Evarts Graham

Evarts Graham

Evarts Ambrose Graham (born March 19, 1883 in Chicago , † March 4, 1957 in St. Louis ) was an American surgeon ( thoracic surgery).

life and work

Graham was the son of surgeon David W. Graham (a leading surgeon in Chicago, temporarily Medical Director of the Presbyterian Hospital) and he studied at Princeton University from 1900 to 1904 and then medicine at Rush Medical College in Chicago, where he received his MD in 1907 made. He then completed his internship at the Presbyterian Hospital, where he also began to study chemistry. This aroused astonishment among the surgeons, but it happened on the advice of an internist friend who had studied with Friedrich von Müller in Munich and got to know his practice of scientific methods in medicine. From 1915 Graham practiced privately as a surgeon, first in Mason City, Iowa. He also got to know the then common practice of resident surgeons to share their fees with the doctors from whom the patients were referred. Later, as President of the American College of Surgeons (1940/41), he did everything in his power to prevent this.

In 1918 he became a surgeon in the US Army, where he was a major researching treatment options for the pneumonia that accompanied the flu epidemic ( Empyema Commission ). These were often the actual cause of death in the flu cases of the pandemic at that time ( Spanish flu ) with its numerous fatalities and caused by secondary bacterial infections (streptococci). He developed surgical methods that allowed drainage of the lung area and thus relieved the lungs without them collapsing. In 1919 he headed a hospital of the US Army in France and in the same year became professor of surgery at Washington University Medical School and chief of surgery at Barnes Hospital, which he remained until 1951. He was also the director of surgery at St. Louis Children's Hospital.

Graham had a prominent position among the US surgeons and was considered a leading thoracic surgeon. Twenty of the surgeons he trained later became heads of surgery at their respective hospitals. His opposition to anesthetists (he used almost exclusively nurses in this capacity at Barnes Hospital) delayed the cooperation of anesthesiologists with surgery in the USA for many years.

X-rays of the gallbladder

His training in chemistry helped him in 1924 when he developed (with Warren Henry Cole) a method to make the gallbladder visible in x-rays with the help of a contrast medium ( cholecystography or cholecystocholangiography). Although initially successful on dogs, the methods initially showed no imaging of the gallbladder in patients with gallbladder problems. However, Graham soon found that this was only the case in patients with impaired gallbladder function, in whom the bile concentration and thus also that of the contrast agent in the gallbladder was suppressed. Ultimately, the method was well suited for detecting gallstones, for example. In 1925 he received the gold medal of the Radiological Society of North America and in 1925 the Leonard Research Prize of the American Roentgen Society.

First pneumonectomy

He was the first to successfully surgically remove a lung ( pneumonectomy ) on April 5, 1933 . Originally only a lobectomy (removal of a lung lobe) was planned, but during the operation it turned out that this alone would not be enough. The operation was performed by James Gilmore, a 49-year-old doctor at Barnes Hospital in St. Louis, who not only survived the operation but lived to a great age (he even survived Graham). He became friends with Graham after the operation and they visited each other.

Studies on smoking and lung cancer

In 1950 he and his student Ernst L. Wynder published an early epidemiological study on the relationship between smoking and lung cancer. Graham himself was a heavy smoker. According to the study, he quit smoking in 1952 and became a staunch public opponent of smoking, but died five years later of lung cancer (since both wings were affected, surgery was not possible). According to von Dragstedt, the investigations by Graham, Wynder, Alton Ochsner and others had the result that hardly any surgeons were smoking at the time of Graham's death, while the conference rooms of the US surgeons were often so smoky in the period before their studies were that the speakers could hardly be recognized.

Honors, private matters

In 1937 he helped found the American Board of Surgery and was President of the American Surgical Association . He was a member of the National Academy of Sciences (1941), the American Philosophical Society , the Leopoldina (1932) and the Royal Academy in Uppsala . In 1943 he became an Honorary Fellow of the Royal College of Surgeons of England and since 1938 he has been an honorary member of the Society of Thoracic Surgeons of Great Britain and Ireland . In 1928 he was president of the American Association of Thoracic Surgery .

In 1925 he was Temporary Surgent in Chief at Peter Bent Brigham Hospital in Boston and in 1939 visiting professor at St. Bartholomew's Hospital in London.

In 1942 he received the Lister Medal . He did not give the Lister lecture until 1947 (Some aspects of bronchiogenic carcinoma). In 1934 he was a Harvey Lecturer.

In 1942 he received the St. Louis Award, in 1937 the John Scott Medal of the City of Philadelphia, and in 1933 the Gold Medal of the Southern Medical Association . He has received several honorary doctorates (including Princeton University , Yale University , University of Pennsylvania , Chicago , Case Western Reserve University ).

In 1916 he married Helen Tredway, with whom he had two children. She later became a pharmacology professor at Washington University. She was also active in community matters and campaigned against air pollution (at her insistence, measuring stations were set up in St. Louis). She died in 1971.

He was from 1931 editor of the Journal of Thoracic Surgery and also co-editor of the Annals of Surgery , the Archives of Surgery and editor of the Yearbook of Surgery (1925).

literature

• C. Barber Mueller Evarts A. Graham. The Life, Lives and Times of the Surgical Spirit of St. Louis , BC Decker 2002 (Mueller was the last chief resident of Graham)
• Lester Dragstedt Evarts A. Graham , Biographical Memoirs National Academy of Sciences
• Siddhartha Mukherjee : The king of all diseases . DuMont Buchverlag, Cologne 2012, ISBN 978-3-8321-9644-8 , especially pp. 329–331.

Web links

• The Surgical Spirit of St. Louis , Washington University, describing Mueller's pneumonectomy operation

Individual evidence

1. ^ B. Jaffe: Evarts A. Graham: The Life, Lives, and Times of the Surgical Spirit of St. Louis . In: Ann Surg. Feb 2004; 239 (2): 293-294. doi: 10.1097 / 01.sla.0000111742.79186.f9 , PMC 1356224 (free full text).
2. ↑ Graham, JJ Singer Successful removal of an entire lung for carcinoma of the bronchus , J. Am. Med. Assoc., Vol. 101, 1933, p. 1371
3. ↑ Horn, Johnson Evarts A. Graham and the first pneumonectomy for lung cancer , J. Clinical Ontology, Volume 26, 2008, p. 3268. Arthur Baue Evarts A. Graham and the first pneumonectomy , J. Am. Med. Assoc., Vol. 251, 1984, p. 261
4. ↑ Graham's biography in the Biogr. Memoirs Nat. Acad.Sc.