Alexis Carrel: The Known, the Unknown and the Unknowable (2024)

Alexis Carrel—1912 Nobel laureate in Physiology or Medicine—is still widely recognized for his pioneering work in vascular suturing and organ transplantation. He was the first US-based recipient of the Nobel and the youngest person of the time to receive the laureate in physiology or medicine. His innovative techniques and discoveries together with a vision that rejection of grafts could be prevented with drugs or radiation, paved the way for organ transplantation to become a reality several decades later.

Alexis Carrel was born in Lyon, France in 1873 into a well to do family involved in the local textile industry. Carrel’s father died when his son was young and although the family faced financial uncertainty Carrel went on to study and train as a doctor at the University of Lyon. He taught anatomy and post-operative surgery and got involved in experimental work which the University was known for. He was well-connected and took an active role in the academic sphere, publishing, and promoting his work to the medical and scientific community.

It has been suggested that Carrel’s early interest in blood vessel suture was piqued by the assassination of the French President, Marie François Sadi Carnot in Lyon in 1894. The dramatic event during which the politician suffered a fatal stab wound to his portal vein, is said to have prompted speculation amongst the medical community in Lyon about whether he could have been saved. Mathieu Jaboulay, the Chief of Surgery in Lyon and Carrel’s supervisor, was at that time involved in developing suturing techniques for blood vessels. Carrel worked in this area to explore and refine existing techniques. According to his biographer David Hamilton, author of The First Transplant Surgeon: The Flawed Genius of Nobel Prize Winner, Alexis Carrel, the surgeon used needles and thread sourced from the local silk industry to refine suturing techniques.

In 1902, Carrel published a new technique for the end-to-end anastomosis of blood vessels in the Lyon Medical. This discovery, which is accepted as the origin of modern blood vessel and organ transplantation, placed him firmly in the spotlight. Carrel described and illustrated a ‘triangulation technique’ in the publication for which he was feted and in much demand as a speaker at meetings and the local scientific society. Carrel’s newly established high profile came with increased scrutiny however, and although he was a dedicated scientist, he tended to court controversy, often in the public media. One such case which Hamilton catalogues is a trip to the shrine at Lourdes with a group of pilgrims, some of whom were in search of miracle cures reputed to occur there. In what today would probably be called poor reputation management, Carrel was quoted in local newspapers apparently claiming to have witnessed a miracle cure at Lourdes. Although he backtracked on the reports and claims to have been misrepresented, the publicity led to his scientific reputation being called into question. This is thought to have been one of the reasons he was denied a senior position at the Lyon Hospital.

Peeved at being blocked for a faculty place, he left France and by 1905 was working with Charles Guthrie on organ transplantation in the Department of Physiology at the University of Chicago. An attachment to the Rockefeller Institute for Medical Research in New York, which continued until 1939, followed and it was here, over the next five or so years that he would perform the research which gained him the Nobel Prize. He demonstrated in 1910 that prior to surgery, blood vessels could be kept viable for longer periods in cold storage. That same year he published a paper in the American Journal of Surgery describing experiments on the treatment of aneurysms of the thoracic aorta. He noted the difficulty of performing coronary anastomosis on a beating heart and stated that it would need to be stopped and placed in some form of support while the surgery was carried out.

During this period, he also foresaw a future in which organ transplantations could succeed with the application of radiation or drug therapy to counteract donor rejection—something that would come into being many decades later. Despite all these achievements, his contradictory nature and unpredictable character frequently detracted from his good works. He was accused by Guthrie and others of failing to give credit to colleagues for collaborations and shared work. Even his appearance with one blue eye and one brown eye, was suggestive of a characteristic ambiguity.

During the First World War, Carrel served as a Major in the French Army Medical Corps and helped develop the well-known and widely used Carrel–Dakin method of treating war wounds which helped to boost his reputation both in France and the USA. Ever the self-publicist Carrel kept the media well informed of his activities and achievements during the conflict. Hamilton describes Carrel as a ‘scientific showman’ who always liked to have a new visual phenomenon up his sleeve to put on display, be it a new suturing technique or the perfusion pump he would later go on to develop. Hamilton says Carrel was only rivalled by Einstein as the celebrity scientist of the day.

After WW1, he returned to the US where he became involved in a high-profile collaboration with the famous aviator Charles Lindberg that led to the development of a perfusion pump for the preservation of organs. Carrel ensured the pump which Lindberg fashioned to his specifications, received widespread exposure in the popular media of the day, irrespective of the efficacy of the device having been tested. A tendency to promote the big idea without attention to the finer detail was, Hamilton notes, Carrel’s frequent modus operandi with new endeavours.

Carrel’s propensity for squandering his good reputation re-emerged later in 1935 with the publication of a controversial and best-selling book, Man, the Unknown—a populist and sometimes contradictory mixture of science and philosophy that espoused goodwill and humanitarian values but also promoted eugenics and an authoritarian view of society. One of Carrels less offensive thoughts on women from the book states: ‘Women should receive a higher education, not in order to become doctors, lawyers, or professors, but to rear their offspring to be valuable human beings’. Although Carrel was not alone in holding these views in the 1920s and 1930s, he became allied with extremists of the day and lost support. During World War II, he further damaged his reputation when he returned to France, not to oppose the occupying Nazis, but to establish a research unit and hospital under the auspices of the Vichy Regime. After the liberation of France in 1944, he was surrounded by rumours that he had collaborated with the Nazis. He didn’t live long enough to attempt to clear his name or to address the accusations and died on 5th November 1944.

The dilemma of how to deal with the legacy of an individual such as Carrel, whose work is valuable but whose beliefs are (particularly by modern standards) unpalatable, is something Hamilton addresses from the perspective of an impartial biographer who neither seeks to raise or diminish their subject. He says: ‘We can still honour his remarkable achievements in science but decline to put a gloss on the many awkward findings. Carrel’s remarkable scientific achievements deserve detailed examination, but there is no need to overstate his contributions nor any reason to minimize his faults, he can be seen as a genius but an elusive, flawed one’.

Conflict of interest: none declared.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.

Issue Section:

CardioPulse

Email alerts

Citing articles via

More from Oxford Academic