The James Buchanan Brady Urological Institute
 
 
 
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James Buchanan Brady
(Diamond Jim)
Patrick C. Walsh
Chairman from 1974 to 2004

Patrick walsh

Patrick Craig Walsh was born on February 13, 1938, in Akron, Ohio, to Catherine and Raymond Walsh. His mother's parents were born in Ireland, reared in Scotland, and traveled to the United States where her father was a mining superintendent. She met Raymond Walsh, a second-generation Irish-German, in Akron, where Raymond owned and operated a retail tobacco store. Walsh's parents were dedicated to their four children and were a constant source of encouragement. His older brother is a prominent attorney in Florida. His younger brother is a supervisor with the Ohio Edison Electric Company, and his sister is a nurse, both residing in their hometown.

As a child, Pat was always interested in biology and nature and spent his summer days looking under rocks and in ponds for insects, reptiles, turtles, and anything that moved. On weekends he took long hikes with his uncle, exploring nature, looking for arrowheads, and traveling to the Indian mounds in southern Ohio. As he grew older he also developed an interest in electronics, received a radio amateur license and spent much time building electronic equipment. His father believed in self-reliance and insisted that he do his best to support himself from the time he was very young. His various occupations were paper boy, parking-lot attendant, and construction worker.

Because of a lifelong desire to become a physician, he selected Western Reserve University for his undergraduate training in hopes that he would be a candidate for their medical school. He received a full-tuition scholarship to undergraduate school and a grant from the Knight Foundation to attend medical school at the same university.

In medical school he came under the influence of a number of individuals who were important in his career decisions. For four years he worked in the cardiovascular surgery research laboratories of Dr. Claude Beck where he was stimulated by Claude Beck's philosophy of innovation and excellence. He also became well acquainted with Benjamin Spock, Frederick Robbins (the Nobel Prize winning professor of pediatrics), and William Drucker, who was affectionately known by the students as "the surgeon who published in the JCI" (Journal of Clinical Investigation). These acquaintances encouraged Walsh to pursue a career in academic medicine. While in medical school he met an attractive and talented interior designer, Margaret Louise Campbell, and they were married in May 1964 just prior to his graduation from medical school.

Walsh went to Peter Bent Brigham Hospital for his internship because of its fine reputation for academics and excellence and because it provided strong basic surgical training with two years of adult surgery and one year of pediatric surgery at the Boston Children's Hospital. These were important formative years, where he came into close contact with first-rate surgeons, such as Francis Moore, Mosley Professor of Surgery at the Harvard Medical School; J. Hartwell Harrison, the Elliott Carr Cutler Professor of Surgery and director of urology at the Brigham; Robert Gross, professor of pediatric surgery; and Donald Matson, professor of neurosurgery. Although Walsh intended originally to pursue a career in neurosurgery, he soon became interested in urology. Hartwell Harrison's service, although small, was filled with interesting problems such as adrenal tumors and surgery on the solitary kidney. In addition, the field of renal transplantation was undergoing its early years of development at the Brigham and there was a great deal of interest in the kidney and surgery on the kidney. This interest was furthered by the exposure to pediatric urology at the Children's Hospital under Alan Perlmutter. These influences led Walsh to select urology for his future specialization.

Guided by advice from Francis Moore and Hartwell Harrison, Walsh was encouraged to move his wife and two young children to the University of California at Los Angeles (UCLA) for his urology residence with a long-range plan of returning to the Brigham once his training was completed. At UCLA, he was exposed to an exciting urology department bubbling with enthusiasm over renal transplantation, renal artery surgery, reconstructive urology, and urological oncology. Willard Goodwin and Joseph Kaufman were outstanding intellects, excellent surgeons, and provided a training program that permitted broad exposure to all areas of urology. Recognizing Walsh's strong surgical skills developed during the three years in Boston they permitted him to devote two of his four years of urology residency to research in urological endocrinology. During this time he worked closely with Drs. William O'Dell, Ronald Swerdloff, and Stanley Korenman on gonadotropin physiology and steroid hormone receptors. While in Los Angeles the Walshes were also blessed with the birth of their third son.

Following completion of his urological residency Walsh fulfilled a two-year tour of military service at the Naval Hospital in San Diego. Here he once again was able to work with Dr. Ruben Gittes, professor at San Diego, who had spent one year at UCLA and with whom Dr. Walsh initiated his research experience in urology. While in San Diego Walsh, was offered and accepted the position as professor and director of urology at the James Buchanan Brady Urological Institute. However, his travel to Baltimore was delayed for one year because of his prior commitment to spend a year in the laboratory of Dr. Jean Wilson at the University of Texas Southwestern Medical School in Dallas. This was one of the most important years of his life. There he worked with Wilson on fetal endocrinology and, together, they first described the syndrome of the 5-alpha-reductase deficiency. In addition, they were able, for the first time, to induce prostatic hyperplasia in the young dog by treatment with a combination of hormones, 5-alpha-reduced androgens and estrogens. This has subsequently proved to be the most useful animal model for the study of benign prostatic hyperplasia. While in Dallas, Walsh also once again came under the strong influence of excellent urology led by Drs. Harry Spence and Paul Peters. These experiences in the laboratory and clinic prepared him well for the position at Hopkins which he undertook on July 1, 1974, 10 years after graduation from medical school.

Pat's career was molded by strong models: his parents who loved and guided him, his teachers in medical school who stood for integrity and scholarly pursuit, and the surgeons at the Brigham and Children's Hospital who exposed him to the excitement of surgical discovery. His urological education was formulated by Hartwell Harrison and Alan Perlmutter who first exposed him to the sound principles of adult and pediatric urology which were later cultivated and enriched by Willard Goodwin and Joseph Kaufman who were responsible for his formal urological training. This strong background was molded and modified by his experiences in San Diego with Ruben Gittes and in Dallas, Texas, with Harry Spence and Paul Peters. Pat embarked upon his career at Johns Hopkins with a rich background in medicine and urology that was fostered by wide geographic exposure.

As indicated earlier, Walsh took over from Scott on July 1, 1974 (Fig. 1). He did so with great energy and enthusiasm, and soon the place was humming again. Happily, he had the complete backing of his predecessor who was to help in any way he could and who was especially fortunate in being able to raise money for the Brady.


Fig.1 Peg and Pat Walsh with Will Goodwin at the 1983 Biennial

As in the case of his predecessor it seems appropriate to describe his activities to the present under several headings: clinical and laboratory research, resident training, teaching, lectures, and visiting professorships, committees, awards, and hobbies.

CLINICAL AND LABORATORY RESEARCH

Walsh's early introduction to research, both at UCLA with Gittes, Swerdloff, and others, and with Jean Wilson in Dallas, as outlined briefly heretofore, provided him with an excellent foundation and a real appreciation of the importance of research in clinical medicine. Walsh's task of upgrading the Brady laboratories was made easier by the presence of Donald Coffey who had succeeded Guy Williams-Ashman as head of the Laboratory of Reproductive Biology. Coffey had shown an intense interest in the offer to direct the Brady Laboratories, and in 1972 succeeded Charles Tesar in this capacity.

Initially it can be said that Walsh's research efforts, both basic and clinical, have been most productive. At the time of his arrival in 1974 he had published more than 50 articles and more than 100 more, 10 years later. His earlier work with Jean Wilson, discussed above, in which they were able to induce prostatic hyperplasia in the dog, provided the stimulus for large-scale, multidisciplinary studies in purebred Beagle dogs in several laboratories at Johns Hopkins in which these findings were confirmed and extended.

With an abiding interest in mechanisms of action in both benign and malignant prostatic growth, Walsh and his younger associates have studied extensively androgen receptors (as well as estrogen receptors) not only in animals but in humans.

Whereas it is often difficult to judge with finality what constitutes an individuals "best" research, it seems rather clear now that Walsh's best clinical research has been his development of the operation of radical retropubic prostatectomy with preservation of sexual potency. At this writing, he has performed over 350 procedures (Fig. 2). It seems certain to most of us that such a procedure is bound to increase the number of patients with early prostatic cancer who are willing to submit to radical prostatectomy, and of a consequence, increase the cure rate.


Fig.2 Walsh performing a nerve-sparing total retropubic prostatectomy.

RESIDENT TRAINING

Under Walsh's guidance, the four-year structure of the Brady residency has been preserved and extended. The residency was reduced from three to two residents per year and the rotations were limited to the Johns Hopkins Hospital and Baltimore City Hospital, which is now Francis Scott Key Medical Center. Years one, three, and four are clinical and year two is devoted to research. In addition, one of the two residents scheduled to proceed through the four years spends an extra six months in research. All residents spend the last six months of the residency as assistant chief of service. During this period they may elect to operate with the chief or operate on only their own patients. Scott believes this has strengthened the program in several ways. Concerning Walsh's residents, as in the case of Young and Scott, a portion at the end of this section is devoted to each.

LECTURES AND VISITING PROFESSORSHIPS

Always in demand, Walsh has served as visiting professor or guest lecturer on some occasions in the past nine years. Named lectureships have included the Robert V. Day Lecture, the Bruce Stewart Lecture, and the Southern Lecture; visiting professorships have been nation- and world-wide.

COMMITTEES, CONSULTANCIES, AND PROFESSIONAL SOCIETIES

Fortunately for all concerned, the administration and faculty have become increasingly aware of Walsh's many abilities and his willingness to serve the institution. In the short period of 12 years, he has been asked to serve on nine search committees, for a term on the Professional Promotions Committee, the Research Space Planning Committee, the Finance Committee of the Advisory Board, and to be Vice Chairman of the Executive Committee for the Medical Institutional Campaign Fund for Johns Hopkins.

In addition to serving on these Johns Hopkins committees, Walsh serves as consultant to the U.S. Naval Hospital, Walter Reed Hospital, the Clinical Center of the National Institutes of Health, the Advisory Board of the National Institute of Diabetes, Digestive and Kidney Diseases as well as several local hospitals. Recently, he was appointed a trustee of the American Board of Urology. He serves also in numerous editorial capacities including the Editorial Board of the Journal of Urology, and as of 1980, is chief editor of Campbell's Textbook of Urology.

He is a member of some 14 professional societies, which include the Society of University Surgeons, the Clinical Society of Genitourinary Surgeons, the American Association of Genito-Urinary Surgeons, the Endocrine Society, and the Peripatetic Club.

AWARDS

Elected to Alpha Omega Alpha at Case Western Reserve University School of Medicine, Pat has continued to be recognized as a real contributor. As early as 1970 he received first prize for laboratory research by the American Urological Association. This was repeated in 1974. In 1978, he was the second recipient of the Gold Cystoscope Award of the American Urological Association and the fourth to receive the Eugene Fuller Award by the same organization. Two awards have been made for outstanding teaching films, the Grand Prize, William R. Smart Film Award of the American Urological Association in 1985, and the Golden Eagle Award of the Council on Nontheatrical Events in the same year. This is a remarkable achievement.

HOBBIES

Years ago a small sign hung in the Brady laboratories that read: "If you like hard work, you can sure have a good time here." Some think Pat Walsh's hobby is hard work, but those who really know him recognize his devotion to his family, his church, and his job, but also his love of sailing, swimming, and cycling.

He, himself, in a recent feature article on "Careers" in the Baltimore Sun wrote: "But the real definition of success in a medical career is often very personal. For me, success is the genuine satisfaction I derive from helping my fellow man."

 






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