Surgery of the Soul: Reflections on a Curious Career. Joseph E Murray. Science History Publications, USA, $35, pp 255
Dr Joseph E Murray has blazed a trail of innovation and excellence in transplantation surgery and reconstructive surgery. His research in transplantation laid the basis for much that is practised today.
His autobiography includes stories of individual patients who — as all surgeons know — are the real heroes. The ‘soul’ of the book is the story of Mr Raymond McMillan, born with a severe facial deformity known as Moebius Syndrome. The chapter titled ‘Surgery of the Soul’ is the story of this extraordinary individual whose initial years were spent in mental institutions. The repair of Mr McMillan’s complex facial deformity was complicated by the fact that he had a heart defect. Ray’s writings, uncovered after his death, reveal a rare human being with an uncanny insight into the workings of his own mind — and his efforts at modifying them:
“I promised myself to be strong that nothing could disturb my peace of mind. To talk health and make all my friends feel that there is something in them…To give so much time to the improvement of myself that I have no time to criticise others. To be too large for worry, too noble for anger, too strong for fear and too happy to permit the presence of trouble. To think well of myself and to proclaim this fact to the world-not in loud worlds but in great deeds. To live in the faith that that the world is on my side so long as I am true to the best that is in me.”(p210)
These are some of the most inspiring words I have read. Dr Murray was fortunate to have patients such as Ray. He writes, “the impact the hospital staff and I had on Ray’s life only partially involved scalpels and sutures… because we cared for him and showed him human compassion and basic human kindness, we gave him a feeling of worth and helped heal his spirit… the greatest benefit we gave Ray was not so much the freedom to control his facial muscles, but rather the freedom for his inner self to grow and glow… surely this was a case of true Surgery of the Soul. With Ray as the benchmark for the highest form of cosmetic surgery, it becomes apparent that the speciality is too precious to trivialise. Ray’s life reinforces the principles of the Hippocratic Oath. All life is precious. His words remind us that our talents and skills can serve in unexpected ways… service to society is the rent we pay for living on this planet.” (page 210).
Dr Joseph Murray decided to become a surgeon very early in his life, influenced by his family doctor Dr George F Curley. He grew up in a farm, and went to the local school. He got into Harvard medical school after an education in liberal arts and sciences. We get glimpses of the young doctor’s keen interest in basic and clinical research. We learn of the tough surgical residency programme at Massachussetts General Hospital where he was fortunate to have mentors like Dr Francis D Moore and Dr George W Thorn. Later he did original work on immunology and perfected surgical techniques in transplantation. Dr Murray was responsible for the first successful human renal transplant, on December 23, 1954, between identical twins Richard and Ronald Herrick. He was also responsible for the first non-identical twin renal transplantation, and the first cadaveric renal transplantation.
From the very first transplant, he laid the foundation for ethical debate on the subject by involving psychologists, psychiatrists and the clergy in the discussions. He and his team at Harvard were meticulous in their basic research, applying the results of animal experiments with utmost ethical concern for patients, and only then launching a surgical procedure This is in sharp contrast to what happened in the field of cardiac transplantation.
Dr Murray’s real interest was the field of reconstructive surgery where he pioneered the concept of reconstruction after radical surgery for head and neck cancer. He was also involved in the development of reconstructive surgery for congenital malformations. This also took him on international medical missions to India (he operated at Christian Medical College, Vellore) and Iran.
Dr Murray met Bobby during medical school days and married her during his surgical residency. We get to know the supporting role played Bobby throughout his ‘curious career’ as she liked to call it, and through his illness — he suffered an unexpected stroke in 1986 from which he fortunately recovered. The crowning glory of his career was the conferment of the Nobel Prize in 1990.
Dr Murray’s autobiography is written in an easy, personal style embellished with stories of unforgettable patients and events. His empathy and honesty shine through the book which is so engrossing it can be finished in one read.
Surgery of the Soul is a ‘must read’ for every medical professional. Each will find something specially appealing to his or her interest, in addition to the overall appeal of the book of a ‘curious career’ of a remarkable doctor.