James Hardy

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Dr. James D. Hardy

Dr. James D. Hardy was chairman of the Department of Surgery from 1955-87. He was one of the original faculty of the University of Mississippi Medical Center who participated in the opening of the University Hospital on July 1, 1955. For more than three decades, Dr. Hardy nurtured the Department of Surgery, and in the process, he became one of the major medical innovators of the 20th century.

Dr. HardyDr. Hardy and his twin brother Julian were born May 14, 1918, in Birmingham, Ala. The Hardy family lived in Newala, 35 miles south of Birmingham. The town of Newala had been named by Dr. Hardy's father combining "New" for New York, the father's place of birth, with "Ala" for Alabama, the mother's place of birth. Dr. Hardy's father, Fred, ran a lime plant in Newala. He also farmed and ran a post office. Dr. Hardy's mother, Julia Poynor, had grown up in Mt. Hebron near Eutaw, Ala. Her father had founded a one-room school. She graduated from the University of Alabama summa cum laude and Phi Beta Kappa, and she obtained an advanced degree in Latin from Columbia University. She taught Latin at Alabama College for Women in Montevallo. In addition to Dr. Hardy and his brother Julian, there was a younger brother, Taylor, and four stepchildren, Agnes, John, Emily and Fred.

Dr. Hardy went to high school during the Depression. To raise money, he and his two brothers, along with some friends, formed a dance orchestra, the "Bama Skippers." Dr. Hardy (third from the left, top row) bought a trombone at a pawnshop in Birmingham, taught himself to play under his mother's tutelage at the piano, and played with the "Skippers" until college.

Dr. Hardy played right guard on the high school football team. He once related that the experience taught him never to quit. Dr. Hardy attended college at the University of Alabama in Tuscaloosa with his brother Julian. He described leaving for college thusly:

"I announced that I had milked my last cow and taken my last dose of castor oil."

Early medical career

He graduated from the University of Alabama in 1938 with a major in chemistry and minors in biology and German. His first academic recruitment was to the German Department at the University of Alabama. As a department chairman, I (Dr. Marc Mitchell) would never be thankful for a failed recruitment, however, we can all count ourselves lucky that the German Department failed. Dr. Hardy had his sights set on a medical career.

At the time that Dr. Hardy attended the University of Alabama, the medical school, like that of the University of Mississippi, offered only the first two years. He had decided that he wanted to attend school in the East, and on the advice of a student at the University of Pennsylvania from a medical family in Alabama, he and his brother Julian set out for medical school at Penn.

At Penn, Dr. Hardy compiled an impressive academic record. He was elected to Alpha Omega Alpha in his junior year, and he assumed his first medical society presidency of that AOA chapter in his senior year. Dr. Hardy's experience with the "Bama Skippers" drew him to performances of the Philadelphia Orchestra under the baton of the legendary conductors Leopold Stokowski and Eugene Ormandy.

Dr. Hardy graduated from Penn in 1942, and he began a residency there in internal medicine, a fact about which Dr. Hardy has reminded me many times within the context of diagnosing his own medical ailments. Dr. Hardy truly exemplifies the principle that inside every great surgeon is an internist fighting to get out. Upon graduation from medical school, Dr. Hardy was also commissioned a first lieutenant in the U.S. Army.

Dr. Hardy was called from his residency to active duty in the army in 1944 where he served until 1946 as a part of the 81st Field Hospital in England, France and Germany. In preparation for deployment in Europe, Dr. Hardy was sent to Stark General Hospital outside Charleston, S.C. It was there on June 3, 1944, that he met Louise Sams. Dr. Hardy described her in his diary:

"…she's a most delightful girl. Brown eyes, brown hair, yellow summer frock, high heels. We went out to dinner, where Arch and I talked … shop all evening. I'm certain the girls … were bored stiff."

He returned to Penn, this time as a general surgery resident and later a resident in thoracic surgery and a Damon Runyon fellow in clinical research. The Army ended a second recruitment of Dr. Hardy into internal medicine.

Dr. Hardy's teachers at Penn became legends. They included Dr. I.S. Ravdin, Dr. O.H. Pepper, Dr. Jonathan Rhodes, Dr. Julian Johnson, Dr. Isaac Starr and Dr. David Drabkin. These associations presaged the famous associations that would fill Dr. Hardy's life.

Dr. Hardy married Louise Scott Sams on July 1, 1949, in Decatur, Ga., just after he finished his general surgery residency. Their first child, Louise, was born a year later while Dr. Hardy was a resident in thoracic surgery. At the end of his term at Penn, Dr. Hardy had earned a master's degree in physiological chemistry, and he had completed the manuscript of his first book entitled "Surgery and the Endocrine System." He described his capabilities as follows:

"I felt comfortable doing general surgery and most routine chest surgery, but not heart surgery though heart operations (closed mitral valve commissurotomy, resection of aortic coarctation, division of patent ductus) were just becoming common and I had helped with a good many. Open heart surgery was still in the future."

When he finished his training at Penn, Dr. Hardy joined the faculty at the Medical College of the University of Tennessee in Memphis, where he spent nearly four years as director of surgical research in Dr. Harwell Wilson's Department of Surgery.

Move to Mississippi

Dr. Hardy was recruited by Dean David Pankratz to found a Department of Surgery at the new four-year medical school of the University of Mississippi to be built in Jackson. Dr. Hardy moved to Jackson in April 1955, and a new hospital was opened in July. He had recruited a full-time faculty into the new Department of Surgery. These included Dr. Orlando J. Andy, professor of neurosurgery; Dr. G. B. Bittenberger, professor of anesthesiology; Dr. William F. Enneking, assistant professor of orthopedics; Dr. Curtis P. Artz, associate professor of surgery; Dr. M. Don Turner, assistant professor of surgery; and Dr. Watts R. Webb, assistant professor of surgery. Curtis Artz went on to become the chairman of the Department of Surgery at the Medical University of South Carolina. Watts Webb became the chairman of the Department of Surgery at Tulane University School of Medicine.

The Hardys bought a house close to the hospital, and Dr. Hardy went to work. His laboratories became involved with transplantation, and work proceeded with kidney, liver, small intestine, parathyroid, adrenal and utero-ovarian transplantation experiments. The magnitude of the experimental work that Dr. Hardy and his colleagues undertook was staggering. As many of you know, I've been categorizing and learning about this work in the process of documenting the history of our department. This is a difficult job because of the number of things that Dr. Hardy investigated.

The activities of Dr. Hardy's faculty and residents in the Surgical Forum of the American College of Surgeons are an example of the output of these laboratory efforts. In 1957, Dr. Hardy's department presented the first "Mississippi papers" before the Surgical Forum in Atlantic City. The group presented 20 papers. This stimulated a famous exchange between Dr. Hardy and his former chief, Dr. I.S. Ravdin, then the chairman of the Board of Regents of the American College of Surgeons. Dr. Ravdin's letter to Dr. Hardy reads:

"The Regents were concerned that several university organizations were not given a place on the program while other organizations were given many places…. Duke and Northwestern, although they turned in a number of requests, did not have a single place on the program."

Dr. Hardy responded:

"I myself was astonished that Duke and Northwestern did not have a paper on the program."

The following year, the program committee of the Surgical Forum clamped down on Dr. Hardy. He could get only 19 papers on at the Forum.

Dr. Hardy and his team painstakingly worked through the technical details of lung transplantation in animals. In early 1963, Dr. Hardy delivered the William Mitchell Banks Memorial Lecture at the University of Liverpool as a part of the annual meeting of the Association of Surgeons in Great Britain and Ireland. During the lecture, Dr. Hardy demonstrated the voluminous work that his group had done with lung and heart transplantation in animals. At the conclusion of the talk, Dr. Hardy said:

"Gentlemen, these transplantations will be performed in man in the very near future."

First human lung transplant

And then, on the evening of June 11, 1963, Dr. Hardy and his team performed the world's first human lung transplant at the University Hospital in Jackson.

That was a significant evening because in the space of a few hours the great science that was under way in Mississippi stood alongside the great social upheaval in which our state found itself embroiled. Dr. Martin Dalton, one of Dr. Hardy's residents, delivered the donor lung to the operating room and scrubbed in for the anastomoses. As the chest was being closed, Dr. Dalton was called to the emergency room to see a patient with a gunshot wound to the chest. That patient was Medgar Evers, the civil rights worker who had been shot at his home. He died in the emergency department of the University Hospital. Earlier that evening, President John F. Kennedy had delivered a report to the nation on civil rights. In that short address, he made the haunting statement:

"Those who act boldly are recognizing right as well as reality."

Dr. Hardy's patient lived for three weeks before succumbing to renal failure. The immunosuppressive regimen consisted of azathioprine, prednisone and thymic irradiation. Dr. Hardy and his group proved that lung transplantation in humans was feasible, but the long-term results were dismal.

It remained for Dr. Joel D. Cooper and his group to report the first long-term survivor from lung transplantation in 1986. Dr. Cooper's group added the immunosuppressant cyclosporin A. On June 15, 2001, Dr. Cooper, the Evarts Graham Professor of Surgery at the Washington University School of Medicine, delivered the first James D. Hardy Lecture in Surgery at the University of Mississippi Medical Center.

President Kennedy had challenged Americans to act boldly. Dr. Hardy continued to act boldly. His colleague, Dr. Watts Webb led the investigations of heart transplantation, and the group demonstrated in animals that heart transplantation could be performed successfully.

First heart transplant

On the evening of January 23, 1964, Dr. Hardy and his team performed the first heart transplant into a human. In an era that did not recognize "brain death," the University of Mississippi team had been ready for months to perform a heart transplant. They had performed heart transplants in a very large number of animals.

The transplant team had come close to performing a transplant on a number of occasions. A donor whose heart had stopped beating and a recipient who was in the hospital awaiting a transplant could not be brought together. Finally, a patient with lower extremity gangrene, hypertension and a history of multiple myocardial infarctions, who was dying of cardiac failure, and a neurosurgery patient, who was dying, were in the hospital at the same time. The cardiac patient deteriorated, and he was taken to the operating room. The neurosurgery patient remained stable.

Dr. Hardy and his team decided to take the heart of a chimpanzee named Bino and transplant it into their patient. The transplanted heart sustained a blood pressure between 90-100 mm Hg for 90 minutes off cardiopulmonary bypass, but the patient died in the operating room from a combination of metabolic derangement and an undersized heart. This operation proved that it was feasible to perform a heart transplant in a human.

It's hard to imagine what someone does for an encore after having performed the world's first human lung and heart transplants within the space of nine months. Dr. Hardy, of course, found plenty to do. He produced 23 books, 139 book chapters, 466 papers and more than 200 films. He held 36 visiting professorships, and he presented 37 invited lectureships. His first office in the American College of Surgeons was that of second vice president to which he was appointed by the Regents to complete the term of Dr. Curtis Artz, one of the original members of Dr. Hardy's faculty, who had died. Dr. Hardy appreciated full well the importance of this office as he described it in his memoirs:

"To illustrate the limited importance attached to this office, at the next meeting at the ACS headquarters in Chicago, I could find no seat that was reserved for the second vice-president ... Finally, I slid into an empty chair adjacent to Professor Mark Ravitch of Pittsburgh, the first vice president, whereupon he leaned over and whispered in my ear, 'Now, never forget for an instant, Jim, that you are only one heartbeat away from the office of first vice president.'"

Continued contributions

Dr. Hardy became the president of the American College of Surgeons in 1980. He was president of the American Surgical Association, International Society of Surgery, Society for Surgery of the Alimentary Tract, Society of University Surgeons, Society of Surgical Chairmen and the Southern Surgical Association. He was editor-in-chief of the World Journal of Surgery.

Dr. Hardy finished 152 chief residents. These physicians were superbly trained, and they established modern surgery in Mississippi. They have had profound influence wherever they set up practices. Many of them went on to significant academic careers as did many of Dr. Hardy's faculty members. He is a giant upon whose shoulders those who inherited his department stand.

The Hardy Society was established in 1991 and is now open to membership of all graduates of the surgical residency and fellowship programs.

Dr. Hardy passed away Feb. 19, 2003, and his memorial service was conducted March, 2003.