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Wenner Dudley Johnson
Milwaukee Journal Sentinel
Obituary
Wenner Dudley Johnson Pioneering heart surgeon. He was born in Madison, WI, USA, on April 3, 1930, and died following a stroke in Milwaukee, WI, USA, on Oct 24, 2016, aged 86 years. In an interview a few years ago for his local television station, cardiac surgeon W Dudley Johnson was asked how, back in the 1960s, he’d gone about introducing a new procedure into his hospital’s operating theatre. I just rang and told them I’d be doing it, he said. His interviewer asked how that compared with now. “Well, we’ve been trying to get a new operation going for at least 3 years”, was Johnson’s mournful response. “It’s now an enormous struggle.” To an innovator like him, the risk aversiveness of contemporary medicine was surely anathema. Retired pathologist Gordon Lang was a close colleague of Johnson’s at the then St Mary’s Hospital in Milwaukee. When he says of his long-standing friend, “Dudley was willing to try new things”, he is understating the position. In fact, as Lang himself observes, Johnson had long been described as “the father of coronary bypass surgery”. An attempt to account for adult behaviour on the basis of childhood experiences is a risky enterprise, and Lang is duly cautious in trying to explain Johnson’s fierce determination to push the limits of cardiac surgery. His father was an academic electrical engineer who moved into industry, but it was his mother, a home economics teacher, who was arguably the greater influence. Johnson had an older brother who eventually became a professor of engineering; “apparently, when they were growing up, his mother favoured him”, says Lang. He thinks this was one of the 248
factors that prompted Johnson to lead such a driven life. “He was the type of individual who wanted to make sure things were going right even in the middle of the night. He’d sleep on a hospital couch so if any problems came up he’d be there to take care of them”, says Lang. Johnson trained at the University of Illinois College of Medicine in Chicago, graduating in 1955 and doing his internship at Cook County Hospital. After 2 years in the US Public Health Service in lieu of military service he moved to Milwaukee in 1959 to start his surgical training, becoming an assistant instructor and later an assistant professor of surgery at the Medical College of Wisconsin. Having chosen vascular and cardiothoracic work, he started to make use of the Vineberg procedure: a forerunner of coronary artery bypass grafting in which the internal mammary artery is implanted into the myocardium to improve the blood flow to the heart. Dissatisfied with this as a remedy for myocardial ischaemia, Johnson first modified and developed it, then looked around for an alternative. He visited the Cleveland Clinic to learn their method of patch grafting for dealing with diseased coronary arteries, but this too he found wanting. As Lang explains, “he thought it would be more reasonable to bypass diseased segments of coronary arteries by placing a vein taken from the leg and sewing it to a normal segment of the artery beyond the diseased segment”. The other end he joined directly to the aorta—and so helped to launch the modern era of coronary artery surgery. He was the first to do a bypass of the left coronary artery and also developed double and triple bypasses. He was a pioneer of endarterectomy of the coronary artery, and the first surgeon in his state to do a heart transplant. This was one area he chose not to pursue. “He thought he could be of more help to more people by concentrating on coronary artery disease”, says Lang. Despite having large hands, Johnson was a dextrous surgeon. “His mother apparently gave the boys lessons in sewing and embroidery”, Lang says. “I don’t know how far that influenced him (in his career choice), but at least he got some early practice with needles.” He was also renowned for his stamina in the operating theatre during sessions that could last for 10 or more hours. Not all his fellow surgeons seem to have found him the easiest person to get on with. “He would challenge them to do what he could do”, according to Lang. But not all could meet that challenge. Johnson still managed to find time for other interests, including music, gemmology, and horticulture. He also visited Cuba in the late 1980s, performing a number of heart operations and meeting Fidel Castro. The country’s leader he noted, was well informed, and even knew the incidence of congenital heart disease. Johnson is survived by two daughters and a son from his first marriage, and by two step daughters from a third marriage.
Geoff Watts www.thelancet.com Vol 389 January 21, 2017
Obituary
Wenner Dudley Johnson Pioneering heart surgeon. He was born in Madison, WI, USA, on April 3, 1930, and died following a stroke in Milwaukee, WI, USA, on Oct 24, 2016, aged 86 years. In an interview a few years ago for his local television station, cardiac surgeon W Dudley Johnson was asked how, back in the 1960s, he’d gone about introducing a new procedure into his hospital’s operating theatre. I just rang and told them I’d be doing it, he said. His interviewer asked how that compared with now. “Well, we’ve been trying to get a new operation going for at least 3 years”, was Johnson’s mournful response. “It’s now an enormous struggle.” To an innovator like him, the risk aversiveness of contemporary medicine was surely anathema. Retired pathologist Gordon Lang was a close colleague of Johnson’s at the then St Mary’s Hospital in Milwaukee. When he says of his long-standing friend, “Dudley was willing to try new things”, he is understating the position. In fact, as Lang himself observes, Johnson had long been described as “the father of coronary bypass surgery”. An attempt to account for adult behaviour on the basis of childhood experiences is a risky enterprise, and Lang is duly cautious in trying to explain Johnson’s fierce determination to push the limits of cardiac surgery. His father was an academic electrical engineer who moved into industry, but it was his mother, a home economics teacher, who was arguably the greater influence. Johnson had an older brother who eventually became a professor of engineering; “apparently, when they were growing up, his mother favoured him”, says Lang. He thinks this was one of the 248
factors that prompted Johnson to lead such a driven life. “He was the type of individual who wanted to make sure things were going right even in the middle of the night. He’d sleep on a hospital couch so if any problems came up he’d be there to take care of them”, says Lang. Johnson trained at the University of Illinois College of Medicine in Chicago, graduating in 1955 and doing his internship at Cook County Hospital. After 2 years in the US Public Health Service in lieu of military service he moved to Milwaukee in 1959 to start his surgical training, becoming an assistant instructor and later an assistant professor of surgery at the Medical College of Wisconsin. Having chosen vascular and cardiothoracic work, he started to make use of the Vineberg procedure: a forerunner of coronary artery bypass grafting in which the internal mammary artery is implanted into the myocardium to improve the blood flow to the heart. Dissatisfied with this as a remedy for myocardial ischaemia, Johnson first modified and developed it, then looked around for an alternative. He visited the Cleveland Clinic to learn their method of patch grafting for dealing with diseased coronary arteries, but this too he found wanting. As Lang explains, “he thought it would be more reasonable to bypass diseased segments of coronary arteries by placing a vein taken from the leg and sewing it to a normal segment of the artery beyond the diseased segment”. The other end he joined directly to the aorta—and so helped to launch the modern era of coronary artery surgery. He was the first to do a bypass of the left coronary artery and also developed double and triple bypasses. He was a pioneer of endarterectomy of the coronary artery, and the first surgeon in his state to do a heart transplant. This was one area he chose not to pursue. “He thought he could be of more help to more people by concentrating on coronary artery disease”, says Lang. Despite having large hands, Johnson was a dextrous surgeon. “His mother apparently gave the boys lessons in sewing and embroidery”, Lang says. “I don’t know how far that influenced him (in his career choice), but at least he got some early practice with needles.” He was also renowned for his stamina in the operating theatre during sessions that could last for 10 or more hours. Not all his fellow surgeons seem to have found him the easiest person to get on with. “He would challenge them to do what he could do”, according to Lang. But not all could meet that challenge. Johnson still managed to find time for other interests, including music, gemmology, and horticulture. He also visited Cuba in the late 1980s, performing a number of heart operations and meeting Fidel Castro. The country’s leader he noted, was well informed, and even knew the incidence of congenital heart disease. Johnson is survived by two daughters and a son from his first marriage, and by two step daughters from a third marriage.
Geoff Watts www.thelancet.com Vol 389 January 21, 2017