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Healthcare Org 1, 1.19 (V) [FUN] Video - Topic 4 - E.A. Codman, An MGH Legend (1)

by my audience before I knew there were family members here because we have in addition to some folks from orthopedics especially JP Warner who was a shoulder surgeon and a decided Cottman disciple owns three copies of his his book on shoulder surgery which is a as a rare rare book indeed and then a knee warsha the Chief of Surgery who was two Chiefs after dr. Russell was also here and Andy chose dr. Codman not only to name the Center for quality and safety in the MGH Department of surgery but also as the topic of his presidential address for the American College of Surgeons meeting earlier this year so there's been a bit of a conman renaissance in recent years for a variety of reasons that you'll hear me describe but I think it's not hard to to say that he is one of the true greats of the MGH in Boston not just in surgery but in the field of medicine he's also an incredibly interesting character and that's one of the things that makes talking about him so much fun and makes his life story so compelling so I'm going to run through this and and give you my take I do have to say that unlike dr. Rocha and probably JP as well I've not done a lot of original scholarship on this topic there's a fantastic book written by a fellow orthopedist named Mallon who I believes down at Duke which is a short and concise and and just brilliantly done written about 15 years ago and then for original source material we at MGH have quite a bit but also the conwy library has quite a bit and I'll actually show you one or two things from the count we library content collection including this cartoon that you may have seen on the way in which I'll explain as part of this talk so welcome everyone thanks for coming out on a winter night to hear about somebody I'll try to make this interesting and it's hard to make Kahneman's life uninteresting so I think hopefully you'll consider me a success when I'm done so very important figure in American surgery i as I said in American medicine generally he's most renowned for his his end results idea which was basically the notion then I'll put it into his own words as we get farther into the talk that it was worthwhile tracking and recording and examining the consequences of medical interventions and this was a powerful and controversial message at the time it remains very powerful now a hundred years after he really kind of put himself on the map for for announcing it and there have been a lot of twists and turns since and then and the time we have for discussion in questions that's part of this theme really is to talk about Kahneman's ideas around outcomes measurement and how they may have changed by the by the modern day and how they may have stayed exactly the same so he is a he was a child of the neighborhood here he was born on Beacon Hill in 1869 his family lived on West Cedar Street this is a picture from Malins book I think it shows a wonderfully willful young face and we have another picture that I'll show you in a second after I run through these bullets his biographer was able to get some of the commentary about him from from school which I'll show you on the next slide but his family were ministers sea captain's traders typically for Beacon Hill at that time uh pretty well-educated apparently did not like the name Ernest and went by Emory or Cod he went to a faith school and then st. Mark's both school still exists there out prep schools out west of Boston and he started out as an indifferent student but ultimately excelled and one the founders medal for being the best student in his graduating class and I love this note for a series of reasons this is a letter to his father which apologizes for the fact that he's going to get a bad mark for decorum for his behavior at school it was not for anything very bad just a prank and I happened to be caught and I can be punished and the reason I like this is for those of you went to boarding school and I I did for a few years my mom gave me back that my letters to her a few years ago and I read them and every one of them finishes with a request for money so I thought that I thought that was a nice way for Kahneman to finish his letter to his father so here's another picture of him as a young man and this is a note about him written by the Fay school historian bright fastidious independent not a joiner erratic conformity and behavior a very popular despite or perhaps because of this some of his decorum difficulties and from constant questioning and challenging a bit mischievous not reluctant to accept a challenge these are characteristics that manifest his later life he started out Harvard College graduated in four years went to Harvard Medical School befriended by his classmate Harvey Cushing one of the quotes in in Allan's book is that Cushing always considered Codman to be his intellectual superior Cushing is those of you who know medical history Cushing was really the father of the field of neurosurgery and maybe one of the most influential doctors in the country for in its first the first half of the 20th century and then after graduating from HMS Codman became a house officer at Mass General Hospital on what was then the East surgical service and apprenticed having completed that with the chief of the surgical service dr. Francis Harrington and was appointed to the staff in nineteen - he then joined one of the surgical societies which is called the Society of Clinical Surgery in 1903 it's been a number of years and in organized surgical societies sort of learning the academic ropes and very importantly he married also around that time 1899 just before he came on the staff at MGH and he married about it's about his family is a very exalted Beacon Hill family Nathaniel Bowditch wrote the famous treatise on celestial navigation we actually give an award at MGH called the Bowditch award every year dr. Ward chairs that committee but the outages are are very sort of influential over many generations lots of time and government and they moved and ultimately lived in Back Bay did not have any children and I'll mention some theories about why that might've be might have been in addition to his dedication to medicine and surgery about it or excuse me Codman was also a very avid outdoorsman they had a place down near Canton and he did a lot of hunting and fishing and he exhaust exhaustively chronicled every trip he would chronicle what lures he was using what shot he was using how many shots he took what birds or fish he caught and and did it with the same degree that he cataloged his medical results this is their home still exists son - 27 at Beacon Street in Back Bay so he made six major contributions I'm really only going to talk about one of them the earliest one was with his classmate Harvey Cushing they were aware that anesthesia which had been demonstrated in at MGH about fifty years previously was still quite precarious and they were the first to put together a chart of the vital signs of people under anesthesia which they called ether charts and this led to the the Ennis the current modern day anesthesia record and it's quite apparent that having a record of a patient's vital signs is a pretty critical thing to do when you have them under anesthesia and by monitoring those vital signs and seeing how they might predict misadventures you obviously can get better at the art of giving anesthesia so that was one thing that he did with Harvey Cushing and then in addition he happened to be at the right place at the right time or maybe the wrong place at the wrong time in that x-rays were brought to the u.s.



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by my audience before I knew there were family members here because we have in addition to some folks from orthopedics especially JP Warner who was a shoulder surgeon and a decided Cottman disciple owns three copies of his his book on shoulder surgery which is a as a rare rare book indeed and then a knee warsha the Chief of Surgery who was two Chiefs after dr. Russell was also here and Andy chose dr. Codman not only to name the Center for quality and safety in the MGH Department of surgery but also as the topic of his presidential address for the American College of Surgeons meeting earlier this year so there's been a bit of a conman renaissance in recent years for a variety of reasons that you'll hear me describe but I think it's not hard to to say that he is one of the true greats of the MGH in Boston not just in surgery but in the field of medicine he's also an incredibly interesting character and that's one of the things that makes talking about him so much fun and makes his life story so compelling so I'm going to run through this and and give you my take I do have to say that unlike dr. Rocha and probably JP as well I've not done a lot of original scholarship on this topic there's a fantastic book written by a fellow orthopedist named Mallon who I believes down at Duke which is a short and concise and and just brilliantly done written about 15 years ago and then for original source material we at MGH have quite a bit but also the conwy library has quite a bit and I'll actually show you one or two things from the count we library content collection including this cartoon that you may have seen on the way in which I'll explain as part of this talk so welcome everyone thanks for coming out on a winter night to hear about somebody I'll try to make this interesting and it's hard to make Kahneman's life uninteresting so I think hopefully you'll consider me a success when I'm done so very important figure in American surgery i as I said in American medicine generally he's most renowned for his his end results idea which was basically the notion then I'll put it into his own words as we get farther into the talk that it was worthwhile tracking and recording and examining the consequences of medical interventions and this was a powerful and controversial message at the time it remains very powerful now a hundred years after he really kind of put himself on the map for for announcing it and there have been a lot of twists and turns since and then and the time we have for discussion in questions that's part of this theme really is to talk about Kahneman's ideas around outcomes measurement and how they may have changed by the by the modern day and how they may have stayed exactly the same so he is a he was a child of the neighborhood here he was born on Beacon Hill in 1869 his family lived on West Cedar Street this is a picture from Malins book I think it shows a wonderfully willful young face and we have another picture that I'll show you in a second after I run through these bullets his biographer was able to get some of the commentary about him from from school which I'll show you on the next slide but his family were ministers sea captain's traders typically for Beacon Hill at that time uh pretty well-educated apparently did not like the name Ernest and went by Emory or Cod he went to a faith school and then st. Mark's both school still exists there out prep schools out west of Boston and he started out as an indifferent student but ultimately excelled and one the founders medal for being the best student in his graduating class and I love this note for a series of reasons this is a letter to his father which apologizes for the fact that he's going to get a bad mark for decorum for his behavior at school it was not for anything very bad just a prank and I happened to be caught and I can be punished and the reason I like this is for those of you went to boarding school and I I did for a few years my mom gave me back that my letters to her a few years ago and I read them and every one of them finishes with a request for money so I thought that I thought that was a nice way for Kahneman to finish his letter to his father so here's another picture of him as a young man and this is a note about him written by the Fay school historian bright fastidious independent not a joiner erratic conformity and behavior a very popular despite or perhaps because of this some of his decorum difficulties and from constant questioning and challenging a bit mischievous not reluctant to accept a challenge these are characteristics that manifest his later life he started out Harvard College graduated in four years went to Harvard Medical School befriended by his classmate Harvey Cushing one of the quotes in in Allan's book is that Cushing always considered Codman to be his intellectual superior Cushing is those of you who know medical history Cushing was really the father of the field of neurosurgery and maybe one of the most influential doctors in the country for in its first the first half of the 20th century and then after graduating from HMS Codman became a house officer at Mass General Hospital on what was then the East surgical service and apprenticed having completed that with the chief of the surgical service dr. Francis Harrington and was appointed to the staff in nineteen - he then joined one of the surgical societies which is called the Society of Clinical Surgery in 1903 it's been a number of years and in organized surgical societies sort of learning the academic ropes and very importantly he married also around that time 1899 just before he came on the staff at MGH and he married about it's about his family is a very exalted Beacon Hill family Nathaniel Bowditch wrote the famous treatise on celestial navigation we actually give an award at MGH called the Bowditch award every year dr. Ward chairs that committee but the outages are are very sort of influential over many generations lots of time and government and they moved and ultimately lived in Back Bay did not have any children and I'll mention some theories about why that might've be might have been in addition to his dedication to medicine and surgery about it or excuse me Codman was also a very avid outdoorsman they had a place down near Canton and he did a lot of hunting and fishing and he exhaust exhaustively chronicled every trip he would chronicle what lures he was using what shot he was using how many shots he took what birds or fish he caught and and did it with the same degree that he cataloged his medical results this is their home still exists son - 27 at Beacon Street in Back Bay so he made six major contributions I'm really only going to talk about one of them the earliest one was with his classmate Harvey Cushing they were aware that anesthesia which had been demonstrated in at MGH about fifty years previously was still quite precarious and they were the first to put together a chart of the vital signs of people under anesthesia which they called ether charts and this led to the the Ennis the current modern day anesthesia record and it's quite apparent that having a record of a patient's vital signs is a pretty critical thing to do when you have them under anesthesia and by monitoring those vital signs and seeing how they might predict misadventures you obviously can get better at the art of giving anesthesia so that was one thing that he did with Harvey Cushing and then in addition he happened to be at the right place at the right time or maybe the wrong place at the wrong time in that x-rays were brought to the u.s.


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