In memoriam J. Alex Haller Jr. MD (May 20, 1927–June 13, 2018)

Abstract

I invite the readership of the Journal of Pediatric Surgery to join me in celebrating the life and career of J. Alex Haller Jr. MD. Alex passed away peacefully at his beloved home in Glencoe, Maryland, with his wife Emily and family at his bedside on June 13, 2018. He was 91. He will be remembered as a first-class pediatric surgeon, a perpetual innovator, a periodic provocateur—and always an advocate for children and our specialty of Pediatric Surgery. Alex was born in Pulaski, Virginia, on May 20, 1927. His father was a practicing dentist. His mother died when he and his brother were of young age, and two aunts stepped in to help their brother raise the boys during the Depression and Second World War. He earned his baccalaureate degree from Vanderbilt in 1947, where he met Emily, his wife of 67 years. Alex went on to pursue a medical degree from The Johns Hopkins University School of Medicine in 1951 and spent the next year in Zurich studying pathology. After serving two years in the Coast Guard, Alex returned to Baltimore to pursue general and thoracic surgery as a Halsted resident under Alfred Blalock at his alma mater, Johns Hopkins. After completing his residency, Alex took up a chief of cardiac surgery position at the University of Louisville. In 1963, Dr. Blalock recruited Alex back to Baltimore once again. This time Alex would lead and develop the newly-created pediatric surgical division that would become his legacy at Hopkins Hospital. In 1964, the Children's Medical and Surgical Center (CMSC) opened at Hopkins Hospital, becoming one of the first hospital-within-a-hospital concepts, with Alex at the helm as the inaugural Surgeon-in-Charge. During his 28-year stint as a division chief and surgical director of the CMSC, Alex created a top-flight clinical, research, and teaching program. One of the initial accredited training programs in pediatric surgery, Alex required fellows to be schooled in clinical as well as research techniques, and this later became a hallmark of the program. Alex's forte had always been thoracic surgery, and in this new role he quickly expanded the program with faculty to develop all of the subspecialty areas in general pediatric surgery. Ever inclusive of talent, he also championed the recruitment of dedicated pediatric specialists for urology, neurosurgery, orthopedics, plastics, otolaryngology, and cardiac surgery. Alex was a surgical innovator, particularly in the area of chest wall reconstruction. His clinical assessment tools for pectus excavatum are widely used today, more than 40 years later. He created the first statewide Level 1 trauma center for pediatric patients in the nation using the “scoop and run” technique to ensure children reached a definitive care center under the “golden hour”. He cocreated the Advanced Pediatric Life Support course, now proctored by the American Academy of Pediatrics. As a researcher, Alex was an early proponent of fetal surgery and developed fetal lamb models for a number of congenital anomalies that plague newborns. He published more than 400 scholarly papers, book chapters, and texts read by aspiring, practicing, and expert medical practitioners around the world. As an advocate for children, he championed palliative care and ethical treatment of the severely ill. He was instrumental in championing gun control legislation in the state of Maryland and at federal level, as evidenced by the passage of the Brady Bill. Known in both hospital halls and social settings as a provocateur, Alex would raise a counterargument on any given subject in order to ensure a thorough debate from all sides and sound resolution. Proof of his provocative and intellectual methods was evident in his end-of-life debates, the founding of the American Pediatric Surgery Association (where he pointed out that the American College of Surgeons is also an important advocate for pediatric surgery), his vocal stance on gun control, his advocacy for multidisciplinary teams in critical care areas (which created a pediatric medical/surgical ICU at Hopkins with the highest case mix index, and the lowest mortality rate among U.S. children's hospital) and many others. Above all, Alex was a devoted husband, father, grandfather and community leader. He and Emily had 4 children, all accomplished in their professional lives, and 16 grandchildren. Alex will be remembered as an outstanding and innovative clinician, an acclaimed researcher, an ecumenical educator, and a tireless advocate for children. These were the four pillars of his life as an academic pediatric surgeon, and he would expect nothing less from us in our professional lives.