After completing his surgery residency at Barnes Hospital in St. Louis and Chief Residency at Brackenridge Hospital in Austin, Dr. Leonard Coleman returned home to Navasota to help his father, Solon, who had suffered a stroke. From 1960 until his retirement in 1994, Leonard was the only surgeon in Grimes County. During the day he performed scheduled surgeries. Approximately 15-18 nights a month and almost every weekend, he was called from his home to successfully complete emergency surgeries. Twenty-five percent of Dr. Coleman’s workload consisted of charity cases.
Surgical Heritage
An improved understanding of disease processes began with the opening ceremonies of Johns Hopkins Medical School on May 7, 1889. William Osler in medicine, Howard Kelly in gynecology, William Welch in pathology, and William Stewart Halsted in surgery formed a tetrarch of excellence that remains reflected in contemporary medical education and patient care.
William Halsted transformed surgery. Born to a family who had made a fortune as wholesalers of European dry goods, Halsted received the best education possible. A superb athlete but indifferent student at Andover Academy and Yale, he made a remarkable transformation at The College of Physicians and Surgeons in New York City, graduating in the top ten of his 1877 class.
Following an 18-month internship at Bellevue Hospital and brief work as a house surgeon there, Halsted had two years of post-graduate instruction in Europe. His experiences in Europe gave him a command of scientific methods and a more sophisticated approach to medicine.
Returning to the United States with an engaging spirit of intellectual inquiry, Halsted desired to establish a school of surgery that would disseminate principles of excellence throughout the world; he wanted to develop a system to generate competent surgeons who could teach proper techniques to others. He more than achieved this goal.
The development of a residency system for training surgeons became Halsted’s most significant and enduring contribution to medical education. Postgraduate surgical residency continues to follow the Halsted approach. Halsted was in charge; the chief resident was second in command followed by a line of residents each with diminishing experience. At each level the surgeons trained and supervised those junior to them. From each senior class of surgical residents, Halsted selected one outstanding physician who would become chief resident under his tutelage the following year. That chief resident, in turn, would instruct the other residents down the line. The process would be repeated each year.
Each senior class had as many as ten surgical residents. From that class only one would become chief resident under Halsted. No matter. Hospitals and medical schools eager to have an experienced resident trained under Halsted signed the other surgeons to become chief residents in their facilities. Thus Halsted’s pyramid of excellence moved from hospital to hospital.
Within a few years of his appointment to Johns Hopkins, Halsted trained seventeen house surgeons, eleven of whom went on to establish university-type residencies similar to those at Hopkins. These eleven spawned 166 chief residents. Within a couple of decades, the surgical methods and techniques of Halsted had spread around the country.
Using Leonard as an example enables us to comprehend the penetrating influence of Halsted’s training hierarchy. If mentors can be thought of as ancestors, Leonard’s surgical progeny follows this progression:
- Great-great grandfather, William Halsted (1852-1922)—brought medical science into the surgical suite.
- Great grandfather, Harvey Cushing (1869-1939)—single-handedly changed the approach to neurosurgery, introduced electrocoagulation (the Bovie) to speed the control of bleeding vessels, and wrote the two-volume Life of Sir William Osler for which he received the Pulitzer Prize in 1926.
- Grandfather, Frederick Amasa Coller (1887-1964)—developed therapy aimed at correcting fluid and electrolyte loss in the surgical patient.
- Father, Carl Moyer (1910-1970)—developed colloidal silver in the treatment of burn victims.
Sir William Oslerhttps://en.wikipedia.org/wiki/William_Osler