The SUS Honors the 2017 Lifetime Achievement Award Winner Courtney Townsend, Jr., MD
The Society of University Surgeons has awarded Courtney M. Townsend, Jr., MD, Professor and Robertson-Poth Distinguished Chair in General Surgery at the University of Texas Medical Branch in Galveston, the 2017 SUS Lifetime Achievement Award. Dr. Townsend is a Professor of Surgery, Department of Surgery; Professor of Physician’s Assistant Studies, School of Allied Health Sciences; and Graduate Faculty in the Cell Biology Program at the University of Texas Graduate School of Biomedical Sciences, UTMB. Dr. Townsend was presented with the Lifetime Achievement Award by SUS Foundation President Dr. Dai Chung on January 30, 2018 at the 13th Annual Academic Surgical Congress in Jacksonville, Florida.
The Society of University Surgeons initiated the Lifetime Achievement Award (LTAA) in 2005. This award was designed to recognize individuals who have had a sustained career in academic surgery with contributions to surgical science. In addition, these individuals have demonstrated a commitment to the Society of University Surgeons whereby they have participated in the Society even after superannuating to Senior Membership status. The Society of University Surgeons seeks to honor and recognize these individuals because of their embodiment of the principals of the Society.
Dr. Townsend was nominated and selected by his peers based on his leadership and contributions to academic surgery, as well as his strong support of the SUS. He has been described as being the consummate surgeon-scientist, mentor, teacher and colleague. His outstanding academic, clinical, research and leadership track record was cited, which included his continuous NIH funding, his mentorship of hundreds of successful academic surgeons, and prolific laboratory work through the support of the American Cancer Society. With this Award, the SUS recognizes Dr. Townsend’s pioneering endeavors in gastrointestinal endocrinology and cancer research, his track record of scientific publications and investigative research, and his leadership in the US Navy, at UTMB, and in many prestigious surgical societies and associations including most recently his term as President of the American College of Surgeons.
A Career in Academic Surgery
Dr. Townsend’s story began in a small town in north Texas. His father was a surgeon and early on he decided he was interested in medicine. At 5 years old, he had determined that he wasn’t going to be a farmer or a cowboy; eliminating the prior two choices he decided he was going to be a surgeon. His father would bring him old instruments and items like suture, and he would subsequently perform operations on his teddy bears. From such humble beginnings, a surgeon was born.
Dr. Townsend’s specific interest in Gastrointestinal Endocrinology and Cancer Research began as a sophomore medical student. At that time, students had 10 weeks off and often did externships before they started their clinical rotations. During these externships, they would learn how to put in a nasogastric tube, Foley catheters, start IVs, etc. Dr. Townsend approached Dr. Truman G. Blocker, who was the Founding Chief of Plastic Surgery and the first president of UTMB, and asked his advice regarding the best place to do his first externship. Instead, Dr. Blocker guided him to his first research position, setting the tone for his career. He had him join a bright young fellow who was running the immunology lab. Dr. Townsend spent 10 weeks doing immunology research supporting the development of a kidney transplant program. In this program, they were using a unique of method of immunosuppression, involving lymphocyte depletion through thoracic duct drainage. Subsequently, Dr. Townsend ended up doing lymphocyte activation studies in cancer, with a goal of developing specific immunosupression which would only affect the cells involved in rejection, and would not affect the cells that fight infection. At the same time, he was working on an alternate approach, the development of antilymphocyte serum and antilymphocyte globulin. Dr. Townsend spent 2 elective periods in the summer after his junior year with Dr. Thomas Starzl, who was doing a lot of early work on the purification of antilymphocyte globulin.
At the conclusion of his general surgery residency he had a planned deferment for thoracic surgery but ultimately decided not to do it as the war was winding down, and instead asked for an extension to do a surgical oncology fellowship instead. He arranged a 2-year fellowship at UCLA with Dr. Donald Morton, who was a pioneer in the field of tumor immunology and immunotherapy. After his fellowship, he served in the United States Navy for 2 years.
After his service in the US Navy concluded, he returned to Texas and began to look for academic surgery jobs. Dr. Townsend chose UTMB in Galveston in 1978 because he thought that it seemed like a nice place to start. He bought a small house and figured that he would stay for maybe 5-6 years and then move on. In Dr. Townsend’s words, 22 years later, he did move on…to a larger house in Galveston! While a faculty member at UTMB, he had a Basic Science colleague he working with but there wasn’t anyone really in surgery doing anything in immunology. Dr. James Thompson, who was the Chairman of the Department, had an active GI/physiology research lab and clinical program. Dr. Townsend began to go to Dr. Thompson’s lab meetings just to be around people who were talking about science. He began learning about GI hormones and what they did, and thought that maybe there were peptide hormones that had something to do with growth of the gut and pancreas cancers. As it often happens in the career of a surgeon, one thing led to another. He explained that the “essence of the surgeon patient relationship is something that no one else can do and nothing can interfere with it. I think there is no higher calling than being a surgeon, I would do it again in a minute knowing what I know about what is going on and knowing what the future will look like simply because the surgeon patient relationship is worthwhile.”
Dr. Townsend described how Drs. Blocker, Starzl, Morton and Thompson served as role models. He had a long relationship with Dr. Thompson; together they had a program project grant for over 25 years, studying both normal and neoplastic activities in the GI tract and pancreas and the effect of GI hormones on those processes. Through this they were able to provide multiple opportunities to medical students, residents, and post-residency fellows. Dr. Townsend paid this mentorship forward, mentoring numerous young surgeons and investigators, including Dr. Riall, the 2017-2018 SUS President. He supports the mission of the SUS is to provide grants and mentorship and develop the future leaders in surgery. Many of his faculty and residents won SUS resident research awards, and the annual meeting was one of the favorite meetings of their trainees.
Dr. Townsend explained that mentorship is different from coaching. Mentorship means taking young people and providing them the opportunity and tools with which they can develop themselves. It is not using them as research slaves, or research assistants where they provide the information and the senior author takes it like it was theirs. If they came up with the idea, Dr. Townsend would have his trainees write the protocol, the abstract after they analyzed the data, and the paper. Finally, they would present the paper as first author.
“I think that the important thing about mentorship is you provide people an example. You tell them how to go about doing things. You walk them through it, review it and re-review it. It’s a supportive role, rather than any kind of master-servant relationship because you want them to develop better than you are. It’s about giving back and the whole thing about education- the teachers are there to make their students as good as they can possibly be, give them the opportunity and help them realize that they have the ability to develop rather than somebody telling them what to do.”
Dr. Townsend has authored or coauthored over 400 articles and has received grants from the NIH and the American Cancer Society. As many know, the challenges facing academic surgeons today are that research funding has become limited and there is a lot of pressure on surgeons to generate revenue. Dr. Thompson, when he was the President of SSAT, started off his speech by saying that the medicine of today is based upon research and if we don’t do the research, then the research of tomorrow will only be that of today and we will have failed. Dr. Townsend thinks that is the key. Surgeons have always been inventive and have striven to improve the lot of their patients.
John Hunter FRS from Scotland is the father of modern surgery. In the late 18th century, one his most famous pupils was Edward Jenner, FRS, the pioneer of the smallpox vaccine. Dr. Jenner wrote Dr. Hunter a long letter on some observations on hedgehogs and an idea about their behavior and things he thought he could do to prove that. Dr. Hunter wrote him back that his argument was sound and questioned why he should think, but rather just do the experiment. Dr. Townsend explained that surgeons have always done the experiment, depending upon what was on hand and using the knowledge that arose. He cited Dr. Charles Huggins, who won the 1966 Nobel Prize after he proved the hormone control of cancer, breast, prostate and thyroid cancer. Dr. Joe Murray also won the Nobel Prize for his work in organ transplantation. Surgeons have continued to do things that improve the lot of patients and surgeons will continue to do that. The types of research have changed. Dr. Townsend stated that that surgical research is research that is done by surgeons-it can be clinical, basic science, population based research, outcomes, disparities. As a surgeon, he says, “You see a problem, investigate the cause of the problems, and try to investigate a solution in order to solve the problem, all in order to improve our ability to do what is right for the patient. Surgery will continue to do that, I have no questions about that.” As another example, he pointed out that the SUS doesn’t say that one has to be a University surgeon of molecular biology, it says that one just has to be involved in high quality scholarly activity of things that will make it better for the surgical patient.
In response to a trend in the Academic Surgical Congress where there appears to be an increase in Outcomes abstracts and a decrease in Basic Science abstracts, Dr. Townsend was asked if this was a negative trend. Dr. Townsend replied that it was not negative. He explained that anybody who goes to see a surgeon, the question always is, “What happened to Mama?” Outcomes research is absolutely appropriate and proper to do and it’s in the realm of academic surgeons to set the bar and perform such studies properly so that the conclusions can be trusted as level 1 evidence and the way to achieve the best outcomes. Basic Science is tough, he explained, the more we learn, the more we found out we need to learn. It takes longer to do that but he believes that there will always surgeons involved in Basic Science. The ones that have good ideas and write good grants will get funding. The same thing applies for outcomes research. Outcomes research is a whole science, it’s not just reviewing some charts and writing a few papers, it’s really applying science and surgeons still have to use the application of the science and the scientific method.
On Pursuing Leadership Opportunities
Dr. Townsend explained that he stayed at UTMB simply because he just never found a better job for him. He believes that people make institutions, institutions don’t make people. From his perspective, surgeons, in order to determine whether they want to pursue leadership roles within their institution or outside of their institution, need to know what it is they want to do and why do they want to do it. For example, he explained that the Chairman’s job is a different job. When you are the Chair, it’s all about everybody else.
“The role of the Chairman is to provide the environment and the resources with which everybody who works can rise to their own individual highest potential. That’s your job, to help them get there. You have already gotten to where you are going to be. There may be some Chairs who want to be Chairs because they want to be able to tell a lot of people what to do and make their own shield shine brighter. That’s not it. The Chair’s shield shines only in reflective glory of the people who they bring along and develop and if you’re successful, people will work with you and they will want to move up because they have achieved a level of excellence that others have recognized and they should. The job of a Chairman is servant to the people, rather than autocratic dictator.”
Dr. Townsend has served in many leadership roles outside of his institution, including President of the ACS, Chairman of the ABS, and President of the American Surgical Association to name just a few. His advice for those pursuing leadership positions outside of the institution would be that you have to be involved in the organization including participating in the activities of the organization and you have to get along with people. He stated that the most important thing people have to understand is “you have to do your job at home. For everyone who wants to take on one of these jobs, you have got to remember it wasn’t strangers that killed Caesar, it was home town boys. And if you don’t take care of business at home, these other things don’t count because nobody at home cares that you’re the President of XYZ, when they call you to deal with something at your local institution. So you have to do that first. You have to do it always.”
On the Society of University Surgeons and the Academic Surgical Congress
Dr. Townsend first became involved with the SUS due to Dr. Thompson, who was the Chair of Surgery and a member of the SUS. Dr. Thompson would take his residents to the SUS Annual Meeting and would also encourage the faculty to present their work at the SUS because it was the premier scientific society in the world. He believes that it still is and that it also is a great place for young people to learn how to do things correctly. He explained that the attendees are around a lot of people close to their age or not far ahead. It’s not like as a young faculty member going to American Surgical where the giants of surgery talked about what they did. It is the young people who are actively involved in investigation. The meetings are where people went to see if they were as good as they thought they were.
In terms of memories of the Academic Surgical Congress and the SUS Annual Meeting that stand out, Dr. Townsend noted that he was pleased to attend the SUS Annual Meeting in San Diego where Dr. Thompson received the Lifetime Achievement Award. At that time, attendees would go around to the different universities in the morning and they would talk about the local programs in the afternoon. He stated “That’s where you really got to know the people. There was a lot of networking and interaction, and you got to see where they did what they did. The SUS has never been a particularly social organization and I think that’s proper; you went to do business. There were a lot of young people who were involved in learning from one another, and competing with one another, it was fun.”
On Essential Pursuits
When asked if he has an interest/hobby that may surprise the surgical community, he explains why his interest may not be surprising, but is essential. When his daughter went away to college, Dr. Townsend decided to take up golf and very quickly decided that he loved it. He said that he would play every day if he could. Often times when he goes to the surgical meetings he will organize a group of friends and play one or more rounds of golf. He stated, “being in Galveston and if the weather is good and there’s no lightning or the winds aren’t blowing more than 25 mph, you can play golf almost every day. The beauty of playing golf is that the venues are so pretty and peaceful, and I think it’s the most restful form of occupation you can have because on every shot you have to concentrate. You can’t bring problems to the golf course and enjoy your day, you have to leave it all behind so I think it’s very restful.”
The Society of University Surgeons and Society of University Surgeons Foundation was honored to present Dr. Courtney Townsend, Jr. with the 2017 Lifetime Achievement Award at the Academic Surgical Congress on January 30, 2018 which took place in Jacksonville, Florida. He is the true embodiment of the type of individual that this award seeks to recognize.