Leaders in Plastic Surgery
Skip other details (including permanent urls, DOI, citation information)
: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. Please contact [email protected] to use this work in a way not covered by the license.
For more information, read Michigan Publishing's access and usage policy.
CHAPTER ONE: Early Influences on the Development of Plastic Surgery in Ann Arbor, Michigan
Our story begins at a time when two major influences were at work in the development of plastic surgery in Ann Arbor and in Michigan. One of the influences was the experience gained by exposure to the mutilating facial and extremity injuries suffered in World War I in Europe. “A European war, fought 5000 miles from home, triggered the development of plastic surgery in Michigan. For it was World War I, with its mass casualties having a high percentage of head and neck injuries, that created the need for more dynamic management of these problems. At first these patients would be treated abroad, particularly in England, but soon this knowledge and skill would span the Atlantic Ocean and come to the Great Lakes—especially to the state of Michigan.”[1]
Early in WWI it became evident to the Allies that a center should be developed where facial and other injuries involving large areas of tissue loss could be treated. Dr. Harold Gillies, a young enthusiastic otolaryngologist in the British Army, was designated to develop such a facility. Although Gillies had little experience in trauma surgery, he attacked the multiple problems with enthusiasm, courage and imagination. Reports of Gillies brilliant work reached North America and several American and Canadian physicians (such as Dr. Ferris Smith of Grand Rapids, MI [see Photo 1]), who were sympathetic with the British cause went to England, before America became involved in the conflict, to join Gillies’ Maxillofacial unit.[2]
In 1916, Smith’s father, Samuel, who was a US senator, arranged for Ferris to join Dr. Gillies in England. Dr. Smith became a captain in the Royal Medical Corps in England and practiced plastic surgery at the Queens Hospital, London. After the war, in 1918, Dr. Smith returned to Grand Rapids, Michigan, to start his plastic surgery practice.
The second influence happened when some oral surgeons, wanting to add to their surgical expertise and credentials, attended medical school and received their MD degree in addition to their existing DDS degrees. Among these was Dr. John Kemper. This allowed him to gain a wider experience in maxillofacial surgery. Dr. Reed O. Dingman, DDS, MD, also an oral surgeon, joined Dr. Kemper’s practice in Ann Arbor. He then completed a formal plastic surgery preceptorship with Dr. Smith in Grand Rapids. Thus, he is an outstanding example of a pioneering plastic surgeon who was a product of both of these influences.
John W. Kemper, MD (1891–1952)
In 1923, Dr. Kemper, an oral surgeon from Detroit, Michigan, enrolled in the University of Michigan (UM) Medical School and received his MD in 1927. During his second year of residency training in obstetrics and gynecology, he was invited by Dr. Chalmers J. Lyons, chair of the oral surgery department, to join the faculty at the UM Dental School as an instructor. As a result, in 1929, Dr. Kemper joined the dental faculty and discontinued his obstetric and gynecological training. Upon the death of Dr. Lyons in 1935, Dr. Kemper (Photo 2) was promoted to full professor and subsequently became head of the Department of Oral Surgery and a consultant at the University Hospital. He became very proficient in the management of patients with cleft lip and palate deformities as well as those with face and jaw lesions. In 1946, he presented a talk titled, “The Responsibility of the Surgeon in Treating Palatal and Related Defects.”[3] He clearly outlined many of the basic responsibilities for surgeons in the care of cleft palate patients that were eventually taught to us by Dr. Dingman, twenty years after this presentation. It highlights the sophisticated knowledge, experience, and humanity that Dr. Kemper demonstrated in 1946.
In 1937, Dr. Kemper became a founding member of the American Board of Plastic Surgery and a member of the American Association of Plastic Surgery, which was the first plastic surgery society in the United States. He was also very influential in the American Society of Maxillofacial Surgeons and was elected as its second president in 1948. His excellent work paved the way for plastic surgery to enter into the medical school curriculum and eventually led to a Section of Plastic Surgery within the UM Department of Surgery. Dr. Kemper served as the chairman for the Department of Oral Surgery until his sudden death in 1952. “John Kemper was a large man with a great heart, a friendly smile, a person of sincerity with a fine sense of fairness. His wise counsel was sought by his associates and his students. He was a big, handsome, friendly person loved by his students, colleagues and patients.”[4]
Reed O. Dingman, MD, DDS (1906–85)
Dr. Reed O. Dingman grew up in Detroit, Michigan (Photo 3). He went to Southwestern High School and then graduated from Wayne State University. He received his AB degree from the UM in 1928 and his DDS degree from the UM Dental School in 1931. In 1932, he completed a master’s degree in oral surgery and became an assistant professor in the Department of Oral Surgery. In addition, in 1932, he enrolled in the UM Medical School, receiving his MD degree in 1936. From 1936 to 1937, Dr. Dingman completed a straight surgery internship at Barnes Hospital in St. Louis, Missouri, under Dr. Minot Fryer. After his internship, he was a resident in oral and maxillofacial surgery at the Geisinger Memorial Clinic in Danville, Pennsylvania, from 1937 to 1939. In 1940, he returned to Ann Arbor, accepted a position as assistant professor in the UM Dental School, and became an assistant to Dr. John Kemper. He also served as a preceptor in plastic surgery at the medical school.
In 1945, as he felt a need for more formal training, he enrolled as a resident in plastic surgery for one year under Dr. Ferris Smith at Blodgett Hospital in Grand Rapids, Michigan. David (Photo 4), Dr. Dingman’s son, related to me his recollection that it was during his father’s time in Grand Rapids in training with Dr. Smith that the accident occurred in which Dr. Smith was hit by a car and subsequently suffered very severe and disabling injuries. According to Dave, his father had to take over a lot of Dr. Smith’s practice in Grand Rapids even while he was still completing his training.[5] In 1946, Dr. Dingman returned to Ann Arbor, continuing as associate professor of oral surgery, and joined Dr. Kemper in a private plastic surgery practice at Saint Joseph Mercy Hospital (SJMH) in Ann Arbor (see Photo 5).
They both felt that there was a need for a formal plastic surgical training experience in Ann Arbor. In his own words, Dr. Dingman explained the origins of the original preceptorship at SJMH:
Following the end of the Second World War, many young men were seeking places in which to train and get experience in plastic and reconstructive surgery. Although there was no formal training program at the University of Michigan, Dr. Kemper and I in 1948 developed a preceptee program for a one- or two-year period to accommodate some of those who wished to come to Ann Arbor. Appointments were to SJMH in Ann Arbor, where we had private patients. Preceptees also worked in the Department of Oral Surgery at University Hospital. Dr. Joseph Ewing of Akron, Ohio, was one of the first to come to Ann Arbor on this basis. He remained for a year and was followed by Drs. Howard Billman, Clyde Litton (1948), Wilmer Hansen (1952), and Paul Natvig (1955). Although this was not an approved residency training program at the time, our trainees were given recognition as preceptees and permitted to sit for examination by the American Board of Plastic Surgery.[6]
Circumstances following Dr. Kemper’s sudden death in 1952 had a profound influence on the history of plastic surgery and its relationship with the UM Dental School. Dr. Dingman was invited to succeed Dr. Kemper as the chairman of the Department of Oral Surgery at the dental school, but he declined this offer and instead accepted a position as an assistant professor in the Department of Surgery at the Medical Center. This decision was thought to be the cause of some resentment over the years within the dental school, specifically within the oral surgery department. It seems Dr. Dingman had a vision that the best chance of ultimately forming a plastic surgery section had to come from within the Department of Surgery at the university by providing good patient care as well as education. He felt that Dr. Frederick Coller, chairman of the Department of Surgery (Photo 6), wanted plastic surgery exposure in the surgery department to enhance teaching for the general surgery residents.
