were required to inculcate the young physicians and surgeons with the
special techniques that were being developed by the increasingly
sophisticated practitioners. The ability to focus on an individual body
system (or organ), boosted levels of sophistication that were unimaginable
just half a century earlier.
Perhaps the most famous orthopedic institution in the world is New
York’s Hospital for Special Surgery. It was the not the first orthopedic
hospital in America—that title belongs to Boston’s “Orthopedique
Infirmary,” now defunct—but it is the oldest still in existence, founded in
1863.^18 Originally called the Hospital for the Ruptured and Crippled
(R&C), the newfound hospital tailored its services to the deformed and the
crippled filling the streets of New York City. At an age where epidemics
were an enigma and tuberculosis was rampant, adults and children alike
suffered the deformity of infectious disease and the catastrophe of trauma;
once incapacitated, ruination was a certainty.
Despite its founding during the American Civil War, R&C did not have
an operating room until 1889, the same year that Saint Marys Hospital
opened in Rochester (with its single OR) and the same year that the Johns
Hopkins Hospital opened. Though not a surgeon, James Knight (1810–
1887) was the founder of the hospital, specializing in “surgiomechanics.”
Instead of operating, Dr. Knight used braces, bandages, and supports to
treat scoliosis, hernias, varicose veins, and even hemorrhoids.^19 He
remained skeptical of surgery his entire career, even as the R&C moved
from its modest beginnings at his home on Second Avenue to a purpose-
built hospital on the northwest corner of Lexington and 42nd Street (now
the site of a Grand Hyatt Hotel). In retrospect, Knight’s conservatism was
well-founded, his career spanning an era before anesthetics, germ theory,
and antiseptic surgery were known; and during a time that no one in the
world could imagine antibiotics.
Virgil Gibney (1847–1927), a farm boy from Kentucky who attended
medical school at University of Louisville, and later, Bellevue Hospital
Medical College in New York, became the second leader at R&C in 1887.
Despite losing the ring finger and little finger of his right hand as an
adolescent, Gibney stubbornly persisted in his desire to become a surgeon,
and fell under the tutelage of Bellevue’s Lewis Sayre (1820–1900), the
first orthopedic professor in the United States. Unlike James Knight, Dr.
Sayre optimistically embraced the role of surgery when caring for