William Halstead (1852-1922)
|
Halstead was born in New York in 1852, the son of a wealthy merchant family who had emigrated from England in the 1600s. He graduated from Yale University in 1874 and matriculated at the College of Physicians and Surgeons in New York. He
was highly regarded as a student and become student assistant to John Dalton, a pioneering experimental physiologist at that time. This association and friend He worked in New York for approximately two years after qualification before money became available for him to continue his training in Europe with Billroth in Vienna, Thiersch in Leipzig, and Volkmann in Halle. His two years in Europe had a profound influence on his future career, in particular the significant differences in surgical training between Europe and North America. He was impressed by the formal training of German surgeons with close integration of basic sciences into the curriculum. At that time most surgeons in America were self taught in stark contrast to the regimented German system. In 1880 he returned to New York where he was appointed demonstrator in anatomy and associate in surgical practice at the Roosevelt Hospital. He established an outpatient department and started experimental work with local anaesthesia and cocaine. Between 1882 and 1886 he published over 20 papers on a wide variety of topics. As a result of his experimental work he became addicted to cocaine which was to overshadow the remainder of his life. By 1886, he was facing professional extinction as a result of addiction to cocaine and later morphine and alcohol. That year he took an extended sailing trip to the Windward islands in the hope of regaining his health. This failed and he was forced to voluntarily admit himself to Butler Hospital, Providence, Rhode Island. He was discharged in November 1886 after seven months of treatment. His career in new York was over and he instead went to do laboratory work in the recently opened Johns Hopkins University, Baltimore. He unfortunately was forced to return to Butler Hospital in April 1887 where he stayed for a further 9 months. He returned to Baltimore in January 1888 once again starting some clinical work and in 1889 was appointed acting surgeon to the Johns Hopkins Hospital. Later that year, he was made associate professor but was not made full professor of surgery until 1892. Despite apparent rehabilitation, he continued to abuse morphine right up until is death in 1922, but during this period it had little effect on his physical and psychological well being. Halstead never wrote a textbook or treatise. All his written contribution were in the surgical journals of the day. In 1889 he published a technique of inguinal hernia repair and in the early 1890s he described a radical mastectomy for breast cancer with which his name is associated. 1892 he described ligation of the subclavian artery. In the early 1900s he published on autotransplantation of the parathyroid gland. Halstead was a great surgical educator who, influenced by his early years in Germany, introduced basic laboratory medicine into clinical practice and a formal training program for junior surgeons. He was the founder of the surgical training program at the Johns Hopkins University on which many other teaching systems were modeled. "The only weapon with which the unconscious patient can immediately retaliate upon the incompetent surgeon is haemorrhage" Bulletin of the John Hopkins Hospital 1912; 23: 191 Recent papers Rutlow I M. William Stewart Halstead. Arch Surg 2000; 135: 1478-1479. |
ship
was to significantly influence his future career as an experimental surgeon.
Printer friendly version