Band of brothers: Creators of modern vascular surgery

Abstract

Band of brothers: Creators of modern vascular surgery W. Andrew Dale; 1996; 511 pages. I first met Andrew Dale in 1959 when I was a second-year resident in General Surgery. He came to Seattle to speak to the Seattle Surgical Society as a guest of J. Thomas Payne, who was then Chief of Surgery at the Veterans Administration Hospital. I had a discussion with him about the emerging field of “Vascular Surgery.” I was very impressed with his obvious enthusiasm for this type of surgery. It was apparent to me that he was a disciple of detail and the need to do things right. In 1970 he held one of the first multidisciplinary meetings on arterial occlusive disease that I was privileged to attend. It is ironic that he was among the first in my view to invite an outsider such as Charles Dotter to talk about his new procedure. Perhaps he saw something that many others missed. Dr. Dale was an elegant spokesman for Vascular Surgery and remained one of the leaders in this field up until the end of his life. He was truly a Southern gentleman. He like many in his book was in the right place at the right time. He worked hard at his profession and he was very successful. Why then would someone in the twilight of their surgical career, and in his case his life, undertake such a unique effort? The title of the book says a lot about why he decided to do this. The title comes from Shakespeare's Henry V. In that play, the English king speaking before the Battle of Agincourt proclaims, “We few, we happy few, we band of brothers; For he today who sheds his blood with me Shall be my brother.” As Dr. Dale noted, Admiral Horatio Nelson also used the term “Band of Brothers” to refer to those captains who fought with him in the Battle of the Nile. Ernest K. Gann, the famed pilot and author, also used the words to describe the group of diverse characters who were joined together by common aspirations and goals. Dr. Dale chose to interview some of the outstanding surgeons of the day who made major contributions to the field of Vascular Surgery. The choices were his, and he admitted to leaving some people out of the narration who others might think should have been included. This fact is acknowledged by both Dr. Dale and Drs. George Johnson and James DeWeese, who completed the task after Dr. Dale's death from leukemia in 1990. The names of those interviewed are well known to all of us. Their status as leaders in this field is not in doubt. However, it must be remembered that this is not a history of Vascular Surgery. It is a fascinating compilation of what went into molding the lives and careers of many of our leaders in vascular surgery. His Band of Brothers consisted of 37 surgeons. For every book review and reviewer it is necessary to point out the strengths, as well as the weaknesses of such an effort. In dealing with the latter first, this is not a historical treatise, such as John Fulton's Life of Harvey Cushing, which is a classic medical history of someone who made monumental contributions to the field of Neurosurgery. Reading this book will not provide the reader with such treatment. It is a series of self-portraits, with all the problems that such dialogue provides. It is also important to realize that this work will be of little interest to those who do not know the surgeons who were interviewed. What then is the value of this effort? For me and I am sure for all who knew these surgeons, either up close or at a distance, will be fascinated by their tales and how and why they ended up where they did and some still are. The tales are full of examples (we used to call heroes) of individuals who helped these surgeons along their way. All who were interviewed were generous, in my view, in giving credit where credit was due. In some cases the views expressed were not particularly kind to some individuals. However, I was impressed by the candor of some of the interviewees. Where will an effort such as this pay off? One of the missing elements in medicine today is a lack of interest in our historical record. My first chief, Dr. Henry Harkins, made sure that both the students and the residents appreciated those who preceded us. If we are fortunate enough to have someone, at some time, want to write a definitive history of this era, there is a lot of useful biographical information here to call on.