Medicine: Surgery, New Style

Seven thousand surgeons swarmed last week through Manhattan's Waldorf-Astoria. Gathered for the annual clinical congress of the American College of Surgeons, they packed room after room to hear technical papers read and discussed. They watched dozens of colored movies (Cine Clinics, they called them) of operations ranging from standard procedures through the specialties to the spectacular. They trooped off by bus and motorcade to 61 hospitals in New York City's five boroughs to watch "wet clinics," as they call the real thing.

Though the assembled thousands included many of the deftest-fingered scalpel wielders and gut tiers in the U.S., and such honored elder surgeons as New Orleans' Alton Ochsner and St. Louis' Evarts Graham, there was none among them who towered above his fellows as did Baltimore's William Stewart Halsted half a century ago, or Halsted's pupil, Harvey Gushing, a generation later. The reason lies not in a decline in the caliber of surgeons, but in a change in the nature of surgery itself.

U.S. surgery is no longer symbolized by the old-style autocrats of the operating table, who made a dramatic entrance into the theater, striped pants showing below their white coats, to operate on a patient they had probably never seen. Skill and ingenuity are as important as ever, and some surgeons are famed for developing brilliant procedures—e.g., Boston's Robert (heart valve) Gross, Johns Hopkins' Alfred (blue baby) Blalock.

But such men, for all their spotlighted brilliance, belong to the new school in surgery, in which the operation is no longer the be-all and end-all. Great surgeons now are concerned with the patient as a whole man, from the salt content of the blood circulating through his fingertips "to the vague fears of mutilation that flit through his mind. One of the deepest preoccupations of surgery today is learning more about the chemistry of the patient's body before, during and after operation.

The Team Approach. Unassuming but nonetheless outstanding among the surgeons in Manhattan last week was Harvard's Francis Daniels Moore. Characteristically, he gave no solo performance. His name appeared in the program only twice, and then as one of a team of authors submitting technical papers with forbidding titles.

Scion of a Boston family which had moved to Illinois, Moore naturally went to Harvard (class of '35), where he became president of Hasty Pudding and wrote the score for its 1934 show, Hades the Ladies. He had thought of making music his career, but anthropology under Earnest Hooton led him to medicine. It was not until his fourth year in Harvard Medical School that Moore decided to become a surgeon.

"I liked the idea of doing something active in the treatment of disease," Dr. Moore now says. "And then I came to feel that there was a tremendous place in surgery for understanding the biology of a patient." That idea was relatively new in the late 19305, but it was beginning to inspire research workers in half a dozen medical centers.