The history of pediatric surgery at the University of California, San Francisco (UCSF) is essentially the history of pediatric surgery in Northern California, which began with a single surgeon: Dr. Alfred deLorimier.
Alfred deLorimier and the nascent field of pediatric surgery
Alfred deLorimier grew up in San Francisco, attended the University of California, Berkeley for undergraduate studies, and later UCSF for medical school. He decided to become a general surgeon and stayed on to train at UCSF at a time when there was no real subspecialty of pediatric surgery established in California. Toward the end of his training in general surgery, he became interested in the surgery of children, in particular the emerging specialty of pediatric surgery which was taking shape in a few centers in the East, where a few trepid young surgeons were devoting their careers to this new field. Alfred deLorimier was determined to became one of those pioneers and signed up to spend two years learning the intricacies of children's surgery at Ohio State University's Columbus Children's Hospital. Interestingly, he went through this very demanding program with Dr. Eric Fonkalsrud from the University of California, Los Angeles. When Fonkalsrud returned to Los Angeles and deLorimier returned to San Francisco as the first fellowship-trained pediatric surgeons, they established the specialty of pediatric surgery in California.
Over the next 40 years, Alfred deLorimier devoted himself to developing the specialty of pediatric surgery at UCSF and in Northern California. He built a thriving practice devoted entirely to children, working primarily at UCSF Moffit-Long and San Francisco General Hospitals, but also covering California Pacific Medical Center and eventually Mt. Zion and Kaiser San Francisco. He founded the Division of Pediatric Surgery at UCSF and single handedly managed his prosperous practice (ably assisted by his wife, Sandy, in the office). He established the Division and managed to obtain funding for basic research in the physiology of diaphragmatic hernia in fetal lambs at a time when most surgeons did not even attempt research.
Dr. Michael Harrison begins research into fetal diagnosis & therapy
In January 1978, deLorimier recruited Dr. Michael Harrison who was just finishing his pediatric surgery fellowship at Children's Hospital Los Angeles. For the next 10 years, these two shared a growing practice, heavy on complex surgical reconstruction in children, particularly for babies with birth defects. The Division continued to thrive under deLorimier's leadership. This was a very busy time when the exciting work in a brand new field attracted talented young surgeons from all over the world to work in the Division and field research laboratory. Harrison devoted himself (and later many bright young surgical research fellows) to developing the new field of fetal diagnosis and therapy. They developed fetal animal models of fetal diseases and applied what they learned in the first fetal surgeries in the world.
In the late '80s and early '90s, UCSF Pediatric Surgery began to take off with the addition of new faculty, first Dr. N. Scott Adzick who had been a research fellow in the laboratory and completed his training at Boston Children's Hospital, then Dr. Alan Flake who had also been a research fellow in the laboratory and finished his training at Cincinnati Children's Hospital. The clinical enterprise continued to grow, and there was a burgeoning new fetal treatment enterprise which proved to be very productive from a research and clinical perspective.
Fetal treatment comes into its own
|From left to right: Dr. Craig Albanese, Dr. Diana Farmer, and Dr. Michael Harrison|
In the 1990s, the UCSF Fetal Treatment Center led the world in the development of fetal surgical interventions for a variety of defects detected before birth. The pediatric surgeons joined with talented UCSF perinatologists, sonographers, ethicists, and scientists to found and develop the complex enterprise of prenatal diagnosis and management of fetuses for complex anomalies. Many talented fellows contributed to this development. As Adzick and Flake were recruited to lead pediatric surgery programs and develop successful fetal surgery programs in the East, bright, new fellows coming through the laboratory continued to expand the Division. Harrison assumed the leadership of the Division and recruited Dr. Rusty Jennings and Dr. Craig Albanese.
Around 1995, Alfred deLorimier retired from active practice to devote his time to growing grapes and making superb wine at the deLorimier Vineyards in Sonoma County. Soon after, the Division recruited back Dr. Diana Farmer from Detroit. Farmer was another UCSF general surgery-trained resident who had worked in the Division of Pediatric Surgery and Fetal Treatment Center laboratory.
In 2000, the UCSF Division of Pediatric Surgery joined with the Division of Pediatric Surgery at Stanford under the leadership of Harrison as Surgeon-in-Chief of the combined Lucille Packard Children's Hospital. When the merger of UCSF and Stanford fell apart in 2002, the pediatric surgeons reluctantly separated but remained close personal and professional colleagues.
UCSF's Pediatric Surgery excellence spreads across the nation
After several years of very productive advances in fetal endoscopic surgery and minimally invasive surgery for newborns and children, Dr. Rusty Jennings returned to Boston Children's Hospital to start a fetal surgery program and Dr. Craig Albanese became the Chief of Pediatric Surgery at Lucille Packard Children's Hospital at Stanford, further expanding the influence of San Francisco pediatric surgery throughout the nation. More talented young faculty were recruited to UCSF: Dr. Hanmin Lee from Emory University in 2000 and Dr. Kerilyn Nobuhara from Children's Hospital Los Angeles in 2003.
Expansion of the UCSF Division of Pediatric Surgery
|From front to back, left to right: Dr. Hanmin Lee, Dr. Diana Farmer, Dr. Shinjiro Hirose, Dr. Kerilyn Nobuhara, Dr. Douglas Miniati, Dr. Tippi MacKenzie, and Dr. Michael Harrison|
When Harrison retired as Division Chief in 2003, Diana Farmer ably stepped in and continued to expand the Division in scope and personnel. In 2006 she recruited Dr. Douglas Miniati who was finishing his training at Texas Children's Hospital, and subsequently in 2007 Dr. Shinjiro Hirose, another former UCSF research fellow who returned from his training at Columbia, and Dr. Tippi MacKenzie who had just finished her fellowship training with former UCSF pediatric surgeons Adzick and Flake at The Children's Hospital of Philadelphia. Farmer also assumed the leadership of all pediatric surgical subspecialties as Surgeon-in-Chief of the new UCSF Children's Hospital.
Thus, the Division has grown remarkably from deLorimier, who founded it alone more than 40 years ago, to a thriving Division of seven active and very productive pediatric surgeons today. Along the way the Division has made amazing contributions to pediatric surgery, the management of tumors in children, the correction of congenital anomalies in newborns, and the founding of the field of fetal diagnosis and therapy. Perhaps even more amazing is the number of talented young surgeons the Division has trained clinically and in the research laboratories. More than 40 trainees and surgeons have gone on to make significant contributions in pediatric and fetal surgery throughout the world.