Notes of the history of the ETA


There inevitably comes a time in the life and career of all of us when we are forcibly reminded of our mortality and advancing age. An invitation to speak on the history of an organisation is just such an event - a reminder that one has become a part of history! I am aware that my contribution comes at the end of a long but stimulating day. I was asked to offer "Notes on ETA history" and this is what I shall do. A former rector of the university of Newcastle once remarked to me that all scientific papers could be divided into two categories - those which were illuminated by slides and those which were illuminated by thought. I have decided, perhaps ambitiously, to aim for the latter, although in my academic days I relied heavily on slides. I found the uncertainty as to which slide would be projected next (this was pre-power point days) kept me, the lecturer, awake and the accompanying darkness kept the audience asleep - an ideal combination. Background to 1965

It is interesting to take a moment to reflect on how much has changed in the world since 1965. This was a key year in the development of communications and the exploration of space. The first commercial communications satellite Early Bird was launched and the first satellite TV programme was broadcast to 9 countries attracting 300 million viewers, although I regret that this was entitled "A Look at Olde England" and it represented my country as a sort of mediaeval theme park! The first space walks took place, the first link-up of manned spacecraft was achieved between Gemini VI and VII and there was an unmanned landing on Venus. Space, however, struck back and a meteorite weighing 45 kg hit Britain, the largest of modern times. The first totally instrument- controlled landing of an aircraft also took place in that year. At a more mundane level, it was the year when that indispensable adjunct to modern living was launched - the credit card.


As we have heard from Christian Beckers today, sadly indirectly, the European Thyroid Association was conceived in Rome 40 years ago. The idea that such an organisation should be created had, however, been germinating in the mind of a number of European scientists in the field for some time and his account of the pre-history of the ETA was as intriguing as the history. It was believed that it was timely to provide a European forum for the exchange of ideas and information - the life blood of scientific research. The model which the founding fathers (and mothers) of the ETA had in mind was the well-established ATA which had already passed its 40th anniversary. In this the thinking of those who took the initiative paralleled that of those who played a leading role in the creation of the European Society of Clinical Investigation which was created at the same time and which held its first annual meeting in the same year as the ETA (1967).

The first formal steps towards the creation of the ETA took place during the 5th International Thyroid Conference in Rome on 24th May 1965, 40 years ago yesterday. Rome was a highly appropriate location for the conception of this enterprise. This is the city which gave birth to other great pan-European enterprises, ranging from the Roman Empire (of which my country was once a colony) to the European Economic Community. It was also appropriate that the first steps towards the creation of the Association should take place over lunch, in view of the important role which social activities, particularly wining and dining, were to play in its meetings. Those present included Donald Alexander, Mario Andreoli, Paul Bastenie, Christian Beckers, Michel de Visscher, Jacques Dumont, André Ermans, Paco Escobar del Rey, Raymond Greene, Dmitri Koutras, Axel Lamberg, Serge Lissitzky, Raymond Michel, Jacques Nunez, Ros Pitt- Rivers, Jean Roche, Nino Salvatore and others. This group included 5 future Presidents of the ETA, the two Vice-Presidents (when that position existed), the founding Secretary-Treasurer and two others who were to be Chairmen of local organising committees. The conclusion of those present, that a European Thyroid Association should be created, was reached very speedily. As St Augustine said, "Roma est locuta, causa finita est" - Rome has spoken, the case is made. Inevitably, after 40 years, a number of those whose vision and commitment made this enterprise possible are no longer with us but it is a matter of pleasure that many are and are with us in this room today - notably Mario Andreoli, Jacques Dumont and Dmitri Koutras.

It is right that we should pay particular tribute today to our Belgian colleagues for the role which they played in the creation of the ETA. Christian Beckers has given us an excellent account of the origins of the Association but what he has not said through modesty should be said and put on record. The position of Secretary-Treasurer has always been a demanding one but the challenges facing the first Secretary-Treasurer were specially onerous. We owe a particular debt of gratitude to my friend Christian, whose energy, drive and commitment were so important in establishing the thriving Association which we have today and setting standards for its administration which have served the Association well. He played a key role in launching the Association, together with support from the other Belgians present at that lunch, notably Jacques Dumont, who served on the interim Executive Committee and on the first substantive committee, and Michel de Visscher, who was the local President of our first meeting in Louvain. Both were later to become Presidents. Indeed Michel was the President when I first joined the Executive Committee. Michel's wife Jacqueline was also a strong supporter and generous benefactor of the Association and a charming and hospitable friend to many of us. The warm message of support which she has sent us today is characteristic of her generosity of spirit.

Trends in Thyroid Research

The development of thyroid research over the last 40 years has been driven by both scientific and technical advances, and in some instances research in our field has provided proof of concept in areas which have illuminated other fields. One can identify a number of major advances which have proved critical to the development of research in thyroidology. Some of these were the products of research carried out in the decade before the Association was established but they led to an explosion of activity in both laboratory and clinical research throughout Europe and also on the other side of the Atlantic.

In particular, one must highlight the ready availability of radioisotopes of iodine which, in addition to their therapeutic value, made it possible to carry out studies in iodine kinetics, iodination mechanisms and thyroid hormone turnover rates. Christian has reminded us of the value of these tools in thyroid research.

The second major advance of the fifties, which was to prove invaluable, was the development of competitive binding assays, particularly radioimmunoassay, following the pioneering work of Berson and Yalow in the US and Ekins, Hunter and others in Europe. A further development in the sixties and early seventies which was to prove critical to many of us was the recognition that the applicability of these approaches was not limited to the assay of proteins and polypeptides but that highly sensitive and specific methods could also be developed for the measurement of small molecular weight compounds of biological importance.

The third advance in the fifties which originated in our own field was the development of the concept of organ specific auto-immunity through the pioneering work on Hashimoto's disease of Deborah Doniach and Ivan Roitt in London and Witebsky and Rose in the United States. Aldo Pinchera's reminiscences brought back memories of the difficulty of the techniques involved in the LATS assay and also of the goldfish assay for EPS - probably the most unreliable bioassay ever devised by man. The frustrations created by this assay were only partially relieved by the feeling of calm engendered by the sight of the goldfish swimming serenely around the tanks in the laboratory.

More recently advances in molecular and cell biology and genetics have led to further major advances in the field. It is to the credit of many members of the Association that they have recognised the value and applicability of these developments in fundamental science and have exploited them to advance the field so successfully.


I have commented on the key roles which our Belgian colleagues played in the creation of the ETA. The scientific strength of the ETA and the quality of its meetings has been a characteristic of the Association since its very earliest days. This strength initially derived from those who provided scientific inspiration from the outset - our earliest Presidents: Jean Roche, Ros Pitt-Rivers (the scientific mother of many of us), Jack Gross (one of Ros's collaborators and pupils), Gabrielle Morreale and Nino Salvatore. This tradition has been maintained by the subsequent Presidents of whom we have seven present here today - all from Aldo Pinchera onwards. Scientific leadership and inspiration was also provided in the first decade by many others - Serge Lissitzky, Raymond Michel, Jacques Nunez, Gilbert Vassart, Amirav Gordon to name but a few - and in clinical research by Dmitri Koutras (who was also Vice-President of the Association) Reg Hall, Axel Lamberg, Jim Crooks, Arne Melander, Donald Alexander and again many others.

Isaac Newton commented modestly, "If I have seen further than others that is because I have stood on the shoulders of giants". We too have had the opportunity to stand on the shoulders of giants but have been particularly privileged in also being able to achieve the contortionist's act of simultaneously sitting next to the giants on whose shoulders we have stood. Many of us in this room were inspired and motivated by our predecessors but the strength of the ETA also derives from the energy, commitment and contributions made by all its members. The culture of the ETA and the openness of its meetings have always made it possible for younger members to challenge, provoke and often instruct their elders - and this has been a hallmark of today's meeting. The inclusiveness of ETA meetings has been emphasised recently by the account in the current newsletter from a young scientist recounting her experiences at her first ETA Meeting in Istanbul.

Many have served on the Executive Committee - more than 80 now - and I believe that the practice of nominating and electing members who have not served previously has much to commend it. It increases the numbers of those actively involved and ensures that a significant proportion of the Committee is always comprised of younger members, who value the experience. There has never been any dearth of candidates for election. This input from younger colleagues has meant that successive Executive Committees have always been willing to scrutinise and evaluate the pattern of activities and they have been prepared to experiment, retaining successful innovations and modifying or discontinuing those which have been less productive. This has made an important contribution to the vitality of the Association, even if once or twice it has led to the re-invention of the wheel! The active involvement of members spreads far wider than this with many younger members being encouraged through the chairing sessions, speaking at planned symposia and membership of subcommittees.

Finally, one must not forget the work of successive Secretary-Treasurers (and I admit that I am prejudiced here). It is remarkable that all who have served in this role are here today with, sadly, the exception of our good friends Christian Beckers and Pierre Koenig who died in 1989.

The role and culture of the ETA

It is perhaps proper to ask on an occasion such as this - what are the roles and functions of the ETA? Or to broaden the question, what is the role of scientific societies in the twenty-first century when so many means of rapid communication are open to us? Their roles, I would suggest, are first to provide a forum for the interchange of ideas and information, but if the ETA were to limit its role simply to being a debating chamber then its impact and significance would be limited. Its secondary but no less important role is to provide a mechanism for the better understanding thyroid patho-physiology and its translation into more effective mechanisms for the prevention, early detection and treatment of thyroid disease. Here I believe the Association has a distinguished record. Work presented at meetings has improved our knowledge of the importance and prevalence of thyroid disease, and enhanced our understanding of its genetics, cellular pathology, patho-physiology and its treatment. The ETA has, however, gone further than this and has played a role in setting guidelines for public health and clinical policy and practice, both at national and European levels. Three areas which one might highlight are the roles which members have played in the prevention of goitre, screening for neonatal hypothyroidism and in assessing and reacting to the consequences of the Chernobyl incident.

I have been a strong promoter of pan-European activities throughout my professional life. It is all too easy to take a circumscribed view and suggest that the multi-cultural, multi-lingual, and increasingly multi-ethnic continent of Europe is characterised by its diversity. Major linguistic, ethnic, cultural and, happily to a greatly diminished extent, political differences separate and even divide our various countries. This diversity adds richness to our continent. We should not, however, forget that in the Middle Ages we were united by a shared language (Latin) and shared common religion. These factors were the basis of a common culture which gave birth to the universities and provided a framework for scholarly communication and collaboration. This framework survived the decline of the shared language and the fragmentation of the common religion, but in science it has not only survived, it has become progressively stronger.

Science was one of the threads which held the fabric of European society together through the often turbulent times of the seventeenth and eighteenth centuries. The European tours undertaken by wealthy scholars at that time established personal contacts amongst learned men throughout the continent and the tradition of a regular exchange of ideas and information amongst those interested in the natural sciences. These communications between individuals were reinforced by the exchange of letters, the publication of periodicals and the founding of learned societies. (There are now nearly 200 European societies in the biomedical sciences).

This is a rich heritage which we share. We all recognise that science is a corporate activity. Each of us is dependent upon others in our own and in cognate disciplines and we know that intellectual interchange is necessary for the development of conceptual thought. Direct contact between scientists remains essential to promote that free traffic in ideas and information which is necessary for the advancement of science. Our meetings provide the opportunity for us to talk together and thus identify common objectives, create mutual trust and goodwill and, in many instances, establish research collaborations which transcend national boundaries. We have all also benefited considerably from the progressive reduction in the cost of air travel and improved means of communication so that direct contacts can be reinforced and travel is no longer the preserve of the wealthy and privileged few. The role of associations such as ours, however, remains an essential one since it provides the framework for establishing these links in the first instance.

The success of the ETA in promoting productive contacts has extended far beyond the boundaries of Europe and the countries bordering the Mediterranean Sea. The ETA, through the quality of the science at its meetings, has drawn in a loyal following of many of the most active researchers from other Associations - most notably from our elder cousin the American Thyroid Association. Many of these have become corresponding members and we have come to regard them as honorary Europeans. They include Lew Braverman, Gerry Burrow, Colum Gorman, Les de Groot, Sid Ingbar, Reed Larsen, Max Mackenzie, Shigenobu Ngataki, Jack Robbins, John Stanbury (the inspiration to many in the ETA), Bob Volpé and many others.

There is an old joke that ETA stands for Extra-Thyroidal Activities. The social programme is an important part of all ETA meetings. It provides a basis for much informal interaction amongst participants and this is as important as the formal sessions. Much good science has flowed from the friendships which have been forged at the annual meetings. These friendships have also enriched the personal lives of many of us, and as I reflect on my varied career spanning many fields and environments, it is those friendships which have proved to be the most durable and those which I have valued most highly. Meeting former colleagues here today has been accompanied by a sense of homecoming. In my own house there existed for many years what my children called the "thyroid bed" in which many of our friends and colleagues from both sides of the Atlantic slept when visiting both Newcastle and London!

These social interactions have been further enhanced by those whom we traditionally and somewhat discourteously refer to as "accompanying persons". There have been many wives and partners of members who have been regular attendees at our meetings. They have provided a positive and cohesive influence, adding distinction and refinement to our meetings. One readily recalls with affection Jacqueline de Visscher (who endowed the Harington Prize), Marisa Salvatore, Gladys Koenig, Atie Henneman, Kiki Pinchera, Doris Studer and many others.

I was invited to offer "Notes on ETA history" and this I have done. Much of what I have said has focused on the people who have made the ETA what it is. These are names which have come readily to mind and I have largely but not exclusively used this is an opportunity to pay tribute to those who are not with us today. I am, however, conscious that there are many others whom I could have mentioned, and I hope that colleagues will forgive any serious oversights on my part.

There is, finally, little point in reflecting on history if one does not also look to the future. The two strengths of our Association have always been the quality of its science and the environment which it provides for productive interchanges to take place. These interchanges are not limited to the annual meeting but they bear fruit through scientific collaboration. The Association has, since its inception, shown a remarkable capacity to reinvent itself and thus it has retained the freshness and vigour which was the hallmark of that meeting in Louvain in 1967 - which was so ably organised by Christian Beckers. I am sure that it will continue to do so. Thus 40 years have brought us from one of the major pillars of our European civilisation (Rome) to the other (Athens) and our joining together here today reminds us that the histories of Greece and Rome were for many years intimately intertwined. I look forward to observing the progress of the Association in future years and, in the more immediate future, to maintaining the traditions of wining and dining with colleagues in a convivial atmosphere as we shall do later this evening.

David Evered
ETA Secretary general (1983-1989)