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Owen H. Wangensteen, M.D. PhD

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1 Owen H. Wangensteen, M.D. PhD
A Legacy of Scientific and Educational Innovation Innominate Society Stanley A. Gall, M.D. November 8, 2011


3 Owen H. Wangensteen M.D., PhD 1898-1981
Professor and Head Department of Surgery University of Minnesota Medical School

4 Goals for Presentation
Early childhood influences Undergraduate and early academic career Process leading up to appointment of Department of Surgery Scientific achievements Educational evaluation

5 Early Childhood Influences
Born on a form near Lake Park Minnesota – mid north part of the state Father immigrated to US from Norway in 1881 Mother born on a farm near Lake Park Minnesota – Norwegian parents Mother died when OHW was 7 years


7 Early Childhood Influences
OHW: prepared to make farming a career Father was impressed with ability to handle sick farm animals Delivered some 300 piglets from 50 sows who had trouble farrowing OHW interested in veterinary medicine but father insisted on Human Medicine

8 Early Childhood Influences
An important character trait developed during which became more obvious with time. OHW developed the trait: “with overwhelming pride not only in completion of a task but completion with such perfection that it taxed his every ability”. Neither time nor effort was counted to achieve a goal.

9 II. Undergraduate and Medical School: Early Education and Early Academic Career
1915 OHW enrolled in the University of Minnesota College of Science, Literature and Arts, NOT Agriculture or Veterinary School 1918 Entered Medical School after a summer of hauling hay and manure on the family farm OHW comment: “through the avenues of pigs and manure and a good spread of each, I finally got into medicine”.

10 II. OHW: Academic Process
1919 – Bachelor of Arts Doctor of Medicine – accelerated due to WWI. Finished #1 in Medical School Elected to AOA


12 II. Post-Medical School Activities
Rotating Internship at University of Minnesota. Did not get residency in Surgery. Influenced by Dr. George E. Fahr Professor of Medicine Great enthusiasm for observation and research OHW decided he did not want private practice

13 II. Post-Medical School Activities
1924: Spent a year at Mayo Clinic as a Surgical fellow 6 months on diagnostic service with Henry S. Plummer 6 months on operative service of William Mayo and Frank C. Mann OHW: William Mayo was a “Surgeon’s Surgeon” Great operating surgeon Remembers everybody Frank Mann: Animal Farm and research laboratories frequented by OHW


15 II. Surgery Training Continued
1925: OHW returned to University of Minnesota and became the chief resident in Surgery at UMH 1926: Offer to go into private practice in S.D. for $15,000/yr. Offer to stay at University of Minnesota as Assistant Professor for $3000/yr.

16 III. Appointment of Department of Surgery Head
1920s: UM converting faculty from part time to full time faculty 1925: Arthur Strachauer, Head resigned 1926: Search committee formed and interviewed three candidates Frances C. Newton – Harvard Mont R. Reid – Cincinnati Owen H. Wangensteen – Minnesota Newton and Reid: commented “there is nothing worth while here nor will there ever be”. Medical School groomed OHW

17 II. Surgical Training 1926: Dean Lyons, arranged for a sabbatical leave to travel and study in Europe Fall 1927-Fall 1928 OHW, wife and 2 yr. old daughter went to Europe Primary site for research was Bern, Switzerland


19 II. Europe Reflections OHW: Recommendation of William Mayo more valuable than the President of U.S. OHW: Treated like royalty by top echelon of well known German Professors of Surgery

20 II. German Professors of Surgery
Ferdinand Sauerbruch →→ Berlin Rudolf Nissen →→ Berlin Martin Kirshner →→ Tubingen Paul Sudeck →→ Hamberg Frederick Voelscher →→ Halle

21 II. Work in Bern Switzerland
Professor Dominique deQuerain Professor Archer Published work with deQuerain on “The Blood Supply of the Normal and Diseased Thyroid Gland”. OHW: Deeply impressed with deQuerain Recounted: Professor deQuerain read widely over the entire range of Surgery and was likely to reply to a narration of a new America practice with “ Ja, das weiss ich schon” (that of course I already know).

22 III. Appointments to Surgery Chair
Dr. Strachauer agreed to postpone retirement OHW sent to Europe for maturing and gathering ideas Found active surgical research labs in Heidelberg and Edinburgh OHW found German professors totally engaged in clinical activities and private practice

23 III. Road to Chair 1928: Return from Europe – promoted to Associate Professor of Surgery 1930: Appointed Head Department of Surgery Named full Professor

24 III. OHW View on Operation of Department of Surgery
Felt his only power was the power of appointment His judgments of whom to elevate to departmental responsibility decided by: Persons motivation Persons competence Interest in research Interest in teaching Likely contributions to the overall enterprise

25 III. Wangensteen’s Operational Philosophies
Professors most important role is to: Create or help synthesize an atmosphere in which the learning becomes: Absorbing Engaging Interest in research Fascinating adventures and experiences

26 III. Wangensteen’s Chairmanship
1930 start: 1 faculty 2 surgical interns 1 surgical fellow 130 surgical beds 1966 (retirement) 18 interns 100 Surgical fellows 200 surgical beds

27 IV. Basis for Scientific and Educational Achievements
The Team Owen H. Wangensteen M.D., PhD - Surgery Maurice Visscher PhD, M.D Ray M. Amberg - Director University Hospital Harold S. Diehl – Dean SOM Minnesota Legislature “The moons were in correct alignment”




31 IV. Members of the Team Maurice B. Visscher PhD, M.D.
Early work with radioisotopes Ground breaking research on digestion : Head Dept. of Physiology Started weekly meetings with OHW & Dept. of Surgery Pioneer in Interdisciplinary collaboration Heart Surgeons: Christiaan Barnard, C. Walton Lillehei, Norman Shumway, many others spent part of Surgery residences in Visscher’s Physiology Dept.

32 IV. Members of the Team Ray M. Amberg – Director UMH 1935-1964
Hospital growth: 400 beds to 760 beds additional 40 beds planned Pharmacist Cultivated and experienced excellent working relationship with Minnesota legislature UMH budget was a line item Instituted free hospital care for members of legislature






38 IV. Members of the Team Dean Harald S. Diehl Medical School Dean 1936
Established MN Medical Foundation for purpose of advancement of the Medical School Publishes Bulletin of MMF OHW was 2nd President Skilled fund-raiser MMF Scholar ships to Medical students By 1967 >$10,000,000 channeled to Medical School Established compulsory TBC and CXR for all patients and personnel in hospital Established School of Public Health 1944

39 IV. Harald S. Diehl Harald S. Diehl
Affiliation with Veterans Administration Hospital Established first Distinguished Award for Alumni 1951; Rules and regulations regarding private patients at UMH Big building program Psychopathic Hospital unit 1936 Variety Club Heart Hospital 1951 Mayo Memorial Building (14 stories) Masonic Memorial Hospital 1956 New Biomedical Library 1958


41 IV. Wangensteen and Funding of Research
Management of affluent patients No bills Private meeting at discharge “whatever you would like to donate will go to research funds “I am always on the prowl for sources of support, a responsibility that incites insomnia and creates the necessity for giving much thought during working hours to this modern day problem of professors”.

42 IV. Wangensteen and Funding of Research
: 2 fellows in General Surgery department 7 fellows state funds 63 fellows USPHS Friends of Department







49 V. Scientific Accomplishments
Studies in Intestinal Obstruction OHW – Referred himself as “a plumber of the alimentary tract”, having worked at both ends but mainly in the middle”. Wangensteen suction device Revolutionized diagnosis and management Reduced mortality from 41%-5%

50 V. Scientific Accomplishments
Wangensteens Suction Device Estimated by Dr. Visscher: saved 100,000 lives by 1960 & 1,000,000 by 1981 Device was never patented Determined that swallowed air caused mechanical distention of bowel and not “toxic factor”. Published a textbook: The Therapeutic Problem in Bowel Obstructions: A Physiological and Clinical consideration 1937.


52 V. Scientific Accomplishments
Revised techniques of radical resection of stomach and colon Initiated 2nd “look” for exploring the abdomen at intervals Introduced concepts of gastric cooling for control of massive hemorrhage Proposed development of a surgical forum for young residents to publish research results-1941 Developed UM Cancer Detection Center 1948

53 VI. Education Innovation
Affiliation between the medical and Graduate schools at UM Effected in 1914 with 839 fellows registered (1960) 35% from UMH 15% from VAH 12% from MGH 5% from AH 33% from other hospitals OHW felt registration in Graduate School signifies: Intent to pursue a graduate degree: monthly stipend

54 VI. Shift from Part-Time to Full-Time Faculty
Took salaries from part-time faculty to hire more surgical fellows. Created backlash with Dean of Graduate School Enlisted friends = Dean Lyon Med School Lotus Coffman President UM William J. Mayo Harsh words for Dean Graduate school “Richard Scammon was a great teacher in my days as a student but it takes other qualities to be a great Dean.

55 VI. Further Considerations
OHW Episode “Kindergarten Cabal” A shift of emphasis to more active participation by young full-time staff for patient care in hospital If shift had failed it would have been decades to make the transaction

56 VI. Departmental Budgets & Personnel
1930: $30, fellows 1940: 9 fellows Significant Increase fellows Legislative Budget Inc. 500%

57 VI. Growth of Department of Surgery
Depression Contraction, dissipation, diversion of interest because of war effort real spirit of the department formed Part-time and full-time associates came to accept OHW and his general plan for development of the department


59 VI. OHW Philosophy on Departmental Operation
Decentralized manner Each faculty afforded staff status and is autonomous Does not need to consult OHW Rarely offers gratuitous advise Each full-time professor controls 15 beds in hospital Residents comment on going on Rounds with OHW: “If you follow him with a pencil and paper, you can write down 20 original ideas each day”.

60 VI. Surgical Training 50% of fellows in General Surgery spend time in experimental laboratories Training 7-8 years Earn PhD in basic science Instructor at 5 or 6th year



63 VI. OHW View of Role of Professor
Teacher Surgeon Investigator Side-line cheerleader Regimental water carrier Create an atmosphere friendly to learning Ability to recognize every type of talent

64 VI. Lessons for Time In Europe 1927-1928
Only two laboratories actually doing experimental work: Eugene Enderlen – Heidleberg David Wilke – Edinburgh Feels no department head can neglect the experimental laboratory

65 VI. Philosophy of OHW The University offers the perspective full-time clinician who professes to follow the academic line the opportunity of making something of himself. He must take care not to become to absorbed in making something for himself.

66 VI. OHW: Student Involvement
Creation of the James E. Moore Society For Scholarship in Medical Students 12 Senior students 12 junior students Monthly meeting at Professor homes Seniors present research papers 1st Dr. Wangensteen’s home

67 VII. Summary Farm boy from rural Minnesota Inspiration from father
George E. Fahr M.D. – excitement for learning European trip – research need Organization of department Multiple Scientific Advancements Educational innovations




71 Bibliography Wangensteen OH: Impressions from A Surgical Study Trip Aboard. Minnesota Medicine 1929; 12: Wangensteen OH: Education of a Surgeon. J. Med. Educ. 1960; 35: Wangensteen OH: The Minnesota Experience in Surgical Graduate Education Surgery 1960; 48: Wangensteen OH: The Fascination of Scholarship and Research: Their Importance in the Education of Surgeons. J. Surg Res. 1961; 1: 5-7 Wangensteen OH: The Therapeutic Problem in Bowel Obstructions Charles C. Thomas 1937 Springfield, IL

72 Wangensteen OH: Glimpses of the University of Minnesota Surgery Department. Journal-Lancet 1963; 83: Wangensteen OH: Then and Now – The Surgical Arena Three Decades Ago. Journal- Lancet 1957; 77: Dietzman R: James Edward Moore: Educator and Surgeon. The Journal Lancet April 1963:

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