Book Cover

An Illustrated History of the Michigan Society of Thoracic and Cardiovascular Surgeons

Fiftieth Anniversary

1965-2015

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A Brief History of the Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS)
By:  Allen Silbergleit, M.D., Ph.D., F.A.C.S., MSMS Delegate/Historian

From its inception, the mission of the Society has been to promote the highest
standards of practice among the relatively small number of certified thoracic surgeons
in the state. An important adjunct of the primary mission was to bring together all of
the certified thoracic surgeons on a statewide basis to form a cohesive group and single
voice to face the rapidly changing socio-economic issues of the times.

The Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS) began life as the Michigan
Society of Thoracic Surgeons (MSTS) in 1965, an era that saw the establishment of many national,
regional and state specialty societies. General medical associations, the American Medical
Association and many state and county societies had been in existence since the nineteenth
century and from the beginning of the era of specialty societies, there had frequently
been a relationship to the older general medical groups. Indeed, the first meeting of the
MSTS in Detroit on September 21, 1965 was held in conjunction with and on the occasion
of the centennial meeting of the Michigan State Medical Society (MSMS). The meeting was
attended by 17 of the 60 board certified thoracic surgeons in Michigan at the time.
The Constitution and Bylaws of the Society were written by Dr. Raymond Barrett, the first
Secretary-Treasurer, and accepted by the membership. Dr. Cameron Haight was the first President.

The original intent of the MSTS was to hold an annual meeting in association with the
annual meeting of the MSMS and this was the case for the first 14 years. In the
meantime, the Michigan Chapter of the American College of Surgeons (MCACS) attracted
the attention of several state surgical specialty societies who considered it appropriate to
meet in conjunction with the annual meeting of the umbrella surgical group in the state.
This arrangement functioned from 1979 until 1986, when the first meeting of the MSTS
took place without an affiliated group. A decision was made at that time to hold every annual
meeting in the summer and generally in northern Michigan, away from the hustle and bustle of the
major population areas in southern Michigan and the problem of members being called
away from the meeting by their offices.

From the beginning, the annual meeting featured  outstanding guest speakers including some
of the most prominent thoracic surgeons in the  nation and the world. In 1970, an added
feature to the scientific program was the presentations by MSTS members and
this has utilized variably in various formats. Another feature was
added in 1991, when a keynote speaker for the meeting was designated  to honor a member of
the Society distinguished in the specialty and in service to the Society. This lecture  is
generally given as a concluding event of the program. A resident competition was  added to
the program in 1992, providing a format for residents in thoracic surgery, general surgery,
peripheral vascular surgery and pediatric surgery to compete for awards.
The competition was in abeyance for several years but then resumed as a highly important
feature of the Society’s annual program.   In recent years, there has usually been an
interesting and entertaining speaker, usually a surgeon of national renown, selected as the
“Luncheon Speaker.”

As cardiovascular surgery had for a few decades assumed an increasingly prominent role in thoracic
surgery, the council and membership considered it appropriate to reflect this in the
name of the organization, although the new name would be slightly longer and
more cumbersome. The Bylaws were revised in 1988 changing the name of the
organization from the MSTS to the MSTCVS.

The Society, with well over 100 members currently, was incorporated as a non-profit
corporation in 1992. This necessitated another revision of the Bylaws, approved by
the membership at the annual meeting held on August 8, 1992 on Drummond Island.

A major recent endeavor of the Society is the Quality Assurance initiative that has taken solid form.
Please see the article on the Society’s 50th anniversary below. This historic move reflects the commitment
to quality that this Society has made to our patients and the State of Michigan.  The intent of
the program is to see that nothing less than the very best care possible in sphere of thoracic and
cardiovascular surgery is provided to every person in Michigan.

The summer sessions held in northern Michigan are programs of national quality, and have added
considerably to the annual meetings, which have become family affairs with spouses and children
present, enjoying northern Michigan in the summer and attending an evening family dinner. Members
of the Society get to know one another and their families during this congenial get-together.
The mission of the Society is fulfilled while providing a substantial number of category 1 CME credits
for a first-rate program in a casual and comfortable setting.

We are celebrating our 50th Anniversary this year during our summer meeting.
Please join us in celebrating.  Click here to register.

A 50TH ANNIVERSARY FOR THE CHEST SURGEONS OF MICHIGAN
by Allen Silbergleit, MD, PhD
With the introduction of tracheal intubation and positive pressure ventilation of the
lungs, true advances in the field of thoracic and cardiac surgery occurred after World War I.
This permitted the safe exploration of the contents of the chest for repair and treatment. For
the first time the lungs, esophagus, diaphragm, certain mediastinal structures, and the chest
wall could be safely treated surgically for congenital abnormalities, traumatic injuries,
malignancies, and degenerative problems. By World War II, the specialty of thoracic surgery
was firmly established, and only work on the heart awaited the arrival of a device which
could take over its function to allow corrections on it.

The heart-lung or cardiopulmonary bypass machine was first used successfully on May
6, 1953 by Dr. John Gibbon at Jefferson Medical College Hospital in Philadelphia, and with
that event, cardiac surgery was on the way to become a true reality. The heart could be
stopped and repairs upon it performed. In other words, the heart-lung machine did for
cardiac surgery what positive pressure ventilation did for the open chest. There were several
medical centers noted for their contributions to the field of cardiac surgery, but many regard
the University of Minnesota in Minneapolis as the epicenter of the birth of open heart surgery.
Five surgeons from the University of Minnesota of that era relocated to Wayne State
University in Detroit in 1962 when cardiothoracic surgeon Dr. Alan Thal was appointed
Penberthy Professor of Surgery and Chairman of the Department of Surgery at Wayne State
University. I was the most junior of these “Minnesota five.”

From the state of Michigan have come many contributions to the field of thoracic and
cardiac surgery. The University of Michigan created the first residency training program in
thoracic surgery in the country in 1928. The American Board of Thoracic Surgery, originally
named the Board of Thoracic Surgery, was founded in Detroit in 1948, and it remained based
in Detroit until 1986. Less known in the history of cardiac surgery was the development and
successful use of a cardiac bypass machine by Dewey Dodrill, MD in 1952, the year prior to Dr.
Gibbon’s widely heralded procedure. Dodrill’s feat is regarded by many as truly the first
operation done on the human heart assisted by a bypass machine. First used at Harper
Hospital in Detroit, the device bypassed only the heart and not the lungs, however, and as a
result it did not receive the acclamation which John Gibbon’s cardiopulmonary bypass
machine received a year later. Dr. Dodrill’s amazing contribution to cardiac surgery has been
well noted in a special publication from The American College of Cardiology fifteen years ago.
Included in that publication are tributes to other Michigan cardiothoracic surgeons who made
original contributions to our specialty. For additional reading, one may consult the masterful 1
two volume work of Larry W. Stephenson of Wayne State University entitled Detroit
Surgeons-300 Years. Published in 2011, the book details interesting facts about innovative
works done by various intrepid surgeons of our state. It also touches on the early interest in
database studies and quality improvement in lung and heart surgery which have  become
hallmarks  of our state society today.

In the early 1960s, there were four cardio thoracic surgery residencies in Michigan:
The University of Michigan, Henry Ford Hospital, Herman Kiefer Hospital, and the new Wayne
State University program. The Kiefer program merged with the Wayne State program. The
Henry Ford Hospital program later closed and still later, the Wayne State University program
went into voluntary abeyance with plans to reopen later, leaving only The University of
Michigan as the sole site of cardiothoracic training in Michigan.
Many prominent thoracic surgeons from Detroit in the 1950s and 1960s had close ties
with The Board of Thoracic Surgery and Wayne State University (WSU). The name of the
university was Wayne University until a name change to WSU in 1956. Raymond Barrett, MD
along with a handful of other established thoracic surgeons and one resident began talking
about creating a society of thoracic surgeons in Michigan. At that time, I was an instructor in
the Department of Surgery at WSU, and simultaneously still a resident in cardiothoracic
surgery at Wayne State University. I became the “voice of the young surgeons” in the creation
of this society. Senior individuals along with Raymond Barrett who were essential to the origin
of the Michigan Society of Thoracic Surgeons as it was initially designated were Conrad Lam
and Paul O’Rourke from Detroit, Herbert Sloan and Cameron Haight from the University of
Michigan, Joe Morris from St. Joseph Mercy Hospital in Ann Arbor, and Richard Rasmussen from
Grand Rapids. I did not consider myself in their league. Dr. Barrett drafted the constitution
and bylaws for the new society, and it was launched in 1965 as The Michigan of Society of
Thoracic Surgeons. As cardiac surgery developed and was playing an increasingly important
role along with general thoracic surgery in the focus of the society, the name was changed to
The Michigan Society of Thoracic and Cardiovascular Surgeons or MSTCVS. This name change
came about at the annual meeting of the society on Drummond Island in 1992.

The first annual meeting of our society was held in Detroit in 1965 and since then it
has been held each year at various sites. Cameron Haight was the first president, and in the
first eighteen years of the society, the meetings were held in Detroit, Grand Rapids, or Ann
Arbor. The founder of the society, Raymond Barrett, served as the first secretary-treasurer,
and did so for 13 years, but he was never president albeit he was an ever driving force in
propelling the society forward. After 1998, the term of president has been for two years, yet
prior to that they served any number of years from one to multiple. With a number of past
presidents and board members who were the founders and stalwarts of the society, a
collection of leaders interested in the sustainability of the group developed. I was most
fortunate and honored to serve as president in 1990, the 25th anniversary of the society and
exactly at the half way point in the 50 year history of the MSTCVS.

In 1984, the annual meeting was held in Traverse City, marking the first time in which
northern Michigan became the venue for the gathering. After 1987, we have met consistently
in some of the most beautiful locations which northern Michigan has to offer, sites which rival
any in the country in beauty and appeal. We have long attracted some of the best known
cardiothoracic surgeons in the country and the world to our meetings. We are privileged to
have many of these speakers reside within our state. Our meetings are events which cover
issues in our specialty and are at the cutting edge, often sparking lively debate. The evening
social events have become among the most anticipated moments of the year, with
opportunities to get to know one another as well as our speakers in relaxed, informal settings.
In recent years, other related groups have been added in overlapping fashion to our
meetings. Invited are perfusionists who congregate for their own scientific sessions, nurses,
PAs, and industry representatives along with their families who service our specialty and
whom we have gotten to know over the years.

The meetings are of a scale in quality similar to the best national meetings we attend.
In addition to the renowned speakers who have graced our lecterns, residents in training
present brief papers on original scientific work. The presentations made by these young men
and women are discussed actively by the society members, and prizes are awarded to the
best talks. We regard this as an important aspect of the mission of our society, namely to
recognize young surgeons and other physicians who represent the future of medicine.

Any discussion of our society would be incomplete if it did not include the important
work done by the MSTCVS Quality Collaborative. Begun in 2001 and ably led by Richard Prager,
MD, Chief of Cardiac Surgery at the University of Michigan and president elect of the Society
of Thoracic Surgeons,  it has become the uniting force behind our society, bringing surgeons
and other health care providers from each cardiac surgery center in Michigan to its quarterly
meetings. It also has attracted great national attention for its organization and ability to
promote quality in cardiac and thoracic surgery. It has been recognized, moreover, by state
politicians and insurance carriers as the voice of quality in our profession. Initially at the
Collaborative’s quarterly meeting, data from the Society of Thoracic Surgeons database for
each hospital were discussed in a blinded fashion. Appreciating the national trend for public
reporting, the Collaborative began presenting in a transparent fashion the data from all the
programs. Site visits from surgeons of different and sometimes competitive hospitals are
regularly made to those hospitals whose programs are in need of areas of improvement. These
audits always create opportunities for constructive interchanges, and result in enhanced
quality. A considerable portion of the annual meeting, moreover, is devoted to reviewing in
private meetings the outcomes of each hospital’s performance. Certainly, this has been a
magnet to attract members of the society, and in its special way, bonded them together. At
this writing, the “collaborative” also scrutinizes general thoracic data in addition to cardiac,
and we are  beginning to look at transcutaneous aortic valve replacement (TAVR) data from
the 17 centers performing this procedure in Michigan.

This year marks the 50th anniversary of our society. We are the third oldest society of
its type in the United States (the New York society was formed in 1917 and the Pennsylvania
society in 1963). Our uniqueness lies in the fact that we gather surgeons and other health
care providers from the entire state and put them in communication with each other on a
regular basis. This is fertile ground for continued improvement and evolution in our specialty.
Finally, of note is the fact that a trio of members from the original founders era are
still around as participants, giving historical perspective and tradition to many of its lively
discussions. Drs. Agustin Arbulu, Robert F Wilson, and I, all from Metro Detroit, were
cardiothoracic residents during the exciting early 1960s when the society was fashioned and
born. I remain active on the Board as long term Historian of the Society and also as the
society’s representative to the House of Delegates of the Michigan State Medical Society and
have attended essentially all of the society annual meetings of the past half century!
Additionally, Dr. Mark Orringer, at the University of Michigan since 1973 and past chairman of
thoracic surgery at the university has spoken at many of our meetings, and carries with him
the strong tradition of excellence in thoracic surgery which the University of Michigan
embodies. Input from both community based programs and the universities takes place side
by side and is equally considered.

And so, in 2015, we celebrate the half-century milestone for a state Cardiac and
Thoracic society which represents the well-over 100 cardio-thoracic surgeons in Michigan. This
summer in Traverse City we plan to celebrate what is great in our Society and specialty as we
continue our endeavor to give the best cardiothoracic care possible. We look forward to
another 50 years of excellence.