Surgery: The Best Hope of All

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(21,000 in the U.S.), but by latest estimate, nearly half of the nation's 90,000 family doctors engage in what they call "minor surgery." Some go on to intermediate or even major surgery, though the A.C.S. insists that "there is no such thing as minor surgery—there are only minor surgeons."

Good v. Great. Given the proper training, most surgeons are competent. Many are extremely good, and a few are great. What makes the difference? "To be great." says the Cleveland Clinic's Dr. Donald B. Effler. "a surgeon must have a fierce determination to be the leader in his field. He must have a driving ego, a hunger beyond money. He must have a passion for perfectionism. He is like the actor who wants his name in lights."

Almost as if determined to live up to that definition even while an undergraduate, Francis Moore wrote both book and music for the Hasty Pudding's 1934 show, Hades, the Ladies, and played a male lead. He now plays many leads: as the one man ultimately responsible for all the surgery done at the Brigham by scores of highly trained surgeons; as secretary of Harvard's joint surgical departments, covering five hospitals; as director of a many faceted research program. There is even a trace of the thespian in the way he lectures—never still, always holding the students' eyes as well as their minds, somehow managing to draw a laugh with such lines as "the brain is an island in an osmotically homogeneous sea."

Like a Pianist. The great surgeons' egoism is reflected in a selective amnesia. Practically any one of them, asked to name the three greatest living surgeons, has difficulty in thinking of two others. Individualists down to their physical characteristics, great surgeons show that even their skilled hands need be of no particular design. Like a pianist's, they may be long and slender or broad and powerful. Dr. Moore's are of medium proportions, kept limber by playing piano duets with his children on paired Steinway grands.

Geared to a revolution in which every advance seems to make his job more complicated, no surgeon can hope to become master of all the mechanical aids that are available. The best and most important work he does is almost always a team effort. But there in the operating room, his team on hand, his patient anesthetized, all the surgeon's knowledge must be instantly available for decisions upon which life depends. "At a given instant," says the Mayo Clinic's famed Heart Surgeon John W. Kirklin, "everything the surgeon knows suddenly becomes important to the solution of the problem. You can't do it an hour later, or tomorrow. Nor can you go to the library and look it up." Because of his own contributions to surgery's body of basic knowledge, his phenomenal ability to recall the right things at the right time and to make the right decision in the operating room or at the patient's bedside, Francis Moore ranks as one of "the half-dozen greatest surgeons.

Knife in the Heart. Perhaps partly by chance, but largely because of Moore's drive and leadership, the great eruption of pioneering progress that is still continuing at the Brigham began soon after he took over as chief. Says one of its most articulate surgeons: "This little place, with only 284 beds, has made more contributions to