Hackel Fellowship in Cardiovascular Pathology

THE HACKELS’ BIG HEART

by DAVID HOWELL, MD PHD

For much of the past year, the Department of Pathology has been celebrating the lives and contributions of Dr. Donald Hackel and his wife, Irene Hackel. Dr. Hackel died in 1994, and Mrs. Hackel passed away on August 18, 2020, but the couple left a major legacy founded on his research and teaching, her support of Medical Center philanthropy, and their joint contribution to a fellowship for Duke medical students: the Donald B. Hackel Fellowship in Cardiovascular Pathology. (The Fellowship bears Dr. Hackel’s name, but is clearly intended by his family to honor both members of the pair.)

Donald Hackel hailed from Boston. He received his undergraduate and medical degrees from Harvard before interning at Beth Israel Hospital, where he met Irene; he then served in the U.S. Army Medical Corps. He completed pathology residency at Western Reserve (now Case Western Reserve) School of Medicine in Cleveland, and subsequently joined the faculty there, working with Dr. Thomas Kinney, then Chief of Pathology. When Dr. Kinney came to Duke as the second chair of the Department of Pathology, he recruited Dr. Hackel as Professor of Pathology in 1960. Dr. Hackel became Professor Emeritus in 1989, but continued to be active in the department for several more years.

Dr. Hackel is best known in the scientific community for his foundational work on cardiac ischemia, but he is perhaps best remembered by his students for his enthusiastic teaching, particularly in small group or one-on-one settings, always bestowed with patience, kindness, and a wry sense of humor. Several current Pathology faculty members recall him spending hours demonstrating the dissection of tiny pediatric hearts with congenital disorders. He continued to participate in “heart cutting” late in his career, when Parkinson disease robbed him of much of his manual dexterity. He typically used an Olympic-sabre-size knife; trainees looked on with concern, but there’s no record of him ever cutting himself. He never tired of teaching, even if it involved repeating the same lesson for a new audience. He was particularly revered by medical students, who honored him with three Golden Apple Awards for excellence as an educator, followed by a Lifetime Golden Apple near the end of his career. (Winners of this award aren’t eligible for consideration for the next five years, so he basically won it each time his name was on the ballot.) He also received a Distinguished Teaching Award from the Duke Medical Alumni Association in 1989.

For all his prowess as a communicator, Dr. Hackel was a gentle, unassuming man who almost never expressed overt disgruntlement. When a promising trainee indicated, during examination of a heart, that he was going into surgery rather than pathology, his response was a smile, a sigh, and a soft, “Oh, that’s OK too.” (That trainee ultimately became a cardiovascular pathologist, so the seed had been successfully planted.)Once, when a coworker was struggling to catch a bus that was pulling away from the curb, a junior colleague saw Dr. Hackel stick two fingers into his mouth and emit a sweet, piercing, boyish wolf whistle that stopped the driver in his tracks. Beyond that, exceptions to his quiet approach were exceedingly rare.

Irene and Donald Hackel at the Cardiovascular Awards Dinner, ca. 1989

Though an expert in cardiovascular pathology, he was fascinated by anything medical. During his time in Cleveland, he served as a pathology consultant to the local zoo. He recounted this experience to the department in a wonderful Grand Rounds; his escapades included crawling into the chest cavity of a deceased elephant with what turned out to be tuberculosis during a macro-necropsy. Even toward the end of his life, when he was coping with two debilitating illnesses, he continued to come to the department, motoring around on a small electric scooter (commonplace nowadays but something of a novelty at the time). During that time, he made a point of seeking out young colleagues and giving them a memento (often an old manuscript about a problem of mutual interest).

The Fellowship bears Dr. Hackel’s name, but is clearly intended by his family to honor both members of the pair.

Irene Hackel was born in Bangor, Maine. She met and married Donald Hackel while she was studying nursing and working in the blood bank at Beth Israel Hospital in Boston, and accompanied him on his academic journeyto Western Reserve and Duke. In addition to raising three children (Connie Katz, Dr. Andrea Hackel, and Richard Hackel), she was an active member of her community and synagogue, a champion of just causes (including women’s voting rights), and a strong supporter of Duke Medical Center. In particular, she played a major role in the establishment of the Nearly New Shoppe, a thrift store created by the Duke Faculty Wives that sold clothing and household items donated by faculty and staff and channeled the proceeds into millions of dollars in scholarships for Duke medical students.

The Hackel Fellowship was initiated in 1990 with funding from the Departments of Pathology, Medicine, and Surgery; dozens of individual donors; and a Charitable Giving Annuity (CGA) created by Donald and Irene Hackel themselves. With Irene Hackel’s passing, the CGA infused more than a quarter of a million dollars into the fellowship endowment. The fellowship was initially used to provide stipends for third-year medical students pursuing a research year in the laboratories of faculty members with primary appointments in the Department of Pathology. Of five Hackel Fellows in this category to date, three have chosen a career in pathology. More recently, the scope of the fellowship has been expanded to include students taking a “post-sophomore” year in pathology, where they serve in a role similar to that of first-year residents. It is anticipated that these individuals, who have committed themselves to an extra year of training, will have a high probability of choosing pathology as their life’s work. The first two Hackel Post-Sophomore Fellows have just successfully completed their fellowship year, and two new successors have replaced them.

Donald and Irene Hackel served and honored the Duke community for decades through their scholarship, teaching, and philanthropy. We in turn remember and honor them with great respect and affection.

Duke cardiopathologist Louis DiBernardo MD, once a student of Dr. Hackel, summarizes these contributions from his assiduous work:

“Dr. Hackel focused on the way the heart and its cells reacted to various forms of injury. He identified the multifactorial nature of cardiac injury and dysfunction during hemorrhagic shock. His research on myocardial ischemia looked at functional and structural changes in the myocardium during and after ischemia. He focused on the conduction system’s response to ischemia, an important aspect given that many myocardial infarct patients die from arrhythmias that can occur within seconds to minutes. In the area of interventional cardiology, Dr. Hackel performed one of the early studies comparing cardiac catheterization and angiography to gross examination—the true gold standard.”

Cutting heart sections with lab technician Pat Cruz, and intern Rex Bentley MD, ca. 1989. Also shown is an x-ray of the injected heart arteries, and at the back, the photographic stand where they documented heart sections on 4x5” B&W film.