PAST EVENTS: Participants in the 5th International Conference on Rare and Undiagnosed Diseases

Participants in the 5th International Conference on Rare and Undiagnosed Diseases (Karolinska Institutet Stockholm, Sweden August 30-31, 2017) Enjoy Dinner with Dr. Margareta Bottiger and Family at Gransäter in the Swedish Archipelago

Those UDNI participants lucky enough to board the boat and snake through the archipelago east of Stockholm were recipients of a treat.  The passing scenery had a mellow beauty, reminiscent of the Adirondacks or Northern Minnesota, many noted. About forty five minutes after departing the dock in Stockholm, we disembarked on a rocky prominence on a peninsula, necessitating a short but steep climb. (Photo 1: Steep but short climb to Gransater on the rocky peninsula)

We had arrived at the stunning family home of the Böttigers, depicted in the book, Gransater: A Summer house Tells (Gransäter - ett sommarhus berättar) by Lars Erik Bo?ttiger. This book notes that “Gransäter at Baggensfjärden was built in the 1880s as a summer break for John and Hildegard Böttiger and with Agi Lindegren as an architect. The building is part of the tradition that began with the 18th century antique-style villas.” We were there as guests of Helene and Mikk Cederroth.

A natural garden area just to the side of the house provided a perfect environment to witness the setting sun and distant shoreline. Helene Cedderoth’s cousin, Disa Böttiger, DVM, who is a veterinarian and scientist, currently spends time at Gransäter with her ninety year-old mother, Dr. Margareta Böttiger (who is Helene Cederroth’s aunt). More on her in a moment. As we gathered around, sipping champagne, standing on a natural rock podium adorned with lingonberry plants, (I mistakenly identified them as pyracantha plants but the low shrub growing habit not typical of pyracantha puzzled me) Disa told us a bit about the home. (Photo 2: Disa Bottiger, DVM, welcomes the UDNI attendees to Gransater)

She was assisted in her efforts by a friendly dog christened Aston, described as the “best mistake ever” and who would probably require more genetic expertise than was even available that evening to define her breed beyond just really loveable and infused with hybrid vigor. The edifice has served as a summer villa and family gathering place for the Böttiger family for over a century. (Photo 3: Gransater)

The Crown Princess Margareta helped design the still preserved gardens. Lars Erik Böttiger, MD, husband of Margareta (not to be confused with the Crown Princess just mentioned), was a Professor of Medicine at Karolinska Institutet. He died in 2009 and is well known for his persistent battle to change the name of the medical journal Acta Medica Scandinavica, founded in 1919, to the Journal of Internal Medicine. Reaching beyond the Scandinavian shores, as Editor-in-Chief, he accepted world-wide submissions and enhanced the international stature of the journal. A well-known Swedish author, PC Jersild, was an author of thirty-five books and a physician, who frequently consulted with Dr. Lars Erik Böttiger regarding forensic and medical issues depicted in Jersild’s novels. 

Helene spent some of her childhood summers at Gransäter. Though she chose not to become a physician, many of her relatives including her grandfather, many of her cousins, and great aunt did become physicians. Margareta Böttiger, MD, PhD, who now lives at Gransäter, age 90 when we were there, played a seminal role in the public health awareness and science of the polio vaccine in Sweden, Eastern Europe and Africa. A colleague of Jonas Salk, she was also a physician-scientist-epidemiologist who was one of the public health pioneers in the early days of the AIDS epidemic in Europe, before the role of the HIV virus in this disease was fully understood.

Just before dinner, standing outside with Mikk Cederroth and Dr. Böttiger, I asked her if she were famous?  (Photo 4: Margareta Bottiger, MD, Phd)

She demurred, but Mikk quickly said yes, having been surprised himself by how much of her career he had discovered depicted on the internet. “Just today I was looking up one thing and found so much more”, he noted.  I had a notebook with me which she agreed to autograph. Dr. Böttiger was Sweden’s state epidemiologist from 1986-1993. For her pioneering and distinguished work in promoting public awareness of the HIV epidemic she was the inaugural recipient of the Gold Field Award from the National Association of Noah’s Ark in Sweden. 

My fortune to sit with her at dinner was not to be, but I did speak with Lisa Schimmenti, MD, Dr. John Philips from Vanderbilt, who, among others, shared dinner with Dr. Böttiger. I did have a stellar culinary experience with some Japanese, German, and American scientists. Lisa recalled that Dr. Böttiger spoke a lot about her work on the polio vaccine, which is how she became friends with Jonas Salk. She completed her PhD in 2005 at the age of 78 and was appointed to the faculty at the Karolinska. In 1957, she had been appointed to the State's Bacteriological Laboratory (SBL). Her dissertation was Studies on immunization with inactivated and live polio vaccines. A robust 149 publications she penned, the last of which was published in Nature. Dr. Schimmenti said of her evening and dinner companion, “that she was a bright, energetic engaging woman who told us stories of her work in Africa and Eastern Europe and her efforts to gain public acceptance of life-saving vaccines.” In 2012, Simon Johansson of Uppsala University completed a Master’s thesis based on archiving her work. “Owing to the uniqueness of the material, this study has focused on the properties of the archive as a working-life archive,” Johansson reported.

Her work on the polio vaccine – she was an advocate of the inactivated polio vaccine – was so admired she began to focus on the epidemiology of infectious illness and spearheaded childhood vaccination programs in Sweden and throughout Eastern Europe. From this platform, her international stature blossomed as she played a seminal role in public health and the HIV epidemic.  William Foege, MD, former director of the National Centers for Disease Control, lamented that he had never met Dr. Bo?ttiger but immediately recalled her name and noted she was a “legend.” (Personal communication 22 September 2017)

In addition to her many professional accomplishments, Dr. Böttiger discussed with those at the table the history of the estate. She advised that Gransäter was built in 1886 and 1887 but had fallen into disrepair and had required extensive renovation to its roof and ceilings. She and her family had decided that it was an essential tie to their parents and other relatives so the formidable repairs were undertaken. Heating was an important issue and this was addressed in an innovative way which involved drawing frigid water from the bottom of the surrounding sea and taking advantage of the difference in its still-less-cold-temperature than that of the air. One could derive a correlation between the home and the family. Both have long traditions.  Both are examples of the best of architecture, hospitality, and humanity. Both have survived trials of difficult times.

The home is a nostalgic example of bygone times and it has been used in filming seven movies including the Girl with the Dragon Tattoo. Dr. Margareta Böttiger has three daughters who are physicians and work at the Karolinska, and her niece Helene Cederroth (and Helene’s husband Mikk) have fostered improvement in the care and treatment of children and adults with undiagnosed diseases throughout the world. “It was an honor to spend an evening with Dr. Böttiger and her family at Gransäter,” noted Dr. John Phillips.

The dinner was superb, with multiple wine varietals, reindeer calf with shallots, cloudberry sauce, and almond potato puree. The menu was printed and included a Snaps song, a traditional Swedish toast with Skane Akavit, spirits spiced with fennel, caraway and anise. The beer chosen was paradoxically named Stockholm Syndrome Red Ale, although none of us felt captive and we were quite enamored of our hosts. Brief tours of the home were conducted, with attention to the exquisite handcrafted furniture. Definitely nothing from IKEA was adorning the premises. Some artwork from Gransäter’s royal visitors hung on the second floor overlooking the stairwell. The exuberant merriment and international conviviality eventually came to an end. Participants, aided by small lights given to each and all by our hosts, ambled several kilometers down a dirt road into the wooded darkness. A light rain kept us company. (Photo 5: Waiting on the busses in the gentle Swedish rain at clearing in the woods)

Several buses appeared out of nowhere and plucked us out of a clearing in the forest and soon delivered us to our hotel. The evening was magical and is unlikely the UDNI members will ever see the likes of such an event again. 

Here is PubMed link to some of Dr. Margareta Böttiger work:

Vaccine safety. Analysis of oral polio vaccine CHAT stocks.

Berry N, Davis C, Jenkins A, Wood D, Minor P, Schild G, Bottiger M, Holmes H, Almond N.

Nature. 2001 Apr 26; 410(6832):1046-7. No abstract available.