In Memoriam
Richard L. Varco
August 14, 1912 - May 2, 2004
The date, May 2, 2004, witnessed the passing of a true giant in American academic surgery. Richard L. Varco, MD was born in Fairview, Montana on August 14, 1912. He graduated from Minneapolis Central High School in 1929 and then went on to earn three degrees at the University of Minnesota. He earned an MB in Physiology in 1936, an MD in 1937, and a PhD with a major in Surgery and a minor in Biological Problems in 1944. He completed his residency training in the Department of Surgery and Physiology in 1943 and joined the faculty of the Department of Surgery under Dr. Owen Wangensteen. By 1950, Dr. Varco had risen to the rank of full Professor. He participated in a number of world firsts that took place at the University of Minnesota. He was first assistant in the first successful direct-vision open-heart operation (September 2, 1952, led by F. John Lewis) and in the first open-heart operation using cross-circulation (March 26, 1954, led by C. Walton Lillehei). He led the first jejunoileal bypass operation in 1953. This operation, performed for hypercholesterolemia, initiated research on surgery for hyperlipidemia that was the basis for NIH program project grant funding for the subsequent 30 years, led by Dr. Henry Buchwald, a protégé of Dr. Varco. Varco co-invented the implantable drug pump in 1969, a pump that was used for heparin delivery, intraarterial chemotherapy and ultimately became the first implantable pump for insulin delivery in 1980.
In addition, Varco was responsible for starting the transplant program at the University of Minnesota. He performed the first organ transplant at the University in 1963, a successful living donor kidney transplant between identical twin sisters, each of whom went on to enjoy many decades of healthy life. His early association with Robert Good initiated the Department of Surgery's interest in transplant immunology, a major program that exists to this day. To quote from the tribute to Varco written by John Najarian in 2002, "Varco's influence was also responsible for keeping and training the key principle investigators and clinicians in heart transplantation, including Christiaan A. Barnard and Norman E. Shumway, the world pioneers in this field.1"
Varco's many honors include the prestigious Lasker Award, often referred to as the American Nobel Prize, which he received in 1955, along with his colleagues C. Walton Lillehei, Herbert E. Warden, and Morley Cohen, for their pioneering work in open-heart surgery.
Varco was legendary for his participation in the American Board of Surgery oral examinations. He was widely considered to be one of the toughest examiners on the Board, though it turned out he was one of the softest graders and often acted as advocates for candidates who felt that they had performed badly under his harsh questioning. Again, to quote from Najarian, "Varco was an eminent clinical surgeon. He operated at least once or twice daily, right up to the time that he retired. When there was help needed in the operating room, he was the surgeon who was called most often.1"
In G. Wayne Miller's book about Lillehei, entitled King of Hearts, Miller describes Varco in the early days of open heart surgery as "a demanding, sometimes gruff man who scared the more timid of the younger residents. Short and beefy, with a shock of thick black hair, he had big paws for hands - meeting him on the street you might have guessed he worked the waterfront. But in fact, he was the slickest of the University of Minnesota surgeons, and that included the Chief. 'When Dr. Varco gets through with a case', a nurse who knew his work remarked, 'it looks like it's the way the Lord made it.' "2
Richard Varco represented a vanishing breed of academic surgeon. He was an exemplary and admired clinical surgeon, an outstanding investigator, and a superb teacher. In these days of super-specialization, it is difficult to fathom an individual who could make so many seminal contributions in so many diverse fields as did Richard Varco. He was a pioneer in open-heart surgery. He started the field of metabolic surgery. He was an early pioneer in the field of organ transplantation, and provided tutelage to the two surgical investigators who would successfully launch the field of heart transplantation.
Varco clearly recognized the fundamental importance of research in the solution of clinical problems. That he had the ability, intellect, energy and perseverance to succeed in so many diverse fields, is his lasting tribute. His legacy, at the University of Minnesota and beyond, is as a model for all academic surgeons. There is no substitute for having an inquisitive mind, for taking difficult problems to the research laboratory, and for having the courage and persistence to take new therapies to the bedside. Richard Varco was able to meet these challenges in an exemplary fashion throughout his career. The field of academic surgery is greatly in his debt, and we will not see his like again.
References
R. Morton Bolman III, MD
C. Walton and Richard C. Lillehei Professor
Chief, Division of Cardiovascular and Thoracic Surgery
Executive Director of Lillehei Heart Institute
University of Minnesota
Minneapolis, Minnesota
