Health Sciences Report Winter 2003

Coleman Laid the Groundwork with Integrity, Compassion
By Susan Sample

Portrait by Sean Graff

Concrete is being poured and girders put in place for the University of Utah's new Orthopedic Center. Yet many of the principles that form the foundation of the Department of Orthopedics have been articulated over the years by one man: Sherman S. Coleman, M.D.

Whether talking with faculty members about what constitutes conservative treatment for congenital hip dysplasia or the need for orthopedic subspecialists, one hears not only the ideas but the exact words of Coleman, who founded the U's Division of Orthopedic Surgery in 1957.

"There is a common thread of thought. It reflects a department that has had time to mature and formulate its philosophy, which Sherm definitely shaped and passed on. He's a quotable fellow," said Harold K. Dunn, M.D., professor and chair of the Department of Orthopedics. Recruited by Coleman in 1969 as the second orthopedic faculty member at the U, Dunn took over as chief in 1981, when Coleman decided to step down.

"We were extremely close. We shared an office at one time; we operated in rooms side by side. It's hard to divorce what my ideas are from his. He was such an exceptional teacher and an extremely good surgeon," said Dunn of his friend and colleague of nearly 35 years.

"Respect comes not just from the University medical community. Every honor that can be bestowed on an American surgeon by his peers has been received by Sherman S. Coleman" is inscribed in a special volume of the prominent journal Clinical Orthopaedics and Related Research, published in 1989 as a tribute to Coleman. But his most recent award is among those that the physician considers his most significant.

Last September, he was presented the first Sherman S. Coleman, M.D., Humanitarian Award by the Utah State Orthopaedic Society. The honor will be given annually to an orthopedist who exemplifies Coleman's excellence in teaching, research, and patient care, and especially his "strong sense of values and commitment to moral values."

"It kind of blew me over," said the 80-year-old orthopedic surgeon when he learned of the award. Although he hasn't practiced medicine for five years, he continues as a senior consultant at both University of Utah Hospital and Shriners Intermountain Hospital for Children. Metastatic bone cancer, which began as prostate cancer about eight years ago, has slowed his movement, but not his passion for orthopedics.

"To know that I've left principles and ethical concepts--compassion, willingness to go out of your way for patients--that's a greater reward than any fiscal one," said Coleman.

"I was strongly academically oriented. Not many physicians are. That's a strong statement, but I believe it," he continued. "What makes an academician? Curiosity, scientific interest, and investigative enthusiasm; a willingness to develop a hypothesis and work it out; and a strong desire to teach."

"I was fussy about whom we hired in the department, based upon their philosophy and enthusiasm. The first question I asked was: what's your understanding of academia? I turned down a lot of young men, especially if they asked "What is the salary?" not "What are the opportunities for investigation and education?""

A native of Provo, Utah, Coleman completed his undergraduate degree at Brigham Young University in 1946. He wanted to venture out of state for medical school and was accepted at Northwestern University in Illinois. After receiving his medical degree in 1948, he completed an internship at Los Angeles City Hospital, then returned to Chicago, hoping to enter a residency program in orthopedics.

"I was put on the back burner. Everyone wanted to go into orthopedics after World War II. There'd been so many injuries to the extremities," he said. Preference was given to veterans who'd served as physicians in the field. Coleman had been a Navy corpsman: "You know what he does: scrubs floors, rubs backs, and empties bedpans."

But his alternate choice, earning a master's degree in surgical anatomy from Northwestern proved fortuitous. He joined Northwestern's teaching faculty. When he was called back into service during the Korean War, he was assigned to teach at the Great Lakes Naval Hospital, where he also had trained in orthopedics and fractures.

Coleman entered Northwestern's orthopedic residency program in 1953. At that time, Primary Children's Medical Center was affiliated with the Chicago program, so Coleman spent a year in Salt Lake City. Two years later, he was offered the position as the first full-time chief of orthopedic surgery at the U of U medical school, which included serving as chief of staff at Shriners Hospital and as chief of orthopedics at Salt Lake City's Veterans Affairs Medical Center.

"How humble it was in its beginning," said Coleman of orthopedics at the U. It's interesting as an American success story.

As a medical specialty, orthopedics began in the late 1800s. "They called them 'strap-and-buckle' doctors, because they put on devices to brace, support, and straighten deformities," said Coleman. At the U, efforts began around 1945 to establish an orthopedic surgery residency program. However, "it was very eclectic and highly erratic. Residents came here for six months to one year. They needed someone to develop the academic program."

That was the charge to then 34-year-old Coleman. It was a slow process with little funding available to him to recruit faculty, but he persevered. "The residency program was really my favorite. You were closest to the students and medical education. Without it, I wouldn't have been in the academic world."

"The U's five-year orthopedics residency has become one of the most sought-after programs in the United States," according to A. Lorris Betz, M.D., Ph.D., U senior vice president for health sciences and U interim president. Or, as Coleman once was told by a resident, "Utah is considered Camelot."

The high standards he set for residents were really a reflection of those set for his own research and patient care. Coleman was interested in the identification of pathological skeletal system tissues in both laboratory and clinical investigations. He is a recognized expert on treating tumors and skeletal deformities. His textbooks on treating congenital hip problems and foot deformities in children are considered classics. Although he had a large adult practice, Coleman estimates that two-thirds of the 20,000-some surgical procedures he performed during his 55-year career were on children "my specialty."

His interest in children's congenital hip disease was a stroke of luck that Coleman attributes to the imaginative assignment he received as a resident from Alfred M. Okleberry, M.D., an early Salt Lake City orthopedic surgeon: screening infants for congenital hip dysplasia.

Okleberry was years ahead of his time. He said, "Every child deserves the dignity of a thorough examination."

"Every evening, I'd unwrap newborns in the hospital nursery and examine their hips and feet," recalled Coleman. Unstable hips are a precursor to dislocated hips. Since the pelvis doubles in size during a child's first year, it's important to treat hip problems during that time. "I examined 3,500 of them. I learned a method to determine newborn congenital dysplasia. From this study, I wrote a paper, which was recognized with publication."

In 1960, Coleman began examining infants on the Navajo reservation, where the incidence of congenital hip dysplasia was determined to be about five times that of Caucasians. The notion of newborn screening then was open to debate; now it is well established.

Respect for his patients, as well as kindness and compassion, was a hallmark of Coleman's medical practice. He often made house calls. Until October 2002, he traveled every month to Juarez, Mexico, where he established a Shriners clinic to identify children needing treatment at the Salt Lake City facility. "I was very enthusiastic about going there for 22 years and seeing those youngsters. So many kids in Mexico need orthopedic care."

When Coleman stepped down as head of orthopedics at the medical school, he devoted more time to pediatric orthopedics. He received other academic offers, but declined. "Losing Shriners," he said, "would be like losing a leg."

"I was dedicated; sometimes to the point where it was strenuous on my family," acknowledged the surgeon, who wrote two textbooks and numerous articles while serving as president of three professional societies. Yet he passed on his passion for medicine to his children. His oldest son, Michael Coleman, M.D., is a cardiothoracic surgeon and his daughter-in-law, Anne Coleman, M.D., a pathologist, both practicing in Ogden, Utah. His son Don "Skip" Coleman, M.D., is associate professor of orthopedics at the U School of Medicine, subspecializing in hand and microsurgery; his wife is Marjorie. His daughter, Jenny, is married to John A. Hawkins, M.D., professor and chief of cardiothoracic surgery in the U Department of Pediatrics.

Coleman met his wife, Jane, 57 years ago at St. Luke's Hospital in Chicago, where she was a senior nursing student. She's refreshed her patient-care skills lately as she helps care for her husband, who has had to curtail some favorite activities, including golf, due to pain from cancer.

"I'm not complaining," he quickly noted. I've seen patients who are in far worse straits than I am. I feel in a lot of ways very fortunate and lucky. I wouldn't change any of the decisions I've made: staying here, continuing to develop a program that was respected, attractive. It's been very satisfying."

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