Murray: Surgeon with soul

When you hear the word “surgeon,” the next word you think of isn’t likely to be “humble.” Surgeons literally hold other people’s lives in their hands. That makes them the court of last resort for patients at death’s door, generals of the operating room, monarchs of the medical profession – and, according to the clichés of popular culture, supposedly encourages many of them to become arrogant, impatient, and egotistical.

That’s why Joe Murray’s autobiography is a welcome antidote to the idea of surgeon as self-absorbed superman.

Joseph E. Murray – Nobel laureate, organ transplant pioneer, and Harvard Medical School professor of surgery emeritus – has one of the most impressive surgical résumés of the 20th century. Yet in addition to his triumphs, Murray’s memoir recounts doubts, struggles, and failures – and shows him trying again and again to solve medical mysteries with the immediate goal of improving a patient’s life. For that reason alone, Murray’s book, “Surgery of the Soul: Reflections on a Curious Career,” should be required reading for every medical student.

When Murray performed the first successful kidney transplant at what was then Peter Bent Brigham Hospital in Boston on Dec. 23, 1954, between identical twins Ronald and Richard Herrick, the doctor and his surgical team made medical history. The idea of replacing diseased organs – not just kidneys, but also hearts, livers, lungs, and so on – went from science fiction to science fact overnight.

Since then, tens of thousands of organ transplants have been performed across the world – more than 20,000 in 1999 just in the United States – giving new life to those who had nearly run out of life, and hope. For his pioneering role, Murray shared the 1990 Nobel Prize in Physiology or Medicine with E. Donnall Thomas, a friend and colleague who graduated from Harvard Medical School in 1946 and is known as the “father of the bone marrow transplant.”

However impressive his résumé, Murray’s newly published autobiography shows him to be engagingly human, and, yes, quite humble. Murray sees a surgeon’s duty as providing service to individuals. Writing of the kidney transplant operation that would eventually make him world-famous, Murray notes that “Although I knew the operation was potentially momentous, in truth, I treated it as just part of the week’s work. … To the individual patient, any operation is momentous.”

That’s why on Christmas Day 1954, two days after making medical history with the Herrick twins, Murray was in the emergency room of Newton-Wellesley Hospital, sewing up a cut on a young boy’s forehead – a simple procedure that easily could have been left to a less seasoned surgeon. But Murray had lived for many years in Wellesley Hills – and still does – and nurses from the nearby hospital would often phone him at odd hours when they couldn’t reach other physicians. “I would never not respond to an emergency,” Murray said in a recent interview. “That’s what being a doctor is.”

But his sense of obligation extends beyond mending physical ills with scalpel and sutures. To Murray, a doctor’s responsibility is to treat each patient as not just a set of symptoms, but as someone with a spirit that can be helped through medical procedures. The title of his autobiography, “Surgery of the Soul: Reflections on a Curious Career” (Boston Medical Library, 2001), stems from Murray’s spiritually based approach to medicine. Though he has in the past hesitated to talk publicly about his faith, for fear of being lumped in with the televangelist crowd, Murray is deeply religious. “Work is a prayer,” he said. “And I start off every morning dedicating it to our Creator. … Every day is a prayer – I feel that, and I feel that very strongly.”

The memoir is a journey through the parallel lives of Murray, the emerging physician, and some of his unforgettable patients. Murray, who entered Harvard Medical School in September 1940, and his fellow students were drafted at the outbreak of war and then rushed through their studies so they could join the war effort. Murray’s first memorable patient was Charles Woods, a courageous World War II aviator who was burned over 70 percent of his body, including his entire head and hands.

Caring for Woods, who according to the medical thinking of the time never should have survived, was an eye-opening experience for the young Dr. Murray, whose wartime service was spent on staff at a military hospital in Pennsylvania. Over the course of two years, Murray and the medical team he was part of performed 24 operations on Woods to give him a functioning face. Murray became fascinated with reconstructive surgery, which led directly to his subsequent work with organ transplants. Murray performed many skin grafts on Woods, and later found that the same biological principles apply whether transplanting skin or transplanting internal organs. Woods’ treatment also led to Murray’s role as a groundbreaking plastic surgeon, creating innovative procedures for correcting congenital deformities.

But what Murray learned most from Woods was a lesson about the human spirit. “If I had been Charles Woods,” Murray writes, “would I have had the will to survive for six weeks [in transit to the military hospital] with 70 percent of my body burned, and the ability to endure two years of unimaginable pain? Would I have had the dignity and confidence to walk out into the world with a disfigurement that would cause people to stare at me for the rest of my life? I honestly don’t know. I know only that Charles taught me what a human being can achieve, and should strive for, in dealing with adversity.”

Murray profiles more than a dozen other patients in his book, including such famous ones as the Herrick twins, and even recounts his own experiences after a 1986 stroke, which ended his surgical career. The memoir is part surgeon’s log, part medical textbook, and part family scrapbook. It’s also part adventure story – some of Murray’s patients are introduced with horrifying tales of their physical ailments and equally disquieting close-up photographs, and a reader is compelled to read about their treatments to find out what happened to them.

But though composed of many parts, “Surgery of the Soul” is all about Joe Murray’s development from a young boy who wanted to emulate his family physician to a Nobel Prize-winning scientist at the pinnacle of his profession.

Looking down from that pinnacle, and back at his life, Murray is modest about his own achievements, understanding of those who disagreed with him, and generous to those who slighted him, such as a Time magazine writer who mistakenly gave the credit for performing the first successful kidney transplant to another doctor. In the hierarchical world of medicine, Murray – who was just 35 years old when he performed the groundbreaking surgery – was listed third on the Brigham Hospital’s own press release after two older doctors who had assisted in the procedure.

“As a surgeon still trying to make my mark, this lack of personal recognition was frustrating,” Murray writes. But an older mentor advised him, “It will all turn out well in the end. Just continue with your lab work and publications.”

Today, at age 82, Murray can attest to the wisdom of that advice – it’s similar to the advice he passes on to medical students today. “I’ve been lucky to spend my life doing what I love,” Murray says – but he thinks young doctors today have it just as good, if not better. Because of recent scientific advances, Murray tells medical students, “it’s the best time in the world to be a doctor because we can treat and cure so many conditions that it was not possible to treat even 10 years ago. … But that isn’t the important thing. The important thing is that we have a life that combines science and humanism. They are inextricably woven together. If you’re alert enough to appreciate it, you won’t get discouraged. And I don’t think there’s any place for discouragement when you’re living on Earth.”

Murray still fits into his World War II Army uniform, and each Memorial Day and Fourth of July he puts it on and proudly marches in local parades. Just as medical science marches on, so does he. To Murray, marching is a personal statement, but it’s also something more – it’s a duty.