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Jul-Sep2002-10(3)
BOOK REVIEW
Surgery of the Soul: Reflections
on a Curious Career
Joseph E
Murray
Science History Publications, USA,
$35, pp 255.
reviewed by Dr C
Ramachandra
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. C Ramachandra
Dr C Ramachandra
is paediatric surgeon at the Manipal Hospital, Airport Road, Bangalore
560 017. Email:ramac@blr.vsnl.net.in