If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
The cartoon raises many questions (Figure 1). Acute observers should note the typo in this essay’s title. It is not a mistake. This drawing was captioned “Plastic Consumation” by its artist. Readers of earlier essays may remember that the springtime “Letter from America” often has involved an uplifting element consistent with that season’s blossoming and renewal.
With that thought, study the cartoon with renewed curiosity. Notice how it appears to have been created on the spur of the moment with no planning whatsoever. See how the figure on the right is partly cut off as if the artist started on the left and ran out of room. Notice the lack of detail in the hands; indeed the figure on the right has some squiggles for a left hand. Both figures have mustaches so we can assume that they are men. Ask yourself who were these men and why were they holding hands? Those certainly look like some type of phallic objects being sutured together. Was there some underlying Freudian theme? What was this cartoon supposed to represent?
Figure 1The drawing encompasses the recto side of the second front endleaf of Gillies’ Plastic Surgery of the Face. The caption reads: “N. York December 12, 1941 “Plastic Consumation”. Swindon. Reproduced with the permission of Archives and Special Collections, Columbia University Health Sciences Library.
The figures are Jerome Pierce Webster on the left and Sir Harold Gillies, its artist, on the right.
Gillies the Consummate Inventor
Using his imagination, Gillies not only developed many of the principles and techniques that formed the basis for twentieth century plastic surgery, but also he devised a number of non-medical inventions. Gillies created an indoor game that combined bowling and putting.
Webster JP to Gnudi MT. Letter September 8, 1959. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 178, Folder 19.
Many readers are familiar with Gillies’ ergonomic needle holder that could both insert and cut sutures and allowed him to compensate for his childhood forearm fracture by minimizing his need to prosupinate his wrist.
Few readers know that Gillies had patented several utilitarian inventions, at least one of which he hoped would reap a financial windfall to compensate for his private practice having suffered during and after World War II. Forever annoyed by inefficiency, he keenly observed that a man wasted movements while dressing and undressing. When undressing, if a man had hung his jacket on a hanger, then he had to insinuate the pants underneath. Similarly, when dressing, a man first had to extricate his trousers from under the hung jacket in order to put them on first. Gillies invented a clothes hanger in which the jacket hung below the trousers that expedited the processes, patented the invention and sought potential investors.
Webster was the consummate plastic scholar. In 1926 John Staige Davis attempted to dissuade Webster from embarking upon a career in plastic surgery by telling him “one could not earn a living from the practice of plastic surgery alone”.
Webster heeded Davis’ warning and found a solution similar to Davis’, but several orders of magnitude greater. Webster married Geraldine Rockefeller McAlpin in 1934. She was a granddaughter of William Rockefeller, John D. Rockefeller’s brother and business partner. She died from complications of childbirth in 1938.
Undeterred, Webster prepared for his role as the first full-time university based plastic surgeon in the United States at Columbia University by visiting Gillies in 1926 and by then spending eight months in St. Louis studying with Vilray P. Blair and James Barrett Brown’s group at Barnes Hospital in St. Louis.
Over 20 years later Millard would take a similar path in his training, first spending time with Gillies and then going to Barnes Hospital in 1949.
Webster collected and cultivated the largest plastic surgery library in the world. Because of his position in various organizations and interest in the history of our specialty, he convinced the American Board of Plastic Surgery, of which he was a founding member, to adopt Tagliacozzi’s likeness for its seal and he convinced the American Association of Oral and Plastic Surgeons to adopt Tagliacozzi’s harnessed patient for its seal. In collaboration with Martha Gnudi he wrote The Life and Times of Gaspare Tagliacozzi that won the Welch Medal from the American Association for the History of Medicine in 1954.
Gillies was the consummate prankster. At the second meeting of International Confederation of PRAS that was held in London in 1959, Gillies hosted a dinner at the Garrick Club for some of his international plastic surgery friends and their wives including Webster. Gillies used this an opportunity to demonstrate the utility of his hanger with a real life demonstration – removing both his jacket and trousers in front of his assembled dinner guests! When Gillies asked Webster’s wife for her opinion of his performance she told him that she had heard that he had done better (Jerome P. Webster, personal communication 1971).
Emily Brune Randall, Webster’s second wife, attended Gillies’ dinner in 1959.
In a subsequent letter to the club secretary, Gillies wrote that, “The spirit of the Garrick Club pervaded the evening… including of course some rather risqué behavior by the host”.
Recent trainees may not recognize that these were giant tubed pedicle flaps. In a 1937 paper, missing from the PubMed database, Webster describes his experience with giant thoracoepigastric flaps. Unlike Davis, Webster recognized Manchot’s contributions to understanding the skin’s blood supply and exploited them in his flap design and description.
Webster’s detailed description included various technical tips for which he credited Gillies as having taught him during their 1926 visit including how to “waltz” a tubed pedicle flap.
Why are these men dancing?
Fast forward to 1941. Germany was at war with Great Britain. Sadly, the Battle of Britain had yielded a fresh crop of patients who required plastic surgery. Gillies, consultant to the British Army, was charged with providing plastic surgery at home. To gain support from abroad for the British war effort, the British Information Office sent Gillies across the Atlantic to lecture in both South and North America. Originally, Gillies was supposed to speak in Boston that November to various surgical groups, including the American College of Surgeons and the American Association of Oral and Plastic Surgeons, but those plans fell through.
Webster had almost single-handedly been responsible for saving it during the depths of the Depression. The 1932 annual meeting had been canceled as the membership had no clinical cases to demonstrate and it appeared as if the 1933 meeting would be canceled as well. In the spring of 1933, Blair had written, “We were getting by until the inauguration; since then things have been just about nothing at all”. Webster organized the 1933 meeting in New York by marshalling the resources of many New York clinicians.
Instead, Webster, then the president of the American Association of Oral and Plastic Surgeons, organized a special meeting whose highlight would be a black tie dinner at the New York Academy of Medicine on December 12, 1941. Webster was ecumenical in his invitations. He invited members of the Academy, various dental, otolaryngological and surgical organizations.
Webster JP to Figi FA. Letter February 6, 1942. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 4.
Palmer A to Webster JP. Letter November 11, 1941. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 6.
The plan was for Gillies to lecture on plastic surgery for the war wounded and show a movie about the human effects of the Blitz.
Five days before the meeting, Japan attacked Pearl Harbor. The following day the United States declared war on Japan, which resulted in Italy and Germany declaring war on the United States on December 11th. Still, the dinner and lecture went on without a hitch.
Gillies gave a copy of his book, Plastic Surgery of the Face, with this drawing to Webster on December 12, 1941. The drawing was a risqué double-entendre typical of Gillies and meant for Webster’s personal amusement. A deeper sense of Gillies’ feelings and his meaning of the drawing can be found in a letter to Webster that Gillies wrote one week later:There aren’t enough words in the English language that I know of that can in any way adequately express my great admiration and affection for you… the meeting was a colossal success, and constituted a many-sided tribute. First of all, it was a tribute of the plastic group of their affection and esteem for their Jerome. Second it was a tribute to me which I can only describe, as I did at the lunch, as the greatest honour I have ever had. And finally, it was a tribute to our medical science in its search for surgical truth.”
Gillies HD to Webster JP. Letter December 19. 1941. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 4.
Despite giant tube pedicle flaps being things of the past, Gillies’ phrase “medical science in its search for surgical truth” still resonates seventy years later.
Financial disclosure
None.
Competing interests
I did my plastic surgery fellowship at Johns Hopkins that now proudly claims John Staige Davis as its first plastic surgeon. I did my plastic surgery residency under Ralph Millard, who was Gillies' co-author and disciple.
Webster JP to Gnudi MT. Letter September 8, 1959. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 178, Folder 19.
Webster JP to Figi FA. Letter February 6, 1942. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 4.
Palmer A to Webster JP. Letter November 11, 1941. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 6.
Gillies HD to Webster JP. Letter December 19. 1941. Located at Archives & Special Collections. A.C. Long Health Sciences Library, Columbia University Medical Center, Webster Collection, Box 4, Folder 4.
00725-X&id=gr1.jpg){kind=link}