BIOGRAPHY

On Sunday, August 19, 1932 Dr. Hilde Bruch entered the dining room of Leipzig's Children's Hospital where she was in residency. Half of the hospital's staff was away on vacation, and Dr. Bruch happened to be the only Jewish person in the hospital. Nothing was unusual about the day, but when she came into the familiar room all conversation suddenly stopped. In an election held on that day the German people chose Adolf Hitler as their president. The wall of silence that greeted Dr. Bruch on that day may have saved her life, for it made her see the terrible threat that Nazism posed for the Jewish people. Though the episode was a minor one, it crystalized Dr. Bruch's fear of Nazism and led to her decision to leave her native Germany as soon as possible -- a decision that would completely change her life.

The Germany of 1933 was far different from the Germany Hilde Bruch knew as a child. She was born March 11, 1904 in Duelken, a predominately Catholic town near the Dutch border where her parents Hirsch and Adele (Rath) Bruch owned and operated a successful livestock business. She remembered with nostalgia playing in the meadows and climbing the trees. She grew up in a family of seven children, the third among four brothers and two sisters. Her childhood ambitions were traditional for her place and time; when asked what she wanted to be when she grew up, she replied, "a mother."

Though her childhood was sheltered and her early ambitions were traditional, the scope of her interests and knowledge began to widen. She remembered that the sinking of the Titantic first made her realize that there was a world beyond her home and those of relatives living nearby. The technology of the twentieth century came gradually to Duelken. Her parents were filled with pride, and she and her siblings shared the excitement when the first electric lights in her town were turned on in the Bruch home. The installation of the telephone and the flight of a Zeppelin over the town created similar excitement.

She attended a one-room Jewish school in her hometown until the age of ten when all the children advanced to the Hoehere Schule or high school. The Jewish school was located across the street from the small Protestant school where the Jewish children went to use the gymnasium and to learn needlework. She recalled that "I was a very disturbing student, because I asked questions. I was very well behaved but I never believed a thing." Her inquisitive nature and her criticism of authority often caused problems for her teachers, but her parents supported her efforts to get the best education possible.

When she was twelve years old the winter was so severe that the schools were closed; the children were taken to a local lake to ice skate with other students from towns nearby. She saw girls there who wore pretty red berets, the symbol of the school they attended in Gladbach. Though she was somewhat shy and a clumsy skater, she made her way out onto the ice to talk to these girls. She learned that they attended a school where a girl could study whatever she wanted. She decided that she would like to attend this school, and her parents agreed even though this would entail commuting on the train. Her family was a traditional and frugal one, but there was a basic rule: "anything that goes for education is acceptable." Her father died when she was sixteen years old, leaving behind a considerable fortune, but by the time she graduated from the Gymnasium in 1923 Germany was in economic crisis. Her large savings account left her by her father would not even buy a loaf of bread.

Nevertheless she was determined to continue her education. She had always enjoyed mathematics and considered becoming a scientist, but the maternal aspects of medicine appealed to her. With monetary support from both sides of her family she entered medical school at Albert Ludwig University in Freiburg. In 1929 she graduated from medical school and became an intern in the Academy of Medicine, a large medical center in Duesseldorf, where she remained one year before moving to the University of Kiel as a research assistant in physiology.

Her interests slowly evolved, and when she became a resident at the University of Leipzig in 1930 she decided to study pediatrics. She remained in training at Leipzig until Hitler's election and her fellow residents' support of his movement made her position intolerable. In October 1932 she went into private practice in a suburb of Duesseldorf. Her decision to enter private practice was motivated by the political climate; she feared that she would be dismissed from any hospital staff.

Dr. Bruch remained in private practice until April 1933 when she closed her office and prepared to leave Germany. She went home to visit her family in Duelken before leaving. They encouraged her to stay and open her practice there. In their small town where Jews, Protestants, and Catholics had a long history of cooperation, they could not perceive the threat of Nazism as clearly as Dr. Bruch. Despite her family's advice, she arranged to leave Germany using her attendance at an international pediatric congress in London in June 1933 as a pretext. She knew she would not return to her homeland.

Dr. Bruch made useful contacts at the meeting and quickly established herself in London. Through her new friends she found employment as a research assistant in child guidance at the East End Child Clinic. She remained in England only one year before deciding that it was too "old fashioned." An uncle in the United States gave her the required affidavit allowing her to immigrate to this country. In September 1934 she left England, arriving in New York in October.

A casual meeting on the ship helped her find employment in her new home. One of her fellow passengers, a biochemist at Columbia Presbyterian Medical Center, introduced her to his colleagues . Among them was Dr. Rustin McIntosh, Chief of Pediatrics at Columbia's College of Physicians and Surgeons, who appointed her assistant in pediatrics at Babies Hospital. Although she rapidly adjusted to her new professional life she became increasingly distressed by news of the events in Germany. The longer she stayed away the more convinced she became that her family was in grave danger. She later said, "It is so difficult to recreate the atmosphere of utter despair and constant worry. Guilt for having left and greater guilt for not being able to do more." Her modest income made it almost impossible for her to bring her relatives to safety in America. Because of this mental anguish, she experienced severe depression which required that she be hospitalized during 1935. This experience gave Dr. Bruch her first contact with psychiatry.

She combined her new-found interest in psychiatry with her interest in pediatrics. At Babies Hospital she created an endocrine clinic where she concentrated on childhood obesity. She found a few children with glandular disorders, but she discovered that in the great majority of cases obesity resulted not from an endocrine disorder but from overeating and inactivity. "I came up with the discovery that nothing was wrong with their endocrines," she said, "but something was very wrong with the way the mothers treated these children." This important insight impelled her to question accepted methods of treatment and that questioning led to what was, in fact, a revolution in thinking about childhood obesity. Rather than accepting obesity as a purely physical disorder, she perceived that much of obesity in childhood had psychological roots. This perception led her to undertake psychiatric training.

In order to further her research interests she left New York in 1941 to study psychiatry and psychoanalysis in Children' Psychiatric Service of the Johns Hopkins Hospital and the Henry Phipps Psychiatric Clinic, and training in psychoanalysis at the Washington-Baltimore Psychoanalytic Institute. She described her training as a "broadening and stimulating experience," and the personal and professional relationships she developed in Baltimore had important consequences for her life and work. Her associations with Harry Stack Sullivan, Frieda Fromm-Reichmann, Edith Weigert, and Theodore and Ruth Lidz began during this period and continued long afterwards.

Dr. Bruch considered Harry Stack Sullivan and Frieda Fromm-Reichmann to be her most influential teachers. When she arrived at Johns Hopkins University she met Dr. Fromm-Reichmann who introduced her to the other women psychiatrists in the Washington-Baltimore area and invited Dr. Bruch to attend her weekly psychoanalytic seminar at Chestnut Lodge. Dr. Bruch felt a common bond with Dr. Fromm-Reichmann since she, too, was a refugee from Nazi Germany. When the United States entered World War II, Dr. Bruch asked Dr. Fromm-Reichmann to become her analyst. As long as the United States was out of the war, Dr. Bruch kept lines of communication open between members of her family in Europe. With the outbreak of war, however, this line was broken, ending any chance Dr. Bruch might have had to help members of her family leave Europe. Her mother and two of her brothers escaped with her help, but her older brother, her older sister, and other relatives died in the Holocaust. Dr. Bruch was unaware of the deaths in her family when she began therapy, but the beginning of the war "was a terrible shock" that created "enormous emotional strain." She was in therapy with Dr. Fromm-Reichmann for several years, and the two women became close friends.

Dr. Fromm-Reichmann introduced Dr. Bruch to Harry Stack Sullivan in 1943. She invited Dr. Bruch to present a case report at her weekly seminar for the usual group and a special guest. Dr. Bruch wrote, "Much later she told me that she had asked me to present the case because I was the only participant in the seminar who . . . did not know enough to be overawed by the reputation of the guest, Harry Stack Sullivan." He was pleased with her presentation of an unusually difficult case, and offered his recommendations for treatment. Dr. Bruch came to share Sullivan's and Dr. Fromm-Reichmann's interest in schizophrenia. In 1943 Dr. Bruch completed her training in Baltimore and returned to New York City. Sullivan supervised her treatment of several patients in New York, and served as her consultant until his death in 1949.

In 1945 and 1946 Sullivan and Dr. Fromm-Reichmann performed a more personal service for Dr. Bruch by helping her young nephew Herbert, the only surviving child of her eldest brother, immigrate to the United States from England. Sullivan used his influence with the State Department to get a visa for the boy, and Dr. Fromm-Reichmann, who had obtained special permission to visit her elderly mother in England, brought Herbert from London in January 1946. Dr. Bruch later adopted her nephew.

The post-war years were very active. Not only did she assume instant parenthood, but she carried on a flourishing private practice while teaching at Columbia University's College of Physicians aril Surgeons. From 1954 to 1956 she directed the Children's Service at the New York State Psychiatric Institute. She was actively involved in research and writing; she published many articles and soon became a recognized authority on schizophrenia and eating disorders.

In 1964 Dr. Bruch accepted an invitation from Dr. Shervert Frazier, chairman of the Department of Psychiatry at Baylor College of Medicine in Houston, Texas, to become professor of psychiatry. Before moving to Texas she purchased a Rolls Royce, saying that she would not "kowtow to Texas Cadillacs." She became professor of psychiatry at Baylor and continued her private practice. As the incidence of anorexia nervosa increased rapidly during the late 1960s and 1970s, she devoted more of her attention to its treatment. Her many books, articles, and lectures on anorexia helped establish her reputation as one of the leading authorities on the subject. Over the years she received hundreds of letters from physicians, anorexics, and their families, and she consulted with hundreds of patients.

Dr. Bruch's accomplishments brought her many awards and distinctions. In 1978 she became professor emeritus at Baylor, and in the same year the president of Baylor University in Waco, Texas, gave her his citation for Meritorious Contributions to the Clinical Sciences. In that year she also received the William A. Schonfeld Award from the American Society for Adolescent Psychiatry. In 1979 the Mount Airy Foundation honored her with a Gold Medal for Distinction and Excellence in Psychiatry. The following year the American Psychiatric Association presented her with its Nolan D.C. Lewis Award. In 1981 she became the first psychiatrist to receive the American Medical Association's Joseph B. Goldberger Award in Clinical Nutrition. In 1984 the Department of Psychiatry at Baylor established the Hilde Bruch Award for Excellence in Psychiatry to be given annually to a graduating medical student.

In the early 1970s Dr. Bruch's health began to deteriorate. She developed Parkinson's disease; its symptoms -- tremors, muscular rigidity, and slowed body movements -- came on gradually and did not greatly interfere with her work routine. By the late 1970s, however, the disease and the experimental drugs used to treat it took a greater toll on her health. She initially resented her loss of abilities and independence, but she also wrote that "In a peculiar way this illness has left me more trusting and hopeful, with greater reliance on finding help not only from physicians whose dedication I gratefully acknowledge but also from many friends and unknown bystanders." She was frequently hospitalized in the later stages of her illness and died on December 15, 1984.

Although Dr. Bruch did not believe in an afterlife, she felt that she would live on through her work, her good deeds, and her good relationships. She was fond of quoting a maxim of Goethe' s : "Damaging truth, I prefer it to advantageous error. Truth heals the pain which perhaps it evokes." Such truth, although painful, enlightens. In her work and in her deeds she applied Goethe's words and endeavored to use the illuminating, healing qualities of truth. She did not blindly accept received ideas, nor did she shrink from controversy. She wrote, "Throughout my life the leit motif of my work has been the effort to diminish areas of ignorance, however small a step any one individual can take, rather than getting involved in debates over the superiority of one or another theory. On danger of being called a . . . rebel, I should like to conclude with a quotation from Maimonides, the great physician-philsospher: "Teach thy tongue to say I do not know and thou shalt progress."