The History of the New England Section of The American Urological Association, by Dr. Kevin Loughlin
The Wyland F. Leadbetter Memorial Lectureship supports a distinguished individual who represents dedication to the clinical as well as academic aspects of urology. This Lectureship was established in 1974 to honor the memory of Dr. Leadbetter. The following overview will provide a brief look at this remarkable physician, whose contributions to the New England section as well as the global urology community are unparalleled.
Dr. Wyland Leadbetter was undoubtedly one of the most gifted clinicians, teachers and leaders in the history of urology. He was known both nationally and internationally for his many accomplishments. As one can imagine, his curriculum vitae and bibliography are extremely impressive.
Wyland was born in Livermoor Falls, Maine in 1897. He attended public schools in Auburn, Maine and graduated from Bates College in 1923. He then chose a career in medicine and went on to Johns Hopkins Medical School. While at Hopkins, he was elected into the Phi Beta Kappa as well as the Alpha Omega Alpha Societies. Dr. Leadbetter continued his surgical and urological residencies at Johns Hopkins.
The surgical service at Johns Hopkins was led by Dr. William Halsted, one of the most influential surgeons of all time. Halsted personally handpicked Dr. Hugh Hampton Young, the father of modern urology, to develop a formal residency program in urology. At the time, it was the only residency program in urology derived from the Halstedian model. Dr. Leadbetter had the good fortune to have trained with these gifted mentors and peers. Their wisdom and relentless spirit formed the foundation upon which Dr. Leadbetter developed his career.
One of the best decisions Wyland made during his residency was to marry Lois Billings in 1934. Lois was a devoted wife as well as a dedicated mother to their 3 children. Wyland was fortunate to have had her constant support, allowing him to pursue his passion for urology. As Wyland aged and his physical health declined, Lois was always there by his side.
After completion of his residency training, he was recruited by Dr. Frank Lahey and appointed staff urologist at Lahey Clinic Boston. He served overseas during the African campaign and the invasion of Sicily. After the war, he went on to be Professor of Urology at Tufts Medical School and remained in this position for seven years. He then served as Clinical Professor of Surgery and Urology at Massachusetts General Hospital. In 1954, Wyland became Chief of the Urology Service at MGH, and remained at MGH until 1970.
During his 36 years of urologic practice, Wyland was a member of many societies and influenced the standard of teaching in urology. These societies included the American Medical Association. American College of Surgeons, International Society of Urology, Fellow of the American Academy of Pediatrics, American Association of Genitourinary Surgeons and the American Urological Association. Dr. Ledbetter served on multiple executive committees and on the National Board of Examiners for urology. He was Secretary and President of the NEAUA and during his last 7 years served as Secretary and President of the AUA. He also served as President of the American Association of Genito-Urinary Surgeons. The Guiteras Medal, the highest honor bestowed by the AUA, was given to Wyland. This was one of many awards Dr. Leadbetter received. Despite his failing health, he insisted on a vigorous workload typical of his drive and determination.
Dr. Leadbetter contributed enormously to the treatment of patients with urologic disease during his career. His imaginative approach to problems never ceased. His method of ureteral intestinal anastomosis for urinary diversion and experimental studies of electrolyte imbalance secondary to bowel absorption was work done early in his career. Wyland proceeded to pioneer the technique of retroperitoneal radical lymph node dissection through a thoracoabdominal approach in testicular cancer. A hallmark publication, co-authored by Cooper and Chute, advanced the therapeutic treatment of testis cancer.1
Finally, his innovative surgical reconstructive procedures in children added yet another prominent landmark in the area of cancer and reconstructive surgery. The principle of a submucosal tunnel with muscle backing for the ureter as an antireflux procedure was developed with Dr. Victor Politano, a young colleague at MGH. This technique gained worldwide acceptance as a major advance in pediatric urology. Dr. Leadbetter worked continuously to achieve perfect results, not accepting the complications seen with these difficult surgical procedures. He always insisted on improving our field and was regularly thinking of new approaches for urological procedures.
Beside these tremendous achievements, Dr. Leadbetter deeply cared for his patients. They not only thought of him as their doctor but as their friend. He understood the whole patient, the physical as well as the psychological aspect of patient care. Teaching and patient care always came first. He would make rounds with the house staff and sit with his patients talking about fishing or camping. Every patient was cared for as if they were his only responsibility.
Perhaps Dr. Leadbetter's true legacy is how he inspired his residents and those who were in contact with him. His manner of teaching was enlightening and his energy was boundless. Dr. Leadbetter always made time to discuss problems, no matter how small they were or how busy he was. He had the ability to listen objectively, getting to the heart of the problem. He would frequently disagree during a discussion and take the opposite approach. His aim was to challenge conventional thought in order to stimulate new thinking on the part of a student. His fund of knowledge was recognized by residents and senior physicians alike.
The qualities described above are ingrained in his residents, many who are now Professors or Chairman of teaching institutions. His tremendous drive and dedication to his patients, students, residents and peers is unparalleled. Wyland F. Leadbetter will always be remembered as a brilliant, imaginative and dedicated giant in urology.
1. Cooper JF, Leadbetter WF, Chute R (1950) The thoracoabdominal approach for retroperitoneal gland dissection: its application to testis tumours. Surg Gynecol Obstet 90: 486–496
Wyland F. Leadbetter Lectureship
The Max Willscher Award is given to one of New England's most talented residents, whose work exemplifies the ingenuity that defines Dr. Max Willscher. Those fortunate enough to have met Dr. Willscher experienced his unbridled enthusiasm and passion for our specialty. He was a wonderful person and an inspiring urologist, whose genius and innovations continue to be inspirational.
Max graduated from Bowdoin College and received his MD degree from Tufts School of Medicine. He subsequently completed his urology training at Boston University under Carl Olson before joining Jim Conway et al in Manchester, New Hampshire. Given his interest in surgical problem solving and product design, the choice to join a private practice seemed a bit incongruous. But Max never viewed himself as a strict academician. Instead, he saw his practice and his patient's problems as an opportunity to ponder solutions to practical issues. Although he wanted to pursue academics, he disliked the politics of it all. However, Max never left academia far behind.
Willscher's 18 years of practice with Manchester Urology were filled with vision, his love of teaching and the constant desire to find a better way. This small private practice in New Hampshire became not only a leading clinical center but was also on the cutting edge of new developments in urology. Max's endless ideas lead to numerous inventions, instrument designs and laser applications.
Some of Max's inventions include a vas clamp that was used for vasovasostomy. When HIV was a big concern in the later 80s and early 90s (due to lack of any effective treatment), he invented a “glove tester” that basically functioned as an electrical circuit which sounded an alarm when a defect in a surgical glove was detected. He also invented a surgical table which was used for all manner of procedures. It could function as both a normal table for supine procedures, but also for cystoscopies and C-arm procedures. Max was constantly meeting with engineers to exchange new ideas.
In 1950, pediatric urology had not yet become its own specialty. Max and his partners did countless MAGPI urethroplasties, ureteral reimplants, UPJ repairs, and orchidopexies. For large stones, many PCNs and even open avascular nephrolithotomy with intraop cooling were done. There weren’t really any cases that Max wouldn’t tackle, (including RCC with vena canal extension requiring bypass). All in all, he was an extraordinary surgeon.
One of his most notable achievements was organizing the New Hampshire urologists to convince the state that it should grant a certificate of need to procure a mobile lithotripter. He then oversaw its administration and management. In 1986, it was the second mobile lithotripter in the United States. Manchester Urology went on to allow urologists from New Hampshire, Maine and Vermont to use the machine until New Hampshire Lithotripsy Inc. (NHLC) was formed by Max and Jim Conway. The mobile technology was subsequently sent to various small hospitals so that patients could be treated within their own communities by their own urologists.
As mentioned previously, Max brought urological lasers to New Hampshire. The Manchester group would train other urologists from far and wide in laser technology. Weekends were spent using a pig lab for training. He founded the Davison Laser Center at Elliot Hospital so that the group could afford the newest and greatest in laser technology. Largely due to Max's urging, lasers were used for bladder tumors (Nd-YAG), prostates, urethral strictures and for debilitation of local skin in anticipation of urethroplasty. The biggest advance, of course, was for the treatment of ureteral stones.
Max also started the Urology Center at Elliot Hospital as a central location for urodynamics, erectile dysfunction, kidney stones and urinary incontinence. It became a self-contained outpatient urologic surgery center and included a large pelvic floor physical therapy program. It was named in his honor after his untimely death.
The New England Section and its activities were an important aspect of his life. He would awaken at 5:30am during Section meetings and go to the various company sponsored breakfasts, then would organize the day with one of his associates so that all the lectures and exhibits were attended (notes were taken!). Max would participate in the various evening functions as well. His energy was unlimited and contagious. Given his love of teaching, Max had a plan to establish a residency program, or at least to be a training site for such. The group had the volume and variety needed, and Max had the instincts to form a program. It would have been an exemplary place to train.
In many ways, Max was your typical “absent-minded professor”. He rarely remembered to have the car inspected, he wore mismatched socks and he was always trying to locate his famous briefcase. And everyone adored him. He was wonderful to patients and to the staff. He was a devoted husband and an excellent father to four great kids. At his funeral the church overflowed with admirers. The OR even closed for the service.
A colleague stated that he “admired the way Max's inquisitive mind worked, his ability to look at a common problem, ask a pertinent question and consider a solution which, in retrospect, always seemed logical and self-evident.” Max Willscher was the consummate surgeon-inventor, a rare breed, especially in this age where careers are made on the back of big data. The Max K. Willscher Research Award is given in recognition of the enormous talent of one of our trainees. I hope that the winner reflects on his/her award and realizes the significance that their contributions, just like those of Dr. Willscher, have on our Section.
Thanks to Drs. Jack Conway, William Bihrle, III and Steve Smith for their insight.
Joseph Dowd and His Many Gifts to the NE Section, by Karim Hamawy, MD
It was the spring of 1988 when the American Urological Association (AUA) last hosted its annual event in Boston at the Hynes Convention Center. Stories of leaky ceilings, inadequate meeting space (less than 300,000 sq. ft.) and attendee housing as far away as Newton compelled the AUA to remove Boston from its annual meeting rotation. Joe Dowd was AUA President that year, and his leadership and vision set the stage for the AUA as we know it today.
This year's meeting of the AUA was held in Boston for the first time in 29 years. The Boston Convention and Exhibition Center, with greater than 2 million sq. ft. of convention space, over 16,000 attendees, a Star Wars-studded event celebrating the work of John Williams, complete with a 68 piece orchestra and a visit from Governor Charlie Baker served to add Boston to the roster of future AUA meetings. Joe would have been very proud. In this article, I hope to share a small part of his great legacy and to highlight his tireless commitment to both the New England and National AUA.
"Joseph Bartholomew Dowd, M.D. was born in 1924 in Somerville, Massachusetts, the third of five children". After completing his early education in local schools, he enrolled at Boston College (BC) in 1941 but was called to active duty in the United State Army. Following his discharge, he returned to BC, graduating in 1949 and was subsequently awarded his Doctor of Medicine degree from Tufts University School of Medicine in 1952. He completed his surgical and urological residency programs in Boston under the direction of Richard Chute and Wyland Leadbetter. He joined the Lahey Clinic in 1960 and was elected Chairman of the Department of Urology in 1969. "Under his aegis, the Department of Urology flourished and acquired worldwide renown". He recruited Drs. John Libertino and Leonard Zinman, who are pioneers in our field.
During his professional life, Joe had "an intense devotion to the specialty of urology, its organizations, and its people". He served the New England Section as Secretary-Treasurer from 1968-1972 and as President in 1975. One of the charter members of the American Association of Clinical Urologists, he served as President in 1980 and was also a member of the American Association of Genitourinary Surgeons. The New England Section elected Joe as Representative to the AUA Executive Committee and he subsequently served as Treasurer from 1981 to 1986. As previously mentioned, Joe (or as many called him, JBD) was President of the AUA in 1988.
During his presidency of the AUA, JBD helped organize and strengthen its governance and structure. He was instrumental in laying the groundwork for corporate reorganization, changes in investment policy and expansion of its facilities and staff. One of his most significant accomplishments was to recruit Jim Gallagher as Executive Director of AUA in 1988. During Jim's leadership, the organization thrived. Its budget quadrupled, assets increased 10-fold and membership grew from 6,600 to 15,000. Several departments were established, such as Health Policy, Government Affairs, Clinical Practice Guidelines, Practice Management, Industry Relations and the Office of Research. Many of these achievements were in great part due to Joe's strategic vision. "In 1992, he was awarded the Ramon Guiteras Medal, AUA's most prestigious honor".
In his retirement, he immersed himself in the alumni activities of his beloved Boston College and was President of their Alumni Association in 1993. "In 1997, he received BC's highest honor, the William McKenney Award. He personally founded the Institute of Learning in Retirement at Boston College, which provides continuing education for seniors and has been an enormous success." JBD was very proud of his alma mater and considered these accomplishments to be the pinnacle of his career.
Apart from these tremendous achievements, JBD was a devoted and loving family man, married to Mary Foley Dowd for 46 years. He was also a gregarious and charismatic "people person", with an enduring sense of humor. "He knew and loved everyone and everyone loved him". He had an encyclopedic memory for people and events. "When he was active in the AUA, he was familiar with virtually every member. He knew the spouses, their children and where they were in school". What he didn’t know, he'd fill in the blanks. One of his many gifts was making everyone feel important and comfortable no matter what his or her station in life might be.
"Joe embodied all of the qualities a great physician and human being should have. He was a gentleman and a gentle man, a role model for all, manifesting integrity, honesty, compassion, and competence, all sprinkled with a little humor. The Code of Ethics of the AUA could serve as a template of Joe's professional life. He accomplished more in his lifetime than many of us could in ten lifetimes." In 1999, the Board of Directors of the New England Section of the AUA announced the establishment of the Joseph B. Dowd, MD – New England Section Lifetime Achievement Award. This honor is bestowed to a deserving individual who aspires to the many ideals set forth by Dr. Dowd, his dedication to the practice of urology and longstanding service to the New England Section. Our Section as well as the national AUA is fortunate to have been graced by this special individual.
2018 Resident Program History Posters
- Lahey Hospital
- Massachusetts General Hospital
- University of Vermont Medical Center
- Boston Medical Center