Stanley J. Dudrick, MD
Department of Medical Education
April 9, 1935 - Jan. 18, 2020
Biography
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 become a cherished teacher at Geisinger Commonwealth School of Medicine.
Learn about The Stanley J. Dudrick, MD, Endowed Chair in Innovative Medical Education.
In memoriam
With sorrow, the Geisinger Commonwealth community marked the passing of our beloved friend and colleague, Stanley Dudrick, MD. While saddened by our loss, we also stand in awe of Dr. Dudrick’s tremendous achievements. He was lauded as a “surgical hero” by the American College of Surgeons (ACS) for his gift to medicine: total parenteral nutrition (TPN), listed by the ACS as among the handful of essential advancements that make surgery possible. And unlike the other revolutionary breakthroughs, the development of TPN was largely the work of one man: Dr. Dudrick, who devoted his life to nurturing and sustaining others. We are honored that he chose to be a member of our faculty and of this school’s community.
Despite his towering achievements, Dr. Dudrick was humble. Geisinger Commonwealth President and Dean Steven Scheinman, MD, relates the story of meeting him in person for the first time: “He introduced himself simply as ‘Stan Dudrick,’ prompting me to ask incredulously, ‘The Stan Dudrick?’ It wasn’t in Stan’s DNA to be arrogant or self-important.”
A former dean of medicine at Dartmouth, Wiley ‘Chip’ Souba, MD, described Dr. Dudrick well when he wrote: “Dr. Dudrick has made the world a little better, touching the lives of thousands of people . . . In a self-effacing way, he has helped each of us understand that leadership is a risky business. People will push back against the leader’s agendas, but Dr. Dudrick has always handled adversity with grace and dignity, choosing to take the high road at every turn.” Another colleague recalled that Dr. Dudrick inevitably insisted that his co-authors be listed first on jointly published papers.
How profound is TPN? It revolutionized the management of critically ill infants and the practice of pediatric surgery, especially in neonates with catastrophic congenital anomalies. It is well known among pediatric surgeons that more than one-third of these often-premature infants were not able to survive curative operations before the introduction of TPN support. Since 1970, after 40 years of TPN, the Neonatology Society reported in 2011 that about 10 million premature infants had survived due to TPN support. It has also saved the lives of countless adults with cancer, burns, gastrointestinal disease, abdominal surgery and other conditions in every corner of the world. For example, nearly every bone marrow transplant unit today has patients receiving TPN because of their inability to maintain a minimal acceptable nutritional status through the gastrointestinal track.
Nourishing patients parenterally was a dream that for more than a century had baffled physicians. Dr. Dudrick reflected on the painful memory of patients for whom “the surgery was a success but they died of malnutrition in the hospital” in the days before parenteral nutrition was possible. Total parenteral nutrition is now a commonplace therapeutic modality, often taken for granted, which only serves to underscore its success.
To the medical community, Dr. Dudrick was a giant. For our school, he was a distinguished and inspiring teacher and mentor. He took great joy in helping to cultivate the next generation of leaders-to-be; in Dr. Souba’s words, it was Dr. Dudrick’s nature to be “curious rather than dogmatic, inquisitive rather than judgmental, empowering rather than patronizing and to remain approachable rather than come across as a know-it-all.” Those qualities made Dr. Dudrick simultaneously beloved and revered.
Our immediate school community and medicine in general have suffered a great loss. But to have had the honor of knowing and working with Dr. Dudrick was a gift for which we will forever be grateful.