photo #8905055

She was denied surgical training because she was a woman. So she studied dead children—and discovered a disease that was killing thousands. New York, 1935. The morgue in the basement of the Babies Hospital was cold, smelling of formaldehyde and stale tobacco. Dr. Dorothy Andersen stood over the tiny body of a three-year-old girl. The chart read “Celiac Disease”—a common diagnosis for children who couldn’t digest food, wasted away, and died. Doctors prescribed banana diets and hoped for the best. Most of the children died anyway. But Andersen wasn’t satisfied. She had seen too many cases of “Celiac Disease” that didn’t make sense. These children were starving despite voracious appetites. They ate constantly but wasted away, with distended bellies and skeletal bodies. And their lungs—always the lungs—were clogged with thick, sticky mucus. Celiac disease never did this. Andersen picked up the scalpel, lit another cigarette, and made the first cut. She wasn’t looking for what the textbooks said she should find. She was looking for the truth that had killed this little girl. Dorothy Andersen was an outsider from the start. Brilliant and ambitious, she had applied for a surgical residency after medical school. She was rejected—not for lack of skill, but because she was a woman. Surgery was for men. Women could study the dead. So Andersen became a pathologist. She wore hiking boots instead of heels. Built her own furniture. Hosted loud parties in her lab. Smoked constantly during autopsies and never apologized for taking up space in a profession that didn’t want her. Now, relegated to a basement full of dead children, she was determined to save the living. She opened the abdomen of the three-year-old girl and found the pancreas. It shouldn’t have looked like that. Instead of soft, healthy tissue, the organ was full of cysts and scar tissue. Hard. Fibrous. Completely destroyed. The ducts that should have delivered digestive enzymes to the intestines were completely blocked. This girl hadn’t died of celiac disease. She had starved because her body couldn’t absorb a single nutrient—no matter how much she ate. Her pancreas couldn’t produce the enzymes needed to digest food. Andersen stared at the ruined organ and realized: this wasn’t rare. It was everywhere. She pulled the charts of nearly fifty children who had died with a “Celiac Disease” diagnosis. She spent nights in the archives, cross-referencing autopsy reports, looking for the pattern she suspected was there. And there it was: scarred pancreas. Thick lung mucus. The same constellation of destruction, child after child after child. It wasn’t celiac disease. It was something completely different—a distinct, unmapped disease hiding in plain sight, killing children while doctors blamed the wrong culprit. She called it “Cystic Fibrosis of the Pancreas.” But identifying the enemy was only the first step. These children were dying in pediatric wards across the country, misdiagnosed and mistreated. Andersen needed a way to diagnose them before they ended up on her autopsy table. She needed a test. She developed a method to extract duodenal fluid—liquid from the small intestine—to measure pancreatic enzymes. It was exhausting and invasive, requiring a tube down a child’s throat into their digestive tract. But it worked. For the first time, doctors could distinguish between celiac disease and cystic fibrosis. They could identify CF patients while still alive. They could begin treatment. Andersen wasn’t finished. In the brutal heat of summer 1948, she noticed something strange: her CF patients were collapsing from heatstroke at alarming rates. She and her colleague, Dr. Paul di Sant’Agnese, investigated. They discovered that these children were losing dangerous amounts of salt in their sweat—far more than healthy children. This observation led to the “sweat test”—a simple, noninvasive diagnostic tool where a small patch of skin is stimulated to sweat and the salt content is measured.