Codman, E. A. (Ernest Amory), 1869-1940

Codman (Harvard, M.D. 1895) was a surgeon in Boston, Mass. and lectured at the Harvard Medical School from 1913 to 1915. He was a visiting surgeon at Massachusetts General Hospital from 1899 to 1914, and consulting surgeon thereafter.

Ernest Amory Codman, a native of Boston, was born on December 10, 1869, and died on November 23, 1940. In the Brahmin fashion, he was educated at St. Mark's School, Harvard College and Harvard Medical School (M.D., 1895). In 1899, he strengthened his Brahmin connections when he married Katherine Putnam Bowditch. Codman's early career was spent at the Massachusetts General Hospital and at Harvard Medical School, where he served as assistant in anatomy and in clinical and operative surgery and as lecturer in surgery from 1900 to 1915. One of the early workers with x-rays, he practiced surgery from 1905 on, specializing in diseases of the bones and joints. Before long, he became an authority on bone tumors and diseases of the shoulder, and he later established a registry of bone sarcoma. His book on The Shoulder, first published in 1934 and still a classic, has the added bonus of an autobiographical preface and epilogue.

Describing himself as “quixotic” or “a little queer,” Codman's personality was very much a factor in his professional life. His was a strong character, uncompromising but with an attractive whimsical streak that, in all but his most strenuous moments, took the edge off his intensity. A good many of those strenuous moments came during his crusade to reform surgical practice and medical care by linking the standardization of hospitals to the creation of what he called “true clinical science.” To achieve this end, EAC formulated and developed his “end result system”--that is, a follow-up on patients to measure surgical and medical outcomes. His attempt to make a systematic study of the clinical consequences of advances in medical science made him part of a larger group of physicians, surgeons, nurses and administrators who were eager to bring industrial efficiency techniques to the practice of medicine.

Beginning in 1910, Codman launched a campaign to have standardization and the end result system adopted by hospitals throughout the land. To serve as a model, he opened a private hospital in Boston and issued annual reports that he mailed all over the country. At the same time, he instituted reforms at the Massachusetts General Hospital and worked through such organizations as the Clinical Congress of Surgeons and the American College of Surgeons (he was instrumental in founding the latter) to spread the gospel of his crusade. Bold and energetic, deeply committed to his mission, Codman not only served as a self-appointed gadfly to his colleagues, he also posed a threat to their autonomy. Openly combative and even outrageous in his tactics, he succeeded in antagonizing potential converts almost as much as he convinced them of the righteousness of his ideas. But he never lost faith in himself or his cause. In the post-World War I era, he continued to participate in the hospital standardization meetings and to promote his end result system.