In Memoriam
Herbert Edgar Warden
MONTANI SEMPER LIBERI
August 30, 1920 - January 14, 2002
The Latin motto of his adopted and beloved State of West Virginia, Montani Semper Liberi, which means, "Mountaineers are Always Free", aptly captures the determined independent spirit, fundamental morality, gift of simplicity and uncompromising loyalty of Herb Warden. He was a pioneer in the development of cardiac surgery and made medical history in 1954 as a member of the surgical team that performed the world's first successful open heart surgery. In 1960 he accepted a position at the new West Virginia University Medical Center where he initiated WVU's open heart surgery program, established a residency program in thoracic surgery and served as a professor of surgery. Herb received numerous honors and awards, including the prestigious Albert and Mary Lasker Award for Medical Research from the American Public Health Association, a citation of merit from the American Medical Association, an Honorary Doctor of Science Degree from his alma mater, Washington and Jefferson College, and the Order of Vandalia Award from WVU, the highest recognition that the University can give, representing a lifetime of service.
He was born in Cleveland, Ohio, son of the late Fred and Eva A. Powers Warden. He graduated from Shaker Heights High School in 1939 and would attend Washington and Jefferson College where he received a B.S. in 1942.
Dr. Warden was a blocking back under Coach Wilbur "Fats" Henry, an all time W.J. star. From 1938-42, Sid Luckman, former quarterback of the Chicago Bears, was also offering coaching help to Warden. These mentors would instill in him a lifelong devotion to intercollegiate athletics. Herb would return to Washington and Jefferson College to serve on the Board of Trustees for a quarter century, receive a Distinguished Service Award in 1968, and an Honorary ScD in 1996.
Herb graduated AOA from the University of Chicago School of Medicine in 1946. He had been a member and historian of the Philosophy Honorary Alpha Kappa Kappa. Counted among the chapter's guest speakers were Doctors H. William Scott and Dallas B. Phemister. Dr. Warden elected to intern at the University of Chicago Clinics, 1946-47. Plans for residency were interrupted for four years by service in the United States Naval Reserve and the U.S. Civil Service. This indentured interval may have been a fortunate circumstance for our discipline, as Herb had been considering seriously specialty training in pediatrics or obstetrics during his Chicago tenure.
In 1951, Dr. Warden began his assistant residency in surgery at the University of Minnesota, and his journey into medical history. Dr. C. Walton Lillehei recruited Herb into the cardiovascular research laboratory in 1953 to join another resident Morley Cohen. Herb and Morley discovered that surgeons could perform intracardiac procedures under direct vision by using the azygos flow (low flow) principle. The two young residents proceeded to explore the technically difficult "self-lung" operation on dogs, in which a lobe of a dog's lung functioned as the dog's own heart-lung "machine". On one autumn day in 1953, they were again struggling with a self-lung preparation. Upon learning that Morley's wife was pregnant with their first child, Herb congratulated him and exclaimed: "Wouldn't it be nice, if you could plug a patient who needed an open heart operation into something like a placenta?" "It would, wouldn't it!" said Cohen. A simple milk pump and a beer hose were added to the azygos factor and the brief but epochal era of controlled cross-circulation was entered.
After extensive trials in the laboratory, the research team added cardiac surgeon Richard Varco, and operated on their first patient on March 26,1954, using cross-circulation and the patient's father as donor. Although the patient, 11 months old, later died of pneumonia, surgeons around the world considered the operation a success. True success occurred on April 23, 1954 with the long-term survival of Pamela Smith, five years old. From March 1954 to July 1955, the team performed 45 open heart operations with donor circulation.
From March to July 1955, the surgeons also used three other bypass methods: perfusion from a reservoir of arterialized blood; canine lungs as an oxygenator; and the DeWall-Lillehei disposable bubble oxygenator. By the end of July 1955, the bubble oxygenator had become the method of choice for all patients. In 1955, the Albert and Mary Lasker Award was given to the four cardiovascular surgeons at the University of Minnesota.
Lillehei Cohen Warden Varco In July 1960, Herbert Warden joined Barney Zimmermann, Walt Moran and many other Minnesota faculty in moving to the new four-year medical school in Morgantown, West Virginia. Warden would have a huge impact on the development of the rural center.
August 10, 1960. On that day, the brand new West Virginia University Hospital admitted its first patient. And on that day, West Virginians learned that their "pop" purchases gave them a personal stake in achieving better health for every resident of the state. A national news magazine describing the opening event headlined its story "The Pop Hospital: Confidence costs only a penny a bottle". The slogan referred to the remarkable way a not so large, not so rich state created a health center to serve all of its citizens by passing a one-cent tax on soft drinks. In the first eight years, one out of every 25 West Virginians had been treated at University Hospital.
Herb Warden was Chief of Thoracic Surgery and Vice-Chairman of the Department of Surgery. William A. Neal, M.D., pediatric cardiologist and former Chair of Pediatrics, was a medical student at the time: "The positive spirit and camaraderie of the faculty were inspiring. A bright light of intellectualism was shining on our campus. Herb's breadth of knowledge in basic physiology and in clinical medicine was awesome and his love of medical history made every encounter exciting for the student".
By March of 1962, Warden had his operative team in place, ready to perform the first open heart surgery in West Virginia. Below the team is assembled one day prior to the landmark operation. He also implanted the state's first pacemaker later in the same year.
In the ensuing years, Dr. Warden and his colleagues would make many innovative and significant scholarly contributions. An important original observation occurred almost at once: Anomalous Muscle Bundle of the Right Ventricle with Intact Ventricular Septum. A Newly Recognized Cause of Right Ventricular Obstruction. Circulation 28:759, 1963.
On game day Saturdays during football season, Warden's heart belonged to the Mountaineers. He'd plant himself on the sidelines of wherever the Gold and Blue were playing, spending over three decades as a team physician. Warden upgraded the physical examination and health-monitoring program, while being the go-to Doc for players, managers, coaches and extended family. Says Coach Don Nehlen, "Herb was a tremendous friend, a gem, a saint. It always gave me peace of mind to have a guy like that traveling with us. Herb would never let 'em get us down. Herb helped us win".
Dr. Warden returned frequently to his office in the medical school up to a few days before his death. Students, residents and faculty were always welcome and many sought him out for advice and counsel. Although finding a place to sit was difficult, a conversation with this soft-spoken man with a quick, dry wit was always easy. His clinical observations were often supported by letters, articles, slides (lantern), x-rays, cineangiograms, and the occasional 16-mm. film.
All of Dr. Warden's residents-general and thoracic-were important to him and he was to them. In 1983, a departmental Surgical Resident Research Award was established in honor of Dr. Warden and two faculty colleagues. It was presented in recognition of their support of excellence in Surgical research and education.
Doug Karen Suzanne Brad
When he wasn't in the operating room or on the road with the mountaineers, Herb spent his most precious time at home with Audrey and their four children. The Warden siblings had an individually unique and loving relationship with their father.
The newspaper reported: " Dr. Herbert Warden was a world-renowned cardiac surgeon who chose to live and work in Morgantown. It is only appropriate that a man who could fix hearts better than anyone be remembered for his own good heart. In many ways there wouldn't be a Ruby Memorial Hospital, and a sprawling Evansdale medical complex, if it hadn't been for the abilities and presence of this gentle physician".
Our profession has lost a surgeon-scientist, the people of West Virginia a surgeon-physician, his students a consummate teacher, and I have said goodbye to a valued and dear friend.
West Virginia Hills (Official State Song)
Final verse:
Oh, the West Virginia hills! I must bid you now adieu.
In my home beyond the mountains, I shall ever dream of you;
In the evening time of life, If my Father only wills.
I shall still behold the vision of those West Virginia Hills
Gordon F. Murray, MD
Professor and Chief
Section of Thoracic Surgery
West Virginia University School of Medicine
Morgantown, West Virginia
Secretary, The Society of Thoracic Surgeons