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The History of The Lilliputian Surgical Society

The initial history of the Lilliputian Surgical Society was presented at the annual dinner of the Society at the Thirtieth Anniversary of Its Founding by George Holcomb, Jr.

George’s Presentation has such charm and so captures the atmosphere of the Society that it was felt that it should stand as the basic historical document. Its presentation and preservation serve to orient the new members to the goals and ideals of the Society. Addenda in 2007, 2011, and 2015 by Howard Filston attempted to maintain some of the gracious style of the original while somewhat expanding and updating the history.

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George Holcomb, Jr.—

Presented at the banquet on the occasion of the 30th Anniversary of the Society (1989)

I am substituting for Hugh Lynn who rightfully should be presenting this historical review of the Lilliputian Society.  Unfortunately, he could not be here because Lee was having hip problems, and he did not wish to leave her alone.  As it turned out, although we greatly miss their presence, some things need to be said about Hugh that you may not know, and he certainly would not tell. 

When I first arrived at Boston Children’s Hospital forty years ago this month, Hugh was there in the rotation ahead of me.  I greatly appreciated his big brother attitude as he explained the dos and don’ts of the hospital routine.  At first I assumed he was sympathetic because I was from the south and was having difficulty with the native language.  In addition I was still on cloud nine as my girlfriend and I decided to get married on the way to Boston.   Later, however, I discovered he took all the younger residents under his wing and assisted them in every way he could.  

Thirty years ago this same caring attitude undoubtedly prompted Hugh, when he was Chief of Pediatric Surgery at Louisville Children’s Hospital, to invite the pediatric surgeons in the surrounding cities to attend a program he organized in conjunction with a chapter meeting of the American College of Surgeons.  In those days, we did not have a journal devoted to our specialty, and no formal programs or a section within the College of Surgeons.  Our only forum was the American Academy of Pediatrics where we had participated in the Surgical Section Meetings for several years.  In our individual practices we had encountered very sick children with unusual congenital anomalies for which we often had no solution.  Gross’s text book did not supply all the answers to these unusual problems, and our past training did not provide solutions either.  Naturally, we were eager to come to Louisville, and to learn all we could and share our experiences.

Those attending were Bob Allen from Memphis; Earle Wrenn was invited but stayed home to cover the service; Lester Martin came from Cincinnati; Gene Lewis from St. Louis; Ide Smith from Kansas City; Dick Segnitz from Lexington; and I came from Nashville.  Fred Arcari was Hugh’s chief resident, and we enjoyed the morning program presented by them at the Children’s Hospital. 

Following lunch, we discussed some of our interesting cases informally as a “bull session.”  Our interests immediately centered on our problems rather than our successes because that was what bothered each of us the most.  When we looked around the room we saw there were no reporters present, no referring pediatricians, no plaintiff’s lawyers and realized our discussions would not be recorded, so we each confessed our sins, admitted our failures, and concluded we needed each other to help solve these difficult problems. 

That evening we enjoyed dinner at Hugh and Lee Lynn’s home.  As we discussed the day’s activities, we agreed that it would be a great idea to organize future meetings with each of us serving as host at our own institution and using a similar format.  As we talked about a name it was jokingly suggested  “…why not Lilliputians?”  So we temporarily accepted that suggestion.  You ladies will be pleased to know that wise old Hugh, insisted from the beginning, that to be successful our group would need to organize activities which would appeal to our wives as much as to ourselves.  Gene Lewis invited us to come to St. Louis for the second meeting in 1961.  This was to be held in conjunction with the Central Surgical Association, and Lester Martin arranged for us to join the same group in Cincinnati in 1962.  These gatherings were so successful, we decided to continue the annual meetings, but establish independence from any national affiliations.  Memphis was the destination for the fourth meeting (1963), and there, bylaws were adopted and other members were elected.  It was agreed that the purpose of the society was to:

  1. Further our knowledge of pediatric surgery.

  2. Enable us to discuss and solve personal problems related to the practice of pediatric surgery.

  3. Assist in the placement or procurement of residents and interns interested in the field, and in every way possible use our facilities to contribute to the advancement of children’s surgery.

In 1964 we followed Hugh Lynn to Rochester, Minnesota, where we were excited about the society receiving a gavel made from the staircase in Dr. Will Mayo’s home.  Our membership was increased and Lilliputian Surgical Society became our official name.  The next year, we traveled to Kansas City, then Nashville and Lexington in successive years. 

The Lilliputian Meetings have proved to be unique and very special because Hugh Lynn’s idea of sharing experiences met the need that each of us felt in the early days of pediatric surgery.  At that time, most of us did not have local pediatric surgical colleagues to discuss or understand our problems.  The informal afternoon meeting became the Albatross Session which continues to be very popular, most informative, and private. 

The third reason for success was the discovery that a smaller meeting was more manageable, more personal, and certainly more pleasurable.  Within this group, very strong bonds of friendship were formed which have been maintained.  Throughout the years, the loyalty felt to this society by the ladies as well as the men has been self evident.  And fourthly, because we remain small, we could witness the host’s entire program, his physical plant, the support services, and talk with his residents and attending staff, thus expanding our knowledge every time. 

The Lilliputian Meetings have been held in all sections of the country, and we have been privileged to see the uniqueness of cities throughout America.  We enjoyed walking through the restoration of downtown Boston and Philadelphia.  We learned Pittsburgh was a good place to live before a national survey told us so.  We dined with the dinosaurs in the Cleveland Museum (of Natural History) and observed Tom Boles fine program in Columbus.  We saw the changing face of Detroit and the steel capitol of the south in Birmingham, Alabama.  

We watched the making of surgical instruments in Durham, cruised the bayous of Louisiana, and dined on the Mississippi River.  We Toured Minneapolis with Bernie and Carol (Spencer), mid-west stock exchange in Kansas City, and enjoyed that famous Texas hospitality in Fort Worth and Dallas.  Moving west, we gathered in Phoenix with a future president of the American Medical Association (Dan Cloud).  Later we thrilled to a performance of the Mormon Tabernacle Choir (in Salt Lake City.)  We’ve picnicked on an Oklahoma oil rig and in the deLorimier’s private vineyard.  We floated the Colorado River and climbed the Mayan Ruins at Chichen Itza following a joint meeting with the Mexican Society of Pediatric Surgeons in Mexico City. 

It has been a short but memorable thirty years.  The scientific programs have always been stimulating and always increased our knowledge.  Each city has had its unique attractions which provided us with pleasurable memories.  Each year the programs seem to get better and better.  Rick and Peggy (Fonkalsrud), we thank you both for all your efforts to give us another stimulating program and such an exciting visit to Southern California.  This is one we shall always remember. 

Hugh, you and Lee birthed us and have guided us through these thirty years with your vision, your wisdom, and your concern.  We salute you in absentia.

Addendum
October, 2007—

Howard C. Filston
Revised: December, 2011; September, 2015; September 2016, September, 2017

There is no way to improve upon the heartfelt history that George Holcomb, Jr.presented at the meeting in 1989.  It gives a real taste of what it was like to be practicing pediatric surgery during the infancy of the specialty.  Most of the pediatric surgeons were alone in their areas of practice, there were no journals, no comprehensive textbook  (Gross’s 1952 text was important but limited and becoming outdated), no APSA, no defined activities for pediatric surgery at the American College of Surgeons and for better or worse, no established specialty of neonatology.  Lilliputians was then and continues to be now a meeting where colleagues from across the country can come together and share their difficult cases with the hope that the extensive experience represented by the members of this group can provide them with helpful suggestions.  This was often true for me when I was in practice alone at Duke for many years.

Hugh Lynn recalls that the name “Lilliputians” was originally suggested by Ide Smith at the first meeting; as noted by George Holcomb, Lilliputian Surgical Society was formally adopted at the 1964 meeting in Rochester, Minnesota.  The Lilliputians, of course, were the little people of Gulliver’s first adventure in Jonathan Swift’s political satire Gulliver’s Travels.  Appropriately, Gulliver was a “ship’s surgeon.”

For Lilliputians the Albatross refers to lingering, complex, difficult cases for which solutions are not readily apparent.

For Lilliputians the Albatross refers to lingering, complex, difficult cases for which solutions are not readily apparent.

The use of the term “Albatross” for the sessions at which difficult problems are presented comes from Samuel Taylor Coleridge’s poem The Rhyme of the Ancient Mariner.  The mariner shoots an albatross following which the ship appears to be under a curse.  The shipmates force the mariner to wear the dead albatross around his neck.  The metaphor indicates a burden to be carried, sometimes indicating that it is a problem of ones own making.  For Lilliputians it refers to lingering, complex, difficult cases for which solutions are not readily apparent.

This little society has continued to flourish in the 29 years since George Holcomb presented his initial history.  Guests have always been welcome; initially they were the source of new members and continue to be so.  The active membership was initially fixed at 25 by by-law.  In 2012 this was modified to gradually increase the active membership to 30.  Criteria for membership perhaps reflect the southern roots of many of the initial members:  in addition to being well-respected pediatric surgeons, a certain graciousness and humility have characterized invitees, traits important in an organization that focuses on seeking solutions to problems the member (or guest) presents as personal dilemmas or even misjudgments.  Evidence of interest in membership has been judged by repeated acceptance of invitations as a guest.  

Although there has never been a “political agenda” to the society, its members have proven to be among the leaders of pediatric surgery in America. Two have received the Ladd Medal from the American Academy of Pediatrics.  Sixteen presidents of the American Pediatric Surgical Association and fifteen chairs of the Surgical Section of  the American Academy of Pediatrics have been members of the LSS.   And one early member was president of the American Medical Association.

The LSS continues to attract guests and members who are not only successful and innovative pediatric surgeons, but also enjoyable people of highest character.  A particularly joyous addition was that of George W. “Whit” Holcomb, III, George’s son.

During the early years, the meeting generally began on Friday evening with the members having dinner at the home of the annual host.  The guests joined in for the Saturday meeting and banquet.  In the early seventies provision was made for the guests to have a dinner together at a separate venue.  However, as the membership expanded with older members reaching inactive or senior status, the numbers became too large to accommodate at the host’s home, so Friday night became a gathering for all.  With the advent of the APSA meeting in the spring, Lilliputians was changed to a September meeting in the seventies.

The fellowship aspect has been expanded with an entire day devoted to the highlights of the city or region of the meeting.  We have enjoyed some great places and seen some venues that we would never have seen as individuals on our own.  We learned to appreciate that such places as Omaha, Nebraska, and Roanoke, Virginia, have a charm and attractions equal to Washington, D.C.   We found that repeat trips to such places as Cincinnati, Kansas City, Memphis, Oklahoma City, and Minneapolis could be just as interesting when seen through the eyes of a different member. 

The scientific format has changed little since the early days; the Albatross Session is still its highlight and often the opportunity is present to see the latest innovations at the host institution.  This was especially helpful in the early years as neonatal units evolved and we were able to benefit from seeing how neonates were being cared for around the country.  Adhering to Hugh Lynn’s repeated admonition that “there must be good science” has kept the society attractive to the best and brightest in our field. 

Although the society never intended to exclude women pediatric surgeons from membership, it is only recently that we have welcomed Mary Fallat, appropriately from Louisville, our birthplace, as our first female member and more recently Diana Farmer.  Thus, although George Holcomb’s initial history accurately portrayed the spouses as the “ladies”,  that has changed for the better.

A Constitution and By-Laws were originally formulated in 1964.  These were extensively revised in 2005 and amended in 2007, 2012, 2015, and 2018.  The organization of the Society was initially simple, there being only one officer, the annual host. However, issues related to maintaining bank accounts and potential issues with the Internal Revenue Service made formal establishment of the Society as a non-profit 501-c-3 entity under the U.S. Tax Code desirable.  In 2015, Mary Fallat initiated the application with professional consultation from her personal CPA, and the IRS acceptance letter was received in time for the required modifications of the Constitution and By-Laws to be ratified by unanimous vote of the active members at  the Annual Business Meeting in Nashville, Tennessee, on 26 September 2015.  One of the requirements was to have an additional officer so that the Annual Host now serves as Treasurer during the year of his/her tenure and becomes president for the subsequent year.  This provides opportunity for an internal audit.

There are now 20 living retired senior members of the society, and it is a tribute to how much the LSS means to these members and their spouses that at least 75% of them continue to come regularly if not annually.  Time has taken its toll, however, and several valued members and beloved spouses have died.  Their names appear in the In Memoriam Section.  Fortunately, we were blessed with the presence of Hugh and Lee Lynn, into their tenth decade.  The guidelines they and the other early members established have proven to be ones that have assured the success and longevity of the Lilliputian Surgical Society for over fifty years.

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Members—

Active Members

Steve Almond

Glen Anderson

Ed Barksdale

Matias Bruzoni

Mary Fallat

Diana Farmer

Andre Hebra

George W. Holcomb III

Jose Iglesias

Max Langham

Charles Leys

Craig Lillehei

Bo Lovvorn

Dennis Lund

Cameron Mantor

Walter Morgan

J. Patrick Murphy

Dan Ostlie

Steve Raynor

Fred Rescorla

Richard Ricketts

David Schmeling

Robert Shamberger

Charles Snyder

Shawn St. Peter

Kuojen Tsao

Glaze Vaughan

Dan von Allmen

Brad Warner

Tom Weber

 

Senior Members

Robert Arensman

Paulsen Armstrong

Bob Bloss

Clint Cavett

Dick Ellis

Howard Filston

Diller Groff

Robert Hollabaugh

Tom Holder

Dale Johnson

Sam Kim

Tom Krummel

Charles Mann

Lester Martin

Kurt Newman

Richard Ricketts

C.D. Smith

William Tunell

Charles Turner

Mory Zeigler

Honorary Members

Dorothy Arcari

Deborah Bishop

Virginia Cloud

Lola Rothman

Anne Sieber

Lynette Wrenn

 
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