Although I hadn’t heard of Ephriam McDowell before today, in turns out that I might owe my life to him. It also turns out that I can learn a lot from him as well.

For others who also had never heard of him, McDowell was a surgeon in the late 1700s and early 1800s who was the founding father of abdominal surgery. He’s pictured on a 4-cent stamp, issued on December 3, 1959, that marked the 150th anniversary of the first successful abdominal operation in the United States. Astute readers may already have calculated that this means the surgery was done in 1809, which means it was done 37 years before anesthesia was first used in surgery. This, in turn, suggests there’s quite a story behind the stamp.

A native of Virginia who grew up in Danville, Kentucky (where his father was land commissioner and presided over 10 conventions that produced the Kentucky state constitution), McDowell studied medicine in Scotland (but never was formally certified as a surgeon or physician). He returned to Danville in 1795 and soon became known as an especially skilled surgeon.

On December 13, 1809, McDowell was called to Green County, Kentucky, about 60 miles from Danville, to help two physicians with what they thought was going to be a difficult delivery. After taking a careful history and making a thorough examination McDowell concluded that by their patient, Jane Todd Crawford, wasn’t pregnant but instead had an ovarian tumor. He told her that after many unsuccessful abdominal surgeries, the world’s best surgeons had concluded that it was impossible to remove the tumor without killing her. But, he added, he believed he had the knowledge and skill needed to try an “experiment” to see if he could remove the tumor without killing her. Fearing the slow and painful death likely to occur if she did nothing, Crawford begged him to try. He agreed to so in his home (where he practiced); she agreed and rode 60 miles on horseback to Danville.

The decision was controversial. On Christmas morning, as he prepared to do the procedure, residents of Danville gathered outside his home to protest, threatening to lynch McDowell if she died. McDowell and Crawford were undeterred. She laid on a wooden table reciting psalms while McDowell carried out the operation. In about 25 minutes he removed most of a more than 20-pound tumor and closed up the incision. Amazingly, Crawford recovered fully, returned home, and lived for more than 25 years.

McDowell, who was known for being especially meticulous, careful and clean, went on to perform several similar operations and also to become a pioneer in lithotomy, a surgical technique for removing stones that obstruct the urinary tract, bladder or kidney-accomplishments that help explain why he’s often been called the father of abdominal surgery. Given this, it’s ironic that it appears that he apparently died from an appendicitis attack in 1830.

I feel like I owe him at least two debts of gratitude. In 1968, when I was 11, I severed my small intestine in a freak (and foolish) accident that could well have killed me. I was saved by a fortuitous set of events that ultimately led to my undergoing emergency abdominal surgery, a procedure that I’d like to believe drew on some aspect of McDowell work. More recently, as a man who is now in his 60s, I have had kidney stones and likely benefitted from his work on that painful problem.

Others have drawn inspiration from McDowell. In a 2004 article published in the Annals of Surgery, for example, Dr. H Biemann Othersen, Jr, a well known and highly regarded pediatric surgeon in South Carolina, wrote the McDowell exhibited seven “basic qualities still important for surgeons today.” Specifically, he argued, McDowell was:

• Courageous. When he agreed to attempt an operation that his teachers had stated was doomed to result in death, he, as well as his patient, showed great courage.
• Compassionate. He was concerned for his patient and responded to Mrs. Crawford’s pleas for help.
• Communicative. He explained to his patient the details of her condition and her chances of survival so that she could make an informed choice.
• Committed. He promised his patient that if she traveled to Danville, he would do the operation. He made a commitment to her care.
• Confident. He assured the patient that he would do his best…
• Competent. Although lacking a formal medical degree, [he had trained with] one of the best surgeons in Europe [and] by 1809 he was an experienced surgeon.
• Careful. Despite the fact that 2 physicians had pronounced Mrs. Crawford as pregnant, he did a careful physical examination and diagnosed that she was not pregnant but had an ovarian tumor. He also carefully planned each operative procedure with a review of the pertinent anatomic details. As a devout Presbyterian, he wrote special prayers for especially difficult cases and performed many of these operations on Sundays.”

After noting that these “characteristics are desired traits in surgeons today, even with our advanced technology,” Otherson added, McDowell has “one final trait, which is helpful to surgeons,” which is that he was

• Courteous. He was humble and courteous in his dealings with others. Even when he was publicly and privately criticized after the publication of his case reports, he did not react with vitriol.

These qualities not only are essential for current surgeons, they also are useful guides for those of us who shouldn’t be trusted with sharp objects, like scalpels.

I’d also add one more lesson indirectly connected to McDowell. When the Weavers made their long-delayed return to the stage for one final concert in November 1980, weeks after Ronald Reagan was elected, Lee Hayes, the group’s amazing bass singer offered sage advice that is as wise today as it was then. “Be of good cheer,” he said. “This too will pass. I know. I’ve had kidney stones.”

Be well (and be of good cheer), stay safe, fight for justice, be courageous, compassionate, and courteous; and work for peace.