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In quest of excellence: Dr. Murl E. Kinal.

IN QUEST OF EXCELLENCE: DR. MURL E. KINAL

The noted neurosurgeon strove not to elevate himself above others but to inspire others to rise to their own maximum potential.

Some people accomplish great things without becoming great people. My father was a great man of great achievements. He projected an integrity and vision so compelling that even today, 23 years after his death, people speak of him with a reverence belonging to historic heroes and saints. He was not a saint. On the contrary, his tremendous personal magnetism flowed from the fact that he was an ordinary man who did and said extraordinary things, who strove not to elevate himself above others but to inspire others to rise to their own maximum potential.

In many ways, he was a blend of the crude and the refined, the peasant and the gentleman. Physically, he was strikingly handsome. A first-generation American, he retained the rugged Slavic features of his Ukrainian parentage. Those features were more rounded than chiseled, and along with his deep brown eyes they gave his face a sensitive appearance.

This handsome, cultured head was supported by a thick, bull neck that I often thought was the source of my father's considerable physical strength. That neck grew out of a burly pair of shoulders that belonged more to a lumber-jack than a neurosurgeon. Like his brother, Emil, Dad had muscular biceps and sinewy forearms, and at the end of those arms were the most remarkable hands I have ever seen on a man. They were at once large and strong, yet elegant and refined. Although his profession called for the most delicate work that hands can do, my father in his spare time sought crude uses for his hands. He was a fair rough carpenter, enjoyed cutting trees with a handsaw or chainsaw, and especially loved planting trees by hand at our farm in Findley Lake, New York. He wasn't afraid of dirt or mud, cuts, bruises, or blisters.

When the work was done, he would wash his hands as if scrubbing for surgery. One of my earliest memories is of my father washing his hands at the sink, working each finger separately, the two hands cleaning each other in a ritual that transcended the simple act of washing hands. No wonder one of his favorite observations about social relationships was "One hand washes the other."

That physical blend of the crude and the refined carried over to his personality. He was capable of the most impeccable manners and genteel charm. Like some educated men, he could adjust the level of his vocabulary to the company in which he found himself. But no matter whom he was talking to, he spiced his language with profanities. He didn't particularly care who was in the vicinity, either.

One of the hospitals Dad practiced at in Erie, Pennsylvania, was the Catholic hospital, St. Vincent. The sisters of St. Joseph worked throughout the hospital, including in the operating room. They greatly admired my father for his custom of walking off to a corner of the room and saying a prayer before sawing into the patient's skull. But during surgery he would fly into a rage if a piece of equipment did not function properly. Suddenly he'd be roaring "Jesus Christ Almighty!" and "Get me a God-d--thing that works!" as nuns and nurses scampered in all directions.

He had many bullish qualities, not the least of which was a ferocious temper. He never lost control of it, but that only made it more awesome. It was not a temper that subsided quickly, either; it simmered for a long time after erupting.

I would not have wanted to be in the shoes of a young man who aroused that temper one night outside the operating room. One type of patient my father grew weary of treating was the reckless driver who would smash his car up on a weekend night. At the start of a pleasant Friday or Saturday evening, Dad would often remark, "Now watch some dumb son of a b-- put his head through the windshield."

That happened one Saturday night, and Dad spent long hours at the operating table trying to save a boy's life. When he emerged into the hallway after surgery, a young punk approached and said something like, "Doc, my buddy better make it, or you'll be sorry." He probably had heard that line used in a movie, but he got a taste of the real world when he tried it out on my father. Dad pushed him around right there in the hallway while giving him a lecture I'm sure he never forgot.

My father never felt superior to other people just because he happened to be a neurosurgeon. He told me many times that it didn't matter what your trade was; all that counted was that you did it to the best of your ability. He judged other people by their commitment to excellence, and he regarded them as equals if their dedication equalled his. It didn't matter whether they were janitors, clerks, teachers, or scientists. He often said that he wished he had become a lawyer instead of a doctor. He was occasionally asked to testify as an expert witness at trials, and he would talk about the experience for days afterward.

Just as he admired people who worked with dedication, he despised lazy, sloppy people, whose existence he took almost as a personal insult. He also detested people who thought doctors were only in practice for the money. Shortly before his 1962 trip to Europe, where he was guest speaker at the annual meeting of the Scandinavian Neurological Society, he was having lunch at a diner near St. Vincent Hospital. The cook had read a newspaper story about the trip, and he commented tauntingly to my father, "It must be nice to be able to take off and go to Europe anytime you want." I guess Dad didn't even look up from his food as he replied, "Yes, it is." Since he was usually so considerate of other people's feelings, he must have been really irked to give that cook such a sharp put-down. This guy regarded my father as just a rich doctor who could afford to take expensive vacations in Europe. He had no idea of the sacrifices medicine required from Dad, and not the slightest inkling of the significance of a neurological convention.

To Murl Kinal, excellence meant hard work. He confided to me once that he did not consider himself an exceptionally bright person. "People sometimes tell me, `You must be a genius,'" he said. "But I'm not a genius. In fact, in medical school, I had a hard time understanding a lot of the work. I made up for it by studying harder than some of my smarter classmates."

Some people say my father worked himself into an early grave. I don't know whether that's true, but I doubt that many people could stand up under the kind of work and pressure that was part of his everyday life. After a tough day, he would eat supper, lie on the couch and read the evening newspaper, then disappear into his study to spend the rest of the evening working at his desk. To give an idea of what kind of work he did, he kept a collection of stillborn fetuses, immersed in jars of formaldehyde, in a cabinet in his study. I would sometimes walk in and find him holding one of those tiny babies in his palm, gently probing at the scalp or brain with small instruments.

It was routine for him to be called for emergency surgery in the middle of the night. Often he would return home as the rest of us were getting up in the morning. He would shower and shave, change clothes, have breakfast, and go off to work again--sometimes right into another surgery. The pressure on him reached a peak about 1959 when Erie, Pennsylvania's only other neurosurgeon moved away, and for a couple of years Dad was the only brain specialist within a 100-mile radius.

In his precious free time, he had no interest in any activity that excluded his wife and children. He was a rakish ballroom dancer, and he also enjoyed photography, sailboating, and fishing. At one point he took up drawing so he could illustrate his research. He loved target shooting with rifle and pistol, but he never hunted, although he encouraged me to hunt. Like my mother, he was a voracious reader, particularly of spy thrillers and biographies of great people.

Dad's response to his incredible workload was to develop a rigorously self-disciplined and meticulous approach to life. Everything he did, whether tying his necktie or driving a car, was done as if he were trying to do it better than anyone had ever done it before. We used to tease him about the way he spread jelly on toast. He would not grasp the toast, but rather rest it on the columns of his fingers and thumb, applying a perfectly even layer of jelly with precise strokes of the butter knife.

However, it would be inaccurate to say he was a perfectionist. Perfectionists are peculiar, and there was nothing peculiar about my father. He was a realist who would never seek something as unattainable as perfection. He was satisfied to aspire to excellence.

I spent many long, boring hours as a child waiting for my father in the hospital. He liked to take me along but always left me in the doctors' lounge or telephone switchboard room. I am glad he never took me into surgery with him because once when he came out, the entire front of his smock and even his shoes were splattered with blood. He was smiling as matter-of-factly as if he were a carpenter who had just come out of his woodshop covered with sawdust.

The switchboard operator, an amiable old lady, prided herself on being able to recognize people out in the hall by the sound of their footsteps. But you didn't have to be the switchboard lady to recognize my father's steps. The steady, confident rhythm of those shoes on the linoleum spoke chapters about what kind of man was wearing them. Those footsteps must have reassured many sick people over the years.

Tragically, my father had another trademark--a frequent small cough that came from smoking more than two packs of unfiltered cigarettes a day. It was his only bad habit, and--I think he believed--one that proved to be fatal.

He had faults. He often refused to consider that there could be legitimate views other than his own on a given subject. He was overly strict with his children, regarding a teenager's social needs as incompatible with character growth and academic achievement. He could be playful, but he disliked silliness or frivolousness. He was hopelessly old-fashioned and was always sarcastic about the latest fads.

I mentioned that some people speak of my father as if he were a saint. Those are usually his former patients. The common thread of their stories is that here was a renowned brain surgeon who was interested in them as people, not just medical cases. He would always engage them in lively conversation about things that were unrelated to their illnesses, and they were flattered that he was interested in what they did and thought.

There were a couple of reasons my father behaved that way toward patients. First, he was genuinely curious about all people. He believed that everyone is excellent at something, and he liked to discover what that was in each person.

Another reason my father was so interested in the personal lives of his patients is that he was seeking clues to their diseases. He talked to me extensively about the mind's power over the body, how placebos worked, how one person through tremendous will power overcame a grave illness, while another gave up and died prematurely. He took a course in hypnosis and practiced self-hypnosis. He told me that, through self-hypnosis, he had developed the ability to partially levitate.

People liked to talk to him because he was a great conversationalist. He always raised the level of conversation by talking about the mind, states of consciousness, human nature, or the future. He liked to pose hypothetical problems and ask each person present what his or her solution would be.

Dad was fascinated by space exploration and was convinced that mankind was already beginning its migration from this planet to other worlds. He and I were driving home from Warren State Hospital in October 1957 when the news came over the car radio that the Russians had launched Sputnik. He bet me $5 that within 10 years, man would set foot on the moon. Had he lived, he would have lost that wager, but not by much. Man did reach the moon 12 years after Sputnik.

As with many men his age, Dad had found World War II to be the greatest adventure of his life, and he never tired of reading and talking about the war. To him it was an arena in which ordinary people were inspired to heroic feats. But although he described the war in romantic terms, I think the massive loss of life he saw as a combat surgeon scarred him. My mother alluded to the fact that it did.

He used to say that combat is the best experience for a surgeon because it causes wounds rarely seen in civilian life. For example, he told of a soldier who was brought into the medical tent with his head completely wrapped in bandages. When my father unwound the bandages, the soldier's face fell away in layers "like the pages of a book."

In Erie, he lost his share of patients on the operating table. I was with him on one such occasion. And there were far worse things he had to face, such as the time the hospital called him at home and asked his permission to remove life support from a hopelessly comatose man. The patient's family had given their consent, but the decision to pull the plug was left up to Dad. "On my word, a man just died," he told me, and I wondered how much he had aged in those few minutes.

He did not believe in keeping people alive at any cost, and he endorsed euthanasia. When a friend of my sister's gave birth to a baby with hydrocephalus (water on the brain), my father told her, "Leave this baby with us, and go home and have another baby." So a newborn child with a life expectancy of a few months or a year was allowed to die sooner, which to my father was the humane decision.

For his research on hydrocephalus, and because of his eloquence and powerful personality, Dad in his mid-40s was beginning to receive international acclaim. That acclaim was important to him not for his ego but for two reasons. First, it was testimony to the level of excellence he had achieved in his field. Even more important, it signified that what he had to offer was bigger than a city or even a nation could contain. His gift would be for the whole world.

He had a winning way with foreign surgeons, and he always took my mother along to help charm them. I have the clipping of an Erie newspaper interview with Dad before his 1963 trip to Buenos Aires, where he presented a paper at the Latin American Congress of Neurosurgery. The story notes: "He will read it in Spanish since, as he pointed out, when South American doctors speak at meetings in the United States, they speak in English, and `I think we would do well to return the courtesy.'" As if learning to speak a foreign language were a mere courtesy! He also spoke serviceable French, German, and Russian out of the same concern, and I should note that my father had no natural talent for languages. I know because we studied Russian together, and he found it as difficult as I did.

The pinnacle of Dad's career was an invitation from the Soviet Union to present a paper at a Soviet neurological convention in Moscow. That was in 1964 during one of the chilliest periods of the Cold War, years before "detente." With the help of a Russian teacher from a local college, he translated the paper into highly technical Russian and spent months practicing his recitation of it.

Father died of cancer on July 3, 1965, two months after his 47th birthday and two weeks before his planned trip to Russia. When the disease was diagnosed six months earlier, he told me that he intended through sheer will power to defeat it or at least force it into a long remission. He spoke at length about people who had defied medical science and overcome seemingly incurable diseases.

I think he might have achieved the miraculous if not for a stroke of bad luck that sapped his desire to fight on. It was just an accident in which he poked his eye with the corner of an enveloped. For some reason the injury did not heal, and his eye dripped profusely much of the time. Imagine having terminal cancer and then suffering a serious eye injury besides. It was more than even my father could shoulder.

When he finally faced the reality of his imminent death, there were only two things that bothered him about it. His marriage to my mother was a love affair of mythological proportions, and he couldn't bear the thought of being without her in this or any other world. And second, there was so much in medicine that he still wanted to accomplish.

When he knew it was inevitable, he turned his attention to dying and did it excellently. On July 2, he took out his fountain pen and, in his meticulous script, wrote letters of resignation to both Erie hospitals. He wrote to his secretary and nurse, thanking them for their years of service. That was his last day of work. He died the next day.

If my father could summarize his life, he might point to a passage he had copied from a book by Jurgen Thorwald and pinned to a shelf in his study: "Destiny seldom rewards the diligent theoretician or the dreamer; it usually reserves both the fame and the material rewards for those who translate dreams and theories into practical realities."
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Author:Kinal, Brian
Publication:Saturday Evening Post
Article Type:Biography
Date:Nov 1, 1988
Words:3089
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