Mayo innovation and teamwork changed my life not once , but twice, nearly 60 years ago. I am writing this tribute to express my gratitude to the Mayo Clinic and staff who helped me.
As a ten year old I had developed Volkmann’s contracture after breaking my left arm. This rare complication destroyed my forearm flexors due to circulatory compromise leading to my muscles being replaced by scar tissue, a painful process. Two of my three forearm nerves were similarly destroyed resulting in severe pain during cold weather and undetected burns.
Mayo orthopedics chairman, Ralph K. Ghormley, was near retirement in 1952 and not taking new cases. An admitting Mayo pediatrician, whose name I wish I could remember, appealed to Dr. Ghormley to see me in consultation. He agreed to do so. Dr. Ghormley assessed my left forearm and doubted that he could help me. He offered a glimmer of hope, “I know an innovative neurosurgeon, Heinrich Svein, who might find a way to help.”
Dr. Svein made clear that a fully corrective intervention was out of the question, but offered to do an exploratory operation to see what options might exist. During a four hour operation he removed dead tissue and transferred the still intact proximal nerves into their remaining nerve sheaths just beyond the injured tissue and secured them to these remaining sheaths with tantalum wire. That intervention involved microscopic neurosurgery in 1952 which was a pioneering procedure for the time.
After my operation he advised my parents and me that these transferred nerves might move into their old sheaths at the rate of hair growth. Regrowth of both nerves did occur over the course of the next twelve months resulting in fully restored sensation. Pain during cold weather and from undetected burns were an experience of my past. I now had a pain free, useable though still impaired, left hand. Drs. Ghormley and Svein had found a way to do what was possible and to make a difference in my life.
My second life changing experience at the Mayo Clinic occurred one year later. During a follow-up visit with Dr. Ghormley my mother noted I was fatigued and drinking a lot of water. Dr. Ghormley nodded and ordered a blood draw. At our next visit he told us in a subdued voice that I was diabetic and that lifelong management was required. He then said, “ Let me direct you to some good people who know what to do with diabetes.”
He referred me to Dr. William Balfour, an internist and a grandson of one of the Mayo brothers. “Pursue your dreams,” Dr. Balfour told me, “and we will teach you how to manage this problem so you can achieve them.” I was eleven years old and the average life expectancy for juvenile diabetes in 1953 from the time of diagnosis was twenty years.
Dr. Balfour emphasized the importance of exercise in maintaining my health. He showed me pictures and accounts of Bill Talbert’s and Ham Richardson’s success playing tennis. Among America’s top players, they too had developed diabetes at my age. I turned to tennis having been inspired by Richardson and Talbert. I won the Indiana 15 and under Boys’ state championship, played varsity in high school and college, then continued for thirty more years. I now follow an exercise regimen.
Hortense Allen, the diabetes team dietitian, taught me over a two week period how to master my diet and manage the details of self care. Dr. Balfour’s and Ms Allen’s treatment philosophy was liberal for the time. I could have a scoop of vanilla ice cream by trading a pat of butter and a slice of bread. If I longed for apple pie, I could have a small piece and compensate by taking extra regular insulin. In truth I never did try the pie even during adolescence. It was not forbidden.
Drs. Ghormley, Svein, Balfour, and Ms Allen engaged me in a collaborative effort to survive and thrive. As a reflection of my bonding to this Mayo team, I memorized my Mayo medical record number in 1953 which I remember to this day. I am now sixty eight, a father of three, and an Associate Clinical Professor at Yale School of Medicine.
Their foresight, compassion, and commitment galvanized my life nearly sixty years ago. I am grateful to Drs. Ghormley, Svein, Balfour and Ms Allen along with the Mayo Clinic context which helped make my life possible.