COMMENTARY COMMENTARY
Walter Dandy (1886-1946): A Personal Retrospective Mary Ellen Dandy Marmaduke, MST, MAT Correspondence: Mary Ellen Dandy Marmaduke, MST, MAT, 3601 SW River Parkway #808, Portland, OR 97239. E-mail: [email protected]
Copyright © 2015 by the Congress of Neurological Surgeons.
W
alter Dandy was born in 1886 and died in 1946. Looking back on her father’s life, Dandy’s daughter, Kathleen Louise Gladstone, wrote: Dandy’s personality was complicated and confusing to many. It is helpful to understand the personalities of his parents because he was a combination of them both. He resembled his father in his kindness, gentleness, and caring for other people. But he was like his mother in his inner-direction, bluntness, short temper, and perfectionism. These traits were often in conflict, and there were many who saw only one side or the other. Those who were willing or able to look beneath the surface usually found the often-buried generous and loving side.1
Walter’s father, John, was an immigrant from England. John had left school after third grade to help support his family. After coming to the United States, John worked first as a fireman and then later as a locomotive engineer. Walter’s mother, Rachel, grew up on her family’s farm in Northern Ireland. She graduated from high school and had worked as a seamstress before immigrating to the United States. They were both members of the Plymouth Brethren, a nonconformist, evangelical Christian movement. Dandy was not religious, but he respected his parents’ beliefs and was profoundly influenced by their values. An only child, Dandy had a close relationship with his parents, who followed his personal and professional achievements closely and with great pride. Walter Dandy believed that family relations were “the finest thing in life.”2 As an adult, he wrote to his parents: Dearest Mother and Father: . . . It’s such a wonderful thing—the most wonderful of this world’s possessions to know that wherever you may be there is someone always thinking about you and of some way to help you. That has always been my fortune, far more than falls to the lot of most people. And somehow I seem to realize and appreciate it more with each passing year. How much you
NEUROSURGERY
have both done for me and how much you have sacrificed to do it and never once looked at the sacrifices but always at a farther and higher goal. Long ago I realized that greatness was not frills and superficialities but the real true blue of unselfish devotion. . .3
EARLY LIFE Walter (Figure 1) started school in a 1-room schoolhouse with other immigrant children from England, Ireland, and Germany. A good student, he skipped a grade and graduated from high school in 1903 as valedictorian. His valedictory address was on the importance of education. At the urging of his teachers, he sought and won a scholarship to attend the University of Missouri (Figure 2). Although only 50 miles from Sedalia, it was a very different world—academia, where he was to spend the rest of his life. Dandy worked in the lab of 2 zoology professors who had earned their PhDs at Johns Hopkins University. After completing 1 year of medical school at the University of Missouri, Dandy followed their advice and entered Johns Hopkins School of Medicine as a second year student. In 1910, he received his MD from Johns Hopkins, where he spent the rest of his career.
MARRIAGE AND FAMILY By 1923, Walter had achieved attention for his groundbreaking treatments of hydrocephalus and acoustic tumors, and was working as an Associate Professor of Surgery at Johns Hopkins. Walter met Sadie Estelle Martin, a dietetic social worker at Johns Hopkins, as they waited for an elevator at the hospital (Figure 3). They soon began to court. Sadie, at 22 years old, was an “old fashioned girl” who eschewed the “flapper” styles of the 1920s in favor of long hair and modest dress. She and her friends had watched the young Hopkins men playing tennis on the hospital grounds; they all considered Walter Dandy quite a “catch.” During their courtship, they took care to avoid the gossips at Hopkins. They would go to restaurants away from the
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 501
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
hospital, or drive to football games in Annapolis. Sadie later recalled that she could hear Walter’s noisy car, a Wills Saint Claire, as it would round the corner near her house. Walter won a Rockefeller education grant to study with physicians in Europe, starting in December 1923. Soon after he returned, he and Sadie were married. He wrote to his parents: [Sadie] surpasses even my highest expectations of what a girl might be. She loves all that is beautiful and good. . ..There has been nothing but joy and happiness and we are confirmed there never will be. I know how happy you will be when you begin to really know her as I do. We have been tramping and canoeing. . ..”4
Years later Sadie would tell their children, “You shouldn’t get married unless you are foolishly in love.” Walter Jr was born on their first wedding anniversary. Sadie later recounted that her husband had burst into tears of relief and gratitude upon seeing that their newborn was healthy. Mary Ellen was born in 1927 (Figure 4), Kathleen Louise in 1928, and Margaret in 1935. The house was now full of “kiddies,” as Walter called his children. Figure 5 shows the Dandy family in 1936. Taken by Dandy’s first resident, Frederich (Fritz) Reichert, it is the only picture of the whole family. It was the first color photograph they had ever seen.
COPING WITH THE PRESSURES OF NEUROSURGERY
FIGURE 1. John Walter and Rachel Dandy, 1888.
In Dandy’s early years at Johns Hopkins, surgical procedures, technology, and postoperative care were in their infancy. Antibiotics were unknown until 1939. Patients often arrived at the hospital too late and postoperative infections were prevalent.
FIGURE 2. John, Walter, and Rachel Dandy after Walter’s Graduation from the University of Missouri, 1907.
502 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 3. Sadie Estelle Martin, 1923. FIGURE 4. Walter Dandy with Mary Ellen and Walter Jr, 1928.
Dandy used the operating room whenever it was available. He performed a remarkable number of surgeries. He empathized with his patients and their families. Sadie recounted the many nights he had paced the floor of their bedroom, concerned about a patient. In the operating room, Dandy was known to throw instruments in frustration. He would occasionally fire a resident in anger, only to reinstate him shortly afterwards. Dandy’s interest in athletics was an antidote to the pressures of work. At Hopkins, he regularly played baseball, then tennis, and, in later years, golf. He also loved to ride the trains. In his early years at Hopkins, to relax, he would sit on a hill overlooking the tracks outside Union Station, and watch the trains go by. On short train trips, he would get a roomette and write. On longer lecturing tours around the country, riding the trains gave him the chance to relax and write, away from the hospital and telephone. Dandy often sought sun and surf on vacations. While a resident, he went to the Eastern Shore of Maryland with his colleagues. In
NEUROSURGERY
the winters between 1915 and 1921, he spent time serving as the resident doctor for the wealthy members of the Jekyll Island Club, on Jekyll Island, Georgia. Later, he would spend a month in the winter in Florida, where he would play golf, bask in the sun, and swim in the ocean. Occasionally, Sadie would join him.
HOME LIFE Dandy’s home life was a refuge, and his relationship with Sadie and their children was a source of joy and rejuvenation. Dandy had high standards for his children, but was a playful and loving father who shared many aspects of his professional life with them. Dinner at the Dandy household was a family affair. The children were expected to be at the table promptly at 6 pm, with clean fingernails and polished shoes, and to observe formal table manners. The conversation, however, was lively and wide-ranging. Walter
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 503
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
FIGURE 5. Walter and Sadie, Walter Jr, Mary Ellen, Kitty, and Margaret, 1936.
would tell the family stories of his surgeries, describing the “beautiful tumor” he had removed, or other details of the day’s operations. He would talk to the children about how stressful brain surgery was, not only for the patients, but also for their families. Sadie instructed the children not to burden their father with their problems until after he had eaten his dinner, but Walter was eager to hear about the children’s experiences. He was warmly affectionate and playful with them. He devised a game called “The Liberty Limited,” after a fast train that came through Baltimore. Two children would sit on a rug at the top of the stairs. Walter would pull the rug down the stairs shouting, “Here comes the Liberty Limited!” amidst much laughter as they thumped to the bottom of the stairs. Other times, Walter would play with “the kiddies.” They would occasionally sit on the couch and try to spit prune seeds into the fireplace. The kiddies were never able to match their father’s skill at this sport. Understanding that children like to show off their mastery of big words, he supplanted the old favorite, “antidisestablishmentarianism,” with the more esoteric-sounding “carotid cavernous arterio-venous aneurysms.” The children didn’t know the meaning of the phrase, but they liked to say it anyway, believing it made them sound grown up. After dinner, he would retire to his and Sadie’s bedroom to change into his old clothes. He’d shake his pants upside down before hanging them up. Hearing coins fall out of the pockets, the children would rush into the bedroom, shouting, “Finders keepers, losers weepers!” The children would scoop up the coins, and put them in their pockets. Sometimes, he would stretch out on the couch and call to Mary Ellen, “Come lie in Daddy’s arms” so they could cuddle. When Sadie announced bedtime, Mary Ellen would demur, saying, “I have to lie in Daddy’s arms,”
504 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
a strategy that allowed her to stay up a little later (Figure 6). Occasionally, Walter would offer Kitty or Mary Ellen 10 cents an hour to rub his head, and 25 cents if they could crawl off the bed without waking him up. Big money for a child during the Great Depression! Each evening at 7 PM, Dandy’s chief resident would call to report on the status of his patients. The exception was Sunday nights, when the children would climb onto their parents’ big double bed and listen to Jack Benny, Charlie McCarthy and “Gang Busters” on the radio. If Dandy wanted to talk to his resident at other times, the children would call Wolfe 5500 (Johns Hopkins Hospital) and say: “Would you ask Dr. . . to call Dr Dandy, please.” Walter kept a photo of himself and another man in tennis clothes on his bedroom bureau. Sadie suggested her children not talk to their father about the man in the photograph, whose name was Harvey Cushing. The children inferred that their father and Dr Cushing were not on the best of terms. Dandy would occasionally accompany the family on outings to the countryside. Mary Ellen captured one such event, using her Bullet camera (Figure 7). He took the family to Ocean City, Maryland, when the children were young (Figure 8). When he went on trips without the family, he would always return with presents. Perhaps the most memorable were the grass skirts and records of Hawaiian music he brought back from his trip to a medical meeting in Hawaii in 1939. Back at home, he wrapped 2 grass skirts around his waist (one wouldn’t fit!) and showed them how to dance the hula. Dandy shared his love of trains with Walter Jr, who had a model train set. When Dandy finally fulfilled his “long cherished desire” of riding an electric locomotive all the way from Baltimore to
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 6. Walter with Mary Ellen, 1929. FIGURE 7. Sadie, Walter, Kitty, Margaret and Fagin in the country, 1940.
New York, he wrote, “What a thrill it was! . . .Wish Walter had been along.”5 Dandy often took his son to the hospital with him on Saturdays to watch him operate. Walter Jr later followed his father into medicine, becoming an anesthesiologist. Dandy had a surgeon’s attitude toward his children’s health and well-being. When they feigned illness to avoid school, he would look them over in the morning and usually say: “It’s all in your head, go off to school.” On the other hand, having seen so many head injuries, he worried about them when they rode horses, and he arranged for elective appendectomies to avoid the risk of a ruptured appendix. He arranged for appendectomies for Mary Ellen and Kitty before they went to summer camp in 1941. A few days before the planned surgery, Mary Ellen had a terrible stomachache. Dandy called his neighbor and colleague, Alfred
NEUROSURGERY
Blalock. The two took her to the hospital and removed her appendix that evening. Blalock removed Kitty’s appendix the next day. A few years later, Walter Jr, needed to have 4 impacted wisdom teeth removed. Dandy arranged to have his son’s appendix removed at the same time. Daughter Margaret was next, so all the “kiddies” became appendix-free! Dandy enjoyed playing softball with his children on a vacant lot near their home. Sadie was afraid that her husband might hurt his hands in these efforts. He had his hands insured by Lloyds of London, but the money would hardly compensate for his love of surgery. A lifelong baseball fan, Dandy was deeply troubled by head injuries suffered during the game. In 1941, he had an opportunity to help make the sport safer. Dandy laid a large sheet of acrylic
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 505
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
FIGURE 8. Kitty, Walter, Mary Ellen and Sadie at Ocean City, 1935.
plastic on the dining room table and gave Sadie the pattern for the inserts that she, Kitty, and Mary Ellen cut out and sewed into a baseball hat, creating the prototype for the first baseball helmet. Sadie later gave the helmet to the Baseball Hall of Fame in Cooperstown, New York.
During the Second World War, Dandy served the US Navy as a “Dollar a Year Man,” receiving $1 of compensation for every year he worked. His inspections of US Navy neurosurgical units took him to many parts of the United States. Among the cities he visited was Los Angeles, where he met various celebrities,
FIGURE 9. At Capon Springs: Judge Hatfield, Walter, Margaret, and Sadie, Claire Kay Austin on fence, 1942.
506 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 10. Walter, Jr, Kitty, Mary Ellen, and Margaret at Johns Hopkins, 2000.
including Errol Flynn, Ronald Reagan, and Ann Sheridan. He became friends with Major Albert of Warner Brothers Studios, and Emil Seletz, a Los Angeles neurosurgeon. Dandy had operated on Dorothy Lamour’s mother and became friends with Miss Lamour, as well. Miss Lamour came to visit the Dandy family while her mother was in the hospital, and gave each child an autographed photograph of herself. She reserved a larger, more glamorous photo of herself for Dr Dandy. Traveling with colleague Winchell (“Wink”) Craig, from the Mayo Clinic, Dandy wrote, “Dr. Craig. . . knows many more surgeons than I do, . . . so I will even up by taking him to see Dorothy!”6 Dandy had operated on a number of FBI agents (“G-men,” as they were called) and had met J. Edgar Hoover during one of his visits to Florida. When Hoover invited him to bring the family to visit the FBI, they all piled into their 12-cylinder Packard with jump seats, and drove to Washington. The children were very impressed, having listened to “Gangbusters” on the radio and being familiar with the work the “G-men” did capturing criminals. The celebrity of greatest interest to the children was the gypsy queen who became Dandy’s patient at Johns Hopkins in the mid-thirties. Sadie was afraid the gypsies would try to kidnap the children, because of the 1932 kidnapping of the Lindberg baby. In an effort to keep the children safe, she had special locks installed on all the windows in their house. Apparently, the gypsies weren’t interested in the Dandy children. During the summers in the 1940s, Sadie and the children would stay at Capon Springs, a resort near Winchester, West Virginia. Dandy would join them when he could (Figure 9). He regarded those visits as the perfect way to enjoy a vacation: A
NEUROSURGERY
hearty breakfast with the family followed by 9 holes of golf and a swim; then, lunch with the family, a short nap, and another 9 holes in the afternoon. After dinner with the family, he would play bridge until “lights out” at 11. Dandy complained about the “lights out” policy to the owner, Lou Austin. Lou would explain that Capon Springs was a place to rest. Very few people said “no” to Walter Dandy, but he obeyed Lou’s rules and they became good friends.
DEATH On April 1, 1946, Dandy was working with his youngest child, Margaret, on the “Victory Garden” in their backyard, when he had to stop because of chest pain. Dandy’s doctor was called to the house. Diagnosed with a heart attack, Dandy was taken by ambulance to Johns Hopkins. He recovered, went home, and had several days with Sadie and all 4 children (Figure 10). He had a second heart attack on April 18, and died at the Johns Hopkins Hospital the following day. Dandy was eulogized by a colleague, pediatrician Edwards Park, who said, “Walter was one of the most lovable men I have ever known; he had a most impetuous, warm, affectionate, friendly nature.”7
Disclosure The author has no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 507
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
REFERENCES 1. Gladstone K. Introduction to Walter Dandy Letters. Congress of Neurological surgeons; 1998. 2. Dandy W. Letter to Dr. James M. Mason. Alan Mason Chesney Medical Archives at the Johns Hopkins Medical Institutions; 1938. 3. Dandy W. Letters to Parents. Congress of Neurological Surgeons; 1925. 4. Dandy W. Letter to Parents. Congress of Neurological Surgeons; 1924. 5. Dandy W. Letter to Family. Congress of Neurological Surgeons; 1936. 6. Dandy W. Letter to Family. Congress of Neurological Surgeons; 1943. 7. Park E. Medical Board Minute; Walter E. Dandy. Alan Mason Chesney Medical Archives; 1946.
Acknowledgments This article would not have been possible without help from: My siblings, Walter, Kitty, and Maggie, who shared their insights and memories; My daughter, Susan Dandy Marmaduke, for her thoughtful editing; Marjorie Kehoe, Accessioning and Reference Archivist at the Alan Mason Chesney Medical Archives at Johns Hopkins Medical Institutions, for promptly sending requested photographs and materials; Kamilah A. Dowling, CPNP, for providing finishing touches, and; James T. Goodrich, MD, who suggested this article and gave constant and valuable support.
COMMENTS
M
ary Ellen Dandy Marmaduke was born in 1927 as the second child of Dr Walter Dandy. Her personal remembrances and talks with other family members plus a review of family documents form the basis of this fascinating and insightful glimpse of a side of an iconic neurosurgeon that is seldom discussed or emphasized. The review is important because it reveals that Dr Dandy was an attentive and loving father. This is not what might be expected by most of the biographic literature on the man, which paints a picture of someone driven by hard work and who is not particularly affection or caring of people other than his patients. This memoir is most interesting, and I was glad to have the opportunity to read it. Dr Dandy seems to have had a part of him that was most admirable and deserves publicity. Russel H. Patterson Jr New York, New York
508 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
M
ary Ellen Dandy Marmaduke, Dr Walter Dandy’s eldest daughter, has written an informative and charming article about her father and family. This fascinating first-hand account of the Dandy family provides a window to Dr Dandy’s personal life away from the hospital and behind his voluminous academic writings. Dr Dandy’s professional accomplishments are legendary. Both Dr Hugo Rizzoli and Dr Irving Sherman (2 of only 8 residents who completed the arduous training under Dr Dandy) independently report that by 1940 (6 years before his death at the age of 62) Dr Dandy was performing over 1000 major operations per year.3,4 It is also well-documented that Dr Dandy published over 160 articles and 5 books.2 His private life, however, as that of most great men and women of medicine, is not as well known. Ms Dandy Marmaduke’s article rounds out for us her father’s character, personality, and values. It shows that he was a family man devoted to his wife and children. His devotion to his parents, whom he moved to Baltimore the year he graduated from medical school in 1910, and the important role they played in his life are clearly evident. It also describes his playful and mischievous nature, which was mostly hidden from his colleagues who witnessed Dr Dandy’s gargantuan efforts as he single-handedly brought the nascent field of neurosurgery into maturity. It is truly fortunate for us and future medical historians that Ms Dandy Marmaduke has taken the time and effort to describe the private side of her father and allowed us to understand him better. We strongly recommend to those readers who enjoyed this article to read her more extensive and detailed account of her father’s life in her book Walter Dandy: The Personal Side of a Premier Neurosurgeon.1 Rafael J. Tamargo Henry Brem Baltimore, Maryland
1. Dandy-Marmaduke ME. Walter Dandy: The Personal Side of a Premier Neurosurgeon. Baltimore: Lippincott Williams & Wilkins; 2002. 2. Fox WL. Dandy of Johns Hopkins. Baltimore: Williams & Wilkins; 1984. 3. Rizzoli HV. Walter E. Dandy: an historical perspective. Clin Neurosurg. 1985;32: 3-22. 4. Sherman IJ, Kretzer RM, Tamargo RJ. Personal recollections of Walter E. Dandy and his brain team. J Neurosurg. 2006;105(3):487-493.
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
Walter Dandy (1886-1946): A Personal Retrospective Mary Ellen Dandy Marmaduke, MST, MAT Correspondence: Mary Ellen Dandy Marmaduke, MST, MAT, 3601 SW River Parkway #808, Portland, OR 97239. E-mail: [email protected]
Copyright © 2015 by the Congress of Neurological Surgeons.
W
alter Dandy was born in 1886 and died in 1946. Looking back on her father’s life, Dandy’s daughter, Kathleen Louise Gladstone, wrote: Dandy’s personality was complicated and confusing to many. It is helpful to understand the personalities of his parents because he was a combination of them both. He resembled his father in his kindness, gentleness, and caring for other people. But he was like his mother in his inner-direction, bluntness, short temper, and perfectionism. These traits were often in conflict, and there were many who saw only one side or the other. Those who were willing or able to look beneath the surface usually found the often-buried generous and loving side.1
Walter’s father, John, was an immigrant from England. John had left school after third grade to help support his family. After coming to the United States, John worked first as a fireman and then later as a locomotive engineer. Walter’s mother, Rachel, grew up on her family’s farm in Northern Ireland. She graduated from high school and had worked as a seamstress before immigrating to the United States. They were both members of the Plymouth Brethren, a nonconformist, evangelical Christian movement. Dandy was not religious, but he respected his parents’ beliefs and was profoundly influenced by their values. An only child, Dandy had a close relationship with his parents, who followed his personal and professional achievements closely and with great pride. Walter Dandy believed that family relations were “the finest thing in life.”2 As an adult, he wrote to his parents: Dearest Mother and Father: . . . It’s such a wonderful thing—the most wonderful of this world’s possessions to know that wherever you may be there is someone always thinking about you and of some way to help you. That has always been my fortune, far more than falls to the lot of most people. And somehow I seem to realize and appreciate it more with each passing year. How much you
NEUROSURGERY
have both done for me and how much you have sacrificed to do it and never once looked at the sacrifices but always at a farther and higher goal. Long ago I realized that greatness was not frills and superficialities but the real true blue of unselfish devotion. . .3
EARLY LIFE Walter (Figure 1) started school in a 1-room schoolhouse with other immigrant children from England, Ireland, and Germany. A good student, he skipped a grade and graduated from high school in 1903 as valedictorian. His valedictory address was on the importance of education. At the urging of his teachers, he sought and won a scholarship to attend the University of Missouri (Figure 2). Although only 50 miles from Sedalia, it was a very different world—academia, where he was to spend the rest of his life. Dandy worked in the lab of 2 zoology professors who had earned their PhDs at Johns Hopkins University. After completing 1 year of medical school at the University of Missouri, Dandy followed their advice and entered Johns Hopkins School of Medicine as a second year student. In 1910, he received his MD from Johns Hopkins, where he spent the rest of his career.
MARRIAGE AND FAMILY By 1923, Walter had achieved attention for his groundbreaking treatments of hydrocephalus and acoustic tumors, and was working as an Associate Professor of Surgery at Johns Hopkins. Walter met Sadie Estelle Martin, a dietetic social worker at Johns Hopkins, as they waited for an elevator at the hospital (Figure 3). They soon began to court. Sadie, at 22 years old, was an “old fashioned girl” who eschewed the “flapper” styles of the 1920s in favor of long hair and modest dress. She and her friends had watched the young Hopkins men playing tennis on the hospital grounds; they all considered Walter Dandy quite a “catch.” During their courtship, they took care to avoid the gossips at Hopkins. They would go to restaurants away from the
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 501
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
hospital, or drive to football games in Annapolis. Sadie later recalled that she could hear Walter’s noisy car, a Wills Saint Claire, as it would round the corner near her house. Walter won a Rockefeller education grant to study with physicians in Europe, starting in December 1923. Soon after he returned, he and Sadie were married. He wrote to his parents: [Sadie] surpasses even my highest expectations of what a girl might be. She loves all that is beautiful and good. . ..There has been nothing but joy and happiness and we are confirmed there never will be. I know how happy you will be when you begin to really know her as I do. We have been tramping and canoeing. . ..”4
Years later Sadie would tell their children, “You shouldn’t get married unless you are foolishly in love.” Walter Jr was born on their first wedding anniversary. Sadie later recounted that her husband had burst into tears of relief and gratitude upon seeing that their newborn was healthy. Mary Ellen was born in 1927 (Figure 4), Kathleen Louise in 1928, and Margaret in 1935. The house was now full of “kiddies,” as Walter called his children. Figure 5 shows the Dandy family in 1936. Taken by Dandy’s first resident, Frederich (Fritz) Reichert, it is the only picture of the whole family. It was the first color photograph they had ever seen.
COPING WITH THE PRESSURES OF NEUROSURGERY
FIGURE 1. John Walter and Rachel Dandy, 1888.
In Dandy’s early years at Johns Hopkins, surgical procedures, technology, and postoperative care were in their infancy. Antibiotics were unknown until 1939. Patients often arrived at the hospital too late and postoperative infections were prevalent.
FIGURE 2. John, Walter, and Rachel Dandy after Walter’s Graduation from the University of Missouri, 1907.
502 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 3. Sadie Estelle Martin, 1923. FIGURE 4. Walter Dandy with Mary Ellen and Walter Jr, 1928.
Dandy used the operating room whenever it was available. He performed a remarkable number of surgeries. He empathized with his patients and their families. Sadie recounted the many nights he had paced the floor of their bedroom, concerned about a patient. In the operating room, Dandy was known to throw instruments in frustration. He would occasionally fire a resident in anger, only to reinstate him shortly afterwards. Dandy’s interest in athletics was an antidote to the pressures of work. At Hopkins, he regularly played baseball, then tennis, and, in later years, golf. He also loved to ride the trains. In his early years at Hopkins, to relax, he would sit on a hill overlooking the tracks outside Union Station, and watch the trains go by. On short train trips, he would get a roomette and write. On longer lecturing tours around the country, riding the trains gave him the chance to relax and write, away from the hospital and telephone. Dandy often sought sun and surf on vacations. While a resident, he went to the Eastern Shore of Maryland with his colleagues. In
NEUROSURGERY
the winters between 1915 and 1921, he spent time serving as the resident doctor for the wealthy members of the Jekyll Island Club, on Jekyll Island, Georgia. Later, he would spend a month in the winter in Florida, where he would play golf, bask in the sun, and swim in the ocean. Occasionally, Sadie would join him.
HOME LIFE Dandy’s home life was a refuge, and his relationship with Sadie and their children was a source of joy and rejuvenation. Dandy had high standards for his children, but was a playful and loving father who shared many aspects of his professional life with them. Dinner at the Dandy household was a family affair. The children were expected to be at the table promptly at 6 pm, with clean fingernails and polished shoes, and to observe formal table manners. The conversation, however, was lively and wide-ranging. Walter
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 503
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
FIGURE 5. Walter and Sadie, Walter Jr, Mary Ellen, Kitty, and Margaret, 1936.
would tell the family stories of his surgeries, describing the “beautiful tumor” he had removed, or other details of the day’s operations. He would talk to the children about how stressful brain surgery was, not only for the patients, but also for their families. Sadie instructed the children not to burden their father with their problems until after he had eaten his dinner, but Walter was eager to hear about the children’s experiences. He was warmly affectionate and playful with them. He devised a game called “The Liberty Limited,” after a fast train that came through Baltimore. Two children would sit on a rug at the top of the stairs. Walter would pull the rug down the stairs shouting, “Here comes the Liberty Limited!” amidst much laughter as they thumped to the bottom of the stairs. Other times, Walter would play with “the kiddies.” They would occasionally sit on the couch and try to spit prune seeds into the fireplace. The kiddies were never able to match their father’s skill at this sport. Understanding that children like to show off their mastery of big words, he supplanted the old favorite, “antidisestablishmentarianism,” with the more esoteric-sounding “carotid cavernous arterio-venous aneurysms.” The children didn’t know the meaning of the phrase, but they liked to say it anyway, believing it made them sound grown up. After dinner, he would retire to his and Sadie’s bedroom to change into his old clothes. He’d shake his pants upside down before hanging them up. Hearing coins fall out of the pockets, the children would rush into the bedroom, shouting, “Finders keepers, losers weepers!” The children would scoop up the coins, and put them in their pockets. Sometimes, he would stretch out on the couch and call to Mary Ellen, “Come lie in Daddy’s arms” so they could cuddle. When Sadie announced bedtime, Mary Ellen would demur, saying, “I have to lie in Daddy’s arms,”
504 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
a strategy that allowed her to stay up a little later (Figure 6). Occasionally, Walter would offer Kitty or Mary Ellen 10 cents an hour to rub his head, and 25 cents if they could crawl off the bed without waking him up. Big money for a child during the Great Depression! Each evening at 7 PM, Dandy’s chief resident would call to report on the status of his patients. The exception was Sunday nights, when the children would climb onto their parents’ big double bed and listen to Jack Benny, Charlie McCarthy and “Gang Busters” on the radio. If Dandy wanted to talk to his resident at other times, the children would call Wolfe 5500 (Johns Hopkins Hospital) and say: “Would you ask Dr. . . to call Dr Dandy, please.” Walter kept a photo of himself and another man in tennis clothes on his bedroom bureau. Sadie suggested her children not talk to their father about the man in the photograph, whose name was Harvey Cushing. The children inferred that their father and Dr Cushing were not on the best of terms. Dandy would occasionally accompany the family on outings to the countryside. Mary Ellen captured one such event, using her Bullet camera (Figure 7). He took the family to Ocean City, Maryland, when the children were young (Figure 8). When he went on trips without the family, he would always return with presents. Perhaps the most memorable were the grass skirts and records of Hawaiian music he brought back from his trip to a medical meeting in Hawaii in 1939. Back at home, he wrapped 2 grass skirts around his waist (one wouldn’t fit!) and showed them how to dance the hula. Dandy shared his love of trains with Walter Jr, who had a model train set. When Dandy finally fulfilled his “long cherished desire” of riding an electric locomotive all the way from Baltimore to
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 6. Walter with Mary Ellen, 1929. FIGURE 7. Sadie, Walter, Kitty, Margaret and Fagin in the country, 1940.
New York, he wrote, “What a thrill it was! . . .Wish Walter had been along.”5 Dandy often took his son to the hospital with him on Saturdays to watch him operate. Walter Jr later followed his father into medicine, becoming an anesthesiologist. Dandy had a surgeon’s attitude toward his children’s health and well-being. When they feigned illness to avoid school, he would look them over in the morning and usually say: “It’s all in your head, go off to school.” On the other hand, having seen so many head injuries, he worried about them when they rode horses, and he arranged for elective appendectomies to avoid the risk of a ruptured appendix. He arranged for appendectomies for Mary Ellen and Kitty before they went to summer camp in 1941. A few days before the planned surgery, Mary Ellen had a terrible stomachache. Dandy called his neighbor and colleague, Alfred
NEUROSURGERY
Blalock. The two took her to the hospital and removed her appendix that evening. Blalock removed Kitty’s appendix the next day. A few years later, Walter Jr, needed to have 4 impacted wisdom teeth removed. Dandy arranged to have his son’s appendix removed at the same time. Daughter Margaret was next, so all the “kiddies” became appendix-free! Dandy enjoyed playing softball with his children on a vacant lot near their home. Sadie was afraid that her husband might hurt his hands in these efforts. He had his hands insured by Lloyds of London, but the money would hardly compensate for his love of surgery. A lifelong baseball fan, Dandy was deeply troubled by head injuries suffered during the game. In 1941, he had an opportunity to help make the sport safer. Dandy laid a large sheet of acrylic
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 505
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
FIGURE 8. Kitty, Walter, Mary Ellen and Sadie at Ocean City, 1935.
plastic on the dining room table and gave Sadie the pattern for the inserts that she, Kitty, and Mary Ellen cut out and sewed into a baseball hat, creating the prototype for the first baseball helmet. Sadie later gave the helmet to the Baseball Hall of Fame in Cooperstown, New York.
During the Second World War, Dandy served the US Navy as a “Dollar a Year Man,” receiving $1 of compensation for every year he worked. His inspections of US Navy neurosurgical units took him to many parts of the United States. Among the cities he visited was Los Angeles, where he met various celebrities,
FIGURE 9. At Capon Springs: Judge Hatfield, Walter, Margaret, and Sadie, Claire Kay Austin on fence, 1942.
506 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
COMMENTARY
FIGURE 10. Walter, Jr, Kitty, Mary Ellen, and Margaret at Johns Hopkins, 2000.
including Errol Flynn, Ronald Reagan, and Ann Sheridan. He became friends with Major Albert of Warner Brothers Studios, and Emil Seletz, a Los Angeles neurosurgeon. Dandy had operated on Dorothy Lamour’s mother and became friends with Miss Lamour, as well. Miss Lamour came to visit the Dandy family while her mother was in the hospital, and gave each child an autographed photograph of herself. She reserved a larger, more glamorous photo of herself for Dr Dandy. Traveling with colleague Winchell (“Wink”) Craig, from the Mayo Clinic, Dandy wrote, “Dr. Craig. . . knows many more surgeons than I do, . . . so I will even up by taking him to see Dorothy!”6 Dandy had operated on a number of FBI agents (“G-men,” as they were called) and had met J. Edgar Hoover during one of his visits to Florida. When Hoover invited him to bring the family to visit the FBI, they all piled into their 12-cylinder Packard with jump seats, and drove to Washington. The children were very impressed, having listened to “Gangbusters” on the radio and being familiar with the work the “G-men” did capturing criminals. The celebrity of greatest interest to the children was the gypsy queen who became Dandy’s patient at Johns Hopkins in the mid-thirties. Sadie was afraid the gypsies would try to kidnap the children, because of the 1932 kidnapping of the Lindberg baby. In an effort to keep the children safe, she had special locks installed on all the windows in their house. Apparently, the gypsies weren’t interested in the Dandy children. During the summers in the 1940s, Sadie and the children would stay at Capon Springs, a resort near Winchester, West Virginia. Dandy would join them when he could (Figure 9). He regarded those visits as the perfect way to enjoy a vacation: A
NEUROSURGERY
hearty breakfast with the family followed by 9 holes of golf and a swim; then, lunch with the family, a short nap, and another 9 holes in the afternoon. After dinner with the family, he would play bridge until “lights out” at 11. Dandy complained about the “lights out” policy to the owner, Lou Austin. Lou would explain that Capon Springs was a place to rest. Very few people said “no” to Walter Dandy, but he obeyed Lou’s rules and they became good friends.
DEATH On April 1, 1946, Dandy was working with his youngest child, Margaret, on the “Victory Garden” in their backyard, when he had to stop because of chest pain. Dandy’s doctor was called to the house. Diagnosed with a heart attack, Dandy was taken by ambulance to Johns Hopkins. He recovered, went home, and had several days with Sadie and all 4 children (Figure 10). He had a second heart attack on April 18, and died at the Johns Hopkins Hospital the following day. Dandy was eulogized by a colleague, pediatrician Edwards Park, who said, “Walter was one of the most lovable men I have ever known; he had a most impetuous, warm, affectionate, friendly nature.”7
Disclosure The author has no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
VOLUME 77 | NUMBER 4 | OCTOBER 2015 | 507
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
DANDY MARMADUKE
REFERENCES 1. Gladstone K. Introduction to Walter Dandy Letters. Congress of Neurological surgeons; 1998. 2. Dandy W. Letter to Dr. James M. Mason. Alan Mason Chesney Medical Archives at the Johns Hopkins Medical Institutions; 1938. 3. Dandy W. Letters to Parents. Congress of Neurological Surgeons; 1925. 4. Dandy W. Letter to Parents. Congress of Neurological Surgeons; 1924. 5. Dandy W. Letter to Family. Congress of Neurological Surgeons; 1936. 6. Dandy W. Letter to Family. Congress of Neurological Surgeons; 1943. 7. Park E. Medical Board Minute; Walter E. Dandy. Alan Mason Chesney Medical Archives; 1946.
Acknowledgments This article would not have been possible without help from: My siblings, Walter, Kitty, and Maggie, who shared their insights and memories; My daughter, Susan Dandy Marmaduke, for her thoughtful editing; Marjorie Kehoe, Accessioning and Reference Archivist at the Alan Mason Chesney Medical Archives at Johns Hopkins Medical Institutions, for promptly sending requested photographs and materials; Kamilah A. Dowling, CPNP, for providing finishing touches, and; James T. Goodrich, MD, who suggested this article and gave constant and valuable support.
COMMENTS
M
ary Ellen Dandy Marmaduke was born in 1927 as the second child of Dr Walter Dandy. Her personal remembrances and talks with other family members plus a review of family documents form the basis of this fascinating and insightful glimpse of a side of an iconic neurosurgeon that is seldom discussed or emphasized. The review is important because it reveals that Dr Dandy was an attentive and loving father. This is not what might be expected by most of the biographic literature on the man, which paints a picture of someone driven by hard work and who is not particularly affection or caring of people other than his patients. This memoir is most interesting, and I was glad to have the opportunity to read it. Dr Dandy seems to have had a part of him that was most admirable and deserves publicity. Russel H. Patterson Jr New York, New York
508 | VOLUME 77 | NUMBER 4 | OCTOBER 2015
M
ary Ellen Dandy Marmaduke, Dr Walter Dandy’s eldest daughter, has written an informative and charming article about her father and family. This fascinating first-hand account of the Dandy family provides a window to Dr Dandy’s personal life away from the hospital and behind his voluminous academic writings. Dr Dandy’s professional accomplishments are legendary. Both Dr Hugo Rizzoli and Dr Irving Sherman (2 of only 8 residents who completed the arduous training under Dr Dandy) independently report that by 1940 (6 years before his death at the age of 62) Dr Dandy was performing over 1000 major operations per year.3,4 It is also well-documented that Dr Dandy published over 160 articles and 5 books.2 His private life, however, as that of most great men and women of medicine, is not as well known. Ms Dandy Marmaduke’s article rounds out for us her father’s character, personality, and values. It shows that he was a family man devoted to his wife and children. His devotion to his parents, whom he moved to Baltimore the year he graduated from medical school in 1910, and the important role they played in his life are clearly evident. It also describes his playful and mischievous nature, which was mostly hidden from his colleagues who witnessed Dr Dandy’s gargantuan efforts as he single-handedly brought the nascent field of neurosurgery into maturity. It is truly fortunate for us and future medical historians that Ms Dandy Marmaduke has taken the time and effort to describe the private side of her father and allowed us to understand him better. We strongly recommend to those readers who enjoyed this article to read her more extensive and detailed account of her father’s life in her book Walter Dandy: The Personal Side of a Premier Neurosurgeon.1 Rafael J. Tamargo Henry Brem Baltimore, Maryland
1. Dandy-Marmaduke ME. Walter Dandy: The Personal Side of a Premier Neurosurgeon. Baltimore: Lippincott Williams & Wilkins; 2002. 2. Fox WL. Dandy of Johns Hopkins. Baltimore: Williams & Wilkins; 1984. 3. Rizzoli HV. Walter E. Dandy: an historical perspective. Clin Neurosurg. 1985;32: 3-22. 4. Sherman IJ, Kretzer RM, Tamargo RJ. Personal recollections of Walter E. Dandy and his brain team. J Neurosurg. 2006;105(3):487-493.
www.neurosurgery-online.com
Copyright © Congress of Neurological Surgeons. Unauthorized reproduction of this article is prohibited
