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Pioneer in Burn Treatment

Library Display Recalls Important Contributions of Stanley Levenson, M.D.

During February, Einstein's D. Samuel Gottesman Library is showcasing "A Tribute to Dr. Stanley M. Levenson" to honor the legacy of its former distinguished university professor emeritus of surgery, who was world-famous for his pioneering advances in burn treatment. The exhibit, on view in the entry to the library lobby, features writings and photography that highlight Dr. Levenson's contributions to his field. It also details the knowledge he gained firsthand while treating victims of Boston's 1942 Cocoanut Grove inferno — the deadliest nightclub fire in history, with nearly 500 fatalities and hundreds of injuries. The temporary exhibit will be followed in May by a permanent one at Jacobi Medical Center, where Dr. Levenson also played a leadership role in establishing the hospital's burn unit at a time when Jacobi was the university hospital for Einstein.

An exhibit in the D. Samuel Gottesman Library details the career of burn treatment pioneer Dr. Stanley Levenson.
Stanley Levenson, M.D.
The exhibit was created and organized by Dr. Marie-Ange Tardieu, a 1985 Einstein alumna who trained under Dr. Levenson. "This is the least I can do to show the impact Dr. Levenson had on me as a student and colleague, and on the countless individuals whose lives he saved," said Dr. Tardieu. "Many people don't fully realize the importance of his work."

Dr. Tardieu, a Haitian-born plastic surgeon and expert in the history of medicine, noted that burn treatment was "in the dark ages" at the time of the nightclub fire.

An Era of Limited Knowledge

As recently as the 1940s, burns were considered a local injury to the skin that had little effect on other tissue and organs. Physicians didn't understand the importance of burn shock, inflammation or the need for fluid replacement. Nor was there much knowledge about the effects of smoke inhalation or the lethal chemicals in smoke that deprive the lungs of oxygen, since the technology for studying blood gases and blood chemistry didn't yet exist.

Dr. Levenson, a 1941 graduate of Harvard Medical School, was skilled in pulmonary medicine and had previously helped design the oxygen mask used by World War II bomber pilots. He had started as a clinical and research burn fellow at Boston City Hospital on Nov. 23, 1942, just five days before the devastating Cocoanut Grove fire.

On that Saturday evening, 1,000 people crowded the popular downtown nightspot — more than double its legal capacity. When an accidental spark led to a quick-spreading blaze, many of the patrons were trapped by exits that were either blocked by decorations or locked.

Boston City Hospital received more than 130 emergency admissions; other local hospitals saw similar numbers. The victims filled hallways, stairwells and waiting rooms. The smell of burned flesh was everywhere.  Even so, the leading cause of death among victims was not burns, but smoke inhalation.

Defying the Odds

During the three straight days that he provided treatment for victims, Dr. Levenson carefully documented all aspects of their care, paying special attention to fluid balance and respiratory distress.

An exhibit in the D. Samuel Gottesman Library details the career of burn treatment pioneer Dr. Stanley Levenson.
Dr. Marie-Ange Tardieu created and organized the tribute to Dr. Levenson
Nearly 40 patients died at Boston City, but many more survived — including Clifford Johnson, a young man in his early twenties who had burns covering over 55 percent of his body. At the time, no one had ever survived burns of over 20 percent.

Mr. Clifford was treated with 17 pints of plasma and 4 liters of normal saline. It was widely expected that he wouldn't live. But thanks to Dr. Levenson's close monitoring and treatment, the young man made a full recovery by 1944.

Soon, the knowledge Dr. Levenson gained in the catastrophe was revolutionizing the care of victims of World War II battles — and changing the face of medicine. It was his studies that revealed how the epithelial linings of the respiratory tracts are injured or destroyed as a result of superheated air in combination with smoke itself.

Using samples and data he obtained from the Cocoanut Grove patients, Dr. Levenson proved that smoke contains various lethal chemicals, including carbon monoxide, hydrogen cyanide and hydrochloric acid.

Providing Expertise in Time of Need

In 2001, Dr. Levenson advised emergency responders treating those injured in the World Trade Center attacks. And today, his influence is still felt, both in the treatment of burns and smoke inhalation, and in the use of surgical nutrition and the study of metabolism.

Dr. Levenson joined the Einstein faculty as a professor of surgery in 1961. He became a university professor in 1986 and professor emeritus the following year. Over the course of his 70-year career, he authored or co-authored more than 390 publications and received a host of distinguished awards, including a 1987 Research Career Award from the National Institutes of Health. He died in 2012, at the age of 95.

"He was an imposing figure," recalled Dr. Tardieu. "But he was also a humble man who didn't give himself enough credit. He saw greatness in his students and he put others before himself. I often wish he were still working with me today."

Posted on: Tuesday, February 18, 2014