Frits L. Meijler; a scientific career chasing his holy grail: the function of the AV node

On 21 December 1984, Stuart Robles de Medina finished his oil-painting of Professor Frits Meijler sitting in a relaxing chair. Today, the painting is exhibited at the Department of Cardiology of the University Medical Center in Utrecht. One year earlier (1983) Stuart’s brother, Etienne Robles de Medina, had accepted the chair of cardiology succeeding Frits Meijler, who continued his career as director of the Interuniversity Cardiology Institute of the Netherlands (ICIN) for which he remained active until his death on 28 December 2010. He was active as director until 1994. Yet even in the last year of his life, when the survival of the ICIN was being debated, he produced a letter in support of the ICIN that was so well composed and sharp that it made the Trippenhuis in Amsterdam tremble, and the ICIN was allowed to flourish and grow with the full support of the Royal Netherlands Academy for Arts and Sciences (KNAW).

An earlier crucial step in his career was his move from Amsterdam to Utrecht. After being trained by Professor Dirk Durrer, he took the position of Professor R.L.J van Ruijven in 1968. Already in 1952, Van Ruijven had been able to make cardiology an independent speciality, and therefore the oldest department of cardiology in the Netherlands. As protégé of Dirk Durrer, Meijler was an important part of the spectacular new developments in cardiology. In addition, he had already met the international players visiting Amsterdam. Meijler performed beautiful studies on the isolated human heart and the mysterious AV node. These subjects kept his attention throughout his active career. As chief of cardiology in Utrecht, he formed a well-respected top clinical institute, known for solid training and stimulating leadership. More then once he stood up to defend controversial viewpoints and he argued his opinion with great passion. He firmly believed that cholesterol was a good thing, only beaten by digitalis which was even better. Sometimes his outspoken opinions were not shared by his colleagues, but they were clearly inspired by the main life events he experienced and his character. In 1973 his dedication and stamina resulted in the first issue of the European Journal of Cardiology. In his first contribution he states: ‘Gadgetry will, however, never replace the well trained nurse, nor the bedside clinician. As long as patients and not their electrophysiological emanations have to be cared for their place will be self-evident and irreplaceable’ [1]. The success of the young journal is enormous and currently is comparable with the Journal of the ACC, with respect to impact factor. Not everything in Utrecht was easy and a direct success, yet in 16 years he built up a innovative institute combining research with clinical cardiology. His work attitude and dedication are still alive in our department. In his period in Utrecht, he also became close to the Dutch Royal family. These relations were crucial for later expeditions set up to record ECGs in a whale. A nice combination of science and adventure from the early days of cardiology. He presented many more details on these trips in 1998. He allowed an extensive interview summarised in the book ‘Wijzers in de Cardiologie’ [2]. In the chapter ‘Een leven in het teken van de AV knoop’ he reviews from his personal perspective the most important innovations in cardiology in the preceding 30 years. Based on five articles he also highlights the rising of electrophysiology and his fascination for the AV node. This focus on the AV node was still there until the very end. His final article balances between philosophy and science and is published in this issue of the Netherlands Heart Journal. In ‘Archetype, adaptation and the mammalian heart’ he concludes: evolution has bypassed the heart in contrast to other organs [3]. Despite this absence of change in the mammalian heart, it remains unclear how the AV node really functions. Meijler himself provided a beautiful and captivating description of his life and the many friends he made in 2007 in the book ‘Mijn oorlog mijn hart’. If you want to know who Frits Meijler was, you should read this very well written book [4].

His book, the letter to the KNAW and his final paper show that until the last moment he kept a critical and sharp mind. He kept on puzzling about essential issues of life in general and cardiology in particular. It must have been hard for him and his family to realise that his body was giving up. His last days were not pleasant. Yet until the very last he was in close contact with his friends of the Utrechtsch Geneeskundig Gezelschap Matthias van Geuns (founded in 1793). On behalf of the department we wish to express our sympathy to family and friends for their loss. The Dutch Cardiology society has lost an important pioneer, a ‘Wijzer’.