Prof. Dr. med.
Isidore Snapper
1889 - 1973

Isidore Snapper was born on January 5, 1889, as the first child of David Snapper (1867-1927) and his wife Helena, née Barends (1867-1935), a Jewish family in Amsterdam.

His father and grandfather Isidore, after whom he was named, worked as diamond cutters. Attracted by the opportunities offered by the diamond trade, the family moved from Frankfurt-Rödelheim to Amsterdam in the early 19th century. The name Snapper, which had already been adopted in Rödelheim, refers to the family’s traditional profession as tailors.

Education and career

Family, education, and professional activities in the Netherlands

At the age of 16, Snapper graduated from the Stedelijk Barlaeus Gymnasium with an early exam (including English, German, French, Latin, and Greek!) in order to study medicine in Amsterdam from 1905 to 1911.

Amsterdam’s professor of internal medicine at the time, Pieter Klazes Pel (1852–1919, Pel-Ebstein fever in Hodgkin’s disease), sparked the young student’s interest in internal medicine. Thanks to his support, Isidore Snapper received a six-month research scholarship at the Imperial Cancer Research Foundation in London in 1909, where he conducted research on tumor vaccination using organ extracts in mice. After completing the equivalent of the current “practical year” in medical school, Snapper passed his final exam on July 6, 1911.

At the age of 22, Isidore Snapper married Henriëtta Maria Jacqueline van Buuren, the daughter of a merchant who had converted to Protestantism, on December 1, 1911. His marriage resulted in significant social advancement for him. Between 1912 and 1917, their sons, Frits and Ernst, and daughter Els were born.

Snapper began his professional career in 1912 in Groningen as an assistant doctor to the famous Hartog Jakob Hamburger (1859–1924), professor of physiology and physiological chemistry. Professor Hamburger had defined the physiological saline solution 0.9%. Dr. Snapper received his doctorate there in 1913 with a thesis on chlorine metabolism in human lobar pneumonia. Until 1917, he was repeatedly assigned to the laboratory of Abraham Albert Hijmans van den Bergh (1869-1943), a professor of internal medicine in Groningen.

Together, Professor van den Bergh and Dr. Snapper were able to elucidate the (patho)physiology of free and conjugated bilirubin.

The aspiring student described his most important teacher, Professor van den Bergh, as always even-tempered, but sometimes also conflict-averse. Together, they jointly published papers on the echinococcosis endemic in the northeast of Holland, on porphyrias, and on stool tests for occult blood.

When van den Bergh left Groningen for Utrecht in 1917, Snapper, then 28, did not want to subordinate himself to a newly appointed professor, so he moved to Amsterdam as an assistant professor in the department of his early mentor Pieter Klazes Pel, who had died in 1919. On June 4, 1919, at the age of only 30 years, Isidore Snapper was appointed the director of the propaedeutic medical department at the University of Amsterdam.

The department consisted of a clinic with 60 beds and a large experimental laboratory. On September 22, 1919 in his inaugural lecture on the topic of “Advantages and disadvantages of new trends in the laboratory and clinic,” Snapper identified himself as a generalist internist and portrayed himself as committed to “bedside medicine” and to ongoing exchange with biochemical laboratory medicine.

From the Wilhelmina Gasthuis, Amsterdam’s second teaching hospital, Professor Snapper played a pivotal role influencing Dutch and Amsterdam medicine in the interwar period.

His scientific work focused not only on the kidneys, bones, and parathyroid metabolism, but also on blood and liver diseases and diabetes mellitus.

Dr. Snapper became a member of the (D)GVS in 1925. He regularly reported on the (D)GVS conferences in Dutch journals. Together with Abraham van den Bergh and Leonard Polak Daniels, he organized the (D)GVS Congress in Amsterdam in 1928.

It is remarkable that the young, internationally renowned professor of medicine still found time to regularly referee soccer matches at both the national and international level. Dr. Snapper refereed as part of his work life balance and as he told his son, to keep himself grounded. He needed the shouts and insults directed at him to remain modest and immune to too much reverence in the hospital.

After 1933

Emigration and work in China

For a long time, the Dutch society felt secure because of its previous experiences in World War I. People who feared a German occupation or emigrated were accused of lacking patriotism. Snapper advised colleagues from Germany and Austria early on not to seek refuge in the Netherlands, as he predicted a future occupation.  With the annexation of Austria by Germany, Hetty and Isidore Snapper actively sought employment in the United States.

Thanks to his ideas on bedside medical teaching in medical education, Professor Snapper had already come into contact in the early 1920s with the US Rockefeller Foundation, which strongly supported this form of propaedeutics. In the spring of 1938 in New York, he was able to sign a contract as the director of the medical clinic of the Beijing Union Medical College, financed by the Rockefeller Foundation. After a leave of absence, the Snapper couple traveled via Southampton, New York, Vancouver, and Japan to arrive at the Chinese capital at the end of 1938, which was already occupied by the Japanese. Snapper was not officially removed from his post in Amsterdam until September 1, 1940, almost four months after the German invasion of the Benelux countries.

Snapper successfully urged his son Ernst to study mathematics at Princeton, also made possible through Rockefeller connections. His daughter Els had already emigrated to the US three months earlier. His eldest son, Frits, a reserve officer, remained in the Netherlands and fled on foot to northern Italy after the occupation. In Italy, Frits Snappers escaped from prison and survived with Italian partisans until the end of the war.

The great foresight and wisdom of his life plans with regard to his small family is underscored by the fate of the majority of the rest of his family.

Snappers’ sister Betsy Vromen-Snapper, the deputy director of the Jewish girls’ orphanage Rapenburgerstraat, was one of the 283 SS “exchange Jews,” who were exchanged from Bergen-Belsen in 1944 for the last deluded Nazi Templers to Haifa.

Four of Snapper’s maternal aunts died in concentration camps. Only one of his aunts survived, four other siblings had died before the war.

His wife`s mother Hetty was murdered in Sobibor in 1943; her father had died earlier.

Prof. Snapper`s father died before the war. Four of David Snapper`s sibling died either in the ghetto or in concentration camps.

The pharmacologist Ernst Laqueur, Dr. Snapper`s friend from his days in Groningen and Amsterdam, survived the Holocaust. Laqueur’s daughter Gerda and her husband Felix Österreicher died of typhus in Tröbitz after being liberated from the death train from Bergen Belsen. Their daughter Renata Laqueur-Weiss survived.

In Beijing, Snapper dealt with diseases caused by malnutrition, such as rickets and beriberi, and was often able to trace the diseases back to specific living conditions and habits. Infectious diseases affecting the liver, such as typhoid fever, amoebiasis, schistosomiasis, hepatitis, cholera, Clonorchis (Chinese liver fluke), but also kala azar and tuberculosis, repeatedly contributed to a large part of his work. Professor Snapper was preoccupied with the realization cholesterol resulted in arteriosclerosis and thereby did not occur in malnourished populations, a notion that was not entirely accepted in the West at the time. He attributed the absence of phlebitis and thrombosis in China to a lack of phospholipids in the vegetarian diet, such as cephalin. With a keen awareness of social policy, he recognized that the opium proceeds from a wedding ring were the cause of the high suicide rate among Chinese daughters-in-law.

In the second half of 1941, there was an increasing repatriation of US citizens in China. There was no option for stateless persons, a condition from which Snapper suffered greatly well into the 1950s. Snapper’s internment on December 7, 1941 (Pearl Harbor Day) was converted to military custody on December 24, 1941, allowing him to continue working as a doctor with restrictions. In July 1942, after eight months, Snapper was exchanged in a Japanese-British/Dutch exchange program via the neutral African-Portuguese city of Lorenzo Marquez (now Maputo, Mozambique) to Liverpool.

Professional activity in the USA

Once again with the support of the Rockefeller Foundation, Snapper traveled via Glasgow and Halifax aboard the Queen Elizabeth to Washington D.C. In Washington D.C., Professor Snapper worked as an advisor to the Pentagon under FBI supervision from 1942 to 1944, compiling dossiers on the (tropical) medical situations in European, Asian, and African countries. This work was important to ensure that the necessary medicines were available in the event of occupation by the US Army. With the publication of his comprehensive book “Chinese Lessons to Western Medicine”`in New York in 1941, Dr. Snapper recommended himself for the position

In 1944, Snapper was appointed the director of the Second Medical Clinic at Mount Sinai Hospital in New York, succeeding Eli Moschcowitz. He was also provided with a large routine and experimental laboratory. His work focused on renal metabolism and liver function testing (Snapper-Saltzmann test), multiple myeloma in diagnostics and therapy, the metabolism of acetylsalicylic acid, and tuberous sclerosis.

Due to disagreements with the hospital management in New York, Snapper moved in 1952 at the suggestion of his friend, pathologist Hans Popper (November 24, 1903–June 6, 1988) to the Cook County Hospital in Chicago, a 3,000-bed facility. In Chicago, Snapper was impressed by the numerous different and rare clinical pictures he saw there and was able to discuss them with his friend Hans Popper at legendary and well-attended clinical pathology conferences. Nonetheless, he still considered the importance of early bedside diagnostics throughout his life. See also his 824-page standard work “Bedside Medicine” published with Alwin Kahn in 1967.

Presumably due to the hot continental climate in Chicago, Snapper returned in 1953 to Beth-El Hospital in Brooklyn, New York.

Professor Snapper opted for this smaller, little-known hospital, since the contract he could sign there, gave him a strong position in disputes with the hospital administration and private attending physicians. Together with the surgeon Dr. Neuhof and the laboratory director Richard Greenblatt, he succeeded in making the hospital increasingly well known. In line with his convictions, he raised clinical training at the hospital to a new level.

Snapper never lost touch with his old home, celebrating his 80th birthday in January 1969 with European friends in Amsterdam.

Isidore Snapper died in New York on June 30, 1973. On July 1, an obituary in the New York Times paid tribute to the “Educator, Researcher, and Lecturer.”