Francis Daniels Moore was a pioneer ahead of his time who made numerous landmark contributions to the field of surgery, including the understanding of metabolic physiology during surgery, liver and kidney transplant, and the famous Study on Surgical Services of the United States (SOSSUS) report of 1975 that served for decades as a guideline for development of surgical residencies. He was the epitome of what a physician should be, a compassionate and dedicated surgeon, innovative scientist, and a medical professional dedicated to quality medical education across all specialties

Cowan, MD, Scott W.

Low, BS, Sara L.

Shah, MD, Ashesh P.

Yeo, MD, Charles J.

English

Name not available

Francis Daniels Moore: one of the brightest minds in the surgical field.

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsDepartment of Surgery, Gibbon Society HistoricalProfiles Department of Surgery2-1-2015Francis Daniels Moore: one of the brightest mindsin the surgical field.Sara L. Low, BSThomas Jefferson University, sara.low@jefferson.eduCharles J. Yeo, MDThomas Jefferson University, Charles.Yeo@jefferson.eduScott W. Cowan, MDThomas Jefferson University, Scott.Cowan@jefferson.eduAshesh P. Shah, MDThomas Jefferson University, ashesh.shah@jefferson.eduLet us know how access to this document benefits youFollow this and additional works at: http://jdc.jefferson.edu/gibbonsocietyprofilesPart of the History of Science, Technology, and Medicine Commons, and the Surgery CommonsThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inDepartment of Surgery, Gibbon Society Historical Profiles by an authorized administrator of the Jefferson Digital Commons. For more information,please contact: JeffersonDigitalCommons@jefferson.edu.Recommended CitationLow, BS, Sara L.; Yeo, MD, Charles J.; Cowan, MD, Scott W.; and Shah, MD, Ashesh P., "FrancisDaniels Moore: one of the brightest minds in the surgical field." (2015). Department of Surgery,Gibbon Society Historical Profiles. Paper 27.http://jdc.jefferson.edu/gibbonsocietyprofiles/27Surgical HistoryFrancis Daniels Moore: One of the Brightest Mindsin the Surgical FieldSARA L. LOW, B.S., CHARLES J. YEO, M.D., SCOTT W. COWAN, M.D., ASHESH P. SHAH, M.D.From the Department of Surgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia,PennsylvaniaFrancis Daniels Moore was a pioneer ahead of his time who made numerous landmark contri-butions to the field of surgery, including the understanding of metabolic physiology duringsurgery, liver and kidney transplant, and the famous Study on Surgical Services of the UnitedStates (SOSSUS) report of 1975 that served for decades as a guideline for development of surgicalresidencies. He was the epitome of what a physician should be, a compassionate and dedicatedsurgeon, innovative scientist, and a medical professional dedicated to quality medical educationacross all specialties.F RANCIS DANIELS MOORE (Fig. 1), also fondly knownas ‘‘Franny,’’ was born the youngest of threechildren on August 17, 1913, in Evanston, Illinois, toworking class parents with New England roots. Ex-posure to the performing arts at a young age combinedwith a classical education, including Latin and fre-quent trips to Europe, groomed him into a culturedand well-rounded young man. These traits enabledhim to flourish at Harvard College from 1931 to1935. He graduated with a major in anthropology,completed premedical courses, and was president ofboth the Harvard Lampoon newsletter and HastyPudding theatrical club.1 He married Laura BentonBartlett in 1935 and went on to obtain his M.D. de-gree cum laude from Harvard.2Moore is arguably best known for his contributionsto understanding the composition of bodily fluids andchemicals in relation to surgery. He completed hissurgical residency at the Massachusetts General Hos-pital (MGH) and devoted his third postgraduate year tothe study of radioisotopes at Huntington Hospital underthe guidance of nuclear medicine pioneer, Dr. JosephAub.1 He eventually became a postgraduate NationalResearch Fellow in isotope physics and its clinical ap-plication.2 He returned to MGH and it was there that hebegan his unprecedented work on the metabolic re-sponse of the human body to surgery.2 The inspirationfor this work can be traced back to the Cocoanut GroveNightclub Fire on November 28, 1942. As a surgicalresident, he was confronted by the arrival of 114 burnvictims and tasked with their care. The complexity ofthe body’s response to burns and the unconventionalyet successful treatment with petroleum jelly byhis colleague, Dr. Oliver Cope, inspired Moore.Thereafter began the 5-year collaboration betweenMoore and Cope in Cope’s biophysical researchlaboratory to explore physiologic changes caused byburns, which culminated in numerous seminalworks on the subject. These studies became in-strumental in revolutionizing the treatment and careof armed service casualties.1The next chapter of Moore’s professional life tookplace in the Peter Bent Brigham Hospital, now BrighamandWomen’s Hospital. He was appointed surgeon-in-chief and the Moseley Professor of Surgery at Har-vard Medical School on July 1, 1948, becoming theyoungest chairman of surgery in Harvard history atthe age of 34 years.2 Brigham was a relatively newhospital, its surgeons more scholarly and more will-ing to think outside the box of conventional medicine.Moore preferred to describe himself as a scientist–surgeon, emphasizing the need for a deep connectionbetween surgery and basic science.1 Using flame pho-tometry, he pioneered studies on the normal fluid andelectrolyte composition of the human body and theirphysiologic changes in response to various stimuli, in-cluding trauma and surgery.1, 2 He published several bookson this topic, the most famous being ‘‘The Metabolic Careof the Surgical Patient,’’ published in 1959. This textbookbecame amust have for every surgeon of the era. His workindirectly enabled the establishment of modern intensivecare units.2, 3 BeforeMoore, surgeons aimed to perfect theanatomical correction of a disease, oblivious to subtlephysiologic changes, frequently resulting inmortality.2 HisAddress correspondence and reprint requests to Scott W. Cowan,M.D., Assistant Professor of Surgery, 1025Walnut Street, Suite 607,Philadelphia, PA 19107. E-mail: scott.cowan@jefferson.edu.121work directly contributed to reduced surgical morbid-ity because it enabled surgeons to detect signs of ho-meostatic instability pre- and postoperatively.Moore also left his mark on the history of transplantsurgery by spearheading the early trials at Brigham.His skill at identifying and molding talented mindsresulted in the assembly of the transplant ‘‘dreamteam,’’ consisting of Joseph Murray, George Thorn,David Hume, John Merrill, and Charles Hufnagel, thusigniting an exciting new era for transplant surgery atthe Brigham. Despite early failures, Moore drovekidney transplant trials onward. In December 1954,Murray performed the first kidney transplant betweenthe identical Herrick twins.2 Moore was also involvedin one of the first liver transplants and early in-tracardiac surgery at the Brigham.2 Transplant surgerygiants such as Murray and Starzl have paid tribute toMoore’s influence on the development of organ trans-plantation, acknowledging that without him, transplantsurgery may not be what it is today.1, 4In the mid-1960s, Moore’s attention turned to issuesof medical education and universal health care. In1970, he chaired a joint committee formed by theAmerican College of Surgeons and the AmericanSurgical Association to carry out a nationwide studyon the demographics, quality, economics, and educa-tion needs of the surgical profession. This study wasnamed the Manpower Subcommittee of the Study onSurgical Services of the United States (SOSSUS).2 The5-year study produced a comprehensive report in Au-gust 1975, including and detailing a huge database ofthe surgical profession and outlining a number ofrecommendations that served as guidelines for surgi-cal residencies for the following decades: importanceof board certification, restricting the number of surgi-cal residencies, continuous medical education, andrecertification.5However, despite his numerous landmark contri-butions, it was his ‘‘soft skills’’ for which Moore ismost fondly remembered. He placed great emphasison communication, which is reflected in his auto-biography on pages 123 to 124.1 He is hailed as oneof Harvard’s most inspirational educators, skillfullydelivering medical knowledge along with the im-portance of compassion and patient respect in thesame breath.2 His residents loved him, althoughthey were never sure if love was what they receivedin return. They received outstanding education, de-livered by a stern yet understanding mentor, whowas always empathetic and encouraging to thoseendeavoring to find their way forward.1–3 Asmany physicians put it, ‘‘If you really want to un-derstand your own work (research), ask Franny tobe your discussor,’’ so thought-provoking were hisobservations.Moore retired from the Brigham in 1976 but con-tinued to be active in the American PhilosophicalSociety (APS) and remained on the Harvard faculty asthe Moseley professor emeritus.1, 4 After Laura’s deathin 1988, he married Katharyn Watson Saltonstall in1990. In 1995 he published his autobiography, ‘‘AMiracle and a Privilege: Recounting Half a Century ofSurgical Advance.’’ He wrote extensively about eu-thanasia as evidenced by these excerpts, ‘‘Injury anddisease can so destroy that warm dwelling place that itis no longer habitable and the dweller. . . had best bepermitted to depart.’’1, 2 Indeed on November 24,2001, when sickness overcame him, he excused him-self from the APS meeting, had breakfast with Mrs.Moore, dictated his last letters, and then died by hisown hand.1Perhaps the closest anyone ever came to capturingthe essence of Francis Daniels Moore was his own son,who described his father as a fisherman, fishing forsouls and minds that he could influence and nurture tomake a difference in the world, especially in themanagement of the surgical patient.2FIG. 1. Francis Daniels Moore.Starzl TE. Francis D. Moore.Proceedings of the American Philosophical Society. Biogr Mem2005;149:605–13.THE AMERICAN SURGEON February 2015122 Vol. 81REFERENCES1. Starzl TE. Francis D. Moore. Proceedings of the AmericanPhilosophical Society. Biogr Mem 2005;149:605–13.2. Folkman J. Francis Daniels Moore: August 17, 1913–November 24, 2001. Biogr Mem Natl Acad Sci 2006;88:268–82.3. Brennan MF. Francis D. Moore. Ann Surg 2002;235:600–1.4. Goode E. (November 29, 2001). Dr. Francis Moore, 88, dies;innovative leader in surgery. The New York Times. Available at:www.nytimes.com/2001/11/29/us/dr-francis-moore-88-dies-innovative-leader-in-surgery.html. Accessed: August 4th, 2013.5. Moore FD. Report on the Manpower Subcommittee, Study onSurgical Services for the United States. Ann Surg 1975;182:526–30.No. 2 FRANCIS DANIELS MOORE ? Low et al. 123

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Francis Daniels Moore: one of the brightest minds in the surgical field.

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