HISTORY Geisinger’s Remarkable First Surgeon, Dr Harold Foss Mark R Katlic, MD, FACS I would either resolve to make of myself the very best doctor I possibly could or I would give up the study of medicine. —Harold L Foss, MD, 1934 1 On September 1, 1915, when Dr Harold Foss began work as Surgeon-in-Chief and Superintendent of the new George F Geisinger Memorial Hospital in Danville, Penn- sylvania, he was not only its first surgeon, but also its only surgeon.That day, the 32-year-old Foss was the only doctor at Abigail Geisinger’s nascent 70-bed hospital. The biogra- phy of this trainee and lifelong friend of the Mayo brothers could be that of several men: President of The American College of Surgeons, founding member of the American Board of Surgery, gifted surgeon and educator, musician, aviator, yachtsman, equestrian, author, cook, husband, and father. Abigail’s handpicked but unproven leader proved a prescient choice. Early years, education Born in Malden, Massachusetts on Valentine’s Day, 1883, Harold Leighton Foss was the son of Eliphalet Foss, an artist, and his Shakespearean reader wife, Louise. He seemed destined for surgery, recalling with fondness later in life the hours spent examining pond water with an old microscope at age 14, and in eighth grade dissecting a dead rat supplied by the school janitor (“by that time nothing could have dissuaded me from a medical and, specifically, from a surgical career”). 1 On Saturdays in high school he would ride his bicycle 7 miles to the Massachusetts General Hospital to mix with Harvard medical students observing the operations of Cabot, Mixter, Beech, and Warren. 2 Foss studied biology at the Massachusetts Institute of Technology and graduated from Jefferson Medical College in 1909. 3 He completed an 18-month internship and residency at the Philadelphia General Hospital, where one of his surgical chiefs—later instrumental in recommending Foss to Mrs Gei- singer’s advisors—was Dr Morris Booth Miller. Years of reading and lectures had taken a toll. “There were countless times both in the premedical course and in medical school when I longed to be free of it all and run away to sea . . . where there could be complete freedom from the incessant grind of study, from the deadly boredom of lecture halls....” 3 When an unusual opportunity arose to become the only physician at North America’s northern- most hospital, Foss booked passage on one of the semian- nual ships; he packed warm clothes and one book, DaCosta’s Surgery. Alaska The final stage of the journey to Candle, Alaska—200 miles and 11 days by dogsled—was completed in the au- tumn of 1910. Foss was welcomed outside the wood-and- sod Fairhaven Hospital by a group of “sourdoughs” and he immediately began caring for these rugged miners and prospectors, Eskimos, and an occasional frostbitten Rus- sian. During the course of his 2 years in Alaska, he treated broken bones, gunshot wounds, medical conditions, and a great deal of tuberculosis (affecting 11% to 15% of the Eskimo population, in his estimate). 4 Foss took to the hardscrabble outdoor life, often jogging behind a dogsled in -20°F weather, eating reindeer, and sleeping under the stars (Fig. 1). He developed fondness and respect for the honest and amiable native Esquimaux, and 50 years later would show visitors to his office the well-crafted parka made for him by an Eskimo patient. 3,4 One could reasonably speculate that Foss’ self-reliant experience in Alaska not only provided him the confidence later to lead Mrs Geisinger’s rural hospital, but also ex- pressly qualified him to do so. A serendipitous postcard Having written a dozen postcards early in the winter of 1911, Foss was about to discard a single remaining post- card, but recalled his former teacher, Dr Morris Booth Miller; Foss sent him the card. When he left Alaska to return to Philadelphia the next year, he was given a message urging him to get in touch with Dr Miller immediately. Miller told him that “an unusual hospital” was being planned and that he considered recommending Foss as its director. 5 Foss—carrying out graduate work in pa- thology and experimental surgery at the University of Pennsylvania 5 —had already planned additional surgical study with Drs William and Charles Mayo; but he agreed to meet with Dr John Baldy (a prominent Philadelphia Disclosure Information: Nothing to disclose. Received July 30, 2007; Revised September 19, 2007; Accepted September 21, 2007. From the Department of Thoracic Surgery, Geisinger Wyoming Valley Med- ical Center, Wilkes-Barre, PA. Correspondence address: Mark R Katlic, MD, FACS, Department of Tho- racic Surgery, 1000 East Mountain Dr, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711. email: mrkatlic@geisinger.edu 443 © 2008 by the American College of Surgeons ISSN 1072-7515/08/$34.00 Published by Elsevier Inc. doi:10.1016/j.jamcollsurg.2007.09.023