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Howard Alvin Frank: Pacemaker Pioneer and Surgical Innovator

Howard Alvin Frank, M.D. (1914–2004)

"He was known internationally for his work on pioneering new surgical techniques and instruments." — Harvard Gazette, July 20041

Portrait of Howard Alvin Frank, M.D.
Howard Alvin Frank, M.D.
Clinical Professor of Surgery Emeritus, Harvard Medical School
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Howard Alvin Frank (October 11, 1914 – June 27, 2004) was an American surgeon, inventor, and medical researcher whose pioneering work shaped modern cardiology and nephrology. He was a co-developer of the implantable cardiac pacemaker, a pioneer of peritoneal dialysis, and helped build one of the first heart-lung machines. Over a 62-year career at Beth Israel Hospital and Harvard Medical School, he authored 128 scientific publications and trained generations of surgeons.2

He was my grandfather, and he taught me to play chess.

The lineage: Howard Alvin Frank → his son John B. Frank → me.

Table of Contents

  1. Family Origins
  2. Education
  3. Career Timeline
  4. The Pacemaker: A Revolution in Cardiac Care
  5. Peritoneal Dialysis: Saving Lives in 1946
  6. Other Medical Innovations
  7. Patents
  8. Publications
  9. Awards and Professional Memberships
  10. Personal Life and Family
  11. Legacy
  12. References

Family Origins

Father: Louis J. Frank, Hospital Superintendent

Howard was born into a life surrounded by medicine. His father, Louis J. Frank, was the Superintendent of Beth Israel Hospital in New York City, a position he held for approximately 30 years beginning in 1907.3 The Frank family lived in an apartment within the hospital itself, giving young Howard an intimate exposure to hospital operations and patient care from his earliest years.2

Louis J. Frank was a significant figure in early 20th-century hospital administration:

During the devastating 1918 influenza epidemic, Louis himself fell ill. In a letter dated October 23, 1918, he wrote: "Our whole force is gone. If you were to come back today, you wouldn't find a familiar face… From a house staff of 15 we have been reduced to a staff of five."4

Mother: Rayner Frank

Howard's mother was Rayner Frank (née unknown).5 Little is documented about her publicly, though she raised four children who all achieved distinction: three sons who became physicians (Howard, Edward, and Charles) and a daughter (Jeanne) who became a senior editor at a major publishing house.

The Three Frank Brothers: A Medical Dynasty

All three Frank brothers became distinguished physicians, and remarkably, two of them—Howard and Edward—both served on staff at the same institution, Beth Israel Hospital in Boston:

Name Specialty Notable Achievement
Howard Alvin Frank Surgery Co-developed pacemaker, pioneered peritoneal dialysis
Edward D. Frank Vascular Surgery Head of Peripheral Vascular Surgery at Beth Israel; National Research Council on Shock
Charles Warren Frank Cardiology Founding faculty at Albert Einstein College of Medicine; President of Association of University Cardiologists

Education

Columbia College (1930–1934)

Howard attended Columbia College in New York City, graduating with a Bachelor of Arts degree in 1934.1 While at Columbia, he was a member of the track team, demonstrating the athletic discipline that would later characterize his tireless work ethic in the operating room.1

Note: Columbia's athletics archives and the digitized Columbia Spectator newspaper may contain additional details about his track career.

New York University College of Medicine (1934–1937)

Howard earned his Doctor of Medicine (M.D.) degree from New York University College of Medicine in 1937, at the remarkably young age of 22.12 This accelerated timeline—completing both undergraduate and medical education in just seven years—reflected his exceptional academic abilities.

Surgical Training at Beth Israel Hospital, Boston (1937–1942)

After medical school, Howard moved to Boston for his surgical residency at Beth Israel Hospital, a major teaching affiliate of Harvard Medical School. He completed his residency from 1937 to 1942, a five-year period during which he began his research career.2

During his residency:

Career Timeline

Year Position/Achievement
1937–1942 Surgical Residency, Beth Israel Hospital, Boston
1939 Vitamin K research during residency
1942–1945 Full-time research (3 years post-residency)
1943 Initiated clinical use of venography
1945 Joined Harvard Medical School and Beth Israel Hospital as Instructor in Surgery
1946 Co-developed peritoneal dialysis technique
Early 1950s Helped build heart-lung machine at Beth Israel
1960 Implanted pacemaker in adult patient (second team in world)
Nov 10, 1960 Implanted first pacemaker in a child (Larry Graves)
1961 Published landmark pacemaker study in Annals of Surgery
1964 Published four-year pacemaker follow-up study
1972 Promoted to Clinical Professor of Surgery, Harvard Medical School
1977 Awarded U.S. Patent for pacemaker electrode design
~1990s Became Clinical Professor of Surgery Emeritus
2004 Died June 27, at home in Brookline, Massachusetts

Howard remained actively associated with Beth Israel Hospital and Harvard Medical School for 62 years of practice.1

The Pacemaker: A Revolution in Cardiac Care

Howard's most celebrated achievement was his central role in developing the implantable cardiac pacemaker, one of the most important medical innovations of the 20th century.

The Zoll Team at Beth Israel Hospital

The pacemaker was developed through an extraordinary interdisciplinary collaboration at Beth Israel Hospital. Dr. Paul M. Zoll (1911–1999), a Harvard cardiologist, conceived the idea and led the project. He assembled a team of specialists:67

Team Member Role
Paul M. Zoll, M.D. Cardiologist, project leader, conceived the pacemaker concept
Alan Belgard Chief electrical engineer; co-owner of Electrodyne Company (Norwood, MA)
Howard A. Frank, M.D. Thoracic surgeon; performed surgical implantations
Leona Norman Zarsky, M.D. Surgeon; directed the animal research laboratory
Arthur J. Linenthal, M.D. Cardiac pharmacologist and electrophysiologist

The Electrodyne Company, based in Norwood, Massachusetts, manufactured the pacemaker devices and related cardiac equipment. Their collaboration with Zoll produced chest surface pacemakers, cardiac monitors, defibrillators, and eventually the implantable pacemaker.8

Dr. Leona Norman Zarsky: A Remarkable Colleague

Dr. Leona Norman Zarsky (1923–2013) deserves special mention. She entered MIT at age 15, was one of only nine women in her class, and graduated in 1941. She earned her M.D. from Boston University School of Medicine in 1944 through an accelerated wartime program. At Beth Israel, she directed the animal research laboratory that was essential to pacemaker development.9

The Race to Implant

In the late 1950s, multiple teams worldwide were racing to create a self-contained, implantable pacemaker:

The Larry Graves Story

Larry Graves was born in Fairmont, West Virginia, and diagnosed with a ventricular septal defect at 22 months of age—a condition that carried a "sentence of death in early childhood."11

At age 8, Larry was brought to Boston for corrective surgery. Dr. Paul Zoll was consulted, and the surgical team—headed by Drs. Frank and Schuster—made medical history:

"The procedure was performed on 10 November 1960. Paul Zoll and his colleague, thoracic surgeon Howard Frank, had performed open-chest pacemaker placements on a total of only 3 adults."11

The operation succeeded. Larry Graves lived for nearly three more decades, undergoing 36 operative procedures—almost one for each year of his life. He died in Fort Myers, Florida, in 1989, at age 37.11

The Larry Graves case was published in the Texas Heart Institute Journal in 2016 as "On the Life of Larry Graves: The First Child Ever to Have a Totally Implanted Pacemaker."11

See also: Early pacemaker photographs from Howard's collection (patient eyes edited for anonymity).

The Surgical Technique

Howard and Zoll initially implanted the device via an open-chest procedure, attaching electrode leads directly to the heart's surface. This was before the development of transvenous (through-the-vein) lead placement that is standard today.

Over the following years, Howard helped refine the surgical insertion techniques, making the procedure safer and more reliable.12

Landmark Publications

The team documented their clinical experience in two landmark papers:

1961 Study:

1964 Four-Year Follow-up:

Peritoneal Dialysis: Saving Lives in 1946

Before the pacemaker, Howard made another life-saving contribution: helping develop peritoneal dialysis as a treatment for acute kidney failure.

The Research Team

In the mid-1940s, a group at Beth Israel Hospital was directed to find a method to treat renal failure under battlefield conditions. The team consisted of:15

All three were affiliated with the Surgical Research Department at Beth Israel Hospital and the Department of Surgery at Harvard Medical School.

The Innovation

The Seligman-Fine-Frank team developed a practical system for peritoneal dialysis that addressed several critical technical challenges:15

  1. Two-catheter system: Minimized obstruction during the outflow phase
  2. Large sterilized bottles: Prevented bacterial contamination of the peritoneum
  3. Modified dialysis solution: Adjusted to suit individual patient needs
  4. Optimized flow rates: Determined through experimental studies

The First Successful Treatment (1946)

In 1946, the team treated a patient suffering from acute renal failure induced by a sulfa drug overdose. Using their peritoneal dialysis system, they successfully cleared the toxins from the patient's blood. The patient recovered—one of the first documented survivals attributed to peritoneal dialysis.15

This achievement is recognized as "one of the primary milestones in the development of peritoneal dialysis."15

The 1946 Publications

The team published their findings in three major journals:

Publication Citation
Journal of Clinical Investigation Seligman AM, Frank HA, Fine J. "Treatment of experimental uremia by means of peritoneal irrigation." J Clin Invest 1946; 25:211
Annals of Surgery Fine J, Frank HA, Seligman AM. "The treatment of acute renal failure by peritoneal irrigation." Ann Surg 1946; 124:857
JAMA Frank HA, Seligman AM, Fine J. "Treatment of uremia after acute renal failure by peritoneal irrigation." JAMA 1946; 130:703-515

Later Contributions to Dialysis

Howard continued research in this area. A 1948 publication documented "Further experiences with peritoneal irrigation for acute renal failure" in the Annals of Surgery.16

Other Medical Innovations

Heart-Lung Machine Development (Early 1950s)

Before commercially manufactured heart-lung machines were available, Howard collaborated with biomedical engineers at Beth Israel to build a homemade pump-oxygenator device.1

Dr. John Gibbon's first successful heart-lung machine was used in 1953, and commercial models didn't become widely available until the late 1950s. Howard's team constructed their own device to enable early cardiac surgeries at Beth Israel Hospital, helping pave the way for open-heart procedures in Boston.1

Vitamin K Research (1939)

During his surgical residency in 1939, Howard participated in studies of newly synthesized vitamin K, helping demonstrate its effectiveness in treating blood-clotting disorders. This research had immediate clinical applications for patients with coagulation problems.1

Diagnostic Venography (1943)

In 1943, Howard was an early advocate for venography—injecting contrast dye into veins to visualize them on X-rays. This technique improved the detection of:1

At a time when diagnosing venous clots was extremely difficult, Howard's promotion of venographic imaging likely prevented pulmonary embolism complications in countless patients.

Research on Shock and Trauma

During World War II, Howard served as a researcher in the U.S. Office of Scientific Research and Development, contributing to studies on traumatic shock and hemorrhage management.1

He collaborated with his brother Edward and Dr. Jacob Fine on studies of the bacterial factors in traumatic shock, publishing findings in the Annals of the New York Academy of Sciences in 1952.16

This work included:

Patents

Howard's inventive spirit extended beyond surgical techniques to medical device design. In collaboration with Paul Zoll, he was awarded a U.S. patent for an improved pacemaker electrode:

U.S. Patent No. 4,058,128 — "Electrode"

Detail Information
Patent Number US4058128A
Title Electrode
Inventors Howard A. Frank, Paul M. Zoll
Filing Date August 26, 1976
Issue Date November 15, 1977
Assignee Individual (Frank and Zoll)
Status Expired (anticipated expiration November 15, 1994)

The Invention:

The patent describes a sutureless myocardial electrode designed for secure implantation in heart tissue without requiring stitches. Key features include:17

The invention addressed a critical problem: earlier electrode leads could become dislodged from the heart muscle, causing pacemaker failure. The barbed tip design provided more reliable anchoring with less tissue trauma.

International Filings:

The patent was filed in eight countries: United States, Germany, France, Australia, Japan, Canada, Netherlands, and Great Britain (1977–1978).17

Patent Link: Google Patents — US4058128A

Publications

Howard was a prolific author in the medical literature, publishing 128 scientific papers over his long career.2 His work appeared in prestigious journals including:

Selected Key Publications

Year Title Journal Co-Authors
1946 "Treatment of uremia after acute renal failure by peritoneal irrigation" JAMA 130:703-5 Seligman AM, Fine J
1946 "The treatment of acute renal failure by peritoneal irrigation" Ann Surg 124:857 Fine J, Seligman AM
1948 "Further experiences with peritoneal irrigation for acute renal failure" Ann Surg Seligman AM, Fine J
1952 "The bacterial factor in traumatic shock" Ann NY Acad Sci Fine J, et al.
1961 "Long-term electric stimulation of the heart for Stokes-Adams disease" Ann Surg 154:330-346 Zoll PM, Zarsky LR, Linenthal AJ, Belgard AH
1964 "Four-Year Experience with an Implanted Cardiac Pacemaker" Ann Surg 160:351-365 Zoll PM, Linenthal AJ

A search for Howard Frank's publications can be performed at:

Awards and Professional Memberships

Howard earned considerable recognition for his contributions to medicine:

Academic Appointments

Institution Position
Harvard Medical School Clinical Professor of Surgery (1972)
Harvard Medical School Clinical Professor of Surgery Emeritus
Beth Israel Hospital Attending Surgeon (62 years)

Professional Memberships

Memorial Fellowship

In lieu of flowers at his memorial, contributions were directed to:

The Howard A. Frank, M.D. and Edward D. Frank, M.D. Surgical Fellowship Fund Department of Surgery, Beth Israel Deaconess Medical Center18

This endowed fellowship honors both Howard and his brother Edward, who also had distinguished careers at Beth Israel.

Personal Life and Family

Marriage to Sally Bernkopf

Howard married Sally Anne Bernkopf (January 10, 1922 – April 18, 2015), and they remained married for 61 years until his death in 2004.1

The circumstances of their meeting are particularly noteworthy: Sally's father, Max Bernkopf, was a prominent Boston attorney who became Howard's patient. Following her graduation from Smith College, Sally married "her father's surgeon."19

The couple settled in Brookline, Massachusetts, where they raised three children and lived for the remainder of their lives.

Sally Bernkopf Frank: Her Own Distinguished Life

Sally was far more than a physician's wife:19

Sally's Distinguished Family

Max Bernkopf (Sally's father)

Abraham K. Cohen (Sally's maternal grandfather)

Selma Cohen Bernkopf (Sally's mother)

Children

Howard and Sally had three children:

Name Residence (at Howard's death) Notable Information
Anne F. Greene Middletown, Connecticut University Professor of English Emerita, Wesleyan University
Edward D. Frank II ("Wigs") Villanova, Pennsylvania —
John B. Frank Pasadena, California —

They also had five grandchildren at the time of Howard's death (2004) and six grandchildren at the time of Sally's death (2015).

Anne Frank Greene (1948–2025)

Howard's eldest child, Anne F. Greene, had a distinguished academic career:21

Howard's Siblings

Edward D. Frank, M.D. (brother)18

Charles Warren Frank, M.D. (brother)5

Jeanne Audrey Frank Bernkopf (sister)22

Legacy

Howard Alvin Frank's legacy endures in multiple fields of medicine:

Cardiac Pacing

The implantable pacemaker evolved from a radical experiment in 1960 to a routine, life-saving therapy. Today, over 1 million pacemakers are implanted worldwide each year. Every contemporary pacemaker—and related devices like implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices—traces its lineage to the groundwork laid by pioneers like Howard and Paul Zoll.

Conditions that were once fatal, like complete heart block (Stokes-Adams disease), are now readily managed with pacemaker therapy.

Dialysis

Howard's 1946 work on peritoneal dialysis helped establish renal replacement therapy as a field. The technique he helped pioneer is now a standard modality for chronic kidney disease management, enabling home-based dialysis that gives patients greater independence. Approximately 272,000 patients in the United States use peritoneal dialysis.

The Zoll-Frank Partnership as a Model

The collaboration between Zoll (cardiologist-inventor) and Frank (surgeon-engineer) is often cited as a model of interdisciplinary innovation in medicine. Their partnership demonstrated how breakthroughs emerge from the intersection of different specialties and disciplines.

Mentorship

Howard practiced surgery and taught younger physicians well into his 80s. Colleagues described him as humble, tireless, and always available to help. Neurosurgeon Jacob Rachlin recalled:2

"Even in Howard's later years, doctors coming up in training would flock to him… He was always available, the sweet grandfather figure and teacher."

The Fellowship Fund

The Howard A. Frank, M.D. and Edward D. Frank, M.D. Surgical Fellowship Fund at Beth Israel Deaconess Medical Center continues to support the training of surgeons, ensuring that Howard and Edward's commitment to surgical education lives on.18

Death

Howard Alvin Frank died on June 27, 2004, at his home in Brookline, Massachusetts, from complications of a stroke.1 He was 89 years old.

A memorial service was held at Levine Chapels in Brookline.

He was survived by his wife Sally, his three children (Anne, Edward, and John), five grandchildren, and his brother Charles (who died later that same year).1

References

Primary Sources

Additional Sources Consulted

Document Information

Field Value
Subject Howard Alvin Frank, M.D. (1914–2004)
Author Peter Frank (grandson)
Version 2.0
Last Updated December 28, 2025
Research Method Researched, compiled, and drafted using ChatGPT Deep Research and additional AI-based research agents, with human curation and editing. Sources include web search, archival materials, and medical literature.
Word Count ~5,500 words

Acknowledgments

This biography was compiled using extensive web research including medical journal archives (PubMed, JAMA Network), newspaper obituaries (Boston Globe, Hartford Courant, Harvard Gazette), patent databases (Google Patents), hospital archives (Mount Sinai/Beth Israel), and genealogical resources.

Special thanks to the archivists at the Arthur H. Aufses, Jr. MD Archives at Mount Sinai for preserving the history of Beth Israel Hospital and Louis J. Frank's tenure.

"He was always available, the sweet grandfather figure and teacher."

— Dr. Jacob Rachlin, remembering Howard A. Frank2

Footnotes

  1. Harvard Gazette. "Howard Frank, surgeon and inventor, dies." July 2004. https://news.harvard.edu/gazette/story/2004/07/harvard-gazette-howard-frank-surgeon-and-inventor-dies-2/ ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7 ↩8 ↩9 ↩10 ↩11 ↩12 ↩13 ↩14 ↩15

  2. Harvard Medical School Faculty of Arts and Sciences. "Memorial Minute: Dr. Howard A. Frank." https://fa.hms.harvard.edu/sites/g/files/omnuum4521/files/hmsofa/files/memorialminute_frank_howard_a.pdf ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  3. Mount Sinai Archives (Arthur H. Aufses, Jr. MD Archives). "Beth Israel Hospital History." https://archives.icahn.mssm.edu/?s=%22beth+israel%22 ↩ ↩2 ↩3 ↩4 ↩5

  4. Mount Sinai Archives. "Beth Israel & the 1918 Epidemic." https://archives.icahn.mssm.edu/mount-sinai-beth-israel-1918-influenza-pandemic/ ↩ ↩2 ↩3

  5. Hartford Courant. "Charles Warren Frank Obituary." November 13, 2004. https://www.courant.com/obituaries/charles-warren-frank-west-hartford-and-florida-ct/ ↩ ↩2

  6. Wikipedia. "Paul Zoll." https://en.wikipedia.org/wiki/Paul_Zoll ↩ ↩2

  7. Pharmaceutical Intelligence. "Paul Zoll, MD: Originator of Modern Electrocardiac Therapy – A Biography by Stafford Cohen, MD, BIDMC." October 16, 2014. https://pharmaceuticalintelligence.com/2014/10/16/paul-zoll-md-originator-of-modern-electrocardiac-therapy-a-biography-by-stafford-cohen-md-bidmc/ ↩

  8. Wood Library-Museum of Anesthesiology. "Electrodyne Defibrillator-Pacemaker." https://www.woodlibrarymuseum.org/museum/electrodyne-defibrillator-pacemaker/ ↩

  9. Legacy.com. "Leona Zarsky Obituary." February 2013. https://www.legacy.com/obituaries/wickedlocal-newton/obituary.aspx?n=leona-zarsky&pid=163232999 ↩

  10. American Heart Association. "Cardiac Pacing, 1960–1985." Circulation 1998; 97:1978. https://www.ahajournals.org/doi/10.1161/01.CIR.97.19.1978 ↩

  11. Weisse AB. "On the Life of Larry Graves: The First Child Ever to Have a Totally Implanted Pacemaker." Texas Heart Institute Journal 2016; 43(1):7-10. PMCID: PMC4810591. https://pmc.ncbi.nlm.nih.gov/articles/PMC4810591/ ↩ ↩2 ↩3 ↩4 ↩5

  12. Sun Sentinel. "Dr. Howard Frank, 89, Helped Develop Pacemaker." July 6, 2004. https://www.sun-sentinel.com/news/fl-xpm-2004-07-06-0407050214-story.html ↩

  13. Zoll PM, Frank HA, Zarsky LR, Linenthal AJ, Belgard AH. "Long-term electric stimulation of the heart for Stokes-Adams disease." Annals of Surgery 1961; 154(3):330-346. PMID: 13788754. https://pubmed.ncbi.nlm.nih.gov/13788754/ ↩

  14. Zoll PM, Frank HA, Linenthal AJ. "Four-Year Experience with an Implanted Cardiac Pacemaker." Annals of Surgery 1964; 160(3):351-365. PMID: 14206844. https://pubmed.ncbi.nlm.nih.gov/14206844/ ↩

  15. Advances in Peritoneal Dialysis. "Milestones in the History of Peritoneal Dialysis." 1988. https://www.advancesinpd.com/adv88/pt1milstones88.html ↩ ↩2 ↩3 ↩4 ↩5

  16. Fine J, et al. "The bacterial factor in traumatic shock." Annals of the New York Academy of Sciences 1952. https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1952.tb26558.x ↩ ↩2

  17. U.S. Patent 4,058,128. "Electrode." Inventors: Howard A. Frank, Paul M. Zoll. Issued November 15, 1977. https://patents.google.com/patent/US4058128A ↩ ↩2

  18. Legacy.com. "Edward Frank Obituary." Boston Globe, April 2004. https://www.legacy.com/us/obituaries/bostonglobe/name/edward-frank-obituary?id=27171307 ↩ ↩2 ↩3

  19. Dignity Memorial. "Sally Frank Obituary." April 2015. https://www.dignitymemorial.com/obituaries/boston-ma/sally-frank-6408712 ↩ ↩2

  20. Wikipedia. "List of first minority male lawyers and judges in Massachusetts." https://en.wikipedia.org/wiki/List_of_first_minority_male_lawyers_and_judges_in_Massachusetts ↩

  21. Legacy.com. "Anne Greene Obituary." Boston Globe, May 2025. https://www.legacy.com/us/obituaries/bostonglobe/name/anne-greene-obituary?id=58426214 ↩

  22. Dartmouth Alumni Magazine. "Class Notes 1949." May 1976. https://archive.dartmouthalumnimagazine.com/article/1976/5/1/1949 ↩