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Biographical entry Sabiston, David Coston (1924 - 2009)

MD Johns Hopkins 1947; Hon FRCS 1982.

4 October 1924
Jacksonville, North Carolina, USA
26 January 2009
Chapel Hill, North Carolina, USA
General surgeon and Thoracic surgeon


David Coston Sabiston was a distinguished American surgeon. As chairman of the department of surgery at Duke University School of Medicine, North Carolina, he was, reputedly, one of the greatest surgeons who ever lived. In 1962, he grafted a vein from a patient's leg to feed blood past a blocked coronary artery, the very first coronary artery bypass grafting (CABG), and promptly became known as a moderniser of cardiac surgery. He was president of virtually all the principal surgical societies in the United States, including the American College of Surgeons, the Association for Academic Surgery, the Society of University Surgeons, the American Surgical Association, the Southern Surgical Association, the American Association for Thoracic Surgery…the list goes on. At the same time, he was kind and generous, a family man revered by his children, grandchildren and colleagues. Yet, to his surgical residents-in-training, he always remained an incredibly tough taskmaster, who would continuously strike fear in their hearts. Love, hate, productivity and camaraderie were the ingredients for his recipe for nurturing young surgical leaders in his training environment at Duke University.

Sabiston was born on 4 October 1924 to David C Sabiston senior and Frances Marie Sabiston née Jackson in Jacksonville, North Carolina, USA. He graduated from the University of North Carolina at Chapel Hill at the age of 19 and went on to medical school at Johns Hopkins, qualifying in 1947. For the next two years the US Army Medical Corps posted Sabiston to the Walter Reed Medical Center, where as a captain he performed cardiovascular research.

After military service, Sabiston returned to Hopkins for his residency under the great Alfred Blalock, who had succeeded Halsted at America's premier surgery training institution. In 1953, Sabiston became an assistant professor, Howard Hughes scholar, and, as the story goes, Blalock's choice to succeed him as chairman. The latter did not happen.

In 1961, Sabiston took a Fulbright scholarship to the Nuffield department of surgery at Oxford. On his return to the US in 1964, Sabiston became James B Duke professor and chairman of the department of surgery at Duke University School of Medicine in Durham, North Carolina. He held that position for the next 32 years, published almost 300 peer-reviewed papers, over 35 books, and many invited book chapters and editorials. One of those works Sabiston's textbook of surgery: the biological basis of modern surgical practice (Philadelphia PA, Saunders), is now in its 19th edition and is still considered the definitive treatise on surgical practice.

At Duke, Sabiston desegregated and reorganised the surgical clinics and made Duke the place to go for surgical care in the South. He produced 138 surgical chairmen or division chiefs. He cultivated a happy, emboldening surgical environment, with an emphasis on basic science research, and he actively encouraged residents and faculty to bring basic science research to the bedside. Many modern discoveries and procedures originated at Duke under Sabiston. These included ablation of atrial arrhythmias, parathyroid auto-transplantation, transgender surgery, many liver resection techniques and minimally invasive surgical procedures, HLA (human leukocyte antigen) and other immunologic discoveries. Sabiston's environment fostered the famous paper on laparoscopic cholecystectomy published in 1991 in the New England Journal of Medicine, which triggered the world's first formal training programme in minimally invasive surgery ('A prospective analysis of 1518 laparoscopic cholecystectomies: the Southern Surgeons Club' N Eng J Med 1991 Apr 18;324[16]:1073-8).

Sabiston's premier surgical training programme preserved the Halsted/Blalock/Hopkins tradition and became known, to the rest of the world, as 'The Decade with Dave'. Some of that label was myth, which the residents loved to perpetuate. Most residents spent only eight years in the programme, including two years of basic science research. Although most rotations were every-other-night call, the residents looked out for each other and were allowed three full days off every other week. The residents referred to Sabiston as 'The Man' or 'TM' for short. A 'positive TM sign' meant Sabiston's Cadillac was in his parking space and everyone had to be on their toes. TM had a passion for detail, cleanliness and formality. Anyone found in scrub clothes outside of the operating room suites flirted with expulsion. Once, the chief resident, who had invented the world's first artificial heart, was sent home to change out of his casual trousers.

Sabiston assumed numerous other leadership roles throughout his career. He served as editor-in-chief of the leading surgical journal Annals of Surgery for 27 years. He also received many awards, honorary degrees, fellowships and memberships of professional societies across the world, including of the International Society of Surgery, the Royal College of Surgeons of England, the Royal College of Surgeons of Edinburgh, the Royal College of Physicians and Surgeons of Canada, the Royal College of Surgeons in Ireland, the Royal Australasian College of Surgeons, and surgical associations in Germany, France, Japan, the Philippines, Argentina, Brazil, Spain and Colombia.

Sabiston retired from medical practice in 1994. He died from a stroke on 26 January 2009 at the age of 84. He was survived by his wife of 54 years, Agnes née Barden, their three daughters, Anne Leggett, Agnes Butler and Sarah Sabiston, and five grandchildren.

William C Meyers

Sources used to compile this entry: [Pearce, J. 'David C Sabiston Jr, Heart Surgeon, Dies at 84'. The New York Times; Duke Medical Center Archives. Biography of David Coston Sabiston, Jr; Wells, SA. 'David Coston Sabiston, Jr: Surgeon, Scientist, Teacher, and Leader'. Clinical Cardiology 2002 25[1]:43-45; Inside Duke Medicine. 'Famed surgery chair David Sabiston dies'. January 26, 2009.; Meyers, W. Under the knife - book manuscript].

The Royal College of Surgeons of England