Adventurer & Icu Doc: An Autobiography by Ake Grenvik, Md, Dj, Mccm

By Ake Grenvik MD DJ MCCM

Born in Sweden in 1929, Ake Grenvik grew up in an educated home during WW II. With limited family finances, he mostly worked his way through all his school years with his first paid job at age 12. In his senior years in high school, during summer vacation, he served as a deck boy on ships traveling to the United States. As a successful student with high grades, he was admitted to medical school in Stockholm, directly upon graduation from high school. Training first in general then cardio-thoracic surgery, he joined the Swedish Air Force Reserve with traditional pilot training for physicians to become a flight surgeon. He also worked as a ship doctor on a large passenger ship during a cruise around the Pacific Ocean. After three years of clinical research as a cardio-thoracic surgical resident in Uppsala with magna cum laude evaluation of his published thesis, he was recruited to the Critical Care Medicine Division at the Medical School in Pittsburgh and brought this to a world leading training program for ICU physicians. He became one of the few founders of the Society of CCM. As a most reputable pioneer in this field, he was invited as a speaker to medical schools around the world. This gave him the opportunity to visit various national parks and wonders worldwide. He published nearly 400 medical articles, including 27 books and was promoted to Distinguished Service Professor at the University of Pittsburgh School of Medicine. Upon retirement at age 80, he devoted his time to the care of his wife and lifetime partner until her death from a serious stroke. At that time, he decided to write his memoirs, encouraged to do so by his mentor and partner in Pittsburgh.

• Language: English
• Publisher: LifeRich Publishing
• Release date: Feb 2, 2018
• ISBN: 9781489715548

Ake Grenvik MD DJ MCCM

Ake Grenvik, MD, a native of Sweden, attended medical school at Karolinska Institute in Solna, a northern suburb of Stockholm. He was recruited to join the Critical Care Medicine Division at the Medical School in Pittsburgh. He became a pioneer in the development of critical care medicine and was a founder of the Society of Critical Care Medicine. Over the course of his career, he published hundreds of articles, twenty-seven books, and retired as distinguished service professor at the University of Pittsburgh School of Medicine.

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Chapter 1

My School Years

My parents, Anders and Elsa Grenvik, were married in the early 1920’s in the small town of Sunne, located in the province of Varmland, halfway between the capitals of Stockholm in Sweden and Oslo in Norway. They were both graduates of the lower level of Swedish high school.

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My parents at wedding

I was born in Sunne in 1929 and grew up here with my older brother Gunnar and younger sister Margareta. Our family occupied the entire top floor of a square building called Slottet, where my father served as manager of a large bank on the bottom floor.

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Slottet

Our paternal grandfather had been a schoolteacher in the outskirts of Sunne. Our maternal grandparents owned a popular hotel, Gastis, also in Sunne.

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Gastis

In 1937, our father was promoted to a higher position at the headquarters of a major provincial bank, Wermlandsbanken, in Karlstad, the local capital of the province. Our mother inherited some money, which was used to buy a small family house in Karlstad. Here, we children would spend our main school years. All of us graduated from high school.

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Home in Karlstad

I had my first date at age 12. We were surprised to find that we were born on the same day in the same year. Her name was Barbro Melcher. But my girlfriend was very unfortunate. She died of leukemia as a young teenager. My best friend and I went to the funeral, a ceremony in all white. I still remember clearly how the white coffin was delivered from the podium to the lower level, where cremation took place. Cremation was very common in Sweden, considered the most hygienic way to bury the dead.

I had my first paid job also at age 12 on summer vacation from school, running errands on my bicycle for the neighbor’s business. My salary was SK 12.50 per week, approximately US $2.00. Not much, but the money value was much higher in those days. During the following years, I had many different jobs. As a member of the high school swim team, I served as a swim instructor in summertime. According to Swedish law, all schoolchildren had to learn how to swim. Sweden is full of small lakes and drowning would be common without the children being able to swim. At older age, I worked one summer on a large farm in the area using horses and tractors for the harvest. Every Christmas leave from school, I worked as an assistant letter carrier, when the accumulation of Christmas cards was overwhelming and extra help was needed to handle that load.

We had a great gang in Karlstad, some 20 teenage boys and girls during the 8 years of lower and upper level of high school.

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High School, Karlstad

We were sticking together all weekends with parties in any parents’ home, whenever available. We went on school excursions, especially the annual ski week up North in the Swedish mountains. But I had to pay my own way as my parents’ finances were very limited. One year, we had a winter survival course. We were given a short emergency snow shovel, a reindeer skin, a sleeping bag, a candle and matches. There were nine of us, six boys and three girls. We were instructed how to build a snow grotto or an igloo. With a thermos of hot chocolate, we were sent out in groups of three on skis and left on the steep slope of a mountainside. My group was digging out blocks of hard snow for an igloo. When darkness set in we were ready for a night temperature of -25 degrees C (-13 degrees F). We crept into our sleeping bags, drank our hot chocolate, used the empty thermos as a urinal and wondered how the girl team would solve that problem. We lit the candle and were surprised by the warming effect of a little candle. When we woke up, the ceiling had settled down several inches by melting the snow. But we had no problem getting out of the igloo.

My brother and I were also active Boy Scouts. We became leaders and initiated the Sea Scout movement in Karlstad, which is an inland port at the top of the large lake Vaenern. We learned and taught rowing and sailing, culminating in sailing a large yawl around the southern end of Sweden. There were 17 of us on board able to handle the four sails, main, mizzen and two foresails. This big ship was lent to us for free by the local Marine station. On the Swedish West Coast, we hit heavy weather and made a top sailing speed of 12 knots. As we entered the port of Malmoe, I was assigned the job to recover the foresails on the bowsprit. Rocking of the ship was difficult to handle by the helmsman with the bow straight into the wind necessary to recover the large sails. The bowsprit dipped so deep into the water, I was covered to my waist with each wave. But I managed to take down the sails and we headed for harbor with help of the engine. The rest of the trip was peaceful. We entered the transversal Goeta Canal, leading us home to Lake Vaenern and Karlstad via the seven locks of Berg, lifting us back up to the water level of Vaenern.

The last summer vacation in high school before starting the graduation year, I decided to travel abroad. I rode a train to Gothenburg, the main port of Sweden on the Atlantic Ocean. I sat down in the waiting room of the sailors’ house where new jobs on ships in port were announced daily. It did not take long before they called for a deck boy on a moderately large ship, M/S Erland, sailing to the Great Lakes of North America. It would be gone for three months, which was ideal for me so I applied and got the job. We left port already the next morning and first headed South to the tip of Sweden then North in the Baltic Sea. This included a passage through the Falsterbo Canal, a narrow time saving maneuver. I had the dogwatch, 12 - 4 on and 4 - 8 off, making it an 8-hour workday. My job included standing at the helm, painting and serving as a look out. The ship had no radar. When passing the Canal it was my turn behind the wheel. The third mate and I had the watch on the bridge. It was very scary in the canal, steering the ship through with only a couple of meters on each side. But there was no collision.

In the North, we loaded containers of paper mill, a common Swedish export item. When filled to the rim, we turned around to get out in the Atlantic. Crossing to North America took 9 days, including passage of the St Lawrence Current from Northern Greenland. In June, this was full of icebergs. The look out in the stem could tell when we were getting close to an iceberg as the air temperature suddenly fell abruptly. A local phone line connected with the bridge. This was useful at night. During the day, the air was clear and icebergs could be seen long in advance. The water was also frequented by whales. It was quite a show.

We were entering the St Lawrence Water Way and steering towards the Niagara Falls. I requested vacation time to see the Falls, but this was denied by the captain, as all hands were needed on board when passing the massive locks. On the lakes, we visited several ports. The electrician and I took a few days vacation and made a bus trip to Chicago where I had my first experience with race segregation. Black people were only permitted to travel far back in the bus. Similarly, they were only permitted in the back seats of a movie theater. The year was 1947 when segregation was still a major problem in the USA.

We loaded Kellogg’s cornflakes in Grand Haven, Michigan, and in Detroit, we took on board large wooden boxes each with a car inside. We were docked right next to the impressive Ambassador Bridge, connecting the US with Canada. After short stops in Quebec and Montreal, we were again heading out into the Atlantic. I returned to my hometown, Karlstad, just in time to start as a senior in high school.

The end of the high school graduation year was full of tests but it seemed to go reasonably well, until the end. My elder brother was studying at the University of Gothenburg and came home a few days over the Easter Holidays. Right at that time he developed an attack of highly contagious chickenpox. All written tests were over but the final oral exam on the day of graduation was still ahead. And the timing was perfect. The night before the exam, I noticed small skin eruptions, indicating the onset of my chickenpox attack. Fever followed and special arrangements had to be made for my final exam. An isolation room with a bed was arranged for me at school. I was transported by taxi. My oral exam included English, Mathematics and History, conducted by my teachers in the presence of special censors from Stockholm. It all went well with significant elevation of my grades. But when I recovered, all partying was over, so I have no fond memory of my high school graduation.

I made another trip to Gothenburg and took a deck boy job on the new M/S Stockholm, a combined cargo and passenger ship trafficking on New York City. Again, I served as a look out but now from the top of the mast, climbing a ladder inside to a protected barrel with telephone link to the bridge. But the Stockholm had radar and the duty officers already knew about any object we lookouts reported to the bridge. On a passenger ship, I was not permitted to serve as a helmsman and only had simpler tasks. We met heavy weather. The Stockholm did not have stabilizers and rolling from side to side was most significant. As a look out, you frequently found yourself in the barrel outside the ship’s side staring directly into the ocean, alternating port and starboard. If heading against the wind, enormous waves raised the bow high toward the sky and then dumped it into the next wave with a vibration and thunder like a gunshot. Furniture in the saloon was tossed around like bowling balls. The passengers were seasick and excellent first class food went to the crew rather than being dumped overboard. It was a great time for those of us who did not get seasick.

A popular game among the passengers was to guess the exact time for passing the Nantucket Lighthouse. Right time was awarded with a monetary prize. If none guessed right, the closest got the award. Eventually, we reached New York City and docked at the Swedish American Line’s pier on Manhattan 57th Street West End. I had a great time sightseeing in NYC, visiting the observation floor of the Empire State Building, at the time the tallest skyscraper of the world, located in the middle of Manhattan in the most populous city of Planet Earth. I watched The Rockets perform at Radio City Music Hall. I went skydiving with a guided parachute on Coney Island. I finally loaded up at Gunner’s shop near the SAL pier. When we left on our return trip to Sweden, I had a 9-kg watermelon in refrigeration below the tarp covering one of the lifeboats. I also had a supply of ballpoint pens, not yet seen in Sweden. I was loaded with fortune cookies, which were unheard of in Sweden. Upon return home, I had a garden party, handing out these cheap gifts to friends and neighbors. The fortune cookies had an American touch to them with texts like it is not improper to kiss a girl’s hand, but it is decidedly out of place or better yet girl who swears she has never been kissed has good reason to swear.

The Stockholm was built in 1948 and became the infamous ship of death 8 years later when it collided in heavy fog with the much larger Italian passenger liner Andrea Doria, in the Atlantic Ocean East of New York City. Andrea Doria sunk after 11 hours with a total of 46 people dying as a result of the collision. 1,660 were rescued by nearby vessels and the Stockholm participated in this rescue operation, before steaming into New York harbor by its own power. After repair, it sold to East Germany and was renamed Volckerfreundschaft.

A couple of days after being back in Karlstad, I received excellent news. The newspapers published lists of those students, accepted into the universities and I was thrilled to find my name among those going to start medical school, especially as my allotted school was my favorite, the Karolinska lntstitute. In retrospect, I was wondering if my chickenpox helped me get more attention and obtain higher grades, which qualified me for immediate medical school admission.

Chapter 2

University Education and Wedding

Medical school started on September 3, 1948. Finding a room for rent in central Stockholm was easy and obtaining a student loan was no problem in those days. Bus line 48 brought me directly to the new Karolinska Institute in Solna, a northern suburb of Stockholm. We started with a year of anatomy, embryology and histology and studied hard for frequent tests and one major exam toward the end of each concluded main subject.

At the end of my first year I had to take a break for mandatory military service. Future physicians needed nine months of basic military training, split in two parts. The first period lasted six months, June - December 1949, so I could resume my medical education in January 1950. During my first military training, I had the opportunity to learn type writing and also took a course in heavy truck driving, both of which skills proved to be very useful later in life. But disaster struck in my family in September. My father was in line for a potential bank presidency, when his professional career abruptly ended. He drowned in the harbor of Karlstad during a heavy rainstorm. The funeral made a lasting impression on me. As an officer of the local Odd Fellow Chapter he was specially honored. All fellows, dressed in tails filed one by one by the coffin, tossing a cypress leaf on it and bowed to the deceased before the coffin eventually was lowered to the cremation floor below.

My brother Gunnar studied at the University of Gothenburg, when he met Ulla, his wife to be. They married in June of 1951 and later parented first Catarina and then Jonas.

When I returned to the Karolinska Institute in January 1950, I took an unpaid job as an amanuensis in histology with the good fortune of being placed at the Nobel Institute for Neurophysiology under supervision of Professor Bror Rexed, who was working on an atlas of the cat spinal cord. Indeed, the cat was the only experimental animal at the Institute. My assigned research was to localize the nerve nuclei in the spinal cord representing skeletal muscles in the legs. I used kittens and cut the main nerve to a large muscle such as gastrocnemius. After 2 weeks, the spinal cord was prepared for microscopic examination, looking for so-called Wallerian degeneration, which clearly revealed those nerve cells in the anterior horn of the spinal cord, which were connected to the affected muscle.

My histology technician was a pretty girl by the name of Inger Valley-Stromgren. But after a few weeks, it became more than research work. Although my research results were very promising, I developed other problems. An itching conjunctivitis was caused by allergy to kitten hair which was shaved off the kittens in appropriate areas both for the surgical operation and finally for the autopsy with removal of the spinal cord. I used protective eyeglasses but they did not help much. The other problem was that I was running out of money and needed a paid job. But Inger and I maintained our relations.

I continued my current courses in physiology and chemistry. When I was done with the final tests in those subjects at the end of the Fall semester, 1951, I invited Inger to my parents house in Karlstad to participate in the after-Christmas Dance at Statt, the main hotel in town. Our old school gang traditionally met up at this event every year. When Inger arrived from Stockholm by train, I met her at the railway station. On the way to my home, she made it very clear that she would not take part in the festivities unless we were getting engaged at the event. So we visited our gold shop, looking for suitable rings to exchange. This was supposed to be a surprise, but unfortunately, one of my mother’s lady