College of Medicine

Editor’s note: The following story was first published in the fall 2019 issue of FSU MED. Dr. Jim Cavanagh, who taught anatomy at FSU starting in 1997, died Saturday in Tallahassee. Every M.D. and PA alumni from the FSU College of Medicine had an opportunity to learn from him and to be influenced by his knowledge and kindness.

(photo:  Dr. Jim Cavanagh, first on right side, as a young surgery resident in the Dartmouth ICU).

THE ELDER STATESMAN OF THE ANATOMY LAB

By Ron Hartung

   James Ellsworth Cavanagh is as far from the stereotype of the puffed-up surgeon as you can imagine, yet surgery was his profession for more than 40 years.

   When he retired, he wanted to do more than just play tennis, photograph birds or visit his grandchildren. So on his last day at Tallahassee Memorial Hospital, he called up Florida State University. There was no medical school yet, but there was a program that provided a first year of medical education. He asked whether it could use his help.

   That was 1997. In the 22 years since, Cavanagh has been an unpaid, unpretentious, unimaginably popular teacher of anatomy at FSU. He’s a favorite of first-year students and teaching assistants. He has never asked for perks, apart from a parking space. And he has no plans to stop volunteering his services.

   “Being with younger people is what keeps me going,” Cavanagh says. “It’s inspiring to me.”

   Class of 2021 teaching assistant Joey Knipe says Cavanagh passes along his passion for medicine by being personable with each student.

   “I will never forget the time before my first anatomy lab as a TA when I was anxiously looking over my notes for the dissection that day, only to look over and see Dr. Cavanagh studying the names and faces of the first-year students,” Knipe says. “He demonstrated to me that in order to be an effective teacher and clinician, it is not only important to have sufficient knowledge, but also the motivation to personally connect with others.”

   Cavanagh’s pedigree is top-notch: B.A. from Dartmouth, M.D. from Harvard, Fellow of the American College of Surgeons, Diplomate of the American Board of Surgery. He has M.D. genes. His father, who started out as a banker in Plattsburgh, New York, eventually became an obstetrician – and was activated in the Army Air Corps in the summer of 1941.

   “They assigned him to Tallahassee’s Dale Mabry Field,” Cavanagh says. “They had drafted almost all of the local obstetricians, so the townspeople went out to the air base and said, ‘Look, we don’t really have an obstetrician around here. Can you help us?”

   Cavanagh’s dad ended up delivering about a thousand babies during World War II. And, for a time, Tallahassee became home. Cavanagh attended Leon High School during the war. He headed back to the Northeast for college, med school and residency. He got married, moved to New Hampshire and for 14 years performed surgery at Portsmouth Hospital. Then came a big change.

   “I got a divorce,” he says. “Actually, I got dumped, to tell you the truth.” What to do next? “I had learned that my favorite classmate at Leon High School was divorced. So in 1976 I came down to talk to her.” He stayed, and they were married. For the next 21 years, he practiced at Tallahassee Memorial – before making the post-retirement leap to the College of Medicine’s anatomy lab.

   Eric Laywell, the lab’s director, marvels at Cavanagh’s energy and dedication.

   “We have practical exams down in the lab, and they’re pretty intense,” says Laywell, an associate professor. “It takes all day because the students have to go through in separate groups. Dr. Cavanagh sits there the entire time, in that cold anatomy lab. He’s there more than I am. He loves to be there.

   “He also still interviews for the admissions committee – and does great interviews. He’s incredibly sharp.”

   When asked, Cavanagh politely declined to divulge his age to FSU MED.

  “I don’t know his age,” Laywell says. “There’s speculation about that every year. Somewhere between 80 and 100, that’s all I can say!”

   When Laywell calls Cavanagh “old-school,” he means it as a compliment.

   “He’s done everything,” Laywell says. “Abdominal surgery, chest surgery, head surgery. I get the impression that that’s just what it was like back in the day. They didn’t have such segregated subspecialties. It’s an interesting slice of history to have him in the class, and I think the students appreciate that. They know that it’s not like that anymore.

    “No matter what you’re doing, he has a clinical story that he can tell about that part of the body.”

   Here’s one of the stories: “One day when I was practicing in Portsmouth, I had to do an epidural hematoma in an 8-year-old girl who had fallen down some concrete stairs. We had neurosurgeons on call, but I couldn’t find them Saturday at noon. She was getting worse. So I called my medical school neurosurgeon. Got his nurse. She said, ‘He’s on vacation – but I’ll give you his number.’ So I called him up. He said, ‘OK, you’re going to have to do it. Why don’t you go get ready, put the patient to sleep, call me up and we’ll go through it together?’ The nurse held the phone. It took 30 or 40 minutes, and it was successful. If I hadn’t reached the neurosurgeon on the phone, I would’ve done the surgery by myself. I think I could’ve done it. I had two months of neurosurgery when I was an intern.”

   Then there’s the story about a woman who’d been in a car crash and damaged her liver: “Her liver had lots of lacerations. My partner and I worked on her. Every time we’d pack the wound with sponges and pull them out, she’d start bleeding like mad. I said, ‘I’m going to go sit down and think about this.’ And I looked up on the wall, and there was this corset that they have for broken ribs. And so I said, ‘OK, we’re going to pull all of the packing and all of the sponges out, sew her up real fast and put the corset on her.’ And it worked.”

   There’s also a story about how he became a surgeon in the first place: “My father was an obstetrician-gynecologist. He was out every night – so I did NOT want to be an obstetrician! I didn’t like surgery, either, because the surgeons were so arrogant. So I decided to be an academic gynecologist. I was accepted by this group in Boston. They told me that I had to take two years of surgery and then do the gynecology. While I was taking surgery, this professor – who was really humanistic, and I liked him a lot – came down and became chief of the service. I said, ‘Well, you know, this isn’t so bad after all.’ So I stuck it out and stayed in surgery.

   “I think if I had it to do over again, I’d probably become a family physician.”

Here are excerpts from the interview Dr. Cavanagh gave to FSU MED for the story that was published in 2019:

Interviewed by Ron Hartung on Feb. 6, 2019

[One of his relatives helped establish the med school at Cornell.]

I was born in Plattsburg, New York. My father was a banker, and his uncle left him enough money to go to medical school when I was about 3…. He trained for two years at Dartmouth, and interned back at Dartmouth, and then went to Columbia to learn OB-GYN. He was in the Army Air Corps and got activated in the summer of 1941. That brought us to Tallahassee when I was in the seventh grade…. [His dad] was drafted and they assigned him to Dale Mabry. They drafted almost all of the local obstetricians, so the townspeople went out to the air base and said, “Look, we don’t really have an obstetrician around here. Can you help us?” So he delivered a thousand babies during the war…. We stayed right here.

I went to Leon High School during World War II. [Eagle Scout: 1947 – he was 17.]

[Bachelor’s, Dartmouth: 1951]

[M.D., Harvard: 1954 (Dartmouth had two-year medical school. Sort of like PIMS. He had to go to Harvard to complete his M.D.)]

[Residency training in both Dartmouth and Boston (about 5 1/2 years)] I was at Boston City for three years. I got drafted into the Navy and did surgery at Charleston (S.C.) Naval Hospital. But when I got through, the group that I was in moved to Portland. I still don’t know what happened! … I went up to Dartmouth and finished. I later got married and moved to Portsmouth, New Hampshire.

Portsmouth Hospital, N.H.: 1962-76

I got a divorce. Actually, I got dumped, to tell you the truth. I had learned that my favorite classmate at Leon High School was divorced. So I came down to talk to her. Which was difficult, because I had to leave the kids behind, and I was at the peak of my practice, perhaps.

[His great-great-great-uncle trained in NYC before the Civil War. He has a display about him hanging in his office.]

They did much more surgery back then than I thought. They finally got anesthesia about 1846…. They were doing surgery without any anesthesia all those years…. It wasn’t accepted widely until just before the Civil War.

[He started volunteering at FSU in 1997. With PIMS.]

I retired from surgery, and I called over here [to FSU] and asked if they needed any help in the anatomy lab. I got hold of Dr. Wainwright, who was professor of anatomy. He said, “Yes, today’s a good day. Come on over.” We were up in the gymnasium at that time. [He showed Cavanagh all around.] Then he said, “Thank you for doing this. If you need any help, you can call me up.” That’s the last time I ever saw him. [Wainwright apparently was doing research and had one foot out the door to UCLA.]

I had a mentor when I was a chief surgical resident, named Dr. William Mosenthal. This was up at Dartmouth. I followed him through the years. When he retired, he started teaching anatomy. So when I was about to retire, I called him up and said, “What am I going to do?” He said, “Why don’t you teach the clinical relevance of anatomy? I just wrote a textbook. I’m going to send it to you.”

[Who taught you anatomy?]

I did.

Back then, a general surgeon did everything. Therefore, I knew all the parts. So it was easy.

Also, Mosenthal gave me this great book…. It’s “The Clinical Relevance of Anatomy.” I know the other anatomy, too, but I try to teach the students the clinical relevance of anatomy…. The textbook has clinical questions about anatomy…. The first chapter is on the back. He says, “Don’t worry about most of the muscles in the back. Just think of the erector spinae [the muscles that straighten and rotate the back] in the middle. The others are not clinically relevant.”

[When did you know you wanted to become a physician?]

My father was a physician. I never decided to do anything else, basically…. I couldn’t figure out anything else to do…. He was an obstetrician-gynecologist. The thing that terrified me was that he was out every night! So I did NOT want to be an obstetrician! I didn’t like surgery, either, because the surgeons were so arrogant…. So I decided to be an academic gynecologist. I really concentrated on that in medical school. I was accepted by this group in Boston. They told me that I had to take two years of surgery and then do the gynecology after that. While I was taking surgery, this professor  – who was really humanistic, and I liked him a lot – came down and became chief of the service. I said, “Well, you know, this isn’t so bad after all.” So I stuck it out and stayed in surgery.

[You seem to have the demeanor of a family physician rather than a surgeon.]

I think if I had it to do over again I’d probably become a family physician.

Surgery has changed so much.

… I had two months of neurosurgery when I was an intern. And also I had an atlas that showed you how to take care of an epidural….

[What was medical school like for you?]

We were spoon-fed and I loved it! The first two years, Dartmouth almost lost its accreditation. They had these ancient professors and they were teaching us 1920 medicine. It was pretty bad. But we taught ourselves. When we got down to Harvard, I would say that all of us were either in the middle third or the upper third of the class. We had great professors … and I took copious notes … and pretty much memorized them. [He got everything from the lectures.] I didn’t really even read any textbooks….

The first operation I did was a hemorrhoidectomy! [At Boston City Hospital] we had great professors.

[He felt faint a few times but managed not to show it. Otherwise, he’s pretty sure he would’ve been kicked out.]

[Teaching has always been part of the job.] In Tallahassee we were teaching residents…. When I was a resident, I was always teaching students. In Portsmouth, not so much. On the other hand, I went to Boston, to Mass General or Peter Bent Brigham about every Thursday for surgical rounds…. In those days I had to do chest surgeries and vascular surgeries and most everything that was going on. Also, we had a shortage of orthopedic people. I often had to do orthopedics. The urologists were usually either drunk or away on vacation, so I had to do some urology! And I had trained well in medical school and also in residency to do gynecology. I did all the gynecological procedures…. My favorite [surgery] was gallbladder – before they introduced laparoscopy…. I did it, but I didn’t like it….

[One of the most challenging – a woman who had been in a car crash and damaged her liver.] Her liver had lots of lacerations. She was short and compact. My partner and I worked on her. Every time we’d pack the wound with sponges and pull them out, she’d start bleeding like mad. I said, “I’m going to go sit down and think about this.” And I looked up on the wall, and there was this corset that they have for broken ribs. And so I said, “OK, we’re going to pull all of the packing and all of the sponges out, sew her up real fast and put the corset on her.” And it worked. 

[Talk about FSU students.]

We have bright students here. I do some interviews [as a member of the Admissions Committee]…. These kids know what they’re doing. I also am teaching the PA students as well now. Right off the bat, first day, they operate on the back. Since the patient is prone, I make everybody do a lumbar puncture…. Then I tell them about spinal anesthesia and epidural anesthesia and so forth…. I also teach them how to intubate [using the manikin]….

I try to learn all their names. I remember when I was in, particularly college, if some professor called me by name, I really felt that was nice. So I do that.

[Why are you still teaching? What do you get out of it?]

Being with younger people. That’s what keeps me going. I enjoy talking to them and making friends with them. It’s inspiring to me.

[When you’re not here…]

I play tennis. I’m a bird watcher and bird photographer. Some of my bird photos have been reproduced in journals. Seeing children and stepchildren and grandchildren and so forth. I also like to work in the yard. I have a big yard and I have a pond. It’s a beaver pond. [Off Old Bainbridge, before you get to Fred George.] The beavers moved in about three years ago and flooded the whole damn place.

[Words of wisdom?]

I try to teach them professionalism. [Which they don’t always appreciate.]