My Friend and Mentor (2014)

Bradley W. Kesser University of Virginia School of Medicine, Charlottesville, Virginia U.S.A.It is said that the measure of a person’s life is its impact on other lives. What an impact Robert “Dr. J” Jahrsdoerfer had. He not only changed the lives of hundreds, maybe thousands of patients—mostly children—that he cared for himself, but he changed the lives of those he mentored and taught and those patients who were cared for by all the surgeons who learned from him. I count myself very lucky and honored to be among those surgeons who learned from Dr. J. In the 1970s, as he told it, he would pour over tomograms thinking about how he could access the middle ear in patients with congenital absence of the ear canal. One day he tried it—by following the bone separating the brain from the ear and the bone separating the jaw joint from the middle ear, he was able to enter the middle ear space and identify the ossicles. He was then able to free the ossicles from the atretic plate so that they could vibrate freely in space and build an eardrum from temporalis fascia. The newly drilled bone needed skin lining. As Dr. J explained, he took a piece of paper and rolled it into a cylinder—the shape of an ear canal—and thought about how, geometrically, he could cover the new eardrum and bony canal with skin. Thus was born the five tabs that are placed in the skin graft, in the deepest part of the new ear canal, such that the tabs align over the new eardrum—a technique still used today. Dr. J published his stunning results in 1978 and was awarded the highest honor of any clinical manuscript in our specialty—the Harris P. Mosher award from the Triological Society (1). As stated by the Triological Society, this honor was created “to perpetuate the ideals of the great teacher for whom it was named and to bestow upon a worthy recipient the responsibility of furthering the highest standards of perfection in the study, teaching and practice of Otolaryngology.” That was it about Dr. J—“furthering the highest standards of perfection in the study, teaching and practice of Otolaryngology.” He was all about “furthering” and never satisfied with his already excellent outcomes. Children could hear better—wow! But he was not satisfied—he wanted them to hear even better, to hear normally, and not have future problems with their new ear. To him, any success was in the past and just created an opportunity to do more. And, indeed, he considered it his responsibility to do more as the award noted. Dr. J was the true embodiment of the gentleman and scholar. He was always thinking—thinking about ways to better operations, to deliver better care, and to operate more safely with better and more consistent outcomes. Of course, he is most well known for pioneering surgery for children with congenital absence of the ear canal and middle ear malformations, and his grading system for selecting candidates for surgery, but many do not know he was the first to publish on the subcochlear approach used widely today to drain petrous apex cholesterol granulomas (2). He also published on trauma to the temporal bone and tumors of the ear. Born in New York, Dr. Jahrsdoerfer received his bachelor’s degree from George Washington University in 1957 and was accepted to the University of Virginia School of Medicine, where he received his medical degree in 1961 with classmates Charles Gross and Charles Cummings. He completed an Otolaryngology residency at the Yale-New Haven Hospital and returned to the University of Virginia, becoming full professor in 1979. Dr. Jahrsdoerfer held a professorship at the University of Texas Medical School at Houston, where he was made Chair of the Department of Otolaryngology in 1982. Dr. Jahrsdoerfer returned to the University of Virginia Department of Otolaryngology in 1995 to continue his passion—evaluating and helping children with congenital ear disease—until his retirement in 2009. Dr. Jahrsdoerfer was a member of numerous prestigious medical societies, including the Triological Society (Past President, 2004), American Neurotology Society (Past President, 1988–1989), American Otological Society (Past President, 1994–1995), Society of University Otolaryngologists, the American Academy of Otolaryngology–Head and Neck Surgery, and the American College of Surgeons. Throughout his career, Dr. Jahrsdoerfer was the recipient of many honors and awards. As noted above, he received the Triological Society’s Mosher Award in 1978 for his work on congenital middle ear malformations, was selected as one of “The Best Medical Specialists in the United States” by Town and Country in 1984 and 1989, and was included in the 1991, 1992, and 1993 editions of Best Doctors in America. He received the prestigious Award of Merit from the American Otological Society, its highest award. He served on the editorial boards of several journals, including Head and Neck Surgery, Laryngoscope, Anales de Otorrinolaringologia Mexicana, and American Journal of Otology; has more than 120 published articles; and wrote a book titled Head and Neck Surgery. I have learned many lessons from this gentleman scholar; practice-based learning—examining your own processes and outcomes and making changes to better those outcomes—is just one of them. I have learned how to talk to patients—how to give families confidence without the big ego. Dr. J was always very dignified and proper, but never condescending—that gave families confidence in him to place their child into his skilled hands. I learned never to feel rushed or act rushed—in the clinic or in the OR. I learned no patient question is unimportant or trivial. I learned to be patient. I learned to be a gentleman. Dr. J was the consummate Southern gentleman. His dashing good looks did not hurt, either. Whether it was holding a door, a greeting, a casual conversation, or a phone conversation, Dr. J made you feel you were important and the only thing that mattered to him at that moment. Even his telephone answering machine greeting says, “Your call is important to us.” He always, without fail, greeted colleagues with a big smile and an outstretched hand to shake. Although he seemed formal and intimidating at first pass, when you got to know him, he was fun and funny, could be relaxed and casual, especially at the craps table! And oh, he had a devilish smile that made you feel great if you could coax one out of him. Dr. J delivered a speech as President of the Triological Society in 2004 entitled, “Giants and Near Giants of Otolaryngology.” In it, he outlined the criteria (a 10-point grading system of course!) for a physician to become a Giant in our field (3). He easily met those criteria—President of the Triological Society, President of the American Otology and Neurotology Societies—and as he stated, we stand on the shoulders of giants. Today, we stand on the shoulders of a giant who, while no longer physically with us, is with us spiritually and who made lasting and far-reaching contributions to his patients and our specialty. Dr. Jahrsdoerfer was the consummate scholar and gentleman; his work and life will forever enrich the patients, residents, medical students, and faculty members with whom he was associated. He will be greatly missed, but his spirit will remain with every child he took care of, with every resident and faculty member he mentored, with his loving family; indeed, with every life he touched.