Ann Thorac Surg 2001;71:1387-1388
© 2001 The Society of Thoracic Surgeons
Our surgical heritage
Leo Eloesser: an American cardiothoracic surgeon in China
Yi Shan Wang, MDa,
Tsung O. Cheng, MDb
a Department of Thoracic and Cardiovascular Surgery, Ren Ji Hospital, Shanghai Second Medical University, Shanghai, China
b Division of Cardiology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
Address reprint requests to Dr Cheng, The George Washington University Medical Center, 2150 Pennsylvania Ave NW, Washington, DC 20037
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Abstract
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We present a brief historical vignette about one of the pioneer cardiothoracic surgeons, Leo Eloesser, from our personal recollections and descriptions of part of his long life that was spent in China. Although this article deals mainly with his time in China during his close association with the senior author, Dr Eloesser is certainly one of the most extraordinary surgeons of the 20th century.
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Introduction
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Leo Eloesser (1881–1976) was an inveterate traveler and fluent in 10 languages [1]. It was in September 1945, soon after the end of World War II, that Yi Shan Wang (YSW) met Leo Eloesser in the National Central Hospital in Nanjing (Nanking), China. Doctor Eloesser appeared as a short-statured but strong and high-spirited man older than 60 years of age, with a warm smiling face, piercing light grayish-blue eyes, and a short and concisely shaped mustache (Fig 1). The director of the Department of Surgery at the hospital introduced YSW to Eloesser for training in thoracic and cardiovascular surgery under his direction and tutelage. Eloesser was, of course, already a world-renowned figure in thoracic surgery at the time, as one of the leading pioneers in the field in the United States, a professor of surgery at Stanford University, and editor-in-chief of the prestigious Journal of Thoracic Surgery, which was the predecessor of the Journal of Thoracic and Cardiovascular Surgery. Eloesser went to China in 1945 with the United Nations Relief and Rehabilitation Administration as a specialist in thoracic surgery.
Eloesser made teaching ward rounds with the surgical staff at the National Central Hospital in Nanjing every Friday morning. YSW was deeply inspired and impressed by his mentor’s teaching capabilities, especially in collecting facts, analyzing causes and effects of each disease, and discussing the differential diagnosis in great detail. His approach was scientific and objective. His planning for perioperative care was meticulous with great attention to every minute detail. For instance, in preoperative preparation of every thoracic surgical patient, he used to teach the patient the importance of an effective cough. He routinely would come to each patient’s bedside to demonstrate the exact technique of an effective cough until the patient could perform it correctly. He used to check on the effectiveness of chest drainage in the early postoperative period by squeezing the chest tubes repeatedly himself. Quite often he would come back in late evenings to the postoperative intensive care ward to check on the condition of his patients. For designing a skin tube or flap for plastic surgery he usually spent much time in measuring and calculating in order to secure the proper length to reach a new site. He was very imaginative and dextrous in using bamboo peel strips to plait a prosthesis for a patient’s amputated lower limb. The patient could wear the prosthesis comfortably and walk with a steady gait. A photograph taken with such a patient standing next to YSW was published in Time magazine with the following caption: "This shows what Chinese doctors are doing."
During an operation Eloesser would demonstrate all the operative steps in classic ways: how to hold knives, clamps, and scissors; how to make and close incisions; how to make proper exposure for the operative field; how to dissect and check bleeding; and how to avoid unnecessary injury to the tissues. He often warned his assistants, "If you don’t respect the tissue, then the tissue will not respect you!" His ingenious chest flap procedures for tuberculous empyema, which enabled pus to be drained out but prevented air from entering the chest cavity, were widely adopted. Indeed, the Eloesser flap operation brought him worldwide recognition. His technique was well described in the first five editions of Christopher’s Textbook of Surgery [2].
Eloesser was still single and continued to lead a very active life while in China. He often drove a Jeep smoking a pipe held tightly between his lips. On most Sundays, he would be accompanied by YSW to go sightseeing, visiting ancient tombs of the emperors of the Ming dynasty and old temples with antiques, which he loved. He paid special attention to the historical inscriptions engraved on the tombstones. He took photographs for records and asked YSW to translate or interpret word by word. He would say to YSW, "I am your student now and you are my teacher!" He liked to climb mountains and used to race with YSW. He chose one peak of Qi Ya Mountain (400 ft high and very steep). His speed was amazingly fast: he could reach the top in 30 minutes, while going down with jumps like a monkey in only 15 minutes. YSW often could not catch up with him. Sometimes on weekends, Eloesser asked YSW to help in organizing dancing parties for social recreation for doctors and nurses in the hospital. He donated chocolates, fruits, cakes, drinks, and canned food. He played both violin and viola beautifully. His performances always received thunderous applause from the audience. His dance steps were steady, elegant, and rhythmic. The onlookers often clapped hands enthusiastically in admiration; Eloesser in return showed his appreciation by frequent nodding of his head and a slight smile on his face.
Eloesser left China in the fall of 1949 to move to New York City to serve with the United Nations International Children’s Emergency Fund. Three years later, he retired to Mexico, returning to the United States annually for the meetings of the American Association of Thoracic Surgery [1]. YSW left Nanjing for Shanghai in December 1948. Twenty-five years later (1973), YSW by chance met Eloesser again in Mexico City. YSW was a member of a Chinese medical delegation visiting Latin American countries, and Eloesser represented the Mexican Medical Association in welcoming the Chinese medical delegation. Eloesser recognized YSW instantly and they embraced emotionally. Eloesser said, "Wang, I challenge you to climb a mountain!" Older and shorter, he was still physically fit. He had been happily married then. Eloesser passed away in Mexico City in 1975 at the age of 95.
Although this article deals mainly with Eloesser’s time in China during his close association with YSW, Eloesser undoubtedly led one of the most peripatetic and extraordinary lives of any American surgeon [1]. Eloesser was president of the American Association for Thoracic Surgery in 1937. In the same year, when the American Board of Surgery was being established, he served on a committee of the American Association for Thoracic Surgery to consider founding an examining board of thoracic surgery. Although his surgical contributions were varied, it was in thoracic surgery that his major contributions were found. Eloesser, Graham, Bigger, and Churchill were pioneers in emphasizing at the outset of World War II the role of pericardiocentesis in the management of cardiac tamponade resulting from cardiac wounds [3]. There were other major contributions Eloesser made in thoracic surgery, too many to be enumerated in this article. In 1982, Harris Shumacker authored a full-length biography of Eloesser to which the readers are referred for more details of this remarkable man’s life [4].
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Acknowledgments
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The authors are indebted to Michael E. DeBakey, MD, for his assistance in reviewing the manuscript.
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References
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Rutkow I.M. American surgery; an illustrated history. Philadelphia: Lippincott-Raven, 1998.
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Eloesser L. Surgery of the pleura. In: Fredrick Christopher: A textbook of surgery, 1st, 2nd, 3rd, 4th & 5th eds. Philadelphia: Saunders, 1936–1949:991–1003.
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Shumacker H.B., Jr The evolution of cardiac surgery. Bloomington, IN: Indiana University Press, 1992:170.
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Shumacker H.B., Jr Leo Eloesser, MD: eulogy for a free spirit. New York: Philosophical Library, 1982.
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S. Wan and A. P. C. Yim
The evolution of cardiovascular surgery in China
Ann. Thorac. Surg.,
December 1, 2003;
76(6):
2147 - 2155.
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