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If you like Thomas Starzl's story, you might also like:
Tenley Albright,
Keith Black,
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Thomas Starzl
Starzl Institute

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Thomas Starzl
Thomas Starzl
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Thomas Starzl Interview (page: 5 / 8)

Father of Modern Transplantation

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  Thomas Starzl

Would you say that you were a budding scholar as a child?

Thomas Starzl: That was the problem.

They had, in the state of Iowa at that time, they gave every child in the state one of these -- something -- Stanford Binet. It was the IQ test. They gave all the students the test, and then they published the ones that were outliers. They published it in the papers, so it was generally known. I had the great misfortune to have one of those high scores, in the top one percentile. They published them not only locally, but for the state. I was in that group, and probably I think at the top of that group, so this was well known. My parents didn't want me to be abnormal. They wanted me to be treated like everyone else. So the idea that I would be sequestered often in a corner reading books and not participating in the rest of life was something they did not want. In fact, as you know, my father had a newspaper and they wanted me to work and do all the normal things.

What about sports? Do you think sports helped you to develop motor skills or team building skills that are relevant in medical practice?

Thomas Starzl: I think the more important skills, manual skills, were developed more by being a printer. I learned how to be a printer. And 70 years ago, most typing, except for linotyping -- you wouldn't even know what that is, I'm sure, but linotyping was a process where you typed a script, whatever was going to be in the newspapers. But it was typed with a system different than a typewriter. So linotypers were very special people that had their own alphabet, their own keyboard. So I learned how to linotype, which in a way was a disadvantage because I learned a form of typing that doesn't exist today, is not the kind that people took up with their Olivettis.

[ Key to Success ] Preparation

So was it the linotyping you credit with developing these manual skills?

Thomas Starzl: I learned how to linotype. That required also mechanical skills. But the important mechanical training was with hand setting. The linotype was producing material that would be just about the same size as in the newspapers of today, because the lead slugs that came out for every line were the actual imprint, things that actually gave an imprint on paper, but anything bigger than that had to be set by hand. So you memorized, and here was an alphabet, and it too was in a strange organization -- not "a, b, c..." -- it had its own formulated structure, and you'd pick up letters and make your headlines or your subheads. That required a lot of technical skill. And there were other aspects of the printing and the newspaper publishing business that required skills. I did all the jobs from being a devil, which requires some explanation, all the way up to doing actual journalism work, or producing an atlas of a map of the county that we lived in. It was called Plymouth County. So there was sort of, when I was working in the newspapers I had to do many things. And of course, I also enjoyed basketball and football, and I was good at those sports. So I really had a very well-rounded life up to the age of 17.

Thomas Starzl Interview Photo
Did you know what you wanted to be when you grew up? When did you choose a career in medicine?

Thomas Starzl: My mother had been sick and required some very serious orthopedic operations when I was probably about ten or something like that. These were high-risk procedures. She went to Sioux City for the operation and was gone for a long time, a couple of months or maybe longer than that. She also had been a nurse. She had a very high respect for the medical profession. And because I was fond of her, naturally that rubbed off. But her background was an interesting one in that she was one of that horde of women who, in order to get out of the kitchen, or do something other than sit around the house all day, had become a teacher. So she was a teacher first. And after doing that for a couple of years, several years, she went to nursing school. So she was a teacher first and then she was a nurse. Then she was a patient after that, so I had quite a bit of exposure to doctors of one kind or another.

There was a doctor named Wendell Downing whose son became a doctor and practiced -- probably still does -- in Des Moines, Iowa. But the older Dr. Downing, recognizing that I was interested in medicine and in surgery, invited me to come and watch operations, which I did, and observed operations that today are rarely done, like radical mastectomy for cancer of the breast and other operations. He taught me some details of anatomy that always stuck. It was always easy to remember the long thoracic nerve of Bell, because that was a nerve which one tried hard to preserve doing a radical mastectomy. So I spent quite a bit of time in the operating room, just watching surgery. I remember at first they were quite concerned that I might keel over and faint at the first sight of blood, but it didn't bother me.

[ Key to Success ] Passion

A lot of people wonder how surgeons cope with this huge responsibility they have for the life and death of their patients. Have you ever experienced anything like stage fright or writer's block going into the operating room?

Thomas Starzl: Oh, I had that every time. That was a little bit unusual. I think most people who went into surgery become steeled to that responsibility, become hardened. Or maybe they don't even have to go through that process, just have a more conventional character and don't view it quite in such a lofty way as you've described.

But you did experience that?

Thomas Starzl: I was always worried. Of course there were textbooks describing operations. Even if I had done an operation 100 times, if I had an operation that I had done two days before, I'd go back and read the book and refresh books, which quickly became tattered and exhausted by constant use. But I think the great worries that tended to accumulate, so that they eventually became very heavy, were about what happened afterwards to the people. So if you operated on somebody with a cancer, you were always worrying that you were going to get that unwelcome phone call from somebody that they had a recurrence. Or in the case of the transplant patient, because the mechanisms of engraftment were not known, transplantation was a field in which big things were accomplished without knowing why and how. There was no reason to hope at the beginning of transplantation that those operations were cured. That is, if you could put a kidney and it had a chance of lasting for a lifetime. So instead the idea was that you had an alien, foreign organ in there that was under constant attack, and even though it lasted for a year, or a couple of years, that it was slowly, slowly going to go away. And if you actually came to know those patients, and I did, at a personal level in almost every case, you were sitting around like a parent watching over a child with an inevitably slowly advancing disease, and that you were going to get a phone call that the end had come. So if you had patients for whom you had a particular affection, and those uncommonly often were children, you just had an idea that you'd never see them grow up. So it was a deadly wait actually.

[ Key to Success ] Courage

What did going through that stage fright, for lack of a better term, what did overcoming it teach you about yourself? Did it remove doubt from you?

Thomas Starzl: Well, I think the first thing it teaches you is not to get too puffed up about your importance. Maybe that's enough of a lesson all by itself.

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This page last revised on May 16, 2011 17:01 EST
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