About William P. Longmire Jr.
William Polk Longmire was born in 1881, one of three brothers living with their parents on a farm in East Tennessee. Polk was rarely used as a given name at that time, but was given to William 32 years following the death of the 11th president, James K. Polk who had also lived in Tennessee. He was known as Polk, and after finishingf high school, and deciding not to remain on the farm, he was admitted to the medical school in Louisville, Kentucky, founded in 1837. He graduated with 350 other students in 1904 at the top of his class, having had only 10 professors as teachers. The Flexner report to the Carnegie Foundation in 1910 indicated the deplorable condition of medical education in the 19th century, including Louisville, and used Johns Hopkins, which had opened in 1893, as the standard to emulate.
After graduating from Louisville, Polk decided to head for Colorado by train, but changed his mind on the way and stopped in the little village of Sapulpa, Oklahoma with about 450 people. The town was near the Indian Territory and was named after the Creek Indian Chief. The Frisco Railroad - later the Great Northern, had a stop there. Polk joined another doctor in General Practice using this office, and married the daughter of the U.S. Marshall, judge, and Mayor of Sapulpa.
Their 4th child, William Polk Longmire, Jr., who was called Bill, was born in 1913. This photo shows Polk and his wife Grace with Mildred and Bill in 1920. Two siblings died in infancy, and his older sister Mildred died in 1953 with melanoma. Bill and Mildred often accompanied their father in an early model car when he drove to see patients. Both asked many questions, and were stimulated by his great humanitarian and naturalistic respect for life somewhat more than by their school teacher mother's more formal religious teaching.
In 1933 the Longmire farm was claimed by eminent domain during the Great Depresssion to clear the land for the Norris Dam on the Tennessee River as part of the 7 state TVA hydroelectric project initiated by President Roosevelt. Bill's grandmother fiercely resisted, but was finally forced to move 50 miles away. Ironically, my father was one of the Civil Engineers working on this project.
Polk assisted a surgeon in Tulsa several times, and then took courses on Surgery in Chicago and then began operating in Sapulpa. Bill did very well in school and skipped a grade. In High School, he was Senior Class President, was elected by fellow students to be the prestigious Moccasin Prince, shown here, played the clarinet and led a band called "Billy Longmire and the Pagans."
He was encouraged by his High School teachers to pursue further education to become a doctor. Bill entered the University of Oklahoma where he excelled and graduated Phi Beta Kappa. His great interest and propensity for hard work attracted the attention of many of his instructors. The Professor of Zoology and the President of the University encouraged him to widen his horizons and apply to Johns Hopkins Medical School, shown here, the first in the country to require a college degree. Bill was accepted in 1934 to the only school to which he had applied, and went to Baltimore at age 21.
He was inspired by Dr. Howard Kelly, the first chief of OB-GYN at Hopkins who was a superb surgeon and was very spiritual, intellectual, and also somewhat eccentric. Bill became interested in Neurosurgery and created anatomical drawings, including this drawing of the brain as well as oil paintings, including this one which hangs in the American College of Surgeons headquarters in Chicago.
He returned to Sapulpa one summer and operated on the tiny brains of several indigenous lizards and in 1937 published his first paper in The American Journal of Physiology entitled "The Central Control of Postural Reactions in the Lizard." Shown here. He made good use of opportunities. As a student he assisted Dr. Walter Dandy, Chief of Neurosurgery at Hopkins who found him to be better than many of his own house staff. He graduated in the top of his class and was elected to AOA. Dr. Dandy influenced Dr. Dean Lewis, Chairman of Surgery since 1925 to take him as an intern. Dr. William Halsted the first Chairman, who died in 1922, had organized a vigorous, demanding surgery residency with emphasis on research, which produced great surgeons to be professors, but he was cool and distant. Dr Lewis was a gifted surgeon and enthusiastic teacher but, he had a stroke in 1938 after 3 months of Bill's internship, and Dr. Warfield Firor became interim Chairman for 2 years.
Dr. Alfred Blalock from Vanderbilt, was appointed as the permanent Chairman of Surgery in 1940. After internship, Bill and Dr. Rollo Hanlon, who later became the Director of the American College of Surgeons, spent a year in the research lab studying mechanisms of shock reversibility. In 1939 Bill and Jane
Cornelius, a receptionist and librarian at the Hopkins Wilmer Eye Institute were married. After the lab year, he was appointed to the prestigious position of surgical pathologist, which assured him of eventually becoming Chief Resident.
In the Fall of 1940, Bill's father had a stroke, and he and Jane returned to Sapulpa to take over his Dad's general practice, including surgery, as indicated in the Tulsa newspaper. A leave of absence was granted by Dr. Firor.
When his Dad gradually recovered and resumed his practice, Bill returned to Hopkins to rejoin the Residency, however Dr. Blalock indicated that there were a large number of Residents in the program and that he did not have a place for him. He continued to help his father in practice, and later said that this time in general practice was one of the most rewarding experiences in his medical education. He returned to Hopkins again in 1942 after World War II started since he had been turned down by the military because of a recurrent inguinal hernia.
He observed Dr. Mark Ravitch, shown here, the senior Resident under Blalock, who had graduated from the University of Oklahoma 4 years before Bill. Ravitch who knew of Bill's exceptional capability convinced Dr Blalock that he should be reappointed as a junior Resident since so many of the senior residents had entered the Hopkins military unit in Europe, which left Hopkins short staffed. Bill excelled and completed his training in 1945, and was then appointed to the Faculty as one of Hopkins' brightest young stars. He was regarded by Blalock as one of his finest Residents and frequently asked for his advice and assistance.
Drs Blalock and Longmire are conversing in the Hopkins courtyard. Conscientious in all his clinical experiences, he was described as both a consummate surgical craftsman and a perceptive, scholarly physician who was low-key, business-like, but understanding, and never harsh.
Before coming to Hopkins, Dr. Blalock had studied pulmonary hypertension in dogs, working with his lab technician Vivien Thomas by creating an anastomosis between the subclavian artery and the pulmonary artery, as shown here. Dr. Helen Taussig, Chief of Pediatric Cardiology had a 3-year-old patient with a severe Tetralogy of Fallot, and she asked Dr Blalock if he would try to perform the shunt on her child. Dr Blalock asked Bill to be his first assistant with, Vivien Thomas closely observing. The operation was successful and the boy recovered remarkably well, and did well for 47 years when Dr. Laks at UCLA performed a complete repair. This historic "blue baby" operation led to the development of operations on the heart to correct congenital malformations.
When Dr. Blalock was asked what area of Surgery Bill specialized in he responded "difficult surgery." He was described as being unusually mature and competent with impeccable judgment, very cool under pressure, and had a charisma which made him attractive to almost all to whom he came into contact.
He also reported his experience with successful repair of TE fistulae in 4 consecutive neonates in 1947, the largest series at that time. He also developed a procedure to repair obstructed bile ducts by anastomosing the jejunum to the ducts in the liver, still called the Longmire procedure.
In 1948, a Search Committee from UCLA, which included Dr. John Lawrence, the first Professor of Medicine and friend of Blalock when they had been together at Vanderbilt earlier, came to Hopkins to recruit Bill to come to UCLA to be the first Chairman of Surgery. Governor Earl Warren, shown here at the dedication ceremony , had appropriated 15 million dollars to construct the new Medical Center at UCLA, which was decreased to 7 million because of the limited state budget, despite the great influence of Dr. Elmer Belt, the most prominent Urologist in Los Angeles and strong supporter of UCLA at that time, who is reported to have put pressure on the Governor's prostate on a few occasions to assure adequate funding.
Dr. Stafford Warren a Radiologist who had served as the chief medical officer for the wartime atomic bomb project in Los Alamos and later tests at Bikini Atoll, was recruited from Rochester as the Dean. In 1948 there were big plans, but minimal construction for the Medical Center. President Truman had recently recommended that Medical School and VA Hospital affiliations be developed throughout the country. The Wadsworth VA Hospital, which had been built in 1927, was the closest available hospital to UCLA. The only other hospital which could be used for UCLA was Harbor Hospital which was 20 miles away and was housed in temporary wooden buildings as an Army Hospital , and was later given to LA County. Dr Blalock noted that Bill was going to a school that didn't exist, to be Chief of Surgery without a hospital, and might be the only surgeon at age 35 eligible to retire.
In 1950, 4 years after World War II, opening of the UCLA Hospital was still 5 years away, and here we see the wooden barracks serving as the Medical School, and Quonset huts for Research Labs. The US State Department created the Marshall Plan to help rehabilitate some of the devastated countries and sent a team of 11 doctors to Germany. Before World War I, several American surgeons had studied under leading German surgeons, including Dr. Blalock, however German medicine was almost decimated for 25 years around World War II.
Dr. Longmire went to Berlin and helped Dr. Fritz Linder, the newly appointed Chief of Surgery in Berlin, and in later years in Heidelberg, shown together here. He performed many operations at the Free University of Berlin, at the time of the Russian blockade. All equipment was flown into Berlin by the U.S. airlift program. Bill performed several cardiac operations, including coarctation of the aorta, Blalock shunts, and mitral valvulotomies. He operated in several cities, and made many recommendations regarding how to develop better training programs. In 1952, he returned for a 3 month sabbatical in Berlin as Visiting Professor to several major German medical centers, and was then requested by the U.S. Army to serve for two years as Surgeon for the Air Force in Germany.
He returned in 1954 and joined Dean Warren, Dr. Lawrence in Medicine, Dr. Andrew Dowdy in Radiology, and Dr. Charles Carpenter in Infectious Diseases to develop the new UCLA Medical Center. He became Chief of Surgery at Wadsworth, and his close friend and colleague from Hopkins, Dr. Harry Muller came as a cardiac surgeon to be Chief at Harbor Hospital. He subsequently became Chairman at the University of Virginia. Dr John Beal from Cornell came to help in GI surgery, but soon left to become Chairman of Surgery at Northwestern University.
Dr. Wiley Barker, shown here with his wife Nancy on the occasion of his 90th birthday, had spent 2 years in the Brigham surgical program in Boston, and then served in the Navy. He found the Brigham program to be overstaffed when he completed his service, and chose to complete his training under Dr Longmire at Wadsworth Hospital. He then joined the faculty at UCLA and became a world renowned pioneer in Vascular Surgery. Dr. Frank Spencer, who had been an intern under Longmire at Hopkins came to the Wadsworth residency, but after 2 years was called into the Korean War where he performed many difficult vascular reconstructions. After his tour of duty, he returned to Hopkins to be Chief Resident and then stayed on the faculty for several years. He later became Chairman of Surgery at NYU.
The first 26 medical students entered UCLA in 1951, although the Hospital construction was delayed by financial consequences of the Korean War, and finally opened in July 1955. The first students took their clinical training at Wadsworth, Harbor, and Santa Monica Hospitals.
Dr. Longmire had an unusual ability to perceive the qualities in people which would allow them to contribute to the academic and clinical function of the Department, and later become successful in their own areas of interest. Dr. Willard Goodwin, also from Hopkins, was appointed Chief of Urology in 1951, Dr Eugene Stern from UCSF was appointed Chief of Neurosurgery, Dr Frank Ashley as Chief of Plastic, and Dr Joel Pressman as Chief of Head and Neck, all in 1952, Dr John Dillon was appointed Chief of Anesthesiology in 1953, Dr Wiley Barker as Chief on General Surgery in 1954, Dr James Maloney, also from Hopkins as Chief of Cardiac in 1955, Dr Charles Bechtol as Chief of Orthopedics in 1957, and Dr Brad Straatsma as Chief of Ophthalmology in 1959.
My personal relationship with Dr. Longmire began in 1959 when I was a second year Resident at Hopkins and Dr. Blalock called me into his office and said that the surgery residency was becoming crowded and that only 2 of the residents at my level would be able to stay on. What would I like to do? When I asked what he would recommend, he indicated that his best former Chief Resident, Dr. Longmire, at the new UCLA Medical Center probably would be his first choice. When I said yes sir, he promptly called Dr Longmire by phone, and in less than 2 minutes of conversation, my future was decided. Somewhat easier than going through the current match program. Perhaps one of the best decisions that I ever made, except for that of marrying Peggy in Philadelphia just before we began our lives together in Los Angeles. This photo taken in 1960 shows Drs Maloney, Dillon, Stern, Longmire, Bechtol, and Pressman, with me on the third row on the left.
Dr. Don Mulder, who had a somewhat similar experience in coming to UCLA from Hopkins a few years earlier, and Dr. Wiley Barker were two of my major mentors. As Chief Resident, we had an unusually large number of newborns with complex malformations, tumors and other conditions with none of the surgeons on the faculty, or in the community having had specific training in this area. On a few occasions we took Dr. Robert Gross' well illustrated textbook, of his surgical procedures at the Boston Children's Hospital, with us to the operating room. Dr. Longmire agreed that there was a great need for a surgeon with special training in Pediatric Surgery to be on the UCLA faculty, and in 1963 he sent me to the Columbus Children's Hospital. In the Spring of 1965 I returned to UCLA as the sixth member of the Division of General and Cardiac Surgery, and one of the earliest full time pediatric surgeons in university medical centers in the U.S.
In the 28 years of Dr. Longmire's chairmanship of a large and busy Department of Surgery, he somehow managed to combine professional travels, cultivation of international good will, service to professional societies, and nurture the Art of Surgery at UCLA with impartial devotion. Despite his many contributions, he always remained humble, and found time to chat with students, residents, and patients, and frequently sought the advice of many junior faculty before making major decisions. As Dr. Mulder, shown here with Dr Longmire, has noted, "those of us who trained with him were exposed to an unusual mentor - short on words, long on example."
This shows Dr Longmire in the Operating Room where one might assist him on one or more occasions depending on the level of training and then perform the operation independently. He did not usually assist the Resident except on rare occasions but was available for consultation and advice.
Here is Dr Longmire as President of the American College of Surgeons. The 73 Residents who were fortunate enough to complete their training, as well as the many others who spent one or more years as junior Residents during the period of his chairmanship until 1977, all hold him in the highest regard with fond affection. He was admired, respected, revered, and indeed loved by residents, patients and colleagues. "The Professor", as he has respectfully been called, with his gentle example and great support, encouraged all to raise their performance to a higher level, and achieve their highest potential. He inspired confidence in residenfts that held in all areas of life, not just the operating room. It is rare that one encounters an individual who is simultaneously an extremely gifted operating surgeon with superb judgment, a remarkably innovative surgical scientist, great teacher and mentor, outstanding administrator, clear writer, and the architect of an exceptionally fine Department. It is difficult to comprehend how one individual could have such a positive impact on his own institution, his colleagues and Residents, and his profession both nationally and internationally. As former Dean Sherman Mellinkoff noted, "his example, his intellect, his character, and his labor are - and will always be implicit in the house he so greatly helped to create."
The Longmire Surgical Society was founded in 1965, shown here at the first meeting, by the 15 Chief Residents trained by Dr. Longmire during the first 10 years of the General and Cardiac Surgery program since the hospital opened in 1955, led by Dr. Don Mulder.
This Society, which is meeting this week, is a tribute to one of the true "giants" in the history of Surgery. Here is Dr Longmire receiving an album indicating the establishment of the Society by his former Residents, with Dr Mulder and myself observing. This is one of the last photos that I have of Bill and Jane Longmire taken in 1998.
By Eric W. Fonkalsrud, MD,Emeritus Professor of Surgery David Geffen School of Medicine at UCLA
Presented to Surgical Grand Rounds, March 24, 2010