| Departments — Endnotes | Spring 2008 |
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Sistine Scalpel I had barely begun my own clinical practice, yet there I was, facing terrible obstacles: The hospital anesthesiologist was unavailable, the nurse anesthetist didn’t know how to intubate, and the only vascular instrument available was a Harken clamp. Fearing the patient was near death, I plunged two needles into the poor man’s veins, set up a liter of saline, administered anectine and pentothal, and intubated him. Then I grabbed some vascular sutures from my car and proceeded to operate with the help of an elderly general practitioner. Except for having to open the abdomen with scissors because the nurse had dropped the scalpel on the floor, everything went well. It was a lucky save. After bringing the good news to the anxious family, I had the chance to review the case with my assistant. “Great job!” he said. “I thought the young fellow was a goner. You remind me of a surgeon who came here more than 30 years ago. His nurse couldn’t find the scalpel, so he opened everything with scissors. We copied him for 20 years until someone told us it had been a mistake. His name was Dan Jones. What a magnificent individual. A good-looking fellow, too.” Daniel Fiske Jones, Class of 1896, was indeed magnificent, a primordial giant from the mythical past. A brilliant surgeon, he knew how to make an entrance: He visited local hospitals in a chauffeured Pierce-Arrow, often followed by another large chariot carrying his scrub nurses and other assistants. “Handsome Dan,” as he was called, interned at Massachusetts General Hospital and then became a surgical apprentice to the legendary Maurice Richardson, Class of 1877. Jones’s rise was meteoric. For eight months during World War I he served as chief surgeon of the Harvard Surgical Unit in France. At MGH he became chief of the fracture service, an attending in the vascular clinic, the surgeon in charge of colon and rectal tumors, and finally, in the late 1920s, chief of one of the surgical services. By the time Jones died in 1937, he was considered one of the nation’s most important surgeons. It isn’t easy to pinpoint what made him so revered. Certainly everyone cites his technical ability and his passion for curing colon cancer. But the best insight I could find came from a speech Jones delivered in 1927 as president of the New England Surgical Society. “It is my conception of the surgeon,” he declared, “that he is the final and supreme authority.” Perhaps it was Jones’s confidence that cast such a mythical light. If so, he was not alone. When I started my internship fifty years ago, our chief, Edward Churchill ’20, could easily have been compared to Zeus. With an ethereal demeanor, he rose above mundane problems to recognize greater truths. He, like Zeus, forged an uneasy truce with the men of godlike stature who surrounded him. And how did the legendary Oliver Cope ’28 fit into this schema? Some say he already thought of himself as God, so perhaps that sufficed. Surgeons have long celebrated a culture of heroism. My fellow residents and I fancied ourselves a band of warriors fighting off disease, rising to heights of grandeur with magnificent saves and a virtuosity that few other professions could claim. Such reverence for the surgeon’s exalted position seems to have changed little in subsequent decades. For several years after my retirement, I taught second-year medical students physical diagnosis at MGH. One morning, a student reported on a vascular patient. After reviewing the patient’s many physical ailments, she mentioned an additional finding: the patient thought his surgeon, Glenn LaMuraglia ’79, was St. Michael and the surgeon-in-chief, W. Gerald Austen ’55, was God. I interviewed the patient and confirmed the student’s findings. Strangely, the official chart didn’t mention the patient’s delusions. Perhaps, I thought, the surgical resident had simply found nothing unusual in the patient’s declarations. From his perch on Mount Olympus, Jones was likely smiling. Anthony S. Patton ’58 is a retired thoracic and vascular surgeon whose career was centered at Salem Hospital in Massachusetts. Photo: Daniel Fiske Jones, Class of 1896 Photo: Massachusetts General Hospital Archives and Special Collections |
There I found a young man writhing in agony. A forklift had pinned him against a concrete wall, crushing his abdomen. His shock was extreme. His pulse was thready and fast, his blood pressure faint, and his belly rigid. He was cyanotic and had no sensation from the waist down.
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