Hobbies of Great Surgeons AID IN LIFE-SAVING MARVELS (Nov, 1933)

I think if this kid showed up at my house I would have been a bit frightened of him:

Consider, for example, the start of the famous New York plastic surgeon, Dr. H. Lyons Hunt. When he was six years old, he told me, he used to fill his mother’s shopping bag with knives from the kitchen and make the rounds of the neighbors on his velocipede. At each house, he would ring the doorbell and gravely announce: “Dr. Hunt is ready to operate.”

Of course today, they could just play video games.

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Hobbies of Great Surgeons AID IN LIFE-SAVING MARVELS

Workshops, Music, Art, And Sports Keep Nerves Keen and Fingers Nimble

By Frederic Damrau, M.D.

IN A recent series of articles in Popular Science Monthly, I told of the marvels of modern surgery and described some of the miracles of the operating room. Since then, scores of readers have written me, asking for facts about famous surgeons and how they fit themselves for their life-work.

How do they get into surgery? How do they keep fit for the nerve strain of the operating room? How do they develop their amazing, life-saving skill? These are the most common questions.

To find out, I talked with famous eastern surgeons and corresponded with others in all parts of the country. The result is a collection of fascinating, human-interest facts about men whose names are synonymous with surgical skill.

Consider, for example, the start of the famous New York plastic surgeon, Dr. H. Lyons Hunt. When he was six years old, he told me, he used to fill his mother’s shopping bag with knives from the kitchen and make the rounds of the neighbors on his velocipede. At each house, he would ring the doorbell and gravely announce: “Dr. Hunt is ready to operate.”

Before he was out of grade school, he was performing real operations—on frogs. When he found that the abdominal organs were covered with membrane, he thought he had made an original scientific discovery. He entered medical school at fourteen and was graduated at nineteen.

From the beginning, his one absorbing interest was the human face. He read every book on physiognomy he could find. He spent hours at the art galleries studying sculptured heads. He concentrated upon mastering the complex network of muscles in the face and neck, a network which comprises one fourth of all the muscles in the body. He practiced molding faces in plaster and clay. Today he molds them in living flesh as one of the world’s greatest plastic surgeons.

Before every operation, he goes over an unretouched, lifesize photograph of the patient. On it, he makes notes, diagrams, measurements. He visualizes every step in the operation and its effect upon the future appearance of the patient. By scientifically working out every detail, he achieves his brilliant results.

I know another surgeon, a famous eye specialist, who, as a boy, was fascinated by eyes just as Dr. Hunt was fascinated by faces. He told me once that he used to make regular trips to the local butcher shop to get pigs’ eyes which the butcher saved for him. He would carry them home and spend hours studying and dissecting them. Even today, before a particularly difficult operation, he will practice it on a pig’s eye, which is remarkably like the eye of a human.

Another New York surgeon, Dr. Ar- thur Stein, recalls a kind-hearted lady who visited his parents when he was eight years old. She asked him: “Arthur, what are you going to be when you become a man?”

“A doctor,” was his prompt reply.

“But why?”

“Because I want to drive a horse and buggy.”

Today he is a doctor and a famous surgeon besides. But he doesn’t own a horse and buggy. Instead, he rides around in a limousine driven by a chauffeur. By the time he achieved his ambition, horses and buggies were out of date and the automobile had come to stay.

For a doctor doesn’t graduate from medical college and begin practicing surgery at once. He doesn’t become an expert over night. He must first spend a number of years in general practice. Then he has to devote two or three years to intensive study of surgical technique under a recognized master.

One man, who has since become a noted surgeon, conducted a humble practice on the East Side in New York City for twelve years before he ventured to use a knife on anything more serious than a boil. Then he spent two years at various surgical clinics, assisting at operations and studying the methods of the masters. He came back a full-fledged surgeon and I have seen him perform amazing feats in the operating room.

The recognized surgeon cannot be a young man. It takes him too many years to prepare for his work. In fact the American College of Surgeons will confer its degree only upon doctors who have been in practice for eight years or more.

On the other hand, the life of the surgeon is notoriously short. The strain of operating daily under great nervous tension is so wearing that many surgeons have died of heart disease in their fifties. Recently, Dr. William J. Mayo lamented the fact that so many of his professional friends had died before reaching sixty.

Only a few weeks ago, I had occasion to note the terrific strain under which a surgeon sometimes works. I had been invited to watch one of my colleagues perform a difficult brain operation. The patient was an important business man. There was grave doubt as to whether he would recover.

Throughout the operation, the surgeon was outwardly calm. There were several minor mishaps that could not be avoided, but he did not lose his temper. I knew he was a man of iron nerve and tremendous self-control because I had played golf with him and had never seen his even disposition disturbed.

But when the strain was over, he was almost in a state of collapse. He trembled as if he had been through the third degree. I had to hold his glass for him while he drank ice water and later he asked me to drive him home because he was afraid to handle his own car.

People who think that surgeons are cold-blooded creatures, unaware that human life depends upon their skill, are mistaken. It is their keen realization that a single slip of the knife may mean death to the patient that adds to the tension. Again there are sudden emergencies for which the surgeon must be prepared.

A dramatic instance of this kind occurred recently in France. Bleeding internally and near the point of death, a woman was brought to the Rothschild Hospital in Paris. Only an immediate blood transfusion would save her life. When all those present were tested, it was found that only the blood of the chief surgeon matched the patient’s and could be used. Without hesitation, the doctor drained blood from his own veins for the transfusion. Then he operated upon the patient and saved her life!

To be prepared for such emergencies as well as for the constant strain of the operating room, surgeons train like athletes to keep physically fit. They regulate their diet and their hours of sleep. A majority of them are total abstainers from alcohol. Many avoid the use of tobacco entirely. Some do not even touch coffee or tea. And all are particularly careful to obtain a good night’s sleep.

“A tired surgeon is a poor risk for any patient.”

That is an epigram of the New York specialist, Dr. Abraham Wolbarst. He makes it a point to spend the evening before a heavy day in the operating room reading light fiction or a detective story to relax his mind. Dr. H. W. E. Walther, noted New Orleans surgeon, obtains the same result by going over his collection of Japanese swords and prints. Dr. Morris Levine, who has achieved results bordering upon the miraculous in his treatment of ”hopeless” mastoid cases, lies on a couch and prays for divine assistance before every operation. Dr. H. Lyons Hunt doses himself in his room and takes a refreshing nap of five or ten minutes before he begins his work. But the most curious preparation of all is made by another New York specialist. He always spends the evening before an operation at the movies. But he doesn’t go to see the show. He sits in the theater, where he will be quiet and undisturbed, and goes over in his mind each step of the operation.

During the World War, I was fortunate enough to serve in the Medical Corps of the Army under Dr. K. Winfield Ney, one of the great brain surgeons. Only a few months ago, Dr. Ney demonstrated a remarkable new operation for the cure of epilepsy. (P.S.M. May ’33, p. 24.) A direct descendant of Napoleon’s great general, Marshal Ney, he was left an orphan at the age of nine and educated himself, working his way through college. He has iron control of himself and has disciplined his nerves to stand terrific strains. During the hectic days when the American divisions were making their famous drives at Chateau-Thierry and in the Argonne, Dr. Ney spent sixteen out of the twenty-four hours in the operating room and often performed as many as thirty or forty operations a day! And one brain operation takes more out of a surgeon than a number of abdominal ones.

To keep fit, he regulates his life like clockwork. He rises at eight and is never known to be late at the hospital. His morning is spent in operating; his afternoon in seeing patients and studying their conditions. Then he takes an hour’s nap before dinner. The evening is passed in playing chess, bridge, or seeing a serious play. Four hours, from eleven at night to three in the morning, are devoted to reading and writing scientific literature. He has found that he is at his best on six hours’ sleep; five at night, from three to eight, and one hour during the day. More sleep impairs his concentration.

Doing fine work with his hands is second nature to Dr. Ney, his mother having been an artist and his father an inventor. When he was twenty, he was an expert on gems. Handling precious stones and designing their mountings helped to develop in his fingers the fine mechanical sense required for delicate operations.

Because it demands a coordination of rapid movements, Dr. Ney practices trap shooting during much of his spare time. Also he trains his fingers for hours at a time by modeling clay, carving wood, and practicing sculpture. In addition, he finds relaxation in working with woods and tools in his home workshop.

But like all surgeons, he is particularly careful, in doing such work, not to injure his hands and fingers. Every cut or blister is a possible source of infection and must be guarded against. One of the prime features of a surgeon’s program of keeping fit is the care of the hands.

To keep the balls of his fingers pliable and sensitive, one noted surgeon in the middle west tells me he always wears leather gloves when he goes fishing. Another was forced to give up baseball because the sport was hardening his hands. Hangnails are particularly dreaded and special care is taken in manicuring the fingers. Dr. Hunt, for instance, since 1902, has never allowed anyone to cut his nails for him. In that year he saw six patients die from infection when a surgeon friend of his developed a hangnail after a manicure. Pus gathered under the broken skin without his knowledge and only after the patients had died did he discover the source of the infection.

In winter, most surgeons wear fur-lined gloves and take special precautions against chapped hands. They rub glycerin or imported coconut oil into the skin every night. In addition, they are careful of the soap they use, choosing only bland varieties which do not contain harsh ingredients.

The “scrubbing up,” which is part of the preparation for every operation, is particularly hard on the hands. As a first step in sterilizing his hands, to prevent the danger of contaminating the open wound, the surgeon washes with soft soap in a stream of running hot water. Using sterilized gauze pads and hand brushes, he goes over his fingers again and again. Then, he trims his nails short and carefully smooths them down. Finally, he immerses both hands in a strong solution of alcohol for two minutes.

After all these preparations are completed, the hands are dried with a sterile towel, powdered, and slipped into sterilized rubber gloves. Thus even if a glove tears during an operation, the surgeon’s hand will carry no germs of infection into the wound.

It can be easily understood how such a process of “scrubbing up,” carried on day after day, results in irritation to the skin. One famous New York specialist has had to quit operating for weeks and months at a time because of hypersensitive skin. But in spite of this handicap, he has attained national recognition by his work.

Frequently, surgeons must fight some handicap that lies in their way. One of my surgeon friends, for example, is nearsighted. Another is lefthanded. Another, a noted eye specialist, had to battle against a trembling of the hand due to nervous tension during operations. He took up golf and credits it with having given him the poise and self-control he needed for his professional work.

Curiously enough, what would appear to be the worst handicap in the world for a surgeon has actually been an aid to the career of another eastern specialist. Imagine a surgeon fainting at the sight of blood! That is what this doctor did repeatedly during his freshman year at medical school. He still has a horror of hemorrhage. However, this very fact has led him to devise special methods to control bleeding. As a result, his operations are practically bloodless and the conserving of the patients’ life-stream in this way contributes largely to their rapid recovery.

Almost all surgeons are constantly seeking to increase the skill of their hands and their ability to coordinate brain and muscle. One surgeon of my acquaintance took up etching as an aid to developing more delicate control over his fingers. Several whom I know learned to play the violin in order to increase the nimbleness of their hands. Again, Dr. Forbes Hawkes, noted for his remarkable operations upon the kidney, learned to play the piano as training for his fingers although he did not care for it as a musical instrument.

In fact, so far as the hands are concerned, there are many points in common between the pianist and the surgeon. The active hands of a Paderewski would have no difficulty in tying a row of stitches rapidly and unerringly.

To perfect himself in this phase of his work, one Brooklyn, N.Y., surgeon reports he spends part of each evening tying knots in strings around a bedpost. In the operating room, he is noted for the speed with which he ties stitches in closing a wound.

Fencing is the method used by another surgeon to keep his eyes and muscles in perfect coordination. In addition, he plays musical instruments that require the use of both hands. For, whereas the average craftsman is skillful with either his right or his left hand, the surgeon must have a high degree of dexterity in both hands. In fact, most of the masters of the operating room are ambidexterous, equally at home when using either hand. I have seen famous surgeons working first with one hand and then with the other, according to which one gave them the best conditions for cutting or sewing during an operation.

Performing operations upon animals for scientific research, is another method by which the surgeon trains his hands to perform delicate tasks. In this work, the experimenter is often dealing with tiny glands and the slightest slip upsets the whole experiment. It is interesting to note that it was through such an experiment that Dr. Frederick Banting, of Toronto, Canada, discovered insulin, the gland extract which has aided thousands of sufferers from diabetes. This discovery by the Canadian experimenter is rated as one of the greatest made in the field of medicine.

Dr. Harry Koster, noted Brooklyn, N. Y., surgeon, is another who carries on experimental work on animals almost continually. He finds it the best preparation he can make for delicate operations upon suffering patients in the hospital.

In recent years, the life-saving record of surgery has been climbing steadily. More than a million operations a year are performed in the United States alone. And the loss of life is notably small. Much of the credit for this remarkable record must go to the infinite pains with which the surgeon prepares for his work and the unceasing efforts with which he seeks to increase his skill and technique.

2 comments
  1. Hirudinea says: March 7, 20139:04 am

    What, no charcuterie?

  2. MySoulWanders says: March 8, 20138:24 am

    Of Course if young want to be Dr. H. Lyons Hunt went door to door offering his Dr services with a bag of knives in tow. Would be arrested and convicted of and then probably dopped up on Ritalin.

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