Donald
L. Paulson, MD, PhD
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A REVIEW
OF DR. PAULSON'S LIFE BY HAROLD C. URSCHEL, JR., MD A
pioneering thoracic surgeon in the management of lung
carcinoma, Dr. Donald L. Paulson died September 1, 1999.
Born in St. Paul, Minnesota, he attended the University
of Minnesota undergraduate and medical schools. He
received not only an MD but also a PhD in surgery and
went on to general and thoracic surgical training at the
Mayo Clinic, where he was a running mate of O. Theron
Claggett. After marrying Peggy Willis, the niece of a
cardiologist at the Mayo Clinic, he completed his
training and joined the army with the onset of World War
II. As chief of thoracic surgery at Brook Army Hospital,
he received extensive experience in thoracic surgery,
performing as many as 15 cases a day, 6 to 7 days a week.
After discharge he went into practice with Dr. Robert
Shaw. They developed a large referral practice from a
5-state area and eventually had 6 associates, including
Drs. John Kee, Harold C. Urschel, Jr., Richard Wood, and
Maruf A. Razzuk. Their practice was a center not only for
esophageal, cardiac, and vascular surgery but also for
thoracic surgery, particularly carcinoma of the lung. Dr.
Shaw developed procedures for superior pulmonary sulcus
tumors and bronchoplastic resections, which Dr. Paulson
popularized and for which he constantly reworked the
data, writing numerous scientific papers. After
evaluating >6000 patients with carcinoma of the lung,
methods for better patient selection for surgery, use of
preoperative radiation, and better surgical techniques
evolved from his constant assessment of outcomes.
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| The thoracic surgical residency in Dallas
was initiated by Drs. Shaw and Paulson at Baylor
University Medical Center (BUMC). Subsequently it was
moved to The University of Texas Southwestern Medical
School and involved Parkland Hospital, Veterans
Administration Hospital, Children's Medical Center, and
BUMC. Dr. Paulson became a member of the Board of
Thoracic Surgery and subsequently served as its chairman,
initiating the first scientific written examination. He
was a champion of general thoracic surgeons in the time
when they were often dominated by cardiac surgery. He
served as visiting professor in many countries of the
world. After he gave up fishing, his major avocation was
the review of outcome data for carcinoma of the lung. He
understood that disease as well as anyone who ever lived.
Dr. Paulson is survived by 2 daughters, Julie Herbst
of Tewksbury, New Jersey, and Margaret Maxson of Dallas;
3 grandchildren; and 1 great-grandchild. He was a strong
individualist, an imaginative “promoter” in
treatment of thoracic disease, and a caring physician.
OTHER REFLECTIONS
Robert I. Parks, Jr., MD
Donald Paulson, MD, PhD, was one of the pioneer
thoracic surgeons in Dallas. I worked with him for 11
years at BUMC. His reputation attracted patients from all
corners of the USA. He was known for many innovations in
thoracic surgery, but perhaps his most significant
accomplishment was the surgical resection of superior
pulmonary sulcus malignant tumors following preoperative
radiation therapy. Prior to this new treatment modality,
superior pulmonary sulcus tumors were universally fatal.
Dr. Paulson was a giant in his field. His motto was
“never compromise.” His forte was his
meticulous preoperative preparation for a surgical case
and then his unwavering dedication to achieving his plan.
His work ethic was very influential in my life, and I
feel I've benefited greatly by my association with Dr.
Paulson and his wonderful family.
Charles B. Shuey, Jr., MD
We all single out individuals who had major influences
on our lives. For me, Don Paulson was one of those
individuals. He was truly a pioneer in thoracic surgery
and, in particular, the evaluation and management of
bronchogenic carcinoma. By carefully documenting his own
experience and through thoughtful analysis of his data,
he developed an approach to management of bronchogenic
carcinoma that forms the basis of what we do today.
In the earlier days, his superior outcomes were
criticized. Critics said his outcomes were biased because
he was too selective. In a sense, he was a pioneer in
this philosophy of selection, which seeks to avoid the
application of burdensome therapies when the likelihood
of benefit is small.
Don Paulson had a gruff, sometimes intimidating
demeanor, but beneath it all was an uncompromising work
ethic and a sensitive, compassionate physician. We have
all been strengthened by knowing him, and his presence
will be missed.
Richard E. Wood, MD
Baylor was home to one of the true giants of thoracic
surgery. Dr. Don Paulson was a founding member of the
Board of Thoracic Surgery, was the chairman of that
board, and personally instituted the written board exams.
He went on to be president of every major thoracic
surgery association. While at Baylor, he produced his
definitive work on the staging of bronchogenic carcinoma.
We were fortunate to have had such a great man in our
midst.
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