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Oliver Wendell Holmes and the “dimple” artifact
Moments in Surgery Oliver Wendell Holmes and the ‘‘dimple’’ artifact Andrew L. Warshaw, MD, Editor in Chief, Cambridge, Massachusetts
From the Department of Surgery, Harvard Medical School, Cambridge, Massachusetts
Gifts from grateful patients to their surgeons are not unusual. These gifts often become both special keepsakes to the surgeons and a reminder of patient gratitude for what they do. Dr Richard Lynn recalled a gift from Mrs Marjorie Brown, whose husband suffered a ruptured aortic aneurysm in 1982. Mr Brown was in shock in the emergency room, with little hope of survival.
Mr Brown not only survived the operation performed by Dr Lynn, but also survived a month-long stormy course of complications that occurred during the healing process. A year later, Dr Lynn removed a gangrenous gall bladder from Mr Brown. The grateful Browns one day appeared in Dr Lynn’s office with a box. ‘‘We want you to
Figure. The original response to Dr Adams’ query from Oliver Wendell Holmes, MD. Reprinted with permission from the American College of Surgeons and Richard A. Lynn, MD, FACS. (Color version of figure is available online.) 292 SURGERY
Surgery Volume 153, Number 2
have this,’’ they said. The box was rather inconspicuous, and Dr Lynn recalls thinking later, ‘‘You can’t judge a book by its cover.’’ The Browns explained that Mrs Brown’s grandfather was a medical student at the time that Oliver Wendell Holmes was a professor of anatomy at Harvard Medical School in the late 1860s. Oliver Wendell Holmes, MD (1809-1894), a renowned physician and poet, is known for being one of the major American poets of the 19th century and for his books, including Autocrat at the Breakfast Table. He is also known for being the father of jurist Oliver Wendell Holmes, Jr. Dr Holmes was one of the first physicians to suggest that disease might be spread by health care workers through the germs they carry. He and Ignaz Semmelweiss recommended that health care workers wash their hands before going to treat another patient, but their recommendations were discounted for decades. Mrs Brown’s grandfather---the Dr Adams in the note on the box---and his fellow medical school classmate Dr. Kittredge, decided to ask Professor Holmes about the anatomy of the dimple. Oliver Wendell Holmes’ charming reply (Figure) was treasured by his student, Dr Adams, who passed it down to his son, who passed it down to his daughter, Mrs Marjorie Adams Brown. Dr Lynn at first doubted the authenticity of the letter, thinking the time period too long for just 2 generations. He learned, however, that Mrs Brown was born when her father was in his 60s and that the father had also been born when his father was in his 60s. The Browns explained to Dr Lynn that he had treated them extraordinarily well and felt that he would appreciate the letter from such a famous physician more than their children would. Dr Lynn says that he has treasured this gift for more than 2
Warshaw 293
decades. As he is assessing property that he might pass on to his heirs, he decided that the American College of Surgeons Archives would be the most appropriate place for it. All 3 of his Orthodox rabbi sons---although interested in this item, which holds so much meaning to their father---agree that in the Archives it can give the greatest pleasure to the greatest number of individuals. The note reads as follows: Dear Sir: I am sorry for your perplexity and more so I cannot give you the anatomical solution to your question. Dimples are not common in the subjects of the scalpel. As to what a dimple means, I would not have asked that question at five and twenty. It used to mean youth and smiles and all that was charming in their day. Looking at it as I do at present, I should say a dimple is an early wrinkle that doesn’t know what it is coming to. Make the most of the innocent little fossae while they last and take my word for it; it is pleasanter investigating them in their native habitat than asking old Professors what they have to say about them. Wishing you all opportunity for their study directly from nature. I am Yours truly, O.W. Holmes Postscript. A year and a half after Mr Brown’s recovery from the gallbladder operation, he developed a melanoma from which he did not survive. Published with gratitude to Dr. Richard Lynn of Palm Beach, FL for providing both excellent surgical care and this piece of history.
From the Department of Surgery, Harvard Medical School, Cambridge, Massachusetts
Gifts from grateful patients to their surgeons are not unusual. These gifts often become both special keepsakes to the surgeons and a reminder of patient gratitude for what they do. Dr Richard Lynn recalled a gift from Mrs Marjorie Brown, whose husband suffered a ruptured aortic aneurysm in 1982. Mr Brown was in shock in the emergency room, with little hope of survival.
Mr Brown not only survived the operation performed by Dr Lynn, but also survived a month-long stormy course of complications that occurred during the healing process. A year later, Dr Lynn removed a gangrenous gall bladder from Mr Brown. The grateful Browns one day appeared in Dr Lynn’s office with a box. ‘‘We want you to
Figure. The original response to Dr Adams’ query from Oliver Wendell Holmes, MD. Reprinted with permission from the American College of Surgeons and Richard A. Lynn, MD, FACS. (Color version of figure is available online.) 292 SURGERY
Surgery Volume 153, Number 2
have this,’’ they said. The box was rather inconspicuous, and Dr Lynn recalls thinking later, ‘‘You can’t judge a book by its cover.’’ The Browns explained that Mrs Brown’s grandfather was a medical student at the time that Oliver Wendell Holmes was a professor of anatomy at Harvard Medical School in the late 1860s. Oliver Wendell Holmes, MD (1809-1894), a renowned physician and poet, is known for being one of the major American poets of the 19th century and for his books, including Autocrat at the Breakfast Table. He is also known for being the father of jurist Oliver Wendell Holmes, Jr. Dr Holmes was one of the first physicians to suggest that disease might be spread by health care workers through the germs they carry. He and Ignaz Semmelweiss recommended that health care workers wash their hands before going to treat another patient, but their recommendations were discounted for decades. Mrs Brown’s grandfather---the Dr Adams in the note on the box---and his fellow medical school classmate Dr. Kittredge, decided to ask Professor Holmes about the anatomy of the dimple. Oliver Wendell Holmes’ charming reply (Figure) was treasured by his student, Dr Adams, who passed it down to his son, who passed it down to his daughter, Mrs Marjorie Adams Brown. Dr Lynn at first doubted the authenticity of the letter, thinking the time period too long for just 2 generations. He learned, however, that Mrs Brown was born when her father was in his 60s and that the father had also been born when his father was in his 60s. The Browns explained to Dr Lynn that he had treated them extraordinarily well and felt that he would appreciate the letter from such a famous physician more than their children would. Dr Lynn says that he has treasured this gift for more than 2
Warshaw 293
decades. As he is assessing property that he might pass on to his heirs, he decided that the American College of Surgeons Archives would be the most appropriate place for it. All 3 of his Orthodox rabbi sons---although interested in this item, which holds so much meaning to their father---agree that in the Archives it can give the greatest pleasure to the greatest number of individuals. The note reads as follows: Dear Sir: I am sorry for your perplexity and more so I cannot give you the anatomical solution to your question. Dimples are not common in the subjects of the scalpel. As to what a dimple means, I would not have asked that question at five and twenty. It used to mean youth and smiles and all that was charming in their day. Looking at it as I do at present, I should say a dimple is an early wrinkle that doesn’t know what it is coming to. Make the most of the innocent little fossae while they last and take my word for it; it is pleasanter investigating them in their native habitat than asking old Professors what they have to say about them. Wishing you all opportunity for their study directly from nature. I am Yours truly, O.W. Holmes Postscript. A year and a half after Mr Brown’s recovery from the gallbladder operation, he developed a melanoma from which he did not survive. Published with gratitude to Dr. Richard Lynn of Palm Beach, FL for providing both excellent surgical care and this piece of history.