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David Alan Bloom 36th recipient of the American Academy of Pediatrics Medal in Urology

      David Alan Bloom was born on July 26, 1945 in Buffalo, New York to Marvin Bloom and Shirley (nee Goldstein) Bloom. The eldest of four children he was soon joined by sisters Ellen Jane, Barbara and Elizabeth. Marvin Bloom was an internist and specialized in hematology. He was an attending physician at Buffalo General Hospital and chief of hematology at Mount St. Mary's Hospital. The family lived for many years on Lafayette Street near the Children's Hospital of Buffalo and presciently, Bloom would recall riding his bicycle around the facility. A precocious child who loved reading and learning, he went to the Park School. Upon graduation in 1963, he enrolled at the Rensselaer Polytechnic Institute in Troy, New York, where he earned a bachelor's in science degree. Returning to Buffalo, he was accepted into the State University of New York at Buffalo Medical School. As he completed his medical degree he contemplated where he would do residency and in which field. While many friends and family hoped he would stay in Buffalo, David heeded the advice of Horace Greeley and headed west to Los Angeles in 1971 where he would enter a general surgery residency at UCLA [
      • Greeley Horace
      New York Tribune.
      ]. General surgery at that time was in a period of great innovation. Total parenteral nutrition, hemofiltration, organ transplantation, and vascular graft reconstruction were just a few of the innovations. David would excel at UCLA under the mentorship of the surgery chair, William Longmire Jr. While finishing up his surgery residency he became acquainted with the urology service and realized that he was interested in a urology career. He was invited to become a urology resident by Willard Goodwin, the urology chair. Goodwin and his successor Joseph Kaufman would become his urology mentors and life-long friends. During this time two other major developments occurred that would affect the rest of his personal and professional life. He became intrigued by developments in the nascent world of pediatric urology. Before his chief year in urology, he traveled to England where he served as a visiting fellow and registrar at the Institute of Urology and St. Peter's Hospital, University of London and worked under the tutelage of Sir David Innes Williams, one of the founders of modern pediatric urology. This would start a lasting pattern of traveling to interact, learn and collaborate with the great figures in our field. The other major development was his introduction by his fellow resident, John Cook, to Martha Lichty. They fell in love and were soon married (Fig. 1). They would have four children, Alex, Amy, Emily, and David. After completing his chief resident year, he began his military service as an active-duty major in the US Army Medical Corps. He was appointed as a staff urologist at Walter Reed Medical Center in 1980 and became chief of pediatric urology at Walter Reed in 1983. Promoted to lieutenant colonel in 1982 he would transition to reserve duty in 1984 and separated in 1990 (Fig. 2).
      Fig. 2
      Fig. 2At David's promotion to Lieutenant Colonel, with Major General Enrique Mendez Jr., commander of the Walter Reed Army Medical Center, and family – Martha and daughters Amy (standing) and Emily (in Martha's arms).
      Edward McGuire had come from Yale University to succeed Jack Lapides as the head of the Section of Urology at the University of Michigan in 1983 (Fig. 3). He needed a pediatric urologist and soon was in contact. The two realized that they shared a common practical approach to urology, especially in the care of spina bifida children and neurogenic bladder patients. McGuire would join the network of superb urologists who were Bloom's colleagues, collaborators and friends. In 1984, Bloom accepted the invitation to come to Ann Arbor and to serve as the chief of pediatric urology. He would become a Professor of Surgery, Urology in 1993 and when the Section became an independent department in 2001, he would be one of the inaugural Professors of Urology. In 2002 he was named the Jack Lapides Professor of Urology and in 2007, he would succeed James Montie, the first chief of the new department to become the second head of the University of Michigan Department of Urology, serving until 2019. The pediatric urology unit would expand under his leadership and guidance. Soon after he came to Ann Arbor, he was joined by Michael Ritchey, and later Harry Koo. He would invite back in 1999 a former resident and mentee, John Park, who had completed a fellowship at Boston Children's Hospital. Joining the team in 2002 would be Julian Wan followed soon thereafter by Vesna Ivancic, Kate Kraft, Courtney Shepard Streur, and Bryan Sack. Bloom was one of the earliest to recognize the utility of specialty practice nurses and incorporated them into the team. They included Jill Knechtel Sanvordenker, Anne Panzl Marcovich, Joanna Maynard, Carla Garwood, Sue Hadden, Erin Gibson, Shannon Johnson, Nancy Street, Sandy Ratliff, and Margaret Perrett. He would serve as a mentor to many medical students, residents and trainees inspiring them to choose pediatric urology as a career. These included David Bomalaski, Diana Bowen, Nina Casanova, Lauren Corona Johnson, Jon Ellison, Richard Grady, Emilie Johnson, Kathleen Kieran, Ted Lee, Duncan Morhardt, Caleb Nelson, John Park, Courtney Shepard Streur, and Julian Wan.
      Fig. 3
      Fig. 3David with longtime friend, colleague, and predecessor as Chair of Urology at the University of Michigan, Ed McGuire.
      Besides his clinical work and mentorship, Bloom would write over 220 publications and 70 book chapters. They covered the whole breadth of the field of pediatric urology including pressure-based management of neurogenic bladder, the appropriate use of urethral dilation, extraordinary urinary frequency syndrome (a term he coined), and one of the earliest papers on the use of laparoscopy in the management of the intra-abdominal testicle [
      • Wang S.C.
      • McGuire E.J.
      • Bloom D.A.
      A bladder pressure management system for myelodysplasia - clinical outcome.
      ,
      • Bloom D.A.
      • Knechtel J.
      • McGuire E.J.
      Urethral dilation improves bladder compliance in children with myelomeningocele and high leak point pressures.
      ,
      • Zoubek J.
      • Bloom D.A.
      • Sedman A.B.
      Extraordinary urinary frequency.
      ,
      • Bloom D.A.
      Two-step orchiopexy with pelviscopic clip ligation of the spermatic vessels.
      ]. It was so early that the terminology then referred to pelviscopy obscuring its ready discovery by those who only search using the term “laparoscopy”. A paper on the necessity of imaging studies after routine ureteral reimplantation presaged future efforts to curtail routine testing and radiation exposure [
      • Bomalaski D.M.
      • Ritchey M.L.
      • Bloom D.A.
      What imaging studies are necessary to determine outcome after ureteroneocystostomy?.
      ]. An enduring interest has been the history of urology, and how significant advancements were made. He would help unearth and credit the first example of percutaneous nephrostomy, remind us of the great effect of Jack Lapides and clean-intermittent catheterization, and how contributions can come from unusual sources, such as when the development of the first practical ventricular shunt to treat hydrocephalus came from the parent of an affected child [
      • Bloom D.A.
      • Morgan R.J.
      • Scardino P.L.
      Thomas Hillier and percutaneous nephrostomy.
      ,
      • Bloom D.A.
      The retrograde idea of Jack Lapides: clean intermittent catheterization.
      ,
      • Baru J.S.
      • Bloom D.A.
      • Muraszko K.
      • Koop C.E.
      John Holter's shunt.
      ].
      In addition to clinical service, research, training and education, Bloom contributed greatly to the fourth aspect of modern academic practice: professional service. At the University of Michigan, he would serve as Associate Dean for Faculty Affairs, help formalize the medical school bylaws, and serve on the executive committees for the medical school and the faculty group practice. Nationally, he would serve on the executive and program committees of the American Academy of Pediatrics, Section on Urology, The Society of Pediatric Urology, the examination of committee of the American Board of Urology and later as a trustee. He would act as a director for the American Board of Medical Specialties, secretary-treasurer and president of the American Association of Genitourinary Surgeons and as a Governor for the American College of Surgeons.
      This rough sketch of the contributions made to our profession does not touch upon the great kindness, humor and warmth shown to his patients, their families, his trainees, and his fellow urologists. Sometimes someone slightly removed can best sum up this effect. When asked how one would describe David Bloom, Helen Park, noted that usually when someone with such skills and accomplishments arrives in a room, they would often announce their presence “Here I am! Whereas with David, he would make the point of recognizing and engaging others and make them feel welcome.” The phrase, “There you are!,” comes immediately to mind [

      Park, Helen, personal communcation?

      ]. David Bloom is a superb urologist, patient teacher, wise adviser, inspirational leader, supportive colleague and great friend and a deserving recipient of the 2020 AAP Medal in Urology (Fig. 4).
      Fig. 4
      Fig. 4David at a meeting with his characteristic equipment – a trusted camera.

      References

        • Greeley Horace
        New York Tribune.
        1865 (Editorial July 13)
        • Wang S.C.
        • McGuire E.J.
        • Bloom D.A.
        A bladder pressure management system for myelodysplasia - clinical outcome.
        J Urol. 1988; l40: 1499-1502
        • Bloom D.A.
        • Knechtel J.
        • McGuire E.J.
        Urethral dilation improves bladder compliance in children with myelomeningocele and high leak point pressures.
        J Urol. 1990; 144: 430-433
        • Zoubek J.
        • Bloom D.A.
        • Sedman A.B.
        Extraordinary urinary frequency.
        Pediatrics. 1990; 85: 1112-1114
        • Bloom D.A.
        Two-step orchiopexy with pelviscopic clip ligation of the spermatic vessels.
        J Urol. 1991; 145: 1030-1033
        • Bomalaski D.M.
        • Ritchey M.L.
        • Bloom D.A.
        What imaging studies are necessary to determine outcome after ureteroneocystostomy?.
        Urology. 1997; 158: 1226-1228
        • Bloom D.A.
        • Morgan R.J.
        • Scardino P.L.
        Thomas Hillier and percutaneous nephrostomy.
        Urology. 1989; 33: 346-350
        • Bloom D.A.
        The retrograde idea of Jack Lapides: clean intermittent catheterization.
        J Urol. 2017; 197: S125-S126
        • Baru J.S.
        • Bloom D.A.
        • Muraszko K.
        • Koop C.E.
        John Holter's shunt.
        J Am Coll Surg. 2001; 192: 79-85
      1. Park, Helen, personal communcation?