|
Hugh Johnson was born in Minneapolis on December 14, 1918, and grew up in Grand Rapids, Michigan. He died on July 21, 1992, in Rockford, Illinois. Rockford was the city where he had lived for 39 years and where he practiced plastic surgery from 1953 until a disabling stroke forced him to retire in 1980, at age 61.
A graduate of Northwestern University, He served his internship at Cook County Hospital, in Chicago, followed by service in the Navy for two and a half years during World War II. He received his surgical training at the Mayo Clinic, where he also earned a master’s degree in plastic surgery.
After the Mayo Clinic, he completed a preceptorship in plastic surgery with Sir Archibald McIndoe and Mr. Percy Jayes at Queen Victoria Hospital in East Grinstead, England.
He was a Fulbright lecturer in plastic surgery at Christian Medical College in Vellore, India, and volunteer physician in Vietnam twice, the first time during the Tet offensive in 1968, and the second time in 1973. He also was a volunteer physician at various leprosy treatment centers in the United States. Hugh made seven trips to Russia as a visiting physician, at a time when very few individuals chose to undertake such a venture.
Hugh Johnson was a pioneer in many areas as well as an extraordinarily resourceful individual. Many of his highly original articles came from his own practice and personal experience, especially during his early years as the only plastic surgeon in northern Illinois, outside the greater Chicago area.
In Rockford, he designed and ran a course for young plastic surgeons under the title “Start a Private Practice Painlessly.” This course had as guest speakers plastic surgeons, bankers, attorneys, writers, accountants and industry representatives. It focused exclusively on the practical aspects of starting a private surgical practice. The course was offered annually for almost fifteen years, starting in 1971 and continuing several years after he was forced to retire from his own practice because of a disabling stroke.
His strong spirit and determination, as well as the courage of his wife Tottie, enabled them to continue living an interesting and active life during his twelve years of disability. In that sense, Hugh and Tottie together became living proof that strength of spirit is, ultimately, the truest and most valuable wealth one can possess.
In addition to his Rockford practice, Hugh also operated, in the early years, at Northwoods Hospital in Phelps, Wisconsin.
A prolific contributor to the literature, he had an originality of thought and pioneering spirit that were evident in many articles, editorials and vignettes he published over the years, some of which touched on topics seldom approached by physician-writers. A few article titles come to mind: “Starting a Private Practice in America” (1957), “What the Public Wants” (1963), “An Ancient Tranquilizer Rediscovered” (1965), “Mississippi Meandering” (1963), “Scrooge Becomes a Saint” (1965), “The Joys of Being a Loner” (1966), “A Plastic Surgeon in the Tet Offensive” (1968), Is there a Doctor on the Plane?” (1970), “Yes, Natasha Can Get a Face Lift in Moscow” (1973), “Sue Me, Sue Me!” (1974), and “Stroke Clubs, Undervalued and Underused” (1984).
This sampling of Hugh’s writing reveals the inquisitive, versatile philosopher he was, and the man of humor his friends knew him to be.
Hugh founded the Midwestern Association of Plastic Surgeons in 1961 and served as its president in 1982. At the June 20, 1992, business meeting, Dr. Robert Parsons had a motion passed which elevated Hugh Johnson’s permanent status to “Founding Member.” Hugh died a few weeks later of complications following open heart surgery.
To summarize Hugh Johnson’s life in one line, one would have to borrow from Frank Sinatra’s signature song: he worked, he shared, he wrote, he contributed and created. But most importantly, “… he did it his way” as a determined, resilient and pioneering individual.
The Midwestern Association of Plastic Surgeons was founded in 1961 by Hugh Johnson who had become the first plastic surgeon in Rockford, Illinois, eight years earlier in 1953.
The 1960’s was the decade when regional societies started emerging, as many surgeons became disenchanted with the national meetings because of their size, the severe competition for program time to present papers, the formality of the proceedings and the politicized behavior of university power groups, particularly those belonging to the more prestigious training programs.
By the mid and late 1960s, the regional societies started connecting with the American Society of Plastic and Reconstructive Surgeons and were well on their way to becoming recognized affiliates.
The first meeting of MAPS was held in Madison, Wisconsin, in the spring of 1961, with eight or ten plastic surgeons in attendance. (Nobody seems to remember the exact number.) This small group included Hugh Johnson of Rockford, Frank Bernard and Gordon Davenport of Madison, Jim Dowd and William Stoneman, III, of Saint Louis, Stuart Landa of Chicago, Fred Weissman of Detroit and Jay Masson of Rochester. According to Frank Bernard, George Pap and Tottie Johnson, Dr. Davenport coordinated the meeting, and Drs. Dowd, Bernard and Johnson were the hosts. Dr. Weissman believes he was one of the first to suggest the group devote some time each year to a “confession session.” The expression, however, might have been coined by Hugh Johnson.
From a handful of members in 1961, the Association then grew to more than 350 members by 1994, in just a little over three decades.
The reason for founding a separate society, voiced at that meeting, echoed the reasons later given by leaders of other regional groups:
• To have a more accessible platform to present papers and problem cases. (The problem cases eventually turned into the famous Saturday morning Confession Sessions.)
• To have a more informal environment for peer interaction and fellowship and to get to know other surgeons in the Midwest better.
• To have a pleasant venue for the exchange of practical ideas in regard to patient and office management and regional referrals, whenever needed.
• To create an opportunity to interact with leading faculty from the plastic surgery training centers, who were usually too busy and distracted at the national meetings.
• To gain information on missionary and volunteer work in Third World countries, as a means of refining skills by teaching others. And with the ultimate goal of helping patients, especially children, who might otherwise go without desperately needed surgical treatment.
The first meeting had a most informal and intimate mood. According to Dr. William Stoneman, III, at the closing of the session, the group watched the finals of a sports event on television in the hotel ballroom, while the ice was breaking up outside on Lake Mendota. That marked the end of the first MAPS meeting. The handful of friends planned the second meeting to take place a year later, and toasted the future of the just-born Midwestern Association of Plastic Surgeons with a glass of beer.
This Saturday morning half-day program followed a unique format from its inception, and survived for decades without change. In recent years, however, the sessions have been modified, perhaps because members from academia usually bring more success stories than failure stories, out of loyalty to their universities and training program directors.
When asked what they would like to see in the next thirty years, a rather large percentage of respondents said they would like to see a return to the original Confession Sessions – candid, honest, where members would seek solutions to difficult cases or unfortunate results, rather than approval for successful work.
One good example of how these sessions went and what kinds of slides were brought was the anecdote involving Bill Huffman from the University of Iowa, who at one meeting showed a slide of a white ischemic Abbe flap to the upper lip. “If a resident had done this,” he said with a smile, “I might have been inclined to dismiss him from the training program. But this didn’t happen to any trainee of mine. It happened to me.”
This type of candor was possible only because MAPS was a small group and the members were, for the most part, non-competing friends. The tone had been set from the beginning that “here we come to learn from each other, and it’s all right to be humble and bring your worst nightmare to share with your colleagues.”
Clarence Monroe expressed it very well when he wrote:
The Saturday morning Confession Session was one of the things which pleased me very much at the time, and actually surprised me. Although we were, in a sense, competitors, we really took our hair down at these meetings, and discussed our most difficult problems and some of our mistakes with each other, without fear of being laughed at or embarrassed. WE often got some excellent advice about how to manage a challenging problem. We all needed some place where we could talk things over, off the record
Adrian Flatt was equally eloquent when he wrote:
The important part of the meeting was Saturday morning, when every member has to bring a BAD case, slides and history were required, and each member threw himself on the mercy of the group for suggestions as to how he could have done better or how they would have done better under the same circumstances. It was a way of learning from each other, not a vindictive session. We all felt at that time this was a vital part of communicating with one’s peers, over significant distances.
And it worked. Many members reported that they had learned more from the honest appraisal of someone’s surgical failure, complication or poor result, than from some else’s brilliant results under similar circumstances.
Most of these excellent teaching cases, the ones showing a bad complication, followed by an analysis of what went wrong and what could be done to improve the situation, never went beyond the MAPS meetings. Perhaps they should have. They might have helped a few more plastic surgeons who may have had a similar experience, but could not bring themselves to discuss their cases openly with anyone else due to isolation, embarrassment or lack of trust.
Fees were also discussed informally at first. But by the early Seventies, the government had started monitoring fee reviews and interpreting some written fee comparisons as “price-fixing.” It then fell to Dr. David Hawtof to remove all written references to “usual and reasonable” fees from the MAPS records during his term as secretary. The topic, a very helpful guideline, ceased to be, officially, part of the program.
On the subject of fee discussions, we have to quote Clarence Monroe again:
The other feature I thought very worthwhile was the study of fees we did several years in a row. Dr. Dowd did some research in this area and brought his findings to the meeting. He showed what a wide variety of fees we (sic) charged for the same work. After the third or fourth year of this, we became a good deal more consistent in our charges. I though this was a real service to or patients No one was identified as charging exorbitant fees, but we narrowed the range for the sake of consistency.
The second meeting took place in the spring of 1962 in Minneapolis, under John Grotting’s presidency.
The group remained small, by any standards, for two or three more years, even though it was growing at a comfortable rate. Because of its informality and lack of rigid definition, several members were able to make significant contributions to MAPS despite the fact that they were not traditional plastic surgeons in general practice. A few names come to mind:
• Dr. William Huffman of Iowa City, the second president of MAPS, who presided at a most pleasant meeting in 1963 at the Wagon Wheel Resort in Rockton, Illinois. Dr. Huffman had been initially trained in otolaryngology and had a strong interest in cleft palate rehabilitation.
• Dr. Adrian Flatt, the 1966 president who was also affiliated with the University of Iowa in Iowa City, was a British surgeon trained in orthopedic surgery who later developed great expertise in hand surgery. He became a pioneer in finger joint replacement in the 60s and 70s. In recognition of his contributions, among other honors, he was asked to become editor for the Journal of Hand Surgery, a position he held for ten years.
• Dr. Janusz Bardach, a European surgeon who joined MAPS at the end of the 70s, had been educated in Poland. He also followed this tradition of diversity at the University of Iowa. He, too, worked in the Department of Otolaryngology and Maxillofacial Surgery and became an expert in cleft-lip and cleft-palate repair.
All three men are examples of non traditional training and backgrounds in plastic surgery. Yet, all three were regarded as outstanding surgeons and teachers, bound to make invaluable contributions to the young Midwestern Association of Plastic Surgeons.
One important highlight, of the second meeting, held on April 13-14, 1962, and hosted by Dr. And Mrs. Grotting, was the discussion of who would qualify for MAPS membership and who would not. Several members volunteered to research the legal aspects of this important organizational topic, in order to include them in the discussion at the 1963 business meeting, a year later.
The next meeting on April 5-6, 1963, was held at the Wagon Wheel Resort in Rockton, Illinois, some 18 miles north of Rockford. Tottie and Hugh Johnson were the hosts. Bill Huffman from Iowa City served as president. According to George Pap, here too, at the Saturday morning Confession Session, “People started pulling out slides of problem cases from their pockets and briefcases, happy to be able to share their worries and headaches with their peers.”
That Saturday morning really set the mood and the tone for the many subsequent Confession Sessions that followed in the next decades. The 1964 meeting was held in St. Louis under Jim Dowd’s leadership. It was at this meeting that the role of MAPS officers was defined and the Senor Member category established. The 1965 meeting took place in Milwaukee. Christopher Dix presides. One important event that year was the establishment of an official liaison person to the American Society of Plastic and Reconstructive Surgeons. Dr. Dix was chairman of the MAPS Constitution and Bylaws Committee and became the liaison officer between MAPS and the national society.
Membership qualifications were discussed again and redefined. It was decided that proof of formal training in plastic surgery, rather than board certification, would be the principal requirement for eligibility.
That year, the ASPRS Newsletter printed what might have been the first item about MAPS activity in a national publication. The article, about 250 words long, was published because of the new recognition of the role of regional societies. The editor of the ASPRS Newsletter was Paul Natvig, of Milwaukee, an active member of MAPS. The article mentioned the creation of the Midwestern Association four years earlier, in 1961, by Hugh Johnson and described its format: registration on Thursday afternoon, formal papers all day on Friday, an Annual Dinner of Friday evening, and the Confession Session on Saturday morning. The article reiterated that this half-day session was considered the highlight of the meeting by a majority of the member surgeons. Adrian Flatt became president of MAPS in 1966. An interesting anecdote, contributed by Bill LeWorthy, describes another highlight of that meeting in Iowa City:
Adrian Flatt displayed a collection of acrylic molds of the hands of the first astronauts, as well as those of President Johnson and other famous personalities. Dr. Flatt had also made an appointment to mold President Kennedy’s hands. The date, unfortunately, turned out to be during the week of the President’s assassination and sate funeral and the had molds were, therefore, never made.
In 1967, the meeting was held at the Mayo Clinic, under the presidency of James Masson. Of historical interest that year were the facts that the Association had total reported assets of $2,110.34 and a total membership of 65 surgeons. That was the year when the first Constitution was approved in its final draft. It was recommended that the document be printed and distributed to all the members. The Association was now six years old. Sadly, two of its charter members had died in the preceding year, John Grotting and William Huffman.
A steady growth of the Association took place in the next five years (1967 to 1971) as young surgeons out of training learned of the existence of this regional group. MAPS meetings now acquired a reputation for being practical informal, friendly and professionally helpful. MAPS was gaining new members at a rate of six to ten a year. This growth was measured, comfortable and easily absorbed by the Association.
At the 1968 meeting in Chicago, under President Clarence Monroe, three important decisions were made:
1) To postpone review of membership applications by two general surgeons until an Associate Membership category could be created.
2) To review with Dr. Monroe, Dows and Hal Griffith the need to pressure the government into getting a plastic surgeon appointed, in an advisory capacity, to the Department of Health, Education and Welfare. The position of Advisor, in matters which included the scope of plastic surgery, was being sought by an ENT surgeon. This, understandably, was considered inappropriate by the plastic surgeons.
3) The presidential chair, financed until that point by Hugh Johnson, became the responsibility of MAPS, whose treasury assumed the cost of this annual gift from then on.
In 1968 MAPS also had proof of International exposure, as it received requests for educational materials from surgeons in Lima, Peru, and Bucharest, Romania. At the 1969 and 1970 meetings, the question of public relations came up, especially in reference to the interactions that the plastic surgeon should have with his/her peers, physicians in other specialties, and the general public. This topic, of course, would become more and more important in the next decade.
In 1970, three relatively new concerns became part of the business meeting agenda:
1) How to deal with applications for membership from geographic locations outside the Midwest: e.g., Oklahoma and Canada.
2) How to deal with applicants who had an interest in plastic surgery but were not formally trained in the specialty.
3) How to screen applicants to insure that all those who claimed membership had indeed been accepted as active members.
The Midwestern Association of Plastic Surgeons had come out of its infancy, as it were, and was now dealing with the problems that affect, sooner or later, all professional associations interested in maintaining a good reputation. These problems, it was agreed, were “nice trouble to have.” The idea of becoming a corporation was discussed and rejected that year. The concept of an expanded membership, which would include Associates – non traditionally trained plastic surgeons – was also rejected.
The completed and revised Constitution and Bylaws were distributed to all members in 1971. The Senior Member category was officially created that year and the membership voted to add spouses’ name to future programs. The fist decade ended with attendance of MAPS member Morrison Beers at the meeting of the Regional Societies Committee of ASPRS, which took place in Montreal on October 4, 1971. The Midwestern Association now had an updated Constitution and bylaws, a presence at the national level, a good financial basis, a membership rapidly approaching the 100-member mark and a crisis-free management structure. Ten years had passed since the meeting of an informal small group of friends in Madison, Wisconsin, in 1961. The Association was now entering its middle decade.
next | previous | home
|
