I’ve had a lifelong interest in discrimination and birth-defects stemming from being bullied for my once-nasal cleft-palate speech. Hence I was interested when college classmate Alain Gunn wrote The Titanium Rib.
The Discrimination Angle
The book is about a device that allows infants born with defective chests and lung function to live. And it’s a true story of two dedicated surgeons —one being a black man who endured discrimination as a trailblazer entering the lily white ranks of American physicians and surgeons. But Dr. Melvin Smith didn’t let it stop him from trailblazing on another front.
Dr. Smith – in combination with his scrub assistant – came up with the idea of a surgical implant to save the lives of newborns who would otherwise die of slow suffocation due to congenital chest deformities. With the help of Dr. Robert Campbell, Dr. Smith struggled for seventeen years to obtain FDA approval of the implant. It soon led to changes in treating children with lung dysfunction. And it revolutionized the treatment of young children with spinal deformities, like scoliosis.
Accolades for Dr. Smith
In a private message to me, author Gunn – also a pediatric surgeon – wrote:
“Melvin Smith was an amazing man, and he deserves more credit than he received. Life dealt with him harshly, but he never complained, nor did he allow others to keep him from enjoying a fruitful life. To me, he was a real role model for what a pediatric surgeon should be. ‘A better man than I am,’ to quote Rudyard Kipling.”
And the parent of a “Rib Kid,” Nikki Jeske wrote:
“I am not sure what RIB # my son is, but he was the first chest wall deformity patient in Utah. I appreciate you consulting with Dr. Smith at PCMC in SLC, Utah and giving my son a chance at life. Thank you flying in to assist/consult on his case. I hope you know what this device has meant to us.”
Here’s the description of The Titanium Rib from its jacket cover.
“A toddler was about to die, but two dedicated surgeons combined their skills to save his life.
This simple humanitarian beginning evolved into a seventeen-year struggle to develop a surgical implant—the Titanium Rib—that saved the lives of thousands of children world-wide and led to revolutionary changes in the treatment of small children with rib cage deformities
The titanium rib’s success came at a cost to both surgeons. Their dogged perseverance and utter dedication overcame impossible obstacles, but at a price.
This story has a happy ending. It shows what good and talented people fighting for a noble cause can accomplish.
But it is also a human story, a true story that depicts a reality in which not every person is wise and caring, societal norms can prevent common sense from being applied to the solution of lethal problems, and nothing good happens without a struggle.”
The Titanium Rib.
And here is my book review –
Some of us have blown into a breathalyzer or a spirometer’s tube with a “floating” ball” after an operation. But few of us have stopped to think about how difficult it is for doctors to measure lung function, let alone treat patients with lung diseases or congenital chest abnormalities. Author Gunn has shown how this really is in his readable, though medically rigorous, account of the decades-long development of a life-saving rib implant for kids who can’t breathe.
It’s not a simple story to tell, but Gunn gets our interest right off as doctors Mel Smith and Bob Campbell — pediatric/thoracic and orthopedic surgeons, respectively — use “Steinmann” pins (normally used to reset bone fractures) to enlarge the deformed rib cage of an infant slowly dying of suffocation. Gunn then tells how these two incredibly dedicated docs fought to keep their first “rib kid” alive with ever larger rib implants to give him enough lung capacity – and a straight enough spine – to reach adulthood.
When the caring, yet innovative, docs find more and more youngsters showing up at their San Antonio, TX hospital, they must then fight to keep manufacturers producing enough of the life-saving implants. And with all this comes an even more epic fight to convince skeptics at the FDA to give them continuing authorization to implant, teach others to implant – all the while sending tons of outcome data to the FDA.
In the end the heroic docs—and some others on their ever-expanding team—pay a price for their historic, pioneering work. Despite this, Gunn’s story is generally an uplifting chronicle of selfless health professionals saving and improving lives.
Further resources re the Titanium Rib
A Titanium Rib Foundation tribute video was shown at a gala event on August 16th, 2013 in San Antonio where Mel Smith did his seminal work. The video honors him and his partner Dr. Robert Campbell, plus RN Lori Buegeler who was also critical to the ongoing success of the rib device. And all three, tragically, died young of medical ailments themselves.