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Did you know? Surgical pioneer defied authority to conduct landmark operation :

December 17, 2015
 In 1963, on the 25th anniversary of the historic PDA operation, Robert E. Gross, M.D., FAAP, reunites with his patient. Photo courtesy of Boston Children’s Hospital Archives In 1963, on the 25th anniversary of the historic PDA operation, Robert E. Gross, M.D., FAAP, reunites with his patient. Photo courtesy of Boston Children’s Hospital ArchivesAfter Robert E. Gross, M.D., FAAP (1905-’88), made history in 1938 to become the first U.S. surgeon to successfully ligate a patent ductus arteriosus (PDA), his boss was furious.

A surgical resident at the time, Dr. Gross operated on 7-year-old Lorraine Sweeney at Boston Children’s Hospital, affiliated with Harvard Medical School, after secretly practicing and planning in the hospital’s postmortem room and animal laboratory. Though he received a go-ahead from the acting chief, Dr. Gross waited until his professor, William E. Ladd, M.D., FAAP, chief of surgery at Children’s, took off for summer vacation.

Collaborating with Dr. Gross was John Hubbard, M.D., FAAP, a pediatrician who persuaded Dr. Gross to undertake the risky procedure, which later was written up in the Journal of the American Medical Association (JAMA.1939;112:729-731).

Dr. Ladd, namesake of the AAP Ladd Medal from the Section on Surgery, was outraged when he learned of the surgery. Some reports say he promptly fired Dr. Gross, while others maintain Dr. Gross went on strike for a few months. Regardless, Dr. Gross eventually returned to the staff.

Subsequently, Dr. Gross made numerous contributions to pediatric surgery, especially in correcting congenital anomalies of the heart.

The relationship between Drs. Gross and Ladd never recovered, though together they helped define the field and inspired many careers. They also co-authored the first textbook on surgery in children, Abdominal Surgery of Infancy and Children (1941), which remained a standard text for years.

Dr. Ladd retired in 1945. Two years later, Dr. Gross filled his shoes as surgeon-in-chief until 1972; he also was the William E. Ladd Professor of Child Surgery at Harvard Medical School from 1947-’66.

Over the years, Boston Children’s has celebrated key anniversaries of the PDA operation, and the patient, now in her 80s, has returned to the hospital to join the festivities. (See 75th anniversary tribute with video interview at http://on.bchil.org/1jE5TjQ.)

Coincidentally, both surgeons also were early leaders in the AAP Section on Surgery. Founded in 1938, the section was the nation’s first organization of pediatric surgeons.

In 1965, the section presented Dr. Gross with the William E. Ladd Medal, its highest honor.

While Dr. Gross is widely credited as the first to perform successful ligation of a PDA, surgeon Emil-Karl Frey claimed to have done the same operation on a 14-year-old boy in Germany earlier the same year. However, Prof. Frey never published a paper about his procedure.

In 1972, Dr. Gross performed his last PDA operation, 1,610 in all. His surgical accomplishments were made all the more remarkable in that he had adequate vision in only one eye. It was not until retirement that he underwent surgery to correct his congenital cataract.

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