

Dr. Lippman died in 1959 in the University of California, Los Angeles Medical Center at age 43. In his obituary of Lippman on January 3rd, 1960, Pauling stated: “There was no one just like him in the world, no-one else with his great combination of respect, love and concern for all human beings, his inflexible moral integrity, his dedication to his patients…I think that there is little doubt that the ailments that caused his death were exacerbated by his trials and turmoils.”

However, the cause of his death was otherwise. It was documented in a death certificate from the Los Angeles County archives as “hepatic failure, due to liver necrosis due to operative procedure on hepatic artery aneurysm.” An associated condition was “peritonitis secondary to stomach perforation.” The medical center has no additional information to add.

Richard W. Lippman was a promising clinician-scientist whose compassionate and principled persona coupled with his creative scientific contributions and a stellar clinical reputation should have earned him the highest accolades. Instead, history has largely overlooked him. The effective termination of his career and his untimely death a few years later, at a young age, robbed him of the opportunity of developing a flourishing clinical reputation and of evolving as a nationally prominent researcher in the space that would soon be known as the field of nephrology.

Disclosures

All authors have nothing to disclose.

Funding

None.