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Instead of receding into the background with the passage of years, the stature of George H. Monks as a pioneer in plastic surgery continues to grow. Dr. Monks described the axial flap in 1889 in a case report, “The Restoration of a Lower Eyelid by a New Method”, in the Boston Medical and Surgical Journal, the forerunner of today’s New England Journal of Medicine. His report is a masterpiece of economy; it is less than two pages, includes five line drawings, a six-week follow-up examination, and one reference. It is nevertheless the seminal report on transference of composite grafts of skin and subcutaneous tissue nourished only by the surgically dissected vascular pedicle.
Alexis Carrel was contemporaneously performing and publishing his studies on vascular anastomoses and transplantation of organs; thus the two cornerstones of today’s current revolution in reconstructive surgery, i.e., axial blood supply to composite grafts and vascular anastomoses to restore vessel continuity, were described almost simultaneously over 100 years ago.
Dr. Monks, born in South Boston in 1853, the son of a successful businessman, was a man of broad interests: crew, chess, theatre, architecture, and travel. A graduate of Harvard College and Harvard Medical School, he was especially fond of anatomy, studying under Dr. Oliver W. Holmes; and of physiology, under Dr. Henry P. Bowditch. An accomplished sculptor, he developed three-dimensional models of anatomical structures, as well as museum-caliber classical figures and objects. He lectured on surgery at the Harvard Medical School and taught pathology and surgery at the Harvard Dental School – a prophetic forerunner of the current close relationship between plastic and oral and maxillofacial surgery. He published on carcinoma of the appendix, fractures of the humerus, acute pancreatitis, aseptic surgical technique and finger avulsion.
He founded and was first president of the Boston Surgical Society; he initiated and commissioned the Bigelow Medal, Boston’s highest surgical honor.
He married Olga Gardner, niece of Isabella Stewart Gardner, the Boston art patroness. His long and happy marriage was enriched by three children: Dr. John Peabody Monks, the Reverend George Gardner Monks, and Mrs. Olga Pertzoff.
Dr. Monks died in 1933 at age 79. His obituary in the New England Journal of Medicine states: “It was always as the artist and man of culture that we shall best remember him – the handsome, debonair Monks, gravely courteous, never ruffled, never hurried, of high intelligence and ideals, high standards, curiously unselfconscious, without a trace of timidity, but always modest and self-effacing, he brought a certain fineness of finish to all he did.”
BIBLIOGRAPHY
Goldwyn RM. “George H. Monks, M.D.: A Neglected Innovator”. Plastic and Reconstructive Surgery 1971; 48:478.
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George H. Monks Lecture 2007
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