The Department of Surgery, University of California, San Francisco

COMMENTARY The Department of Surgery, University of California, San Francisco HE DEPARTMENT OF pression of gratitude for the medical arrows with him in Golden Gate Surgery at the Uni- education his daughter had received Park and learning the skills of game versity of California from the “Medical Department” of UC hunting. Pope, who became an ex- (UC), San Francisco, (Figure 2A).2 After the disastrous pert in Yahi culture, later wrote a was shaped by Gold 1906 earthquake damaged or de- book about Ishi’s medical history TRush–era adventurers who stayed on stroyed most of the city’s existing hos- and several books about archery. after the gold ran out. In 1852, South pitals, the urgent need for medical fa- During that time, Harold C. Carolina surgeon Hugh H. Toland, cilities necessitated remodeling the Naffziger, MD (Figure 3B), under MD, was lured to California by gold medical school building so that it whose dynamic leadership the de- fever, crossing the 2000-mile over- could serve as a hospital. The first UC partment would gain national land route by wagon train. By then, Hospital opened in 1907 (Figure 2B), prominence, had returned to UC to gold reserves were declining and the under the direction of surgeon Harry teach and develop a first-class sur- number of miners was increasing Mitchell Sherman, MD. Toland con- gical center. Naffziger was born in dramatically. Whereas many other tinued as professor of surgery until his the mining town of Nevada City, forty-niners headed home or turned death in 1880. He was succeeded by Calif—another legacy of the Gold to poker or crime, Toland estab- Robert A. McLean, MD (Figure 2C), Rush. He had served as intern and lished an enormously successful sur- a California native, a graduate of resident surgeon at the UC Hospi- gical practice in the boomtown of Toland Medical College, and profes- tal and obtained the position of as- San Francisco. He founded the sec- sor of anatomy, who introduced for- sistant resident surgeon at the Johns ond medical school, Toland Medi- mal coursework in the new science of Hopkins Hospital in Baltimore, Md, cal College, in the Far West in 1864, bacteriology into the curriculum. working under William Stewart Hal- timing that coincided with a new McLean was succeeded in 1899 by sted, MD, and Harvey Cushing, MD. state law permitting the use of pau- Thomas W. Huntington, MD, who While there, Naffziger recognized pers’ bodies for study by accredited had trained at Harvard University the superiority of Halsted’s system physicians (Figure 1).1 Through (Boston, Mass) and at Massachu- of training surgeons and became the efforts of Richard Beverly Cole, setts General Hospital (Boston) be- aware of the need for experimental MD—another Gold Rush pioneer fore heading west to develop a pri- research programs in medical and an accomplished surgeon who vate surgical practice, treating work schools.4 Although Naffziger had had arrived in San Francisco aboard injuries, hernias, and appendicitis for wide experience in every field of sur- a steamship in 1852—the college be- railroad companies. In the same year, gery, after World War I, he limited came the Medical Department of UC Huntington performed the first total himself to neurological surgery and, in 1873, with Cole as its dean and gastrectomy for carcinoma, after with Cushing, was among the very Toland, the first chair of the Depart- which the patient reportedly sur- first physicians in America to spe- ment of Surgery. The early surgical vived for many years without evi- cialize in this field.4 Naffziger gained curriculum consisted of “lectures on dence of recurrence.2 national renown for his many dis- the principles and practices of sur- Wallace I. Terry, MD, another tinctive contributions to the new gery, demonstrations of surgical California native, became chair in specialty of neurosurgery, includ- technique on the cadaver, and clini- 1912 when the Medical Depart- ing craniotomy decompression for cal lectures at the college building ment was renamed the UC College brain tumor, orbital decompres- and the adjacent county hospital.”2 of Medicine. By 1915, the college was sion for pressure exophthalmos, and Anesthesia was scarce, when it was officially designated the UC Medi- the first partial hypophysection for available at all, and Toland, Cole, and cal School. In a tragic reflection of Cushing disease.5 Naffziger contrib- the other surgeons performed op- that time, the last Yahi Indian was uted perhaps more than anyone to erations on a table in the middle of found starving in Oroville, Calif. He the national reputation that the UC the ward. “Blood and noise were the eventually was brought to live at the Medical School now enjoyed. When principal features observed by the UC Museum of Anthropology at Par- Naffziger succeeded Terry as chair goggle eyed spectators.”3(p39) nassus, where he was named “Ishi,” of the Surgery Department in 1929, In 1898, the school moved to its the Yahi word for “man.” Univer- he developed a residency program present location in Parnassus Heights, sity of California surgeon and modeled after Halsted’s with the help overlooking Golden Gate Park. The outdoorsman Saxton Pope, MD, of H. Glenn Bell, MD, a general sur- land was donated by former city (Figure 3A) became his physician geon who had been chief resident mayor Adolph Sutro, in part as an ex- and close friend, shooting bows and under another Halsted resident, (REPRINTED) ARCH SURG/ VOL 140, DEC 2005 WWW.ARCHSURG.COM 1143 Downloaded from www.archsurg.com at UCSF/Library, on December 20, 2005 ©2005 American Medical Association. All rights reserved. A B C Figure 1. Hugh H. Toland, MD, and the Toland Medical College, San Francisco, Calif. A, Toland (1806-1880). B, Illustration of Toland Medical College, circa 1866. C, Medical students in the Toland Medical College Dissecting Room, circa 1870. Photograph by Edward Muybridge. Mont Reid, MD, in Cincinnati, Ohio. fornia (Figure 3C). He was pro- In 1951, UC established a medi- Naffziger wanted residents to expe- foundly interested in the patho- cal school in Los Angeles, the first rience basic science as part of the logic features of the resected surgical of 5 new medical schools in the UC curriculum and established the first specimens, a habit that he in- system. The oldest UC Medical research laboratory on the Parnas- grained in his residents, many of School became distinguished as the sus campus. whom had a rotation in surgical pa- UC, San Francisco (UCSF). During In 1947, Naffziger left the Sur- thology to enhance their skills in this the tenure of Leon Goldman, MD, gery Department to chair UC Medi- very important aspect of surgical as chair of the Surgery Department cal School’s new Department of Neu- training.6 One of those residents was from 1956 to 1963, pioneering con- rological Surgery and Bell became Edwin “Jack” Wylie, MD, a pioneer- tributions to vascular surgery con- the Surgery Department’s new chair. ing giant in vascular surgery, who, tinued to be made, including the first A superb technical surgeon, Bell em- in 1951, was the first in the United axillofemoral artery bypass in 1962. phasized the Halstedian tradition of States to perform thromboendarter- Experimental and clinical gastroin- careful dissection, upgrading the ectomy for atherosclerotic aor- testinal research continued, and standards of general surgery in Cali- toiliac occlusive disease. some of the earliest transplantation (REPRINTED) ARCH SURG/ VOL 140, DEC 2005 WWW.ARCHSURG.COM 1144 Downloaded from www.archsurg.com at UCSF/Library, on December 20, 2005 ©2005 American Medical Association. All rights reserved. A B C Figure 2. The University of California Medical Department, San Francisco, Parnassus Heights location. A, Photograph of the new Parnassus Heights campus with a streetcar in front. B, The Medical School building at Parnassus, refitted to house a 75-bed teaching hospital in 1907, is shown here in a 1947 drawing by Ralph W. Sweet (1892-1961), professor of Medical Arts and Illustrations at University of California Medical School. C, Robert A. McLean, MD (1858-1918) in an 1874 photo. (REPRINTED) ARCH SURG/ VOL 140, DEC 2005 WWW.ARCHSURG.COM 1145 Downloaded from www.archsurg.com at UCSF/Library, on December 20, 2005 ©2005 American Medical Association. All rights reserved. A C B Figure 3. Saxton Pope, MD, Howard C. Naffziger, MD, and H. Glenn Bell, MD. A, University of California surgeon Pope, a close companion of the last Yahi Indian, Ishi. B, Naffziger (1884-1961) in his military uniform in 1918. C, Partial scene from a 1937 mural by Bernard Baruch Zakheim depicting the history of medicine. Called the Cole Hall Murals after their original location at the University of California Medical School building lecture hall named for University of California, San Francisco, founder Richard Beverly Cole, MD, this scene shows Bell (1893-1981) performing surgery in the left center foreground. experiments in discordant and con- kidney transplant was performed at other legacy from the Dunphy era cordant species were conducted, UCSF in 1964, and a perfusion ma- has been the major impact his train- which helped set the stage for fur- chine was developed that success- ees have had on surgery ther investigative and clinical ef- fully preserved donor kidneys for 48 forts in xenotransplantation. Endo- hours, an innovation that made throughout the English speaking world. crine surgery was a personal legacy UCSF’s transplantation series one of For a time, it seemed that the imprima- of Goldman. However, additional the most successful in the world.8 tur of the W.W.B.S. (Worked With Bert Society, one of those never organized but changes were in store when J.

Load more