Professor of Surgery
Icons and legends achieve their place in history by refusing to accept conventional wisdom. Consider the words of Stanley J. Dudrick, MD, in a 2009 paper he wrote. Speaking of the “prevailing dogma” of the medical community in the 1960s, he said, “Feeding entirely by vein is impossible; even if it were possible, it would be impractical; and even if it were practical, it would be unaffordable.” Yet, as a surgeon, Dr. Dudrick refused to accept that a patient who underwent a brilliant surgery could still die days later from something as prosaic as malnutrition. This recalcitrance sparked a remarkable odyssey of discovery ultimately leading to total parenteral nutrition (TPN).
Dr. Dudrick’s pioneering work resulted in fundamental insights into metabolism and the nutritional needs of critically ill patients. It required creative approaches to research in laboratory animals critical for development of therapies in children and adults, numerous advances in the technology of intravenous tubing, pumps and central catheterization and major advances in the approach to antisepsis from the pharmacy to the bedside.
The remarkably broad benefits of Dr. Dudrick’s work include demonstrating the feasibility of TPN in laboratory animals, the courageous and successful application of this technology to critically ill infants and subsequently adults, a broad and comprehensive body of work characterizing the complex metabolic issues requiring monitoring and management, a panoply of technical advances in the composition and delivery of hyperalimentation solutions and the maturation of the science surrounding each of these realms. The revolution in infusion technology that his work sparked has itself given rise to stem cell transplantation, extracorporeal membrane oxygenation and the general approach to care of the critically ill patient.
In the four decades since its development, TPN has transformed patient care and has made possible altogether the field of intestinal transplantation. The number of lives of children saved by TPN stands at more than 10 million, and the benefits to adults with a range of conditions has been no less substantial. Despite the accolades and recognition won during a brilliant career as a surgeon, researcher and professor, Dr. Dudrick still had one unfulfilled dream. As a son of Nanticoke, he longed to return to and serve his home community. More than 50 years later, that dream came true. Dr. Dudrick was able to return to his roots and today is a cherished teacher at Geisinger Commonwealth School of Medicine. Dr. Dudrick’s humility and gentility prevent students from guessing the august place their professor of surgery holds in American medicine, but the textbooks correct that perception, as do the faculty and staff. We are all indebted to Dr. Dudrick and honored and privileged that he is a member of the Geisinger Commonwealth community.