Gerald was born in Johannesburg on July 13,1937. Raised in Orange Grove, Johannesburg, attended the local preparatory school and then Highlands North High School from where, along with six other 1954 matriculants, he was accepted to the Witwatersrand Medical School, starting in 1955.
The years of learning basic and medical sciences were challenging. To relax over the weekends, small groups of friends used to meet to play tennis. Gerald also met other players in games of squash at the university squash courts in Parktown. And there was the wonderful campus pool for swimming and practicing diving.
Journey in Pathology
After graduating and completing internships in Medicine, Surgery and Pediatrics, at Coronation Hospital, Johannesburg, Gerald joined the staff of the South African Institute for Medical Research as a trainee pathologist. Gerald met and married Cynthia Cohen (MB BCh 1964) in 1965. In 1968, he qualified as a Fellow of the South African Faculty of Pathologists.
Many older colleagues had travelled to England for further study. Gerald also chose to pursue an academic career at the Postgraduate Medical School at Hammersmith Hospital, London, choosing to work in chemical pathology. A position to work in protein clinical chemistry was available which he was glad to fill. At the same time, Cynthia furthered her career by attending the course at Hammersmith Hospital and graduated with the Diploma in Clinical Pathology. At the end of two years Gerald graduated with the Membership of the Royal College of Pathologists.
In their spare time they enjoyed the cultural opportunities in London’s museums and the theatre district. They also took weekend trips to Cornwall, Huddersfield, and Nottingham to meet Cynthia’s erstwhile pen pals and visited many acquaintances who were also living in London. After returning to Johannesburg in 1972, they happily welcomed a lovely red-haired daughter who brought a new charm into their lives.
Cynthia returned briefly to London to write the examinations for the Membership of the Royal College of Pathologists. When she came back to Johannesburg, she joined the staff of the School of Pathology, newly formed by the merger of the Witwatersrand Medical School and the South African Institute for Medical Research and focused her interests in surgical histopathology. At this time, Gerald was also appointed to the School of Pathology.
He continued his interest in clinical chemistry and set up a new clinical chemistry laboratory at the Johannesburg General Hospital for testing patient blood samples. He implemented multichannel automated blood analyzing systems for routine analysis of blood samples. Also he accomplished setting up computer controlled positive sample identification, important in reporting accurate patient results.
Gerald continued his studies in protein chemistry which was of interest to the hematologists of the Johannesburg Hospital Hematology Clinic, that served a large number of patients with dysproteinemias. This was a rich source of investigative work and, together with other co-authors, he contributed to 43 scholarly papers, published in various high citation index medical journals.
To America: Hershey Pennsylvania
In mid-1976, Gerald and Cynthia were invited to interview for positions at the Hershey Medical Center in Pennsylvania. They both were offered appointments in the Pathology Department which they accepted. At that time, rioting broke out in Soweto and other areas of South Africa that negatively impacted obtaining visas to immigrate to the United States. Consequently, there was a delay until January 1977, when applicants were able to start immigration procedures and commence jobs in the United States that they had been offered.
Following its opening in 1967 the Hershey Medical Center developed into an active and competitive tertiary care facility. In the small town itself were 15.000 inhabitants, many of whom were employed in the Hershey Foods Corporation.The town had a lovely aroma of chocolate and hence was called “Chocolate Town, USA”. Following the Shulman’s arrival, the Pathology Departmental staffing was re-organized. Gerald was asked to change his focus from Clinical Chemistry to Blood Banking, a discipline in which he had a little previous training. This became an opportunity for an on-the-job learning in a new discipline.
Life in Hershey required reorientation to living in a small town established in corn fields. Yet all the conveniences of large cities were available. Most social activities centered around colleagues at the Medical Center
It was interesting to learn about members of the Amish community, in nearby Lancaster. They formed America's oldest Amish settlement, where thousands still live a centuries-old "Plain" lifestyle. Arriving in Amish Country allows one to step back in time to enjoy a slower, more peaceful pace – one where the horse and buggy remains a primary form of transportation, and where windmills dot the landscape, providing power harnessed from nature.
Ploughing the old way without mechanical implements
To the sunbelt: Little Rock, Arkansas – Atlanta, Georgia – Galveston Texas
After six Pennsylvania winters, Gerald was attracted to relocate to the sunbelt. He found an opportunity at the Arkansas Region of the American Red Cross Blood Services. Cynthia luckily found a fine position in the Pathology Department of the University of Arkansas Medical School. While they discussed their plans to move in their daughter’s presence, they were unaware that she had paid no attention. In retrospect they should have openly discussed their plans to move clearly ensuring her understanding. One day a large removal van arrived at their home and the little girl was shocked to realize that they were moving from Hershey. It was very traumatic for her and she wept bitterly all the way they drove to Little Rock. This was a lesson to remember to always communicate clearly with one’s child.
It was then that they first heard about ‘Tornado Alley’. At that time, Little Rock was experiencing extensive damage from tornado storms - a difficult time to arrive when they needed to find a place to stay and have their household goods delivered. Luckily all turned out well and they settled down to start at their respective places of employment.
After a year, political intrigue in management in the Arkansas Blood Services Region induced Gerald to move to the American Red Cross Blood Services, Atlanta Region. There he participated in teaching and research with local blood bank physicians.
He collaborated with the HTLV-1 investigating group at the Centers for Disease Control, who had interest in profiling blood donor samples and studying demographics for a possible relationship to adult Tcell leukemia/lymphoma and demyelinating disease called HTLV-1 associated myelopathy/tropical spastic paraparesis. Cynthia was offered a Pathology Faculty position at the Emory School of Medicine where she worked very productively for 34 years. Both of them were busily occupied with work responsibilities but could also enjoy many cultural opportunities in Atlanta.
In 1976, Gerald needed to undergo emergency coronary artery by-pass surgery leading him to resign his position. A year later, Gerald recovered his health and was offered a position as Blood Bank Director at the University of Texas Medical Branch in Galveston.
’Old Red’ is the original building of the University of Texas Medical School in Galveston Texas in 1891
His responsibility was to supervise an active blood transfusion service that also collected volunteer donor blood. Testing, preparation of blood components and distribution of blood products to a 650-bed hospital was carried out on site. The bank blood inventory was also supplemented with imported blood products from the Gulf Coast Regional Blood Center in Houston.
As the Blood Bank Director, Gerald set up an active service providing increased use of salvaged autologous blood for patients undergoing surgery while experiencing sizable peri-operative blood losses. In addition, he supervised autologous pre-operative blood component sequestration in the operating room. This coincided with HIV being found to be transmitted by some donor blood products. A massive national demand for autologous and directed blood transfusions placed heavy burdens on blood banks with coercion to provide these services. The situation was further complicated by media misinformation that increased the public fears and demands. The Federal Food and Drug Administration became even more actively involved in ensuring that compliance with legal requirements was met to safeguard the safety of the blood supply. This was accompanied with institution of even more frequent and more stringent inspection procedures.
With changing institutional priorities at Galveston, the Hospital Administration desired to provide services in immuno-histocompatibility and transplantation. In Gerald’s opinion, Galveston would only provide a small additional immunologic service. He was reluctant to become a competitor with the services of the huge centers of the University of Texas in nearby Houston, Texas.
This was an opportune time in 1998 for Gerald to take his retirement. Instead, he returned home to Atlanta, and became interested in working with a contractor to remodel and modernize an Atlanta house that had been built 70 years previously. He and Cynthia lived in their new home comfortably for 20 years.
Their daughter, son in law and family of two children chose to move to Argentina. This was a wake-up call for them to realize that they were an elderly couple who needed to secure backup plans for help in an emergency situation. The responsibility and expenses of home ownership led Gerald and Cynthia to sell up and downsize. They moved to a nearby independent senior living facility where they are very happily settled.
Gerald learns Hebrew on Zoom with an excellent Egyptian tutor, living in Athens, Greece, where he works for the Athens University Language Institute. Another interesting young man, living in Abu Dubai, the United Arab Emirates, also participates in some of the lessons. Cynthia uses ‘Duolingo’ to learn Spanish and has enjoyment conversing with their grandchildren who are bilingual. They both participate in many Zoom programs on art, culture, literature and secular presentations. Time goes by very fast while we wait out a scientific solution of the complexities of Covid-19.
Biography contributed by
Gerald Shulman, MB BCh (Witwatersrand) FCP (South Africa) MRCPath and FRCPath (United Kingdom)
Atlanta Georgia, July 2020
Blattner WA, Jacobson RJ, Shulman g. Multiple myeloma in South African
Lancet 8122: 928-929,1979.
Shulman G, and Jacobson RJ. Immunocytoma in black and white South Africans.
Trop Geograph Med 32: 112-117, 1980.
Jacobson RJ, Shulman G. Plasma Cell Myeloma and Waldenstroms
Macroglobulinemia in Black and White South Africans. Progress in Myeloma 1980
Williams AE, Fang CT, Sandler SG, Shulman G, et al Prevalence of human immunodeficiency virus type 1 p24 antigen in US blood donors - an assessment of the efficacy of testing in donor screening Science April. 240, 4852, 643-646. 1988
Williams AE, Fang CT, Sandler SG, Shulman G, et al. Seroprevalence and epidemiological correlates of HTLV-I infection in U.S. blood donors. N Engl J Med; 323:1312-1317. 1990
Khabbaz RF, Heneine W, Grindon A, Hartley TM, Shulman G, Kaplan, J. Indeterminate HTLV serologic results in U.S. blood donors: are they due to HTLV-I or HTLV-II? Journal of Acquired Immune Deficiency, 31, Dec 1. 5 (4) 400-404. 1991
Busch MP, et al including VATS Group (Shulman G). The viral activation transfusion study: rationale, objectives and design overview. Transfusion 36:854-859. 1996.
Vertrees RA, Conti VR, Lick SD, Zwischenberger JB, McDaniel LB, Shulman G. Adverse effects of postoperative infusion of shed mediastinal blood. Ann Thorac Surg 62:717-73, 1996.
Blais, RE, Hadjipavlou, AG, Shulman, G. Efficacy of Autotransfusion in
Spine Surgery. Comparison of Autotransfusion alone with Hemodilution and Apheresis. Spine ;21(23):2795-800. 1996
Shulman G. Impact of reservoir hematocrit and processing parameters on the quality of the processed blood product. AINS-AnasthesiologieIntensive Dec;37(12):734-8. 2002
- Jacobson RJ, Shulman G. Plasma cell myeloma and Waldenstrom's macro-globulinemia in black and white South Africans. In: M. Potter (Ed) Progress in Myeloma, New York: Elsevier North Holland, Inc., 81-91, 1980.
- Shulman G. Ethnic differences in immunoglobulin and their abnormalities. In: Ritzmann SE, Daniels JC (Eds) Serum protein abnormalities: Diagnostic and clinical aspects, New York: Alan R. Liss, 71-96, 1983