Department of Thoracic Surgery

DEPARTMENT HISTORY

Since 1955 the Department of Thoracic Surgery at Vanderbilt University Medical Center has grown to become an independent specialty surgical department that provides education and treatment for diseases of the thorax, including the lungs, esophagus, mediastinum, chest wall, as well as acquired and congenital diseases of the heart and thoracic cavity. The phases of this transformation in these programs reflect advances in knowledge and skill in these fields and the growth of the hospital in contributing to these facets of surgical resident education and patient care.

The recent revolution of Thoracic Surgery reflect the values and goals of the University in rapidly changing times to accommodate the needs of our patients and students, as well as the interest and ability of the faculty and chair in Thoracic Surgery at Vanderbilt.

Effective January 1, 2004, the Department of Cardiothoracic Surgery was reconfigured as the Department of Thoracic Surgery and the Department of Cardiac Surgery through the efforts of Dean Steven G. Gabbe, M.D., School of Medicine, upon the recommendation of R. Daniel Beauchamp, M.D., Professor and Chair, Section of Surgical Sciences, and the approval of the Executive Faculty of the School of Medicine, and Board of Trustees of Vanderbilt University. Joe B. Putnam, Jr., MD, FACS was selected as the first Chair, Department of Thoracic Surgery.

Davis C. Drinkwater, M.D.

In March 1997 Davis Drinkwater, M.D., joined the Vanderbilt faculty as the William S. Stoney Professor of Surgery and Chairman of the Department of Cardiac and Thoracic Surgery. Dr. Drinkwater, is a 1969 graduate of Harvard University and a 1976 graduate of the University of Vermont Medical School. In between, he earned a graduate degree in physiology from Harvard.

He served both his surgical and cardiothoracic and vascular surgery residencies at McGill University in Montreal and a subsequent fellowship in thoracic surgery at The Hospital for Sick Children in London in 1983. He was a cardiothoracic fellow at Children's Hospital Medical Center in Boston in 1984.

Dr. Drinkwater came to Vanderbilt after 12 years at UCLA where he was professor of Surgery at the UCLA School of Medicine and director of the UCLA Cardiac Transplantation Program. He was also chief of Cardiothoracic Surgery at Wadsworth's Veterans Administration Hospital, and associate medical director of the UCLA Perfusion and Assist Device Service. He brought to the Department his very broad and extensive clinical experience in both congenital and adult heart surgery and transplantation. One of his primary areas of clinical interest was the surgical treatment of end-stage cardiac failure.

William H. Frist, M.D., FACS

A native of Nashville, William H. Frist was born February 22, 1952 into a distinguished medical family. Bill Frist graduated from Princeton University in 1974 where he specialized in health care policy at the Woodrow Wilson School of Public and International Affairs. He got his first taste of politics during his college years when he served (1972) as a congressional intern. In 1978 Frist graduated with honors from Harvard Medical School and spent the next seven years in surgical training at Massachusetts General Hospital; Southampton General Hospital, Southampton, England; and Stanford University Medical Center. He is board certified in both general surgery and heart surgery.

As a board-certified thoracic surgeon and a specialist in heart and lung transplantation, Dr. Frist was a member of the faculty at Vanderbilt University Medical Center from 1985-1994. Under his passionate leadership, Dr. Frist founded and subsequently directed the multi-disciplinary Vanderbilt Transplant Center, which became a nationally renowned center of multi-organ transplantation. Dr. Frist performed over 200 heart and lung transplant procedures, including the first successful combined heart-lung transplant in the southern United States. Frist has written more than 100 articles, chapters, and abstracts on medical research and five books: Transplant, which examines the social and ethical issues of transplantation and organ donation; Grand Rounds in Transplantation; Tennessee Senators, 1911-2001: Portraits of Leadership in a Century of Change; When Every Moment Counts, a family guide on bioterrorism; and Good People Beget Good People. He was admitted into Fellowship of the American College of Surgeons in 1994.

In 1994 Bill Frist was elected senator from Tennessee as a Republican, becoming the first practicing physician to attain the office since 1928. A fourth generation Tennessean whose great, great grandfather was one of Chattanooga's 53 original settlers, Frist is the 54th U.S. Senator from Tennessee. On November 7, 2000, Senator Frist was elected to a second term in the United States Senate by the largest margin ever received by a candidate for statewide election in the history of Tennessee. Senator Frist now serves as the Senate Majority Leader and head of the National Republican Senatorial Committee. Legislatively, the generally conservative Frist has focused on health-care issues.

Member of The H. William Scott, Jr. Society

Harvey Bender, M.D.

Chairman, Cardiac and Thoracic Surgery 1971 - 1997
Cardiac and Thoracic Surgery separated from the Department of Surgery
Establishment of Cardiothoracic Surgery Fellowship at Vanderbilt
A member of the American Board of Thoracic Surgery and served as Chair
A member of the Residency Review Committee for Thoracic Surgery
Strong interest in developing programs in heart and lung transplantation, children’s heart surgery, and resident education

In 1971, Dr. Harvey Bender came from Johns Hopkins University to become the head the Vanderbilt Division of Thoracic and Cardiac Surgery in the Department of Surgery. During his first and second year Dr. Bender increased the cardiac and thoracic experience for residents rotating through the Division, with cooperation from Dr. Duncan A. Killen and Dr. Harold Collins. Dr. Collins was a Vanderbilt Chief Resident in 1956-1957. His clinical focus was more on cardiac than thoracic surgery. The educational experience also began to emphasize collaboration. “Dr. Freisinger and his excellent group in Cardiology in the Department of Medicine brought splendid collaboration and strong support for Dr. Bender and his associates,” (Scott, et. al.). Dr. Killen left Vanderbilt in 1972 to enter private practice, and Dr. Collins left to become Head of the Division of Cardiac and Thoracic Surgery at the University of Illinois Medical School in Peoria.

In 1974-1975 the Vanderbilt Department of Surgery was reorganized into the Section of Surgical Sciences. At that time a number of surgical specialties which had been divisions within the Department of Surgery became separate departments. On July 1, 1975, Dr. Bender became Chairman of the newly formed Department of Cardiac and Thoracic Surgery.

“Dr. Bender’s excellent program has been expanded by the valuable input of Dr. Darryl Fisher and the appointment of Dr. Issam Shaker. The residency program has been expanded to a two-year one which includes rotations to the Cardiac Surgical Service at St. Thomas Hospital headed by Dr. William S. Stoney. Dr. Bender has continued as Chairman of the Executive Committee of the Vanderbilt Professional Practice Program and has continued to contribute greatly to the strength of this Medical Center,” (Scott, et al.)

Around 1993, residents ceased rotating to St. Thomas Hospital for cardiothoracic surgical training.

A symposium was held in honor of Dr. Bender at the time of his retirement in 1997. In the words of his colleague, Walter Merrill, M.D., 'Dr. Bender has certainly been a pivotal figure in the growth and development of the department over the past 25 years, particularly with the increased activity in children's heart surgery and in the development of the heart and lung transplantation programs. He has also been instrumental in general and thoracic surgical resident education at Vanderbilt over the years. Last but not least, he has held, and continues to hold, important leadership positions here at Vanderbilt and nationally.'

Rollin A. Daniel, Jr., M.D.

Chief Resident, Surgery, Vanderbilt, 1937-1938
Joined Vanderbilt faculty
Chief of Cardiothoracic Surgical Service
CT Surgery was a part of the Department of Surgery
Clinical focus more thoracic than cardiac
A founding member of the American Board of Thoracic Surgery and served as Secretary

Rollin Daniel, M.D., provided early leadership for the development of thoracic surgery as a patient care specialty at Vanderbilt. He received both his BA. and M.D. from Vanderbilt, the latter in 1933. He interned on Dr. Brooks’ service after which he spent a year at Barnes Hospital in St. Louis with Dr. Evarts Graham, which kindled his interest in thoracic surgery. He returned to Vanderbilt and became Chief Resident Surgeon in 1938. He conducted research with Alfred Blalock, M.D. and also shared a private practice of surgery with Drs. Eve and Edwards. Upon Dr. Blalock’s departure for Johns Hopkins in 1941, Dr. Daniel assumed responsibility for the Vanderbilt Thoracic Surgical Service. At this time, and until 1971, thoracic surgery at Vanderbilt was a surgical service within the Department of Surgery. Dr. Daniel became Professor of Surgery in 1953. In the following year, he reentered the private practice of Surgery although he retained his teaching responsibilities at Vanderbilt.

In 1956 Vanderbilt began to take greater educational and patient care advantage of the diversity of experience presented by different hospitals in the area by forming associations with them. “Significant changes in the residency programs were initiated in the academic year 1956-1957. A most important change was the integration of the residency in General Surgery into a five-year balanced program that united the Surgical Services of Vanderbilt Hospital with those of Thayer General Veterans Administration Hospital. In addition, a tour of duty at the Tennessee Tuberculosis Hospital was incorporated at various stages of the General Surgical Residency. Hence, the Residency in General Surgery sponsored by Vanderbilt University would be based on an aliquot of 1150 beds provided by three hospitals. . . . A residency in Thoracic Surgery was developed in conjunction with the Middle Tennessee Tuberculosis Hospital, and under discussion was a plan to obtain approval from the Council for an integrated residency in General Thoracic Surgery based on the 1150 beds available in Vanderbilt, Thayer, and Middle Tennessee Tuberculosis Hospitals so that a resident who completed a five-year program of this integrated nature might be qualified for Board Examinations in both General and Thoracic Surgery.

The Middle Tennessee Tuberculosis Hospital, under the overall direction of Dr. Hubbard, developed an excellent program in Thoracic Surgery under the Service leadership of Dr. Robert McCracken with the consultation of Drs. Daniel and Dively. The Service proved to be an excellent addition to our residency training program.” (Scott, HW Jr., et al., The History of Surgery at Vanderbilt.)

In 1969-1970, Dr. Daniel still supervised the training programs in thoracic surgery although he continued to maintain a private practice. Drs. Harold A. Collins and Duncan Killen supervised the Thoracic and Cardiovascular Program at Veterans Administration Hospital. The Chief Residency experience in Thoracic and Cardiac Surgery was added and, according to Dr. H. William Scott, Jr., Chairman of the Department of Surgery, “made a good start.” The Middle Tennessee Chest Disease Hospital—one of the hospitals affiliated with the Vanderbilt surgical education program---experienced a reduction in patients with tuberculosis and so opened these beds to patients with nontuberculous thoracic disease. This, Dr. Scott said, “greatly enhanced the activities of the service.”

From 1970 until his retirement, Dr. Daniel served as Chief of Surgery at St. Thomas Hospital in Nashville. He is remembered by colleagues and former residents each year with the Rollin A. Daniel, Jr. Lecture.

Alfred Blalock, M.D.

Alfred Blalock was born in Culloden, Georgia on April 5, 1889. He graduated with an AB degree in 1918 and entered Johns Hopkins Medical School where he was awarded the M.D. in 1922. Blalock spent the next two and a half years at Hopkins, completing an Internship in Urology, and then an Assistant Residency on the General Surgical Service, followed by a Fellowship in Otolaryngology. During the summer of 1925, he moved to Boston to begin a Residency at the Peter Bent Brigham Hospital. However, he never unpacked his bags. Instead, he accepted the position as Resident Surgeon in the program of the newly constructed Vanderbilt University Hospital in Nashville, joining his good friend and fellow Southerner, Tinsley Harrison, who was Vanderbilt's first Chief Resident on the Medical Service. Alfred Blalock arrived in Nashville, TN on September 17, 1925 to work with Barney Brooks, Professor of Surgery and Chief of the Surgical Service.

Dr. Brooks was chairman of the Department of Surgery from 1925 until 1952. At that time Vanderbilt graduated one chief resident per year, its first being Alfred Blalock, M.D. After completing his residency Blalock stayed on the faculty to do research on shock therapy.

Blalock is known for his pioneering research on the nature and treatment of hemorrhagic and traumatic shock, and is credited with saving the lives of many casualties during World War II, and with the first open heart operation for tetralogy of Fallot (blue baby). But his teaching techniques also set him apart.

“He was entirely dedicated to the education of students and residents,” says Dr. Walter H. Merrill, professor of Cardiac and Thoracic Surgery at VUMC. “He talked a lot over the years about his real joy in life – working with residents. He liked to give positive reinforcement. He was courtly and courteous.”

At Vanderbilt, Blalock was active in teaching the 3rd and 4th year medical students and was placed in charge of the surgical research laboratory. Blalock's laboratory experiments at Vanderbilt proved that surgical shock was due to 'loss of effective circulating blood volume and refuted the basis for the beneficial and extensive use of blood and plasma in the care of wounded men in W.W. II.'*

Blalock's very productive years at Vanderbilt were marred by recurring bouts with tuberculosis. He took the 'cure' at the Trudeau Clinic, remaining there for a year. He then went to Europe as a traveling Fellow, visiting many well known surgical clinics and surgical research laboratories. His tuberculosis recurred and he received treatment in Berlin and at Cambridge. Blalock returned to Vanderbilt and kept up a heavy schedule of teaching, operating, research, and writing. By the time he was 40 years of age the number of his publications exceeded 100 and he had published his monograph entitled, Principles of Surgical Care: Shock and Other Problems. Blalock's experimental work during the decade of the 1930's was 'enormously facilitated by the expertise of Vivien Thomas, a high school graduate, who begun to work in laboratory as Dr. Blalock's technician.'*

He thereafter became Professor of Surgery and Chairman of the Department of Surgery at Johns Hopkins. Another of his research interests was pulmonary hypertension. Using dogs, he devised an operation in which the subclavian artery was anastomosed to the pulmonary artery. 'This failed to produce pulmonary hypertion, but was the procedure used many years at Johns Hopkins in the original blue baby operation.'*

The Alfred Blalock Surgical Resident Award is given annually to the principal investigator and author of the best laboratory or clinical research report made during residency. Special Consideration is given to any new or innovative approach to a surgical problem and the nature of the findings reported.

*Scott, H. William. History of Surgery at Vanderbilt University. History of Surgery at Vanderbilt University. Nashville: Vanderbilt University Medical Center, 1996. pp. 52-58

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