The medical community mourns the loss of cardiothoracic surgeon Harold C. “Hal” Urschel, MD, who died at age 82 on 12 November 2012. Ironically, Dr. Urschel died of a heart attack that occurred in a Los Angeles hotel room as he was finalizing his presentation on stem cell therapy for the 2012 Scientific Sessions of the American Heart Association. He will be remembered for his multifaceted career and his many research interests, of which cardiac stem cell therapy was the most recent.
Harold Clifton Urschel, Jr., was born on 17 February 1930, in Toledo, Ohio, and grew up in the nearby town of Bowling Green. From an early age, he was an avid outdoorsman skilled at hunting and fishing. His father, a third-generation engineer at the Urschel Engineering Company, was a successful inventor and a consultant for several large steel companies. Young Hal spent his free time in his father's workshop and developed a strong affinity for machinery. When Hal was 13 years old, his father had the third in a series of heart attacks and died at age 43. Hal, his mother, and his 2 siblings moved in with his maternal grandparents, who lived nearby. The family was close-knit, shared many simple pleasures, and was deeply involved in the Methodist church.
Hal's parents always impressed upon their children the importance of education. In high school, Hal excelled not only at his academic studies, but also at sports. Because of his skills in football, he earned a full scholarship to Princeton University. There, he played with one of that era's best and most innovative football teams, which remained undefeated throughout his freshman and senior years. After graduating cum laude from Princeton, he attended Harvard University Medical School, in Boston—again on a full scholarship and again graduating cum laude (1955). Although he had originally been expected to become an engineer in accordance with the family tradition, the medical scholarship was too good an opportunity to pass up.
While at Harvard, Urschel met his future wife, Betsey Bradley. They went on a group skiing trip but were each dating someone else at the time. However, Urschel had an accident in which a ski pole injured his femur, and Betsey took care of him for the rest of the trip. The two were married in 1954 and eventually had 5 children.
Urschel completed his internship, residency, and chief residency at the Massachusetts General Hospital, in Boston. His training in general, vascular, cardiac, and thoracic surgery was grueling, but it turned him into a superb physician. He also served in the U.S. Navy and was Chief of Experimental Surgery at the National Naval Medical Research Center in Bethesda, Maryland. He chose surgery because it fit his lifestyle and used many of the traits that he had developed in playing football, such as precision, physical stamina, and the ability to work well with a team. During his training period, he was strongly influenced by Drs. Joseph Murray, Edward Churchill, Dwight Harken, and Paul Dudley White, who served as his teachers or mentors.
In 1963, Urschel and his family moved to Dallas, where he took a position at the Baylor University Medical Center (BUMC). Later, he became a professor of cardiovascular and thoracic surgery at the University of Texas Southwestern School. He was also a visiting professor at various national and international medical centers.
Urschel spent his entire surgical career at BUMC, performing a wide range of cardiothoracic operations. His published articles reveal his broad interests: lung cancer, esophageal cancer, chest-wall tumors, hiatal hernias, coronary artery disease, aneurysmal disease, valve disease, atrial fibrillation, and pacemakers, among others. He and his team were the first to resect superior pulmonary sulcus carcinoma and had the world's largest series of such patients. Urschel not only published several early articles on hypothermia for cardiac operations, but also, many years later, described the use of intraoperative balloon angioplasty as an adjunct to coronary bypass. However, his articles kept returning to a topic for which he became well known: thoracic outlet syndrome (TOS), or compression of blood vessels or nerves in the thoracic outlet. This condition often affects competitive athletes, and Urschel himself acquired it while playing high school football. At that time, many physicians believed that TOS did not really exist. Urschel helped establish the diagnosis and management of this condition; by 2007, he had performed 5,102 TOS decompressive procedures. On a different front, toward the end of his life, he was involved in researching the use of stem cells to treat heart failure in oncology patients.
Urschel was the president of the Society of Thoracic Surgeons, the Southern Thoracic Surgical Association, the American College of Chest Physicians, the Texas Surgical Association, and the International Academy of Chest Physicians. At a young age, he served as director and examiner of the American Board of Thoracic Surgery; he was also chairman of that group's Residency Review Committee for cardiovascular and thoracic surgery. An excellent writer, he published more than 300 articles and edited or otherwise contributed to 7 books. He also received 2 honorary doctorates and numerous other awards for contributions to his field.
Hal Urschel was known for his energetic, direct personality and for his authoritative manner in the operating room. He was equally well known for his warm-heartedness, compassion, and lifelong devotion to the Christian faith. He is survived by his wife, Betsey, and their 3 sons, 2 daughters, and 7 grandchildren. I extend my deepest sympathies to his family, colleagues, and friends.
Urschel's life and work will remain an inspiration to the surgical community. At the moment of his fatal heart attack, he was working on a presentation designed to advance the understanding of heart disease. I cannot imagine a more fitting final image by which to remember him.
Denton A. Cooley, MD
Surgeon-in-Chief and President Emeritus, Texas Heart Institute at St. Luke's, Episcopal Hospital, Houston