Surgery: The Best Hope of All

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from the rest of medical science has been closed for good. Gone is the era of the "great man" in surgery, dominated by the European Geheimrat system. The great man seldom saw the patient before an operation. He arrived early at the hospital, scrubbed up and donned a gown that left a length of striped pants showing below. He operated swiftly, with never an unnecessary stroke of the scalpel or a needless word to his assistants and nurses.

Usually, when he had cut out what had to be cut out, he departed, and left an assistant to close the surgical wound. If he ever saw the patient again, it would be on "grand rounds," when he would expatiate on the case loudly and authoritatively to surgeons in training.

European medicine and surgery, for all their shortcomings, were still the world's best until the 1930s. and an American who aspired to greatness in surgery went to Europe for training. The U.S. remained a medical outpost. Its own great man was Johns Hopkins University's William S. Halsted (1852-1922), who nurtured a frontiersman's egalitarian ideas: residents in surgery (M.D.s who have finished their internship and are in specialist training) should be encouraged to use both their hands and their heads. The most brilliant product of Halsted's revolutionary residency system was the great brain surgeon

Harvey Gushing, who was named the Brigham's first surgeon in chief in 1912.

Direct Action. Though the first tentative beginnings of the courtship between surgery and medicine can be traced back to Cushing's work on the pituitary, no man has done more to effect the marriage than Dr. Francis Daniels Moore, 49, and few have done nearly so much. When Gushing retired from the Brigham in 1932, Moore was still a Harvard undergraduate, fascinated by anthropology. At the end of his junior year, he switched to medicine, and four years later to surgery. By then Frannie Moore's personality was emerging, and he has no difficulty in explaining his choice of specialty: he likes direct action, and it seemed to him that of all the doctors the surgeon was the one who acted most directly for the patient and had the most intimate contact with him.

Three days after he got his B.A. (cum laude) in 1935, Moore married Laura Benton Bartlett, a childhood friend from Winnetka, 111. They settled in Brookline, where they have raised a family of five. Moore got his M.D. (cum laude) in 1939. It was an exciting time in surgery. New theories, new techniques were being developed. Daring decisions were being made. American surgery was poised to leap ahead as Europe's medical centers lost some of their best brains to Hitler's anti-Semitism and to World War II.

Preparing himself to be a leader in the American advance, Francis Moore went straight into a nine-year progression through intern, resident, and assistant in surgery at Massachusetts General Hospital. There, in 1942, he was one of the surgeons who treated survivors of the Cocoanut Grove nightclub fire. That holocaust, in which 500 died, emphasized surgery's need to know far more about a burn victim than the state of his skin grafts—to know what is happening to his emotions and to a dozen of his body chemicals.

Heavy Water. With Dr. Oliver Cope, then his chief, Moore studied the anemia of bum victims and their liability to blood clotting in their