In Passing // Bill Coffin
Joseph E. Murray (1919-2012)
Discovery is a painful process, born from often failed and costly experimentation, the doubt of others, and villainization by those who do not share in the vision being sought. This is especially true of medical discoveries, which carry with them a special set of ethical challenges that require the most steady of moral compasses and the courage to follow them even when the rest of the world howls in outrage. Even under the best circumstances, such efforts fail or produce underwhelming results, calling into question the wisdom of the enterprise. But those who prevail deliver to humanity truly transformative discoveries that instantly transcend the personal glory of the original discoverers. Dr. Joseph E. Murray was one such discoverer, whose work in organ transplantation, immunology and reconstructive surgery won him a Nobel Prize and led to surgical techniques that have saved hundreds of thousands of lives.
Murray wrote that he had wanted to be a surgeon as long as he could remember, and in his early school days, he marveled at the periodic table and the details of an orderly universe. He dedicated to studying the natural sciences, and focused on medicine. After graduating from the College of the Holy Cross, it was on to Harvard Medical School, though World War II soon interrupted what would have been an orderly career progression.
As a nine-month surgical intern at the Valley Forge General hospital in Pennsylvania, Murray tended to wounded soldiers, but he showed an intense interest in reconstructive surgery. His interest was noted and instead of being shipped off to a battlefield medical center, he was kept stateside for the remainder of the war, where he took an interest in researching skin grafts for burn victims.
That the body rejected foreign skin grafts fascinated Murray, who theorized that the closer the genetic relationship between donor and recipient, the slower the rejection. He experimented with skin grafts between a set of twins, which led to further research into organ transplantation, which by the 1950s, still had never been successfully accomplished.
Despite numerous failures, Murray worked diligently at methods to transplant organs, consulting extensively on the ethical matters of the subject. In 1954, he performed the first successful organ transplant when he transplanted a kidney between a pair of twins. He recorded the first successful transplant between non-identical subjects in 1959, and the first transplant using a cadaver kidney in 1962.
Murray was the chief of transplant surgery at Peter Bent Brigham Hospital in Boston, where he interned before WWII, and where he returned afterwards. He retired from Brigham in 1971 to focus on reconstructive surgery, where he treated hundreds of patients with facial deformities stemming from congenital causes, drastic surgical procedures, facial injuries and other causes. He advocated for the research that would lead to the first facial transplant surgeries. He was elected to the National Academy of Sciences and the Institute of Medicine. He was a member of the Pontifical Academy of Sciences, which advised the Vatican on science issues. In 1990, he was jointly awarded the Nobel Prize in Physiology or Medicine, along with E. Donnall Thomas, “for their discoveries concerning organ and cell transplantation in the treatment of human disease.”
For such a brilliant career, it is easy to overlook how difficult it was for Murray to achieve the breakthroughs on which his other success followed. His received severe public backlash for experimenting in transplantation, especially by those who felt he was conducting “Frankenstein” experiments, or simply playing God. Medical colleagues decried Murray’s transplant research of violating the first creed of medicine: do no harm. Others simply felt Murray would ruin what would be an otherwise promising career by pursing something doomed to failure.
In all cases, Murray persevered, buoyed by his own optimism, a burning desire to help others, and a deep fascination with the mechanics of nature. But perhaps it was the virtues of his patients that gave him the most strength. He was deeply inspired by the courage and willpower of the burn victims he treated, and of his early transplant volunteers who knew the early procedures might not work, but perhaps the failures would inform later successes.
“My life as a surgeon-scientist, combining humanity and science, has been fantastically rewarding,” Murray wrote in his autobiography for the Nobel Foundation. “In our daily patients we witness human nature in the raw—fear, despair, courage, understanding, hope, resignation, heroism. If alert, we can detect new problems to solve, new paths to investigate.”