The Joy of Surgery – In Vivo! The Life of Clement A. Hiebert 1926 – 2008

Clem’s life reflected the “Joy of Surgery.” The magic stuff, the grail that moved him to become a surgeon, that even now beckons through the jaded mists of tedium and time. Strip away the corrupting dullness and look afresh at our profession. Clem contended that it was the most splendiferous of all professions. By exploring a remote island off of Newfoundland he developed the three wonders of the surgeons world: the wonders of the body, the mind and the spirit, and put them forth in a book, of his life basically, entitled: "Seldom Come By."

Clem was born in Boston in 1926, moved to Maine shortly thereafter and graduated from Bowdoin College. He matriculated from Harvard Medical School to the Massachusetts General Hospital for his surgical training. It was during his medical school training experience in Newfoundland, at the Grenfell Mission, that his life changed and he recognized the great values embodied in surgery, which subsequently guided his life to the end. 

At the Massachusetts General Hospital, he excelled at every aspect of surgery with enthusiasm, creativity, and developed a “Pied Piper” philosophy. It was here that he was ignited within by a realization that the excitement of esophageal surgery should be his lifelong pursuit. Clem spent a year in Bristol, England, as a Senior Registrar for Sir Ronald Belsey. Belsey had been Churchill’s Fellow in 1939 at the Massachusetts General Hospital where he collaborated with Dr. Churchill in writing the first article on the segmental resection of the lung. Ronald repaid Dr. Churchill by taking a series of MGH residents in the late 50’s and early 60’s to the Frenchay Hospital in Bristol, and allowing them to mature and perceive the wonders and creativity of his genius. Clem thrived in that environment, and developed the Hiebert modification of the Belsey Mark IV hiatal hernia and gastroesophageal reflux repair. Clem taught it to all of the residents at the Massachusetts General Hospital. In 1988 Clem delivered his Presidential Address to the New England Surgical Society, which was published in 1989 in the Archives of Surgery. His skill in writing has few peers, and is unparalleled in the surgical literature. His article entitled “Seldom Come By,” described the exhilaration of a career in surgery from the point of view of the body, the mind and the spirit. It was so inspiring that David Sabiston, Chairman of Surgery at Duke University Medical School, had 800 copies passed out to his surgical residents and medical students interested in surgery. It was such an exciting creative examination of the profession that subsequently Clem was encouraged to take time off at the expense of the Rockefeller Foundation and turn it into a book. After 5 months in Bellagio, Italy, this book, “Seldom Come By,” was published. 

While Clem was a resident at the Massachusetts General Hospital, he would bring patients into the surgical grand rounds with the bagpipes playing “Bridge Over the River Kwai.” The patients always smiled from ear-to-ear. Clem was an ardent skier, mentoring me, which subsequently helped me meet my future wife. He was recruited to help us edit Pearson’s first textbook on the Esophagus, and Thoracic Surgery.  However, his skill at writing and experience was so extensive that we made him a co-editor. This was Griff Pearson’s book on Thoracic Surgery and Esophageal Surgery by Pearson, Cooper, Deslaurier, Ginsberg, Hiebert, McKneally, Patterson and Urschel. 

Clem believed that “Surgery works and is part of things that work. We thrive on it and are nourished by it. Operating restores the surgeon even as he or she restores the patient. A surgeon would rather work on his project in the operating room than eat, drink or sleep.” Surgery is the irrevocably invasive remedy that links patient and surgeon more clearly than other areas of medicine. The exaltation of pain relieved, life prolonged and the body restored is a celebration that goes on and on and is multiplied both by the quality of new life and restoration. Decades later a patient may recall the very date of the event especially if the surgeon has added caring to his curing. The prescription filled, the diet proposed and advice given leaves less of an imprint. 

His life on the Ship of Hope, anchored off the coast of Africa, further inspired his dedication to the caring of others, and represented Clem Hiebert to a "T." Physiologically, we know that Clem’s talented brain ceased with his last heartbeat, but his unique and stellar spirit live on imparting his inspiration and wisdom to us all, and to his patients who were lucky enough to be touched by his magnificent life. 

 

DEATH COMES TO THE PHYSICIAN

“ENTER, DEATH, MY OLD ACQUAINTANCE!

I WILL NOT CALL THEE FRIEND FOR

WE HAVE BEEN ADVERSARIES THESE FIFTY YEARS.

SUCCESS AT TIMES HAS BEEN THINE,

AND FAILURE LIKEWISE – WHEN VICTORY HAS BEEN MINE.

NEITHER CAN I DEEM THEE WHOLLY EVIL,

FOR AT TIMES THOU HAS BROUGHT SURCEASE FROM SUFFERING

IN THOSE WHOM MY POOR SKILL COULD NOT EASE.

WHEN THE SHADOW OF THY PRESENCE HOVERED OVER THOSE

WHOM THOU DIDST NOT TOUCH,

WAS THIS TO TEST THE METTLE OF THEIR SOULS

OR TO CHALLENGE ME TO GREATER ENDEAVORS?

THOU DOST NOT ANSWER.

SO THOU HAS COME FOR ME.

I KNOW THEE TOO WELL TO FEAR THEE.

COME,  LET US WALK ARM IN ARM

DOWN THE LONG CORRIDOR

UNTIL I ENTER THE PORTALS OF ETERNITY,

FROM WHENCE THOU ARE FOREVER BARRED.”

- FROM “A TWENTIETH-CENTURY SURGEON”

             CLAUDE E. WELCH

 

Harold C. Urschel, Jr., MD
Chair of Cardiovascular & Thoracic Surgical Research,
Education & Clinical Excellence
Baylor University Medical Center
Dallas, Texas  USA