The foundation of a department: John A. Waldhausen, M.D.

Nearly a year after his death on May 15, 2012, it is still hard to imagine what the Department of Surgery, the Penn State College of Medicine and the Penn State Milton S. Hershey Medical Center would be today without the enormous contributions of John A. Waldhausen, M.D.

Waldhausen, the founding chair who led the department for a quarter century, was a world-renowned cardiac and thoracic surgeon and researcher, known for pediatric heart surgery. His immediate recruitment and ongoing support of William Pierce, M.D., who had been working on an artificial heart since he was a medical student, early on put Penn State Hershey and Pierce's artificial heart and heart pump on the medical field's international radar. He also played critical roles in the establishment of both the forerunner of Penn State Hershey Heart and Vascular Institute and the Medical Center's Level 1 Trauma Center.

His greatest legacy, though, may lie in his mentoring of scores of medical students, interns, residents and faculty members—including a number of surgeons who went on to establish international reputations in their specialties or became chairs of surgery at outstanding academic medical centers. In addition to Pierce, that list includes:

  • Thomas Rohner, M.D., who headed the department's urology division for thirty years
  • David Nahrwold, M.D., professor emeritus at the Northwestern University Feinberg School of Medicine, where for fifteen years he was the surgery chair
  • Thomas M. Krummel, M.D., who succeeded Waldhausen as chair of surgery and  now chairs the Department of Surgery at the Stanford University School of Medicine
  • Peter Dillon, M.D., M.Sc., another Waldhausen recruit who now, as Department of Surgery's (at Penn State Hershey) fourth chair, is the John A. and Marian T. Waldhausen Professor of Surgery—an endowed chair Krummel initiated after he himself replaced Waldhausen
  • Robert V. Rege, M.D. '75, professor and chair of the Department of Surgery at The University of Texas Southwestern Medical Center and holder of the Hall and Mary Lucile Shannon Distinguished Chair in Surgery
  • Richard J. Lung, M.D., F.A.C.S. '77, was appointed honorary professor of Plastic Surgery at the Peking Medical College of the Chinese Academy of Medical Sciences, Beijing, China in 2005.

"There's no question the work he did propelled the department onto the national scene," says Dillon, whose department now includes more than sixty surgeons and researchers and a total staff of 200. "You wonder who else they could have gotten who would have been as focused and so strongly associated with both clinical excellence and academic development. To build a department from scratch and have it recognized so much for its research and scholarly work was quite an achievement."

Born in New York City in 1929, Waldhausen spent his first ten years in the New York suburbs. He and his family also made frequent trips to Europe because his father was a representative of the Siemens Corporation. At age ten, just prior to World War II, his family moved to Germany, where he lived throughout the war. Waldhausen, who chronicled his earlier years in a 2005 memoir, "Finding Home in a World at War, 1929-1963," returned to the United States in 1947. After initially failing to get into a college, he was accepted at what is now the University of Great Falls, in Great Falls, Montana; he graduated magna cum laude in three years with a B.S. degree in chemistry and mathematics.

After earning his medical degree at St. Louis University in 1954, he did his surgical and research training at The Johns Hopkins University, the National Institutes of Health, the University of Pennsylvania and Indiana University, where he ultimately joined the faculty as a cardiac surgeon. While at Indiana he developed the subclavian flap procedure for the management of coarctation of the aorta, a common defect in infants and children. Combined with related medical therapy he developed with others, this groundbreaking treatment reduced mortality in infants born with this defect from 60 percent to 3 percent and virtually eliminated recurrence of the disease, which had been a common occurrence.

After he was appointed associate professor of surgery in 1966 at the University of Pennsylvania, he established the cardiac surgical service at Children's Hospital of Philadelphia, which today has one of the largest such programs in the world. Then, in the fall of 1969, he was appointed the founding chair of the Department of Surgery at the Penn State College of Medicine—a position he would hold until 1994.

 "To have the vision and foresight to leave the august, established halls of CHOP, where he would have had a great career, to come out to a Penn State Hershey Medical Center that wasn't even built yet to be its first chair of surgery was a great leap of faith on his part," says Dillon.

Under Waldhausen's supervision all surgical services were established, including those that now hold full departmental status, including orthopaedic surgery, neurosurgery, and ophthalmology. He was also a major proponent of the Cardiovascular Center—the forerunner of the Heart and Vascular Institute—and the Trauma Center. In 1972-73, he served as the interim dean of the College of Medicine and provost of the Medical Center. Later, in 1993, he was appointed associate dean and director of the Penn State University Physicians.

Among his first hires to the Department of Surgery were colleagues of his at the University of Pennsylvania, including Pierce, who had been continuing to work on developing an artificial heart since his days as a Penn medical student, then at the National Institutes of Health and then back at Penn. Pierce says Waldhausen was always very supportive of his artificial heart research. "The first thing we did was establish the machine shop that today has blossomed into a modern computerized machine shop that can do just about anything," Pierce recalls. "To everyone else, it was a machine shop. But to him, it was a surgical research laboratory. Our group continues to be the number one academic center in the world working on the mechanical heart, and it was all due to his foresight."

Pierce also credits Waldhausen for insisting that the trauma center achieve Level 1 status and pushing for the launch of Penn State Hersey Life Lion Critical Care Transport helicopter program in 1986. "People wondered how that could ever be financially feasible," recalls Pierce, "But that was his personal decision. He came in one day and said, ‘We're going to do it.'"

"Now, when people see TV newscasts of that big beautiful bird picking up patients, they say, ‘If it's good for trauma patients involved in a horrible car accident, the Medical Center is good enough for me.'"

Another early Penn recruit was Rohner, who was intrigued by the offer to head the urology division even though he was not yet board-certified. But in selecting a lot of young doctors in their early thirties, Waldhausen recruited well, says Rohner: about a half dozen of those early recruits were later elected and served in leadership positions on their ABMS surgical specialty boards.

The Department of Surgery, the College and the Medical Center were all-consuming for Waldhausen. "He would call me every night at 9 o'clock and we would talk about the department and what needed to be done," says Nahrwold, one of Waldhausen's best friends and his vice chair.  (They first met while doing hospital rounds at Indiana University, when Waldhausen was a resident and Nahrwold was an intern.)

Waldhausen published more than 200 peer-reviewed research manuscripts and nearly fifty book chapters, and was the senior editor of three books. In late 1994, he began a five-year term as the editor of the Journal of Thoracic and Cardiovascular Surgery, the field's leading journal. He also served as president of both the American Association for Thoracic Surgery and the Society of Clinical Surgery; first vice president of the American Surgical Association; secretary of the American College of Cardiology; had a leadership role in the American College of Surgeons; and was a director of both the American Board of Surgery and the American Board of Thoracic Surgery. A member of the Alpha Omega Alpha Honor Medical Society, in 1994 he was inducted into the Society of Scholars of The Johns Hopkins University.

The founding chair also stressed the importance of such endeavors to those he mentored: "All of us shared John's belief and interest in not only being a good practitioner of surgery but also in having an interest in regional and national organizations related to excelling in your specialty," says Rohner, who retired four years ago and earlier served as the Medical Center's chief of medical staff.

Nahrwold agrees: "He felt it was his responsibility to get his faculty advanced academically and that meant pushing us to write papers and make presentations and, at the appropriate time, pushing us for membership in prestigious societies and organizations"—even if such activities ultimately resulted, as in Nahrwold's case, in losing him to another institution.

"The defining characteristic of John's tenure was his support, without reservation, of his faculty, residents and students," adds Nahrwold, who last year celebrated the 100th anniversary of the American College of Surgeons by co-authoring "A Century of Surgeons and Surgery: The American College of Surgeons 1913-2012."  " He was a very loyal individual and engendered loyalty as a result of that."

From the time Dillon became the interim chair, in spring 2006, he included Waldhausen in department activities as much as possible. "My philosophy was that it was important for the department to acknowledge the contribution he had made in starting the department," he says. After Waldhausen's retirement in 2000, he still visited weekly with folks in the department's main office.

Dillon, who was named Chair in the summer of 2007, and his wife Judy, say Waldhausen and his wife, Marian set the standard on how to run the department. "From the time he first recruited us as a young family, they were always gracious and supportive of us. We appreciated how they conducted the department's social affairs," Dillon says. "They were a model couple and we felt that it was important to model ourselves after them."

Judy Dillon, MSN, MA, RN, the Department of Nursing's community outreach coordinator, concurs: "They gave the right feeling of what Hershey people had to offer, that we are a family." Of Marian, who met her husband while he was training at Johns Hopkins, Judy says, "she was elegant and had such a presence about her. She was the matriarch of surgery."

Waldhausen's wife of fifty-four years died just a few months before him, on Valentine's Day 2012. Afterwards, so many people wanted to visit with Waldhausen at the Masonic Village at Elizabethtown that Judy set up an informal schedule to make sure he had a visitor every afternoon, but wasn't overwhelmed.

It was, she says, quite a procession: "I was just in awe of how this group of people—some of them with strong personalities and a lot of expertise—came together so many years ago to develop a medical center. And how their wives came together with them to host recruitment dinners in their houses and showed families the town and said, ‘You want to be here. This is going to be a fabulous medical center.'

"There was just such a passion and belief that they were going to make this happen, and they did."

Among those visitors was Pierce. The last time he saw Waldhausen, his former chair stirred from sleep and, looking at Pierce, with a twinkle in his eye he asked: "So, what's new in the department?"

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