Donald A. Malt died on October 5, 2002, after a protracted illness, thus ending a brilliant academic surgical career in his 71st year of life. Professor, prolific writer, editor, productive investigator, courageous clinician of undaunted spirit, he came to be regarded by the scores of young surgeons he mentored as the prototypical academic surgeon.
Ron was born on November 12, 1931, in Pittsburgh, Pennsylvania and reared in St. Louis, Missouri. He earned a Bachelor of Science degree from Washington University, and graduated from Harvard Medical School in 1955. Although initially intrigued by psychiatry, an experience in the operating room of William McDermott as a medical student led him to elect surgery as his calling. He entered the first level, as an intern in 1955, of the unique surgical residency program that Edward D. Churchill had developed at the MGH immediately after WWII. The Department of Surgery at that time was a wonderful place for a student of surgery, with a galaxy of superb staff surgeons and a talented vibrant surgical house staff. Ron fulfilled his military service obligation after internship in the laboratories of the School of Naval Aviation in Pensacola, Florida. He re-entered the MGH surgical residency program in 1958, finishing as Dr. Churchill’s last Chief Resident in 1961-62.
A number of the MGH staff surgeons under whom Ron worked had a deep and lasting effect on him. The most important was probably Edward D. Churchill, who was the embodiment of the university surgeon – a surgical scientist – who elegantly brought applied research to the problems of the evolving field of thoracic surgery. Mirroring his mentor, Ron developed an exceptional expertise in clinical surgery while pursuing his interest in basic science in a productive laboratory for most of his career. This laboratory fostered the careers of scores of young researchers. His work brought him international renown and friends. Surely Ron’s career would have been a source of great pride and satisfaction to Dr. Churchill, one of the great surgical educators of the century. Richard H. Sweet also had a profound effect on Ron. Sweet had unparalleled technical facility in the operating room and a complete knowledge of even the most minute details of anatomy. He had analyzed every operation into a series of steps and had the right instrument for each one. Ron studied his skill and technique and sought to match it at each major operation. He admired other characteristics of his beloved “Sir Richard” – his precision in the use of words, his impeccable appearance, and the efficiency he brought to his schedule in everything he did. A third important surgeon in Ron’s development was Oliver Cope. Ron had worked with Cope during the summers in his medical school career and had published with him. Cope was a frequent source and dramatic advocate for brilliant ideas, often using an approach that most suggested an Old Testament prophet. Cope was occasionally neither sensitive nor correct, and Ron had the knowledge and insight to avoid these characteristics. However, one could see in Ron the same gleaming eye and forceful persuasion of Cope himself.
During his chief residency at MGH, on May 23, 1962, a team under the direction of Ron successfully accomplished the replantation of Everett Knowles’ traumatically severed right arm. No one, to that point, had succeeded in restoring a completely severed limb. This feat immediately made Ronald Malt an internationally renowned surgical figure at the age of 30. Ron handled this acclaim with maturity and appropriateness.
Ron was invited to join the surgical staff by Dr. Paul Russell following the completion of a period of full time research training at MIT. Following his return to MGH, he quickly established a productive laboratory, focused upon the study of compensatory hypertrophy/hyperplasia of the kidney, liver, and bowel. He also developed a large referral practice centered on complex clinical cases and was a prolific contributor to the literature of his interests.
Ron became the Chief of Gastroenterological Surgery at MGH in 1970, Visiting Surgeon at MGH in 1972 and Professor of Surgery at HMS in 1975. He served as Associate Editor of the New England Journal of Medicine from 1965 until 1993. This was a position in which Ron derived a great source of pleasure and pride. During his tenure in that position, he was closely associated with Joseph Garland and Franz Ingelfinger, who he greatly admired and respected, and in many ways sought to emulate. He co-edited, with Sir Peter Morris, the first edition of the Oxford Textbook of Surgery in 1994. He also authored the remarkable book The Practice of Surgery in 1993, a compilation of surgical approaches and techniques that he personally favored, and which was dubbed by the MGH surgical house staff “My Way.” By the middle years of his surgical career at MGH, Ron had become a singular member of the Department- an “original.” He took the time to be an excellent teacher for each individual resident who came to his service. He was always in the front row of Grand Rounds and on the occasions when he could not attend GI Rounds, he carefully arranged for some other senior GI surgeon to be there. He passed on to the residents and the rest of us his vast knowledge of matters medical and otherwise, from Shakespeare to the Latin roots of even trivial words, from the name of the best restaurant in Montreal to the use of the library at the Royal College of Surgeons in London.
His curiosity, habit of minute analysis, wide reading, and vast and seemingly faultless memory all were well known. He was one of the few surgeons of his era to whom the residents assigned their own nickname, this being “The Falcon.” By this name they meant to note his sharpness of eye, fearlessness and elegance of plumage. His contributions to the surgical literature numbered in the hundreds, and every paper had his personal stamp. He was unremitting as a proofreader, as all of us who wrote with him can testify. What he wrote and influenced was factual, logical, and always with an important point. He wrote and edited books and dozens of book chapters. He was especially generous in passing along to other members of the Department opportunities for contributing to the surgical literature. Scores of residents made their first appearance in print under the careful supervision of Ron Malt.
Much of his practice involved complex cases, many with more than one previous operation. He became so well known for his ability with such cases and his willingness to take them on that they made up a large part of his referral practice. His undaunted spirit and boldness in applying new techniques and ideas, as well as his ability to do his best, helped him to succeed in the management of these extraordinarily difficult patients. He was efficient in the extreme and had a remarkable capacity for work.
Ron was a person of towering intellect with a remarkably wide range of interests. In everything, whether a bottle of wine or a pair of operating scissors, he sought the highest standard. For him, nothing was done that did not need to be brought to the highest attainable level of excellence. He was unfailingly loyal to his residents, his friends and his colleagues, as well as to the Department of Surgery, along with its history and traditions. He was a person of great integrity, honesty and candor. He was quick to evaluate and accept new things, from flying on the Concorde to pushing the button on the gallstone lithotriptor, a device that he had brought to the hospital himself. Everything he accomplished was done so with dignity, style and pride.
It is difficult to contemplate the tragedy of his final illness and to think that this remarkable person is no more. For many of us it is still possible to picture his tall, spare figure, striding with purpose out through the White Building Lobby at MGH, impeccably dressed for the season, umbrella in hand, and maybe with even a parting “so it goes.”
He leaves his mother, Ruth Malt, his wife of fifty-one years, Gerry, and their children, R. Bradford Malt of Boston, Barbara C. Malt of Allentown, Pennsylvania, and Margaret J. Malt of Cambridge, Massachusetts, and two grandchildren.
Their loving devotion lent great grace to the difficult final chapter of Ron’s life.
Ashby C. Moncure, Chairperson
Charles M. Ferguson
Leslie W. Ottinger