In Pursuit of an Eponym

In our society, eponyms play an important role, helping to identify or explain many things. According to Webster's Ninth New Collegiate Dictionary, an eponym is “1) the person for whom something is or is believed to be named; 2) a name (as of a drug or a disease) based on or derived from an eponym.” Individuals in medicine who are fortunate enough to be recognized as (or by) an eponym usually take pride and some comfort in knowing that they might thereby, in some small measure, be immortalized. In the early years of modern cardiovascular surgery, many young trainees, including myself, were helped to learn this new specialty by eponymous references to Cushing, Halsted, Blalock, and other eminent surgeons. A few, like me, even aspired to eventual eponymous recognition themselves.

Some individuals, such as Charles Penrose, apparently achieved this goal by simple means. I always believed that he simply removed the gauze from inside a cigarette drain, which thereafter became the well-known Penrose drain. Likewise, the name Mayo is well known not only because of the Clinic, but because of the surgical scissors and the instrument tray identified by this eponym. Other eponyms have been introduced by less satisfying means. I recall a delightful young surgical resident named Nelson whose claim to fame was based on 2 blunders that he made during the early years of open-heart surgery. We called one blunder the Half Nelson and the other the Full Nelson. (Wrestling aficionados will recognize the analogy.) Dr. Nelson even boasted that his blunders were “firsts,” thereby reinforcing these eponymous applications of his name.

Some surgical procedures are extremely complex, so an eponym simplifies their description. Examples include the Bentall procedure for aortic root replacement, the Whipple operation for pancreatic carcinoma, and the Ivor Lewis esophagectomy for carcinoma of the esophagus. The Ross procedure is used for treating aortic valve disease: the patient's pulmonary valve becomes an autograft for replacing the aortic valve and root. Imagine having to describe these procedures fully at each mention!

Another popular means of attaining an eponym is to invent a surgical instrument. Today, countless instruments and devices are best known by their eponyms. My early mentor, Alfred Blalock, would not permit the surgical supply house Murray Baumgartner, Inc., of Baltimore, to put his name on any instrument in its catalog. In my opinion, he was overly modest. René Favaloro is well known for designing a unilateral self-retaining retractor for use in internal mammary artery dissection, but this invention is a minor example of his illustrious contributions to coronary artery bypass techniques. I may be less modest than other surgeons in this regard, as I have permitted the use of my name on numerous instruments. One surgical tool that is especially popular with the Texas Heart Institute's resident staff is a pair of scissors that is a longer and slightly heavier version of the standard Metzenbaum scissors. I requested that they be listed in the manufacturer's catalog as “MY scissors.” This allows a young surgeon to ask the instrument nurse to pass MY scissors, indicating the surgeon's maturity and self-confidence.

Although my career has been a long one, I do not know of any procedure that bears my name. A number of procedures that I originally devised are now well known by the name of another surgeon, but at this stage of my career, I do not choose to question or challenge anyone in this regard. Truthfully, I envy Dr. Penrose for his easy passage to surgical fame.