Viggo Clemmesen
a Danish Ophthalmologist.
by Mogens Norn.
Why a short story concerning the Danish Axel Viggo Clemmesen (VC), who lived from 1910 to 2001 as a busy ophthalmologist?(Fig. 1) Because he beside his in Næstved , South Zealand, also had many idealistic humanistic works (§§ 1-11).
He was first educated as physiatrist , one of the last educated until this medical speciality was converted to rheumatology in Denmark (1).
VC wrote a scientific paper concerning ambulatory physical medicine , based on his brother Svend Clemmesen’s work in Helwegs clinic where CV also worked.
VC used his physical medicine knowledge also in his last days for his own rheumatism and lumbago. He constructed a special very comfortable bed for himself with rope to his ceiling and two handles (2).
VC did many ophthalmic scientific works. The M.D. thesis from 1944 was ”Central and indirect vision of the light adapted eye” (3). It could be considered as a continuation of the famous optic – physiologic studies of Marius Tscherning (1854-1939).
VC discovered as the first, that details in up to 30 degrees from fovea centralis horizontally and 20 vertically correspond to tap – photoreceptor diameter, but outside this correspond to tap – distances.
The M.D: thesis was rejected by the ophthalmic professors Henning Rønnne and Eiler Holm, but the faculty of Copenhagen ordered them lessons in modern sense physiology, thereafter the M.D. thesis was accepted.
VC’s continuous work with different colors and eye tension was done in a special constructed instru-ment, now kept in the Medical Museion, University of Copenhagen (RIN 101480).
In the economic difficult time during WWII with scientific works VC received a job in the Ministry , working in the Danish Civil air defence. He was recommended by the surgeon Ole Chievitz (1883-46) known from the war in Finland 1918 and in 1942-43.
In VC’ work in the ministry he and the staff was invaded by the German occupation force. The Germans did not find the secret British plans for invasion in South Jutland, kept in this Danish office , so they get not in prison.
VC lectured in Danish Ophthalmologic Society about war gasses and in the pharmacological Institute concerning combat chemicals.
After WW II VC continued the service and worked scientifically with infrared- light binoculars for military night-operations and discussed ultraviolet and laser light as military arms. He also critised the late and small military defence of Denmark at the German invasion in Denmark in April 9. 1940 and he never forgot the war – traumas.
In 1947 VC got his ophthalmic practice and eye department in Næstved. He choose this town, situated 89 km from the capital: “Because some think, this Metropolis Copenhagen is the umbilicus of the word”.
He worked from 8 to 20 and had duty every night or second night in 45 years in Næstved and worked also in 8 small hospitals as consultant at the neighbourhood (1).
VC and his wife converted in 1946 to Catholicism. VC prayed to Got when he worked with his MD thesis, before difficult surgery and in many of the dangerous situations in his journeys and expeditions. He fought for what he believed was the truth: Jesus Christ was born and wrapped in poor rags, not in a crib and his Mother Maria was a very young pregnant girl (15-16 years old), not a grown up woman as seen in many pictures (2). VC became chair man for the catholic vestry in Our Lady´s church in Næstved.
French oriented: VC´s family had good friends in France: Lulu Devorsine was VC´ “spiritual twin-sister” Her mother had a miracle in her puerperal fever, seeing a young woman, the Saint Thése of Licieux nursing her in the terrible period.
VC and his family was often in France. “Half of my ophthalmic heard is in France” he claimed (2). He was a delegate in Section Monospecialisée d`Ophtal, he represented our country in the French Ophtal. Soc, and he was chairman in Alliance Francaise in Næstved in 19 years (1), He received the title: officer of l´order des Palmes Academiques and the medal (now kept in Medical Museion in Copenhagen). - “But Danish prophets are not approved in their own country” (2).
Greenland.: VC traveled to all destinations in Greenland as ophthalmic specialist. It was at that time a dangerous task. In one of his journeys only 14 of 24 days was with patients, 10 days was with very bad weather and impossible transport possibilities. The instruments were bad, no slit lamps.
VC was right, when he critised the Danish – Greenlandic government concerning the bad ophthalmic service in Greenland. Together with the Blind Association he did much for the inuit. It was difficult to get specialists to service, so his journeys in 1968, 70, 73 and 75 was “trouble journeys , often in his holidays” (1).
His letters to his wife Dodi were long, but also touching. “Perhaps it is good to write letters to each other, than you express topics ..One self has a sweat wife, I love overall in the word” (4).
There are 0,24% blind people in Greenland, most caused by acute narrow angle glaucoma, perhaps complicated with iritis. VC initiated the “national league Greenland” in 1962 with the inuit and member of the Danish parliament Nicolaj Rosing as vice-president. VC was elected as president.
VC’s scientific work concerning acute glaucoma was fundamental with direct gonioscopy with lupe-spectacles, useful in difficult situations in a boat or plank bed. His work was continued by Poul Helge Alsbirk (5): Narrow inuit angle and laser treatment. To day, glaucoma blindness has diminished drastic. VC was the author of the important eye compendium for the district doctors in Greenland .
South Africa, Nigeria, Saba etc: In 1972 VC went to South Africa. Here he found, that the Bantu – negroes had a 0,4-0,5 mm thinner lens crystalline, and iris is flat. He took 300 dias of patents, an onchocerciasis blind person, lions, ostrichs etc. for lectures.
In 1976 VC went to Nigeria in 3 weeks, his work was very difficult: War, the hot climate, the telephone was dead, transport difficulties and he had no cash in the last days. The conclusion of his scientific work is, that glaucoma in Nigeria was plateau iris, not narrow angle, as it was in Greenland. No less than 46% was blind at the first eye specialist visit. (Fig. 2)
The journey to Saba in Caribia 1975 was also scientific with his wife Dodi as assistent. In 1978 to Abu Dhabi in the Arabic Emigrates. He was in India and Senegal. He took also many study tours, visited eye departments in Hamburg, Barcelona, Paris, Nantes, Lyon, Greece etc. Altogether more than 70 journeys! This was very seldom for an ophthalmologist, especially, between WW II and the modern globalization.
I.A.P.B., the International Agency for the Prevention of Blindness, was founded in 1975 with help from W.H.O. From 1978 VC was registrar general secretary. The president Wilson got blind 11 years old in an explosion accident. Nevertheless Wilson became a jurist, lectured in Oxford University, Commandor of the British Empire Order.
There were in 1975 40 mill. blind people. At the general assembly in Oxford with ophthalmologists , other experts and representatives from the governments, the conclusion was: “Not just to cure, but to prevent blindness throughout the word. History was being made” (6).
VC worked severely in IAPB for its economy and interests. He had a stand for IAPB in the European Congress in Brighton, Paris, Tunis and Denmark. He educated in word- blindness: Trachoma, xerophthalmia, onchocerciasis, curable blindness (cataract, spectacles) , glaucoma and accidents. In Africa was only one eye specialist serving one million inhabitants pr. year, in Denmark one for 0,03 million persons.
VC traveled for IAPB in Senegal , where they had “ no interest in ophthalmology, no instruments, no sterility, in the Bush”. (7) In 1984 VC was in India (Fig.3), worked together with the catholic brother Paul (Fig.4), who worked for 1250 leprosy- patients. Paul did surgery at 1000 patients pr. Year. After that journey VC founded a “Brother Paul help” committee for his friends in India. The 3. IAPB general assembly was in New Delhi, India, with 400 participants.
VC worked in IAPB until 1990. At that time IAPB had 1200 projects and 100 countries involved .
Family: VC’s father was captain in the Danish army. He had 6 boys. Four of this studied medicine: Carl Clemmesen became specialist in psychiatry, Svend in physiurgy, Johannes in pathology and the youngest VC in ophthalmology. – So many medical doctors in one relatively poor family were very seldom in that time!
VC’s wife was his beloved Dodi (Karen Magrethe) They got 2 boys and 3 girls. Dodi died in 1993. The family was very interested in dogs. VC’s last was called Krølle who died in 1997, 16 years old: “1/6 of my lifetime” (2). VC could never forget his last friend.
Ophthalmo – history:
VC was the first to establish the ophthalmologic part in the medical history museum in Næstved (2). He studied Bartisch’ original text book from 1720-30.
He visited the famous pioneer – surgeon Joaquin Barraquer in Spain: Modern cataract extraction, cornea – transplantation, in his clinic in Barcelona. Barraquer did lens- extractions in young myopic girls, so they could see through IOLS without spectacles. VC was critic against his methods.
VC was friend with the famous Jules Francois in Belgium and professor Dubois Poulsen, France, Jörn Draeger in Hamburg, who developed the hand held applanation –tonometry useful in Greenland in stead of the Norwegian Hjalmar Schiøtz – weight - tonometer from 1905 (2).
In his old days VC was critical against the modern ophthalmology. The specialists can not do real refraction, they use Octopus instead of specialist – examinations on the wall in 2 m’ distance a.m. the Danish Jannik Bjerrum (2). – But the new generation of eye doctors need help from assistents and technics…
Summary.
VC was a highlight in Danish ophthalmology, because he was not only a good eye doctor, but also a biomedical scientist, and an idealistic working humanist, globally as well as in Denmark.
References.
1) Clemmesen, Axel Viggo: Mit liv var som en slæderejse En øjenlæges erindringer med efterskrift, 1998,183 pp , printed in 30 copies,( in Danish).
2) Clemmesen, Viggo: Private letters to M. Norn, from 1990 to 2001. In Danish.
3) Clemmesen,V: Central and indirect vision of the light adapted eye. Acta physiol. Scand. 1944.Suppl. XXVII Copenhagen pp.206. In Danish.
4) Clemmesen,V: Journey letters; handwritten on air mail paper to his wife Dodi. In Danish.
5) Alsbirk, P.H.: Eye health service in Greenland. Acta Ophthal. 2002: 80: suppl. 234: 39-43.
6) I.A.P.B. News no.1
7) Danish Ophthalmologic Soc. Archive in Medical Museion, University of Copenhagen. In Danish.
VC IN VARIOUS SETTINGS