many postgraduate students he taught so well, he was always a friend as well as a tutor. To the patients, he brought not only sound clinical judg- ment, but also great kindness and compassion. He held strong and unswerving political views and was unafraid to express his feelings when he felt there was injustice. He was above all a humani- tarian. His sufferings from a chronic vascular dis- order started at an early age so that he understood well the meaning of pain, and this perhaps height- ened his compassionate understanding of his patients’ problems.
His interests outside the realms of orthopedics were many and varied. He had numerous friends in both the literary and theatrical worlds. Football remained a passion throughout his life and he was orthopedic adviser to the Chelsea Football Club for many years. He loved all card games and was a formidable opponent at both bridge and poker.
Above all, he was a man of immense charm, wit and complete integrity, which made him respected and loved by innumerable friends in every walk of life. Professor Lipmann Kessel died in London on June 5, 1986, aged 72, leaving be- hind his wife, two sons and two daughters.
1917. Because of financial reverses, he had to dis- continue his medical training for about a year.
Such a misfortune as insufficient funds would have daunted a less hardy soul than Albert Key, but he capitalized on his financial setback. He taught anatomy at the University of Chicago and Creighton Medical School. While supporting himself, he studied assiduously to become even more proficient in anatomy. He was able to return to Johns Hopkins University and to join the class of 1918. The interlude spent in teaching anatomy may well have led him into the realm of orthope- dic surgery, since that discipline is primarily re- lated to anatomy, both gross and functional.
Early in 1917, because of the continuing war in Europe and the expectation that the United States would be forced to take up arms, Dr. John Finney organized a war hospital unit at Johns Hopkins and conceived the idea of allowing medical stu- dents to serve in the capacity of interns. Albert Key was one of the 32 students who volunteered, and, when the United States entered the war, he enlisted with the others as a private in the Army Medical Corps. The months that followed were filled with new experience and hard work for John Albert and for the others who made up the Johns Hopkins Hospital unit no.18. They landed in St.
Nazaire, France, in June of 1917. The unit was moved to Savenay and then to Bazoilles-sur- Meuse. There it occupied a hospital with barracks built around a central building, which was called
“the chateau.” As “students,” Albert and his group were assigned to work as interns when there were patients and they were relegated to the “clean-up squad” when there were none.
During the winter of 1917–1918 he worked on the unit’s orthopedic ward. During the spring of 1918 the students received cablegrams from their university, informing them that they had been awarded their degrees as Doctors of Medicine.
Soon after Albert was transferred, and in the months that followed, he worked with a rehabili- tation battalion, which had been organized under the general planning of Dr. Joel E. Goldthwait.
During his service at Bazoilles, Dr. Key courted and married Eleanor Myer, an attractive nurse affiliated with the unit. Later there were two sons, John Albert, Jr., and Frank. Dr. Key was greatly admired for his rare devotion to his family, and when John Albert, Jr., was reported missing in action while serving as an air force pilot in the Pacific Theater in 1943, intimate friends were convinced that Dr. Key would never recover from the shock of the tragedy.
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Who’s Who in Orthopedics
John Albert KEY
1890–1955
Dr. Key attended the Alabama Polytechnic Insti- tute where he earned a Bachelor of Science degree in 1913, following which he entered Johns Hopkins University as a member of the class of
From 1919 to 1922 he received his graduate training at the Children’s Hospital and Massa- chusetts General Hospital in Boston. A portion of this time was spent with Dr. James Stone, chief of the surgical service at the Children’s Hospital, under whose excellent guidance Dr. Key received his general surgical training. During the latter part of this time, he was resident in orthopedic surgery at Massachusetts General Hospital on the service of Dr. Robert B. Osgood. Dr. Goldthwait was then at Devereaux House in Marblehead, Massachusetts, and with ambitious energy, Albert also followed courses there, meanwhile having garnered a Peabody scholarship. He utilized part of his time on that scholarship to undertake some hematological investigations. He had been attracted to hematology during his first year in medical school and was particularly interested in the histological study of blood and bone marrow.
His endeavors in this field were successful, and he published two important papers: “Studies on Erythrocytes with Especial Reference to Reticu- lum, Polychromatophilia and Mitochondria” and
“Lead Studies. IV. Blood Changes in Lead Poi- soning in Rabbits with Especial Reference to the Stippled Cells.” Men of authority in the field of hematology speak of these papers as excellent fundamental studies.
In 1921 he became instructor in applied phys- iology at Harvard University and, in the follow- ing year, he went to the University of Maryland as instructor in orthopedic surgery.
In 1924, it was the aim of the National Advi- sory Board of the Shriners’ Hospitals for Crippled Children to have their institutions throughout the country represent the highest clinical standards.
In addition, through laboratory and clinical research, they planned to make contributions to the investigation of the cause, prevention, and treatment of crippling conditions in childhood.
Dr. Key was appointed director of research for all the Shriners’ Hospitals, with headquarters in St.
Louis.
From 1924 until the end of 1930, while chief surgeon at the St. Louis Unit, I was fortunate to have had the opportunity to observe Dr. Key’s research, to become familiar with his ability as a teacher of undergraduate and postgraduate students, and to be stimulated by his keen inter- est in the clinical problems of crippled children.
He contributed much to our service and took an active part as an operating surgeon, in ward rounds, and in the outpatient service. More than simply a colleague, Albert became my friend, and
I venture to say no man ever had a truer one. In discussion, although he always spoke with frank- ness, vigor, and honesty, his never-failing genial- ity and good humor left no room for bitterness.
Unfailingly his repartee was sparkling, but without a barb; his brilliant logic and even temper, his willingness to allow others to explore the great reaches of his intellect and tremendous mental capacity, gave him his rightful place as counsellor, guide, and mentor in matters orthope- dic. He made the words “orthopedic surgery” and
“progress” almost synonymous, and he ranks among those who laid the foundation for ortho- pedic surgery as a specialty. Dr. Key had begun fundamental research early in his career and never abandoned this work. He continued his work along these lines and always correlated his research work with the clinical approach.
In spite of his multitudinous duties at the Shriners’ Hospital, his enormous ability for work enabled him to make outstanding contributions in experimental and clinical studies. During this period, “The Reformation of Synovial Membrane in the Knees of Rabbits After Synovectomy,”
“The Mechanisms Involved in the Removal of Colloidal and Particulate Carbon from Joint Cavities,” and the “Cytology of the Synovial Fluid of Normal Joints” were among his out- standing works.
In 1928, he published some thought-provoking articles on arthritis, among which were “Ex- perimental Arthritis. The Reactions of Joints to Mild Irritants” and “The Pathogenic Properties of Organisms Obtained from Joints in Chronic Arthritis.” Experimentally, by creating defects in the articular cartilage in the joints of animals, he produced changes very similar to those seen in chronic hypertrophic arthritis. His results were published under the titles “Experimental Arthri- tis. The Changes in Joints Produced by Creating Defects in the Articular Cartilage” and “Trau- matic Arthritis.” He was not unmindful, however, of the clinical aspects of his chosen field and pub- lished “The Non-Tuberculous Hip in Early Life.
II. Childhood,” “The Non-Tuberculous Hip in Early Life. III. Adolescence,” and “Some Diag- nostic Problems in the Hip in Early Life.” About this time Dr. Key wrote an article on brittle bones and blue sclera, which he termed “hereditary hypoplasia of the mesenchyme.” This article contains the original description of the tissues, including skin, tendons, blood vessels, muscles, bones, and joints, in a case studied from the clin- ical, roentgenographic, and laboratory aspects.
172 Who’s Who in Orthopedics
His article “Epiphyseal Coxa Vara,” which con- tains an exhaustive bibliography, was accepted as his thesis for membership in the American Ortho- pedic Association. He contributed two sections, one on “Idiopathic Bone Fragility (Osteopsathy- rosis)” and the other “Fractures and Dislocations of the Extremities” as part of Graham’s Surgical Diagnosis.
The integrity of his publications, as of all his work, is and will remain beyond question. Pro- fessionally and socially, Albert believed in and lived the truth. With Dr. Sherwood Moore, in 1928, he made an English translation of Normal and Pathological Physiology of Bone, from the original French by Leriche and Policard. Since he had but little opportunity, he spoke almost no French; upon reading his impeccable translation, Leriche inquired how he had been able to sur- mount the difficulties of a foreign language. With his flair for absolute truth, Albert replied, “Avec le dictionnaire.”
He became associated with the Washington University School of Medicine in 1926 as associ- ate in clinical orthopedics; in 1927, he was appointed assistant professor of clinical orthope- dics and, in 1931, head of the division of orthopedic surgery and clinical professor.
Although his hospital duties were long and arduous, often when they were finished, some- times as late as five in the afternoon, his terrific drive compelled him to begin work on some project of his own. In such an endeavor, his criti- cal and analytical mind had full scope. He was full of intellectual curiosity. Not only was he dili- gent and persistent in his investigation, he was original. His original ideas were never-ending, and he pursued not one, but many simultaneously.
Once he stated that he had decided long before that one should not select a single research project and pursue it to its conclusion, but that it was better to keep working on other subjects simulta- neously. Otherwise, in working to complete but one, a person might be slowed down and thus spend years to finish it.
His own drive was a great stimulus to those with whom he worked. He was constantly trying to advance his younger men and associates into positions at the school and toward membership in orthopedic societies. Several times he said that he hoped some day his younger men would be among the leaders in orthopedic surgery. He was totally unselfish, both with his time and his money. He made private loans to those who needed them, and it is known that he paid the
salary of his first fellow in orthopedic surgery at Washington University. Furthermore, he became interested in the School of the Ozarks. This was a small Missouri school whose interests were directed mainly toward the education of under- privileged children. Each year Dr. Key endowed a likely scholar with a fellowship.
Immersed though he was in serious work, his love and zest for sports always managed to shine through. I shall never forget the fishing trips we took together in California, Idaho, Oregon, and British Columbia. There was never a dull moment, due to his unfailing good humor, his ready wit, and his joy in seeing others catch more and bigger fish than he did.
He was always the center of attraction in any gathering, whether in mixed company or profes- sional groups. His ability to start a conversation and to control it was unique. He had as broad a knowledge of orthopedic surgery and of general medicine as anyone I know. He was extremely kind and modest to the point where, when asked to give a paper or make some other presentation, he willingly shared his honor with one of his col- leagues; in fact, he often turned the whole matter to the other man’s credit. He was never too busy for a conference on a problem—research, clini- cal, or otherwise. He had a prodigious memory, especially for the minutiae in orthopedic litera- ture. His presence at any function, social or medical, was practically a guarantee of its success. He was an active member of Theta Nu Epsilon, Gamma Alpha, Alpha Omega Alpha fra- ternities, and was a Phi Beta Kappa.
In 1955 he became Professor Emeritus of Clinical Orthopedics at Washington University in St. Louis and head of the Division of Orthopedics, a position he held until his death.
Although his entire life was productive, he made especially valuable contributions to the progress of orthopedic surgery during the years 1931–1955. Among them was the excellent book The Management of Fractures, Dislocations, and Sprains by Key and Conwell. In Cowdry’s Special Cytology he described synovial membranes, joints, and bursae. He found time to contribute to The Practitioners Library of Medicine and Surgery, Military Surgical Manual of the National Research Council, Clinics, Instructional Course Lectures of The American Academy of Orthopedic Surgeons, Lewis’ Practice of Surgery, A Textbook of Surgery by American Authors, Bancroft and Murray’s Surgical Treatment of the Motor-Skeletal System, Ghormlley’s Orthopedic 173
Who’s Who in Orthopedics
Surgery, Cirzrrgia de L’rgezzcia, Cole’s Opera- tive Technic and Clinical Orthopedics. Among his many articles that have appeared in scientific journals, he will be remembered for his work on osteogenesis, bone atrophy and absorption, the use of the sulfa drugs in clean and infected wounds of both soft parts and bone, experimental and clinical observation of the effects of com- pression in arthrodesis, lesions of the interverte- bral disc in the production of backache, and countless other topics. He was a member of the Committee for Investigation of the Kenny Treat- ment of Poliomyelitis appointed by the American Orthopedic Association, the American Academy of Orthopedic Surgeons, and the Section on Orthopedic Surgery of the American Medical Association. His constructive criticism of the Kenny method of treatment in infantile paralysis and his evaluation and report on this method of treatment remain a masterpiece.
It has been said that he never missed a meeting of the American Orthopedic Association, an asso- ciation of which he was president during 1945 and 1946. At the meetings of the American Academy of Orthopedic Surgeons, his contribu- tions to discussion were eagerly sought. His knowledge of orthopedic surgery was so profound that, in discussing papers, he could seize on the salient points and illuminate them as nobody else could. He was a member of the American Medical Association, American Surgical Association, American College of Surgeons, American Radium Society, Missouri Medical Association, Orthopedic Research Society (of which he was president at the time of his death), Clinical Ortho- pedic Society, Southern Medical Association, Southern Surgical Association, and the Robert Jones Club. The meeting of this Club in St. Louis in 1954 was organized by Dr. Key, and he had the fullest cooperation from his confreres; although he was most grateful, he suffered from “an embar- rassment of riches”—everyone wanted to speak on his program. Needless to say, the meeting was a great success. Adding to that success, he invited all the members of the Club for dinner at his home in St. Louis, an evening long to be remembered.
Some of us were fortunate enough to spend a weekend with him at the “Keyhole,” his country place in the Ozarks.
Dr. Key presided at the first Orthopedic Section of the Forum on Fundamental Surgical Problems, of the American College of Surgeons in 1951. He organized this section of the forum and all suc- ceeding meetings of this section until his death.
These meetings were held at the time of those of the Congress of the American College of Surgeons.
His presidential address before the American Orthopedic Association, “Education and Certifi- cation of Orthopedic Surgeons,” bears the imprint of his clear and lucid mind. This article contains what I would consider fair and just criticism of the National Board of Orthopedic Surgery. Dr.
Key did not arrive at his conclusions without long and considered judgment. He voiced his objection to the regimentation of orthopedic surgeons and to a self-perpetuating board, which existed at that time. In his analysis of the group comprising the American Orthopedic Association, he found that their qualifications for this specialty varied and that their success had been obtained by a variety of routes. He objected to a uniform, prescribed method of training and, as he stated in the final paragraph of his address as delivered to the Association,
. . . I suggest that our Board alter radically their policy of demanding that a candidate follow a rigidly outlined course of orthopedic training and that they recognize the incontrovertible fact that satisfactory orthopedic surgeons have been and can be developed in many dif- ferent ways. Their standards of excellence should not be lowered and they can demand more time devoted to practice, but they should not close the door of our specialty in the face of men who are well qualified, but whose education has not been along the lines which they have laid down. They are not omniscient but with the best of intentions they are becoming omnipotent and this is not to the best interests of orthopedic surgery of the future. Finally it is to be reiterated that the func- tion of the Board is to establish minimum standards;
for the practice of and not to dictate the future devel- opment of orthopedic surgery.
This presidential address should be read and re-read by all aspirants to the field of orthopedic surgery, as well as by those who have already arrived, for stripped of all unnecessary verbiage as it is, it contains the outline of basic training, educational requirements, and necessary qualifi- cations for a true orthopedic surgeon.
Dr. John Albert Key died at his country home near Steelville in the Ozarks on August 6, 1955.
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