Sixty Years on a Cutting Edge, 1950–2010: University of Colorado Department of Surgery

Book Cover
Bruce C. Paton, M.D.

Golden, CO: Fulcrum Publishing, 2010. Index, endnotes, black and white photos. v + 210 pages. 10” x 9”. $50.00 hardcover.

Stuart A. Schneck, M.D.

Dr. Bruce Paton, former chief of cardiac surgery at both the Colorado General Hospital and the Denver Veteran’s Administration Hospital and former acting dean of the University of Colorado School of Medicine, has written a most informative book about the development of the university’s Department of Surgery between 1950 and 2010. While the book jacket implies that only surgical residents and faculty members will be fascinated by this book, I believe its appeal is greater and will extend to those within any discipline in medicine as well as to anyone in higher education who has contact with a medical school.

Following an initial background chapter about the origin and development of the medical department (the eventual School of Medicine) at the University of Colorado that began in 1883, the book goes into great detail about the remarkable growth and advancement of the Department of Surgery during the past sixty years due in large part to the efforts of its five chairmen—Drs. Henry Swan, William Waddell, Thomas Starzl, Alden Harken, and Fred Grover. Each of these men was different, each had strengths and weaknesses that are well described, and each made remarkable advances for the department and sometimes for surgery in general. Swan’s pioneering work in cardiac surgery, Waddell’s expansion of the department that brought in exceptional people in many surgical subspecialties, Starzl’s pioneering efforts in transplantation—particularly of the liver, Harken’s further development of the educational and training programs, and Grover’s broadening of departmental research and support of lung transplantation all have moved the Surgery Department to a position of respect and excellence within the surgical community. An impressive number of its trainees and faculty members have gone on to head academic surgical departments of their own, achieve other national positions of note, or have gained prominence as private practitioners.

While most of the book describes the Surgery Department as it evolved through Colorado General Hospital, University Hospital, and now the University of Colorado Hospital, Paton devotes a chapter to the Denver Health Medical Center, which many of us still call the Denver General Hospital (DGH). He describes the tumultuous political relationship between the university and DGH, but more importantly he recounts the growth of the DGH surgical department—its development of emergency medicine to the point where it is now a leader in trauma care in the country, the great research output of the surgical faculty during the energetic leadership of Dr. Ben Eiseman, and the blending of outstanding community surgeons into the program. Dr. Paton describes similar growth and excellence in the Surgery Department at the Veteran’s Administration Hospital in a separate chapter.

Dr. Paton intersperses the historical description of the development of the Surgery Department with perceptive commentary about the current controversy regarding the limitation of work hours for residents in training, the changes in surgical education over time, the impact that organ transplantation has made in revising the definition of death, medical advances brought about by Colorado surgeons, and the financing of academic salaries and research as Medicare and medical insurance have evolved.

Much credit is given to the enormously important work of Dr. J. Cuthbert Owens who evaluated and improved emergency units throughout Colorado. The extraordinary pace at which some surgeons produced clinical and research papers is underlined by the description of Dr. Thomas Starzl, who at one time was producing a complete scientific paper every 7 1/2 days on his way to a career total of more than 2,100 published papers. This reviewer once wrote a paper with him; he was finished in three days and berated me for taking an extra two days to finish my portion.

There are lessons in this book that can be transferred to any discipline within medicine and to any human activity. Despite being consistently under-funded (as is the School of Medicine today) and cramped for space, the success of the surgical department has been based on the efforts, intellect, and dedication of individuals who had as their goals the advancement of knowledge, the improvement of surgical care and treatment, and the intensive education of surgical trainees for the good of society.

I have had the privilege of seeing the growth and development of the Department of Surgery firsthand since 1954 and have interacted with many of the surgeons discussed in the book. The changes in the sixty-year period, so well described by Dr. Paton, are nothing short of extraordinary and prove, once again, that there is no one pathway or personality that leads to success. The sum total of the impressive story told by Dr. Paton is a surgical department of which both the medical school and the state can be proud.

Reviewer Info: 

Stuart A. Schneck, M.D., professor emeritus of neurology at the University of Colorado School of Medicine, graduated from the University of Pennsylvania School of Medicine. His rotating internship there had a surgical emphasis and he then trained at the University of Colorado Medical Center in internal medicine and neurology and in neuropathology at Columbia University. He has been president of the medical staff at University Hospital in Denver, associate dean for clinical affairs at the University of Colorado School of Medicine, president of the American Board of Psychiatry and Neurology, and president of the Alpha Omega Alpha Honor Medical Society.