Posted by: Lisa Hill | March 9, 2014

Under the Microscope, by Professor Earl Owen #BookReview

Under the MicroscopeThis is a fascinating autobiography: I’ve never read one by a doctor before and the story of this man’s life and achievements was really good to read.

Professor Earl Owen spent his professional life pioneering techniques in microsurgery, and you may recall seeing in the media some of his more high profile achievements such as reattaching fingers, doing hand transplants in France, reversing vasectomies and operating to repair foetal abnormalities in utero.

Interestingly, if you search for Earl Owen at Wikipedia you will find only two churlish references:  if you read what it offers about hand transplants you might think that they only occurred in the US and those that didn’t owe it entirely to US research.  Uh-huh.  Sometimes Wikipedia hostility to the French borders on absurdity, eh? As for Australian contributions to this pioneering microsurgery, well, here’s what WP has to say about it:

A microsurgeon on the team, Earl Owen from Australia, was privy to the detailed basic research, much of it unpublished, that had been carefully gathered by the team in Louisville.

What you’re meant to infer from this is obvious, and it’s highly offensive.  I’d correct it, if I thought that the perpetrators of this slur would let the correction stand.

So it’s a good thing that Professor Owen has used his retirement to tell his own story, and the list of awards he’s received at the back of the book is enough, I think, to put the author of this shabby article about pioneering surgery in his place.  You can also see on Professor Owen’s website the impressive list of techniques he pioneered – as part of a team, of course, nobody does this kind of work alone, and Owen gives due credit to all who worked with him.  These include the Russians who marked Queen Elizabeth’s ten years on the throne with the gift of a new type of long-view microscope, which was donated to Owen’s hospital and used by him in the early days;  David Keeler of Keeler’s Instruments who manufactured his prototype micro-instruments; the craftsmen at Zeiss Optics who made him a foot-operated microscope; and a couple of Germans called Spingler and Tritt, who set up their own cottage industry manufacturing the sutures and micro-needles that were needed.  (He had met these Germans when they were working at Johnson and Johnson in the US, but their company representatives (in complete ignorance of life-saving microsurgery Own had already performed on the infant Peter Taylor in 1965) thought that ‘there was no such thing as microsurgery yet, and if there were, it would happen in America first’.  (p.137)

Support from his colleagues wasn’t universal but there were many who encouraged the visionary: the senior paediatric surgeons at the Great Ormond Street Hospital; his brother-in-law Paul who operated with him to reattach little Jason Todd’s finger, the first operation of its kind; and of course Professor Jean-Michel Dubernard from Lyon in France with whom he worked on hand transplants,  transforming the lives of the recipients.  There were wonderful people who helped with fund-raising too (and you can make a donation if you like at the Microsearch Foundation now located at the University of Sydney).

An autobiography, however, has to be more than a recount of achievements to be interesting.  Professor’s Owen’s story explains the man behind the achievements.  I particularly like this short excerpt which sums up this man’s attitude to his work:

Surgeons have different personalities from physicians.  We see and diagnose the condition, then want to get on and fix it as soon as possible.  We haven’t the slightest interest in treating patients with medication for month after month.  We like to operate and we like being in charge of their recovery.  But as impatient as we can be, it’s important to make time to keep our patients fully informed.  My patients always got profuse notes with pictures and diagrams, and information about external sources to which they could go for further knowledge.  They were always instructed to phone me up in my rooms when they had even a small doubt or any question. (p. 297)

Professor Owen says that he learned the importance of keeping patients fully informed as a child.  He was born with a birth defect that was incorrectly diagnosed and was overdosed with radiation as a newborn.  This left him with damaged bones, left uncorrected for far too long even though his family was blessed with any number of medicos.  (They say ‘the cobbler’s children go the worst shod’, don’t they?)  Eventually aged eleven he was subjected to nine months of painful operations and left lying in a bed alone in a basement hospital room with visits from his parents dropping off as the months went by.  It was during this dreadful time that he resolved that when he grew up he would devote his life to becoming a caring surgeon, and a note that he sent to his grandfather at the time survives to confirm this early ambition.  His words aren’t always clear, but his intention certainly is:

I have to become a really good surgeon, good enough to be a teacher, and I just have to be good enough to operate on children who were born with something wrong that at the moment they don’t know how to fix it. I must work out ways to help those children who, like me, were born with a strange unknown birth defect, or a cancer, other abnormality that the poor kid had somehow developed while in his mother.

I must not only do it but somehow I know that it will work if I really want to work on it until it does.  if I work hard enough this can be done.  I don’t want to be paid to do this, I just want to grow up fast and just do it until I am satisfied that children born like I was, or even worse off, could be made to walk again, and run, and be normal, and not in pain.

And that’s not all.

I am going to teach as many doctors, particularly surgeons, how to communicate and tell their patients, of any age at all, even if small children, everything they should know about what is actually wrong with them and all about how they heal and get better and stronger.  Kids should never be frightened of their doctor.

Doctors really should be taught how to encourage their patients to ask questions, and then never avoid telling the, the correct answers.

I will keep this right in front of my thoughts while I am awake. (pp. 40-41)

To say that he achieved these childhood ambitions is an understatement, and it was inspiring to read about how his neo-natal and in utero microsurgery has developed so that now it’s almost commonplace.   So many babies living normal lives thanks to his vision is amazing.  But Professor Owen also ventured into all kinds of other enterprises.  He designed the instruments and microscopes that he needed, and the ergonomic chair that he needed in order to be able to complete operations that lasted sometimes for up to fourteen hours.  If you find the chairs at the Sydney Opera House comfortable,  Professor Owen ( a talented musician and fan of classical music) designed them too.  Distressed by the terrible injuries he helped to repair, he contributed to workplace reforms mandating protective guards on industrial machinery as well.

Some aspects of his work were controversial, and his defence of vivisection may distress some readers.  The analysis of the breakup of his first marriage is a bit one-sided (his ex-wife died in 1987) and those of us who resolved domestic turmoil over a women’s right to a career of equal importance may perhaps read between the lines and interpret his wife’s actions differently.

There’s a small collection of interesting photos and, at the front of the book, tributes from Professor Jean-Michel Dubernard and from Vladmimir Ashkenazy (whose son owes his leg to Professor Owen) but I would have liked an index, and perhaps a timeline.

Under the Microscope is a tribute to resilience, courage, and imagination.  Highly recommended.

Author: Professor Earl Owen
Title: Under the Microscope
Publisher: Vintage (Random House) 2014
ISBN: 9780857981196
Source: Review copy courtesy of Random House Australia

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Fishpond: Under the Microscope


Responses

  1. I have read a memoir by a doctor, Mohamed Khadra. It’s called Making the cut: A surgeon’s stories of life on the edge. I read it before I started my blog so it’s a while. He’s not a pioneer in the sense that Owen is but his is a fascinating story, including one of overcoming prejudice. He offers interesting insight into doctor training. I particularly enjoyed his discussion concerning his use of poetry in his training of doctors, arguing that poets have made a life-time study of human nature and have much to teach about humans. Each chapter in the book starts with some lines from poetry.

  2. That sounds interesting, Sue. LOL Owen has a go at writing some poetry in his defence of vivisection but …um … let’s just say that his strengths lie elsewhere!

    • LOL … I don’t recollect that Khadra tried that!

  3. I have a special interest in medical memoir, they’re usually fascinating no matter the author. I read one by a local doctor in NZ, he talked too much about cars and planes from memory, but the medical insights were fascinating- he worked through the time when CPR was introduced! I’d never considered that being introduced, it was amazing. I’m usually better at buying them, than reading them, but do always enjoy them when I get the chance- they always share fascinating insights. The other group that I keep meaning to read is the comedians, they often write books, and I don’t know that I’ve ever read one, but I always want to.

    • You’ve nailed it, Louise, it’s reading about these things that we take for granted being researched, trialled and the courage it takes to do that that’s so absorbing. I mean, imagine being the first to do surgery in utero, it would be terrifying, I think!

  4. […] ANZ Lit Lovers Book Review Start at Sixty Book Review Geek in Sydney Book Review Australian Medical Association Book Review […]

  5. Interesting-esp as I have discovered that I am related to his second wife, through her paternal line.

    • Hello Candia, it’s always nice when the family history reveals someone to be proud of, eh?


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