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Owen H. Wangensteen , M.D. PhD. A Legacy of Scientific and Educational Innovation Innominate Society Stanley A. Gall, M.D. November 8, 2011. Owen H. Wangensteen M.D., PhD 1898-1981. Professor and Head Department of Surgery University of Minnesota Medical School 1930-1966.
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Owen H. Wangensteen, M.D. PhD A Legacy of Scientific and Educational Innovation Innominate Society Stanley A. Gall, M.D. November 8, 2011
Owen H. Wangensteen M.D., PhD1898-1981 • Professor and Head • Department of Surgery • University of Minnesota Medical School • 1930-1966
Goals for Presentation • Early childhood influences • Undergraduate and early academic career • Process leading up to appointment of Department of Surgery • Scientific achievements • Educational evaluation
Early Childhood Influences • Born on a form near Lake Park Minnesota – mid north part of the state • Father immigrated to US from Norway in 1881 • Mother born on a farm near Lake Park Minnesota – Norwegian parents • Mother died when OHW was 7 years
Early Childhood Influences • OHW: prepared to make farming a career • Father was impressed with ability to handle sick farm animals • Delivered some 300 piglets from 50 sows who had trouble farrowing • OHW interested in veterinary medicine but father insisted on Human Medicine
Early Childhood Influences • An important character trait developed during which became more obvious with time. OHW developed the trait: • “with overwhelming pride not only in completion of a task but completion with such perfection that it taxed his every ability”. Neither time nor effort was counted to achieve a goal.
II. Undergraduate and Medical School: Early Education and Early Academic Career • 1915 OHW enrolled in the University of Minnesota College of Science, Literature and Arts, NOT Agriculture or Veterinary School • 1918 Entered Medical School after a summer of hauling hay and manure on the family farm OHW comment: “through the avenues of pigs and manure and a good spread of each, I finally got into medicine”.
II. OHW: Academic Process • 1919 – Bachelor of Arts • Doctor of Medicine – accelerated due to WWI. • Finished #1 in Medical School • Elected to AOA
II. Post-Medical School Activities • Rotating Internship at University of Minnesota. Did not get residency in Surgery. • Influenced by Dr. George E. Fahr Professor of Medicine • Great enthusiasm for observation and research • OHW decided he did not want private practice
II. Post-Medical School Activities • 1924: Spent a year at Mayo Clinic as a Surgical fellow • 6 months on diagnostic service with Henry S. Plummer • 6 months on operative service of William Mayo and Frank C. Mann • OHW: William Mayo was a “Surgeon’s Surgeon” • Great operating surgeon • Remembers everybody • Frank Mann: Animal Farm and research laboratories frequented by OHW
II. Surgery Training Continued • 1925: OHW returned to University of Minnesota and became the chief resident in Surgery at UMH • 1926: Offer to go into private practice in S.D. for $15,000/yr. • Offer to stay at University of Minnesota as Assistant Professor for $3000/yr.
III. Appointment of Department of Surgery Head • 1920s: UM converting faculty from part time to full time faculty • 1925: Arthur Strachauer, Head resigned • 1926: Search committee formed and interviewed three candidates • Frances C. Newton – Harvard • Mont R. Reid – Cincinnati • Owen H. Wangensteen – Minnesota • Newton and Reid: commented “there is nothing worth while here nor will there ever be”. • Medical School groomed OHW
II. Surgical Training • 1926: Dean Lyons, arranged for a sabbatical leave to travel and study in Europe • Fall 1927-Fall 1928 OHW, wife and 2 yr. old daughter went to Europe • Primary site for research was Bern, Switzerland
II. Europe Reflections • OHW: Recommendation of William Mayo more valuable than the President of U.S. • OHW: Treated like royalty by top echelon of well known German Professors of Surgery
II. German Professors of Surgery • Ferdinand Sauerbruch →→ Berlin • Rudolf Nissen→→ Berlin • Martin Kirshner→→ Tubingen • Paul Sudeck →→ Hamberg • Frederick Voelscher→→ Halle
II. Work in Bern Switzerland • Professor Dominique deQuerain • Professor Archer Published work with deQuerain on “The Blood Supply of the Normal and Diseased Thyroid Gland”. OHW: Deeply impressed with deQuerain Recounted: Professor deQuerain read widely over the entire range of Surgery and was likely to reply to a narration of a new America practice with “ Ja, das weissichschon” (that of course I already know).
III. Appointments to Surgery Chair • Dr. Strachauer agreed to postpone retirement • OHW sent to Europe for maturing and gathering ideas • Found active surgical research labs in Heidelberg and Edinburgh • OHW found German professors totally engaged in clinical activities and private practice
III. Road to Chair • 1928: Return from Europe – promoted to Associate Professor of Surgery • 1930: Appointed Head Department of Surgery • Named full Professor - 1931
III. OHW View on Operation of Department of Surgery • Felt his only power was the power of appointment • His judgments of whom to elevate to departmental responsibility decided by: • Persons motivation • Persons competence • Interest in research • Interest in teaching • Likely contributions to the overall enterprise
III. Wangensteen’s Operational Philosophies • Professors most important role is to: Create or help synthesize an atmosphere in which the learning becomes: • Absorbing • Engaging • Interest in research • Fascinating adventures and experiences
III. Wangensteen’s Chairmanship • 1930 start: 1 faculty 2 surgical interns 1 surgical fellow 130 surgical beds • 1966 (retirement) 18 interns 100 Surgical fellows 200 surgical beds
IV. Basis for Scientific and Educational Achievements The Team • 1898-1981 Owen H. Wangensteen M.D., PhD - Surgery 1930-1966 • Maurice VisscherPhD, M.D. 1936-1968 • Ray M. Amberg- Director University Hospital 1935-1964 • Harold S. Diehl – Dean SOM 1936-1959 • Minnesota Legislature • “The moons were in correct alignment”
IV. Members of the Team • Maurice B. Visscher PhD, M.D. • Early work with radioisotopes • Ground breaking research on digestion • 1936-1968: Head Dept. of Physiology • Started weekly meetings with OHW & Dept. of Surgery • Pioneer in Interdisciplinary collaboration • Heart Surgeons: Christiaan Barnard, C. Walton Lillehei, Norman Shumway, many others spent part of Surgery residences in Visscher’s Physiology Dept.
IV. Members of the Team • Ray M. Amberg – Director UMH 1935-1964 • Hospital growth: 400 beds to 760 beds additional 40 beds planned • Pharmacist • Cultivated and experienced excellent working relationship with Minnesota legislature • UMH budget was a line item • Instituted free hospital care for members of legislature
IV. Members of the Team • Dean Harald S. Diehl • Medical School Dean 1936 • Established MN Medical Foundation for purpose of advancement of the Medical School • Publishes Bulletin of MMF • OHW was 2nd President 1949-1954 • Skilled fund-raiser • MMF Scholar ships to Medical students • By 1967 >$10,000,000 channeled to Medical School • Established compulsory TBC and CXR for all patients and personnel in hospital • Established School of Public Health 1944
IV. Harald S. Diehl • HaraldS. Diehl • Affiliation with Veterans Administration Hospital • Established first Distinguished Award for Alumni 1951; Rules and regulations regarding private patients at UMH • Big building program • Psychopathic Hospital unit 1936 • Variety Club Heart Hospital 1951 • Mayo Memorial Building (14 stories) • Masonic Memorial Hospital 1956 • New Biomedical Library 1958
IV. Wangensteen and Funding of Research • Management of affluent patients • No bills • Private meeting at discharge • “whatever you would like to donate will go to research funds • “I am always on the prowl for sources of support, a responsibility that incites insomnia and creates the necessity for giving much thought during working hours to this modern day problem of professors”.
IV. Wangensteenand Funding of Research • 1966-1967: 2 fellows in General Surgery department • 7 fellows state funds • 63 fellows USPHS • Friends of Department
V. Scientific Accomplishments • Studies in Intestinal Obstruction • OHW – Referred himself as “a plumber of the alimentary tract”, having worked at both ends but mainly in the middle”. • Wangensteen suction device • Revolutionized diagnosis and management • Reduced mortality from 41%-5%
V. Scientific Accomplishments WangensteensSuction Device • Estimated by Dr. Visscher: saved 100,000 lives by 1960 & 1,000,000 by 1981 • Device was never patented • Determined that swallowed air caused mechanical distention of bowel and not “toxic factor”. • Published a textbook: The Therapeutic Problem in Bowel Obstructions: A Physiological and Clinical consideration 1937.