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Point of View

A whispering giant
By William D. Morain, M.D.

All three were from the greatest generation and each had risen to the top of his craft. One was of the big screen. One was of the small screen. One was of the slide projector. They died on the same day, and we mourn them all.

Gregory Peck was named the greatest hero in motion pictures by the American Film Institute for his portrayal of Atticus Finch. David Brinkley received the Presidential Medal of Freedom for journalistic achievement. And Radford Tanzer received the firstever standing ovation given by the American Society of Plastic and Reconstructive Surgeons, for a presentation he made on ear reconstruction. But all were self-effacing gentlemen's gentlemen.

Radford Tanzer received the first-ever standing ovation given by the American Society of Plastic and Reconstructive Surgeons.
Illustration: Suzanne DeJohn

I watched Gregory Peck act. I watched David Brinkley report. But I never watched Rad Tanzer operate. By the time I arrived at Dartmouth, he had retired after 31 years on the DMS faculty. In fact, I had been hired to make up for his absence—in no way to replace him. But I became his friend and soon learned why 4,000 plastic surgeons had heard of New Hampshire.

I had the privilege of conducting a three-hour taped interview with Rad—who was 97 at the time of his death—when he was but a youthful 76. He said that none of it could be published during his lifetime without his permission, a promise I faithfully kept.

Firstborn: The firstborn of an upstate New York dentist, Rad spent his early years working in his father's laboratory. The Christmas he was five, he became the first kid in town to possess a pair of skis when his father persuaded a friend at the lumberyard to bend a couple of pieces of wood and attach some leather toe straps. With an early interest in medicine and a high school nickname of "Doc," Rad graduated as valedictorian at age 14 and proceeded to Dartmouth College, in part to continue his passion for skiing.

Rad went on to Harvard Medical School, a surgery residency at Strong Memorial Hospital in Rochester, and a year of cancer research at the Rockefeller Institute. After some hardscrabble years in private practice in the 1930s, Rad became the first senior fellow in plastic surgery under Jerome Webster at Columbia Presbyterian. He said of his famous professor, "I feel that I learned from Dr. Webster the importance of attention to detail. He was a perfectionist. Everything he did had to be just right before he would stop."

After additional training with other greats in the emerging field of plastic surgery, Rad learned of a position available back in ski country, at his alma mater, and grabbed it. He became the fifth surgeon at the Hitchcock Clinic and began performing every procedure he'd ever learned, devoting about 15% of his time to plastic surgery.

World War II produced a call to set up a plastic surgery unit at a hospital in Utah. Later, after a transfer to Cushing General Hospital in Massachusetts, he performed the first index-to-thumb transposition. Rad also pioneered a procedure to repair the burned hands of soldiers who'd been shipped home from Europe. And he treated some ear amputations, using the then-traditional framework—merthiolate-preserved rib cartilage from cadavers— only to find some time later that it had badly shriveled.

Piecemeal: It was five years after his 1951 discharge that destiny struck. An infant born lacking an outer ear was referred to Rad. It was a reconstructive challenge that had stumped all who had tried it before. So, as he described it later, "I spent one winter just thinking about the problem, working with paper and pencil. I finally came to the conclusion that the reconstruction had to be approached piecemeal. I devised the concept that the ear is composed of four planes . . . put together in a series of right angles. I decided that the scaphahelix complex was the essential feature and that if I could make that successfully, the other three components could be added to it either at the same operation or at a subsequent operation. . . . I worked out on paper the method that I eventually used on this boy in 1957." Remarkably, the six-stage procedure required but a few modifications over the years from his hypothetical plan.

Rad was warmly honored by those from throughout the world who trekked to his remote New Hampshire locale to watch him work. In 1972, he was granted the highest honor in his profession—the presidency of the American Association of Plastic Surgeons.

Spontaneity: Rad was not without his spontaneous side. When in his 90th year he married my neighbor, I saw two lovers as enamored of each other as I've ever seen. But he felt spontaneity had no place in surgery. "I think any surgeon should have a complete and clear picture of what he is going to do in an operation before he sets a knife to the patient," he said. "On more than one occasion, I have sent patients home after coming in to the hospital for an operation because I had not fully resolved in my mind what it was that I should do."

It is this singleness of purpose—this acuity of vision—that quali- fies Rad for the same zenith level of achievement as David Brinkley and Gregory Peck. That acuity, the use of wisdom and creativity to solve a vexing reconstructive problem, delivered many children from disfigurement. An entire era of plastic surgery history came to an end with his passing. Rad Tanzer slipped away as quietly as he lived—as though he were whispering into all those lovely ears.

"Point of View" provides a personal perspective on some issue in medicine. Morain served on the DMS faculty from 1976 to 1997 and on this magazine's Editorial Board from 1984 to 1993. He is now editor of the Annals of Plastic Surgery, from which this essay is adapted with the permission of Lippincott Williams & Wilkins (Morain WD, "The Prince of Pinnae," Ann Plast Surg 2003;51(2):219-220; www.annalsplasticsurgery.com).

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