Surgical Limits: The Life of Gordon Murray (review)

This is a well-researched, engagingly written story of a bold, brilliant, skilled, and cantankerous Canadian surgeon, Donald Walter Gordon Murray, whose successes and failures have the flavor of Greek tragedy. The author, Shelley McKellar, is a thirty-six-year-old professional historian who came reluctantly to biography, with special gelidity toward doing "dead white guy history," as she notes with whimsical frankness in her preface (p. vii). But her interest in technological innovation and Gordon Murray's 1940s work on the artificial kidney machine overcame her initial aversion to biography: she saw Murray not merely as a famous, controversial surgeon, but as one whose career shed light on a period of striking change in the nature of North American clinical practice and biological research during the early and middle twentieth century. It was her hope to present Murray fairly in these complex circumstances, and this reviewer gives her high marks on achieving her goal.

Gordon Murray grew up, the fifth of seven children, in a Scottish immigrant community not far from the Toronto academic community where he spent his mature career. Voluntarily interrupting his medical study for two years of service as an artilleryman in the Great War that claimed the life of his younger brother, Murray was devastated by his loss and bitter about the "shirkers" who avoided military service. Three years of postgraduate education in Britain after finishing his five years of Canadian medical education made him an Anglophile and a skilled surgeon well grounded in basic science, especially anatomy. His career exemplified his great operative skills, combined with an intense curiosity, unusual ingenuity, and a striking compassion for patients that won their esteem and affection. His early operative successes in the developing field of surgery for congenital heart disease, and his basic research on heparin as applied to vascular surgery, established his fame throughout the surgical world. Popular journalism hailed surgeons of the 1940s and 1950s as heroes and wonder workers who challenged previously accepted surgical limits. It was difficult not to subscribe to the adulation of patients and journalists alike, and Murray signed on to this iconic image.

Buoyed up by early clinical and research progress in the cardiovascular area, Murray turned his immense talents to the problems of the artificial kidney, with extensive laboratory investigation crowned by widely celebrated success in one comatose patient and lesser success in well over a dozen others. He always considered the dialysis work as a subset of his heparin research. The analogous, independent work of Kolff in the Netherlands and the United States, buttressed by a team of dialysis experts and manufacturers, gradually came to dominate the field, while Murray's cardiac practice and tendency toward solitary endeavors inhibited the wider application of his work in Canada. His unwillingness to act as an inspiring leader for a diverse group of collaborators was an unfortunate characteristic that dogged this phase of his career, and led to greater problems in ever-more-challenging projects involving cancer therapy and the attempted restoration of function in patients with a damaged spinal cord. The controversial case of Bertrand Proulx was catastrophic for his professional reputation.

In a six-page conclusion on "surgical limits," the author has provided a concise, balanced analysis of a period when the potential of surgery seemed limitless, but the reality fell short of the expected miracles. Murray's pursuit of the independent research institute he fiercely sought and ultimately attained was impaired by his difficult interpersonal relations and his refusal to seek funds from the Medical Research Council that required detailed research plans. Moreover, his separation from a potentially collegial academic environment denied him the cross-fertilization that would have furthered his own ingenious notions. He was unsympathetic to the new standards of investigation, circumscribed by regulatory and ethical restrictions.

McKellar's initial experience with oral history provided useful analysis by numerous colleagues and professional contemporaries. Their comments illumine Murray's dedication to his family, his students...