J. Rudolph Jaeger, M.D.
by William Whiteley, M.D.
James Rudolph Jaeger was born October 29, 1895 on a farm near Clarksville, Missouri, a small village on the Mississippi River. He attended a one-room schoolhouse before high school, graduated from the University of Missouri, and received his M.D. degree from the University of Pennsylvania in 1920. After internship and chief residency at Denver General Hospital, he joined his uncle in the practice of general surgery in Denver, Colorado. He was also an Instructor in Surgery and Neurology at the University of Colorado School of Medicine.
Having taught anatomy for six years and being in charge of pathology and physiology at the University of Denver School of Dentistry, J. Rudolph Jaeger became interested in neurosurgery. In 1928, just prior to the coming Great Depression, he moved his family to Baltimore for the purpose of studying nine months with Dr. Walter Dandy, the famous neurosurgeon at Johns Hopkins, and later referred to as the Father of American Surgery. While studying under Dandy, the extent of Jaeger's neurosurgical training was observational. Because neurosurgery was mostly cavity-oriented and more instrumental than manual, he took Dandy's advice and specialized in areas that required similar expertise as the ear, nose, and throat, clinically examining such cavities while learning, utilizing and modifying various instruments.
Returning to Denver in 1943 to pioneer his newly-learned surgical knowledge, he suddenly found himself in the awkward position of being not only the first and only neurosurgeon there, but the first and only neurosurgeon in every Rocky Mountain state west of the Mississippi River. Dr. Jaeger's exceedingly busy professional life also included being the only neurosurgeon on staff of six hospitals as well as being Chief of Neurosurgery at the University of Colorado School of Medicine. In an attempt to train others, he wrote 14 of his eventual 61 scientific papers, and began producing the first neurological documentary and training motion pictures, for which he would become famous in the medical world.
Having spent much time and energy in teaching medical students, he emphasized to the profession at large the benefits of neurosurgical care even in view of the widespread pessimism about it at the time. But within a number of years, Jaeger, who had also just become President-elect of the United States Chapter of the International College of Surgeons (of which Professor Thomas A. Shallow at Jefferson was President), was approaching a point of exhaustion and seeking relief from the overwhelming burden of work in Denver and the surrounding area. As such, an invitation from Shallow and Dean Harvey Perkins to come to Jefferson, dedicate his talents to this institution and found a department of neurosurgery, was most welcome. Nevertheless, a serious problem in Jaeger's leaving Denver related to the war and the efforts by the government as well as the medical profession to continue to provide adequate health care for the local community. The other three neurosurgeons, who Jaeger had trained, had already been drafted into military service leaving Jaeger, once again, as the only surgeon covering a vast geographical region. When the War Manpower Commission heard of his proposed move to Jefferson it raised a great outcry and objection even though Jaeger had no intention of leaving until he found his own replacement, such eventually becoming the person of Dr. Olan Hyndman of Iowa City, Iowa.
Finally, having relocated to Philadelphia by 1943, the Board of Trustees at Jefferson gave official authorization on May 25, 1943 for J. Rudolph Jaeger to found the Division of Neurosurgery in the Department of Surgery, at Thomas Jefferson University Hospital (the Division later obtaining Departmental status in July of 1969). Although, up to that time, he had not trained any residents, Jaeger was enthusiastic about getting started and so selected Dr. William Whiteley among many hopefuls as his first Resident.
By 1959, Jaeger had established Rudolph Jaeger Productions and along with Whiteley had produced 21 documentary motion pictures detailing all the major neurosurgical procedures. Jaeger's motion pictures were dramatic demonstrations of surgical triumphs and very popular at scientific meetings and conventions, such as the American Medical Association conventions, where he was the first to show such films.
Jaeger, like other surgeons at Jefferson, was forced by circumstances to perform his own anesthesia. Therefore, when he arrived in Philadelphia he brought along his own equipment (much of it personally invented or modified by himself) for administering inhalation anesthesia, open-drop ether, endotracheal intubation and other procedures. Unfortunately, the dispersion of operating rooms on the second, third, fourth, sixth, eight and fourteenth floors as well as through out three different buildings (not including the outpatient department), created an anesthesiologist's logistical nightmare. It was not until 1955, after the Foerderer Pavilion was erected, that operating space was finally consolidated and an official Department of Anesthesia established.
Among the challenges associated with developing a Department of Neurosurgery (where instrumentation was inadequate and required constant designing, crafting, modifying and repairing), was the fact that a departmental workshop, specializing in pre- and postoperative equipment, needed to be set up. Also, a neurosurgical art and photography facility to support scientific papers, teaching and scientific exhibits also needed to be established. Other demands included teaching medical students, nurses and residents (virtually the profession at large), conducting neuroradiologic procedures and most importantly, developing an experimental research laboratory, which Jaeger designed, organized and established in the college building on Walnut Street, appointing David J. LaFia as the first Research Associate in charge of the new laboratory.
J. Rudolph Jaeger was not only a skillful surgical technician, but a mechanically ingenious innovator. He devised many operating techniques and invented a host of neurosurgical instruments, among which were the first surgical headlamp (which he eventually manufactured and marketed); forceps and retractors; aluminum and gold aneurysm clips and applicator forceps; disc removal curettes. He also pioneered and developed apparatus and monitoring techniques for safe surgery in an upright position; an improved technique for cordotomy with more permanent results; a catheter technique for intravenous fluid and blood administration; and last, but not least, the methodology and instrumentation for continuous spinal drainage during brain surgery, now known as "spinal tap." All of these innovations and inventions were created out of necessity and well before any commercial devices were available.
In 1957, J. Rudolph Jaeger conceived of the Philadelphia Neurosurgical Society, which he founded in 1958 with the help and cooperation of other academic chiefs of neurosurgery in Philadelphia: namely Robert Groff of the University of Pennsylvania, Axel Olsen of Hahnemann Medical College and Michael Scott (class of 1932 at Jefferson) of Temple University. This Society included neurosurgeons, not only from Philadelphia, but throughout Pennsylvania, New Jersey, Delaware, Maryland and Washington D.C. The name was changed to the Mid-Atlantic Neurosurgical Society in 1967. Although its patron saint was Charles Harrison Frazier, it owed its existence to J. Rudolph Jaeger. Two days before he died on August 16, 1968, Jaeger had performed his five hundred twenty-fifth tic doloureaux operation, one of many cures he had discovered.
Many of J. Rudolph Jaeger's 21 Residents (some of which were personally trained by himself while active as divisional chief), went on to distinguished careers. Among these were Stacy L. Rollins, Jr., (who in 1972, removed the spinal canal bullet from an Alabama Governor following an assassination attempt on his life) and Tai Joon Moon (Resident in neurosurgery from 1954 through 1957 and a fellow in the Department of Neurology at Jefferson in 1957), who pioneered nurosurgery in Korea, established the Korean Board of Neurosurgery and became the President of Confederation of Medical Associations in Asia and Oceana, and later the President of the World Medical Association.
J. Rudolph Jaeger's relatives (and all ancestry, including James Jaeger, his grandson) had settled in Missouri, USA by 1850 as farmers and physicians.
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