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Dr. Joseph Murray

Ian McCulloch, M.D., Richard Ehrlichman, M.D., and Erin Taylor, M.D.

“There is something about the practice of surgery that has meant the most to me…our patients teach us about life.” --Joseph Murray, M.D.

Dr. Joseph Edward Murray left an indelible mark on the mission and philosophy of Harvard Plastic Surgery. His unwavering curiosity, commitment to mentorship, and technical excellence set the standard for academic surgeons everywhere. Dr. Murray’s growth within the Harvard community, direct impact as an innovator, mentor, and surgeon, and enduring legacy forever have changed the Harvard Plastic Surgery program.

From its early years, Harvard Medical School has impacted the development of plastic surgery in America. The first surgeon to specialize in plastic and reconstructive surgery, Dr. John Mason Warren, was the son of the founder of Massachusetts General Hospital; his grandfather was one of three founding faculty of Harvard Medical School. John Mason Warren performed the first rhinoplasty and the first excision under anesthesia on a pediatric patient in the United States. During the first World War, Dr. Varaztad Kazanjian transformed the field of facial reconstruction, nicknamed “The Miracle Man of the Western Front.” Upon returning to Boston, Dr. Kazanjian, with Dr. Bradford Cannon, established the first clinic devoted to cleft lip and palate patients in Boston. Dr. Kazanjian allowed for Plastic and Reconstructive Surgery to be recognized as a surgical specialty, as opposed to a special interest, when he became the first Professor of Plastic Surgery at Massachusetts General Hospital in 1941. Dr. Cannon was an innovator in the treatment of acute burn injuries during the Cocoanut Grove nightclub fire and helped to pioneer the use of split thickness skin grafts at Valley Forge Hospital. While at Valley Forge Hospital, Dr. Cannon recruited the young surgeon, Dr. Joseph Murray, who provided perhaps some of the greatest contributions to medicine of any plastic surgeon in the modern era.

Dr. Joseph Murray, a native of the Boston area, matriculated into Harvard Medical school before entering general surgery residency at the Peter Bent Brigham Hospital. During residency, he was inducted into the Medical Corps of the U.S. Army. He served on the Plastic Surgery unit at Valley Forge Hospital with Dr. Cannon under the supervision of Dr. Barrett Brown where they treated acute burns and reconstructed disfigured faces and hands from battle. While treating burn patients, they made an interesting observation with temporary cadaveric skin grafts: although allografts were eventually rejected, critically ill or severely immunocompromised patients’ cadaveric skin grafts survived much longer than those of healthier patients. This finding contributed to Dr. Murray’s innovations in organ transplantation, where whole organ transplantation may be successful if the correct host milieu were achieved. Throughout Dr. Murray’s career, patients strongly influenced his innovative concepts.

After Valley Forge, Dr. Murray eagerly returned to Boston at Brigham and Women’s Hospital: “being able to return to the Peter Bent Brigham Hospital was worth the wait. The dynamic, caring, and intellectually stimulating environment was everything I had hoped it would be.”¹ Despite being told that Boston did not require another plastic surgeon given Drs. Kazanjian and Cannon, Dr. Murray persisted, becoming renown for oncologic head and neck reconstruction as well as within the innovative transplantation program. When the transplantation program head, Dr. Hume, was called away to the Korean War, Dr. Murray assumed the leadership role within the program. Strongly influenced by his experience with burn patients at Valley Forge, Dr. Murray hypothesized that a transplanted kidney may survive if the donor and recipient had identical immunologic profiles. In the dog model, he first removed and retransplanted kidneys as isografts, later demonstrating successful allograft kidney transplantation in genetically identical dogs.

In 1954 the opportunity to test his theory in humans presented itself when 23-year-old Richard Herrick presented to the Brigham with renal failure secondary to chronic nephritis. Richard’s identical twin, Ronald, was willing to donate one of his kidneys in this uncharted territory. The operation was performed without incident on December 23, 1954 with a surprisingly uneventful post-operative course. When Dr. Murray was asked if he understood the significance of the Herrick transplant while he performed it, he replied, “to the individual patient, any operation is momentous. As such, one prepares for each case as it comes, thinks about it ahead of time, and anticipates and identifies trouble spots that could waste time or lead to complications. In that sense, the Herrick operation was no different from any of the other procedures that surrounded it.”²

Herrick’s transplanted kidney survived for eight years, allowing for Richard to marry his recovery room nurse and father two children. Sadly, his underlying disease eventually overcame the transplanted kidney, leading to his death in 1962. Ronald, his donor brother, went on to live a healthy life until he succumbed to congestive heart failure at age 79. Dr. Murray’s impact on transplantation further extended to developing a safe chemical immunosuppressive regimen such that whole organ transplantation would be possible in patients without a genetically identical twin. Dr. Murray was awarded the Nobel prize in Physiology or Medicine in 1990 for his work on renal transplantation in conjunction with Dr. Donnell Thomas, a pioneer in the field of bone marrow transplantation.

Dr. Murray’s success with the transplantation program overshadowed his accomplishments as an academic plastic surgeon in reconstructive, burn, and craniofacial surgery. Dr. Murray expressed, “even as I was immersed in my challenging work in transplantation biology, I never lost sight of what I considered my true calling—playing a leadership role in plastic surgery, especially in the area of facial reconstruction in children.”³ His friendship with Dr. Paul Tessier developed after learning both performed single-stage corrections of Crouzon syndrome facial features. Dr. Murray insisted that Dr. Tessier become a consultant at the Brigham and Boston Children’s Craniofacial Deformity Service. As one of the first of its kind in the United States, the service quickly attracted patients around the globe.

Dr. Murray forever impacted the Harvard Plastic Surgery community. He attracted and mentored formidable titans of pediatric craniofacial and hand surgery, Dr. John Mulliken and Dr. Joseph Upton. Dr. Mulliken published over 500 manuscripts over the course of his career that has spanned six decades, including his work on vascular anomalies and single-stage bilateral cleft lip repair. Dr. Upton, also an accomplished academic surgeon and titan within the Boston plastic surgery community, treated thousands of complex pediatric hand deformities, attracting both patients and aspiring hand surgeons around the world.

Dr. Murray’s commitments to teaching and mentorship were far-reaching. He took every opportunity to interact with medical students. He implored young student-doctors to dream big, wisely understanding that previous unconquerable diseases would be treatable one day. Three traits Dr. Murray found “essential ingredients for a medical doctor” included curiosity, imagination, and persistence.⁴ His passion for the next generation of physicians led him to create the first plastic surgery residency program in Boston, a combined program between the Brigham and Children’s Hospital, in 1964, for which he exclaimed, “a joint residency program in plastic surgery—at last!”⁵ Following his lead, Dr. Cannon formed a program at Massachusetts General Hospital shortly thereafter. Dr. Frank Wolfort followed suit with Cambridge City Hospital, now within Beth Israel Deaconess, which became the third program in the early 1970s. These three programs functioned independently, and at times, as rivals, for many years.

In 1999, with the insistence of Deans Tostesen and Silen, these Boston plastic surgery programs merged to form one combined Harvard Plastic Surgery residency. The fusion of these strong residencies became one of the most impactful training programs in the world. The first graduating class of the combined Harvard Plastic Surgery program produced two chairmen of major academic institutions. Twenty years of graduates of the Harvard Plastic Surgery program have included 7 chairpersons. From academia to private practice to industry, Harvard Plastic Surgery graduates have affected change within the plastic surgery community.

Dr. Murray’s legacy continued in the leadership of the Harvard Plastic Surgery division chairs. In 1994, Dr. Elof Erickson succeeded Dr. Murray as chair of the plastic surgery department at BWH, spanning three decades. Under his tenure, the Brigham and Women’s Hospital Plastic Surgery program contributed to discoveries in wound healing, tissue engineering, and allotransplantation. Dr. Murray remained strongly involved in the community, with his final publication describing the success of Boston’s first face transplantation, performed by Dr. Bohdan Pomahac at the Brigham. Leadership at Massachusetts General Hospital similarly flourished under Dr. John Remendsnyder and Dr. James May after Dr. Cannon’s retirement. During their tenure, Massachusetts General Hospital Plastic Surgery became a world leader in the fields of free tissue transfer, burn reconstruction, and general aesthetic plastic surgery. The division at Beth Israel Deaconess Medical Center, led by Dr. Robert Goldwyn with a near 25-year tenure (1972-1996) and most recently by Dr. Bernard Lee with over a decade of tenure, similarly has contributed significant innovations in microsurgery, lower extremity salvage, and hand surgery. In 2019, the Beth Israel Deaconess Harvard Plastic Surgery program was created as a separate residency to that of the Mass General Brigham Harvard Plastic Surgery program.

The current leadership of the Mass General Brigham Harvard Plastic Surgery Program include Dr. Andrea Pusic at Brigham and Women’s Hospital, Dr. William Jay Austen at Massachusetts General Hospital, and Dr. John Meara at Boston Children’s Hospital. Their impact on faculty, residents, medical students, and patients have been far-reaching, with one of the most comprehensive plastic surgery academic programs today. The forty-two full-time faculty of the Harvard Plastic Surgery program form one of the largest academic plastic surgery groups in the world. A recent publication ranking the lifetime academic achievement of plastic surgery residency program faculty found Harvard to be one of the most productive. The program trains a complement of twenty-four resident surgeons, graduating three integrated and two independent residents per year. Residents of the program certainly embody the “essential ingredients” so valued by Dr. Murray with curiosity, imagination, and persistence. They form a hard-working, collaborative community passionate about plastic surgery, exceptional patient care, and innovation through research.

Dr. Murray understood the significance of how collaboration within a community contributes to innovation: “no one person is responsible for progress in any field, especially in present-day medicine. Were it not for Harvard Medical School, the Brigham & Women’s Hospital, and the Children’s Hospital, and the persons who founded and maintained them, I would never have been able to accomplish what I did.”⁶ Similar to how his surrounding community shaped Dr. Murray and his accomplishments, Dr. Murray forever shaped the Harvard Plastic Surgery community and the greater world of medicine.

Erin Taylor, M.D.
Harvard Medical School
Division of Plastic Surgery
Brigham and Women’s Hospita
l 45 Francis Street, Boston, Massachusetts 02115
etaylor@bwh.harvard.edu

¹Joseph Murray, MD, Surgery of the Soul, p. 46.
²Joseph Murray, MD, Surgery of the Soul, p. 85.
³Joseph Murray, MD, Surgery of the Soul, p. 143.
⁴Joseph Murray, MD, Surgery of the Soul, p. 226-7.
⁵Joseph Murray, MD, Surgery of the Soul, p. 144.
⁶Joseph Murray, MD, Surgery of the Soul, p. 225.

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