Oliver Cope
Encyclopedia
Oliver Cope was an American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 known for his work in parathyroid surgery, burn
Burn
A burn is an injury to flesh caused by heat, electricity, chemicals, light, radiation, or friction.Burn may also refer to:*Combustion*Burn , type of watercourses so named in Scotland and north-eastern England...

s treatment and breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

 treatment. He is also remembered for describing the Churchill-Cope reflex
Churchill-Cope reflex
The Churchill-Cope reflex is a reflex in which distension of the pulmonary vascular bed, as occurs in pulmonary oedema, causes an increase in respiratory rate .It was described in 1929 by Edward Delos Churchill and Oliver Cope....

.

Biography

Oliver Cope was born in 1902 in Germantown, Pennsylvania. He went to Haverford College
Haverford College
Haverford College is a private, coeducational liberal arts college located in Haverford, Pennsylvania, United States, a suburb of Philadelphia...

 in 1919, transferred to Harvard University
Harvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...

 the following year, and graduated in 1923. He then attended Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

, graduating M.D.
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

 in 1928. His surgical training was carried out at Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...

, where he became an assistant to Edward Delos Churchill
Edward Delos Churchill
Edward Delos Churchill was an American surgeon known for his work in thoracic surgery and remembered for describing the Churchill-Cope reflex.- Biography :...

. During this time he and Churchill published the findings of research which described the Churchill-Cope reflex. He married Alice DeNormandie in 1932, and was awarded a Moseley Travelling Fellowing after completing his surgical residency. The couple travelled to Europe, starting in Berlin where they witnessed Nazi persecution of Jewish academics. They left Germany and moved to London, where Cope studied under Sir Henry Dale
Henry Hallett Dale
Sir Henry Hallett Dale, OM, GBE, PRS was an English pharmacologist and physiologist. For his study of acetylcholine as agent in the chemical transmission of nerve impulses he shared the 1936 Nobel Prize in Physiology or Medicine with Otto Loewi.-Biography:Henry Hallett Dale was born in Islington,...

 at the National Institute of Medicine. During their time in London they developed a friendship with Harold Himsworth
Harold Percival Himsworth
Sir Harold Percival Himsworth, KCB was a British scientist, best known for his medical research on diabetes mellitus.-Early life:...

 of University College Hospital
University College Hospital
University College Hospital is a teaching hospital located in London, United Kingdom. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London ....

; during the Second World War Himsworth's children stayed with the Cope family in Cambridge, Massachusetts
Cambridge, Massachusetts
Cambridge is a city in Middlesex County, Massachusetts, United States, in the Greater Boston area. It was named in honor of the University of Cambridge in England, an important center of the Puritan theology embraced by the town's founders. Cambridge is home to two of the world's most prominent...

.

Parathyroid surgery

Cope returned to Massachusetts General Hospital in 1934, also joining the faculty of Harvard Medical School. At that time, Edward Churchill and others such as Fuller Albright were starting to perform surgery for the treatment of hyperparathyroidism
Hyperparathyroidism
Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone . The parathyroid hormone regulates calcium and phosphate levels and helps to maintain these levels...

. Before carrying out surgery, Churchill asked Cope to perform dissections to study the parathyroid glands, to increase knowledge of the normal and abnormal anatomy of these glands. This led to an increase in the success of such surgery. Cope was also involved in the treatment of a patient, Captain Martell, who had previously had exploratory operations to search for parathyroid adenoma
Parathyroid adenoma
A parathyroid adenoma is a benign tumor of the parathyroid gland. It can cause hyperparathyroidism.CT scans or sestamibi parathyroid scintigraphy can be used in detection.It can be associated with Cyclin D1 expression....

s which had been unsuccessful. In 1932 Churchill, assisted by Cope, performed the first removal of a parathyroid adenoma from the mediastinum
Mediastinum
The mediastinum is a non-delineated group of structures in the thorax, surrounded by loose connective tissue. It is the central compartment of the thoracic cavity...

, having converted the initial neck operation to an open thoracotomy
Thoracotomy
Thoracotomy is an incision into the pleural space of the chest. It is performed by a surgeon, and, rarely, by emergency physicians, to gain access to the thoracic organs, most commonly the heart, the lungs, the esophagus or thoracic aorta, or for access to the anterior spine such as is necessary...

. By 1936 Churchill and Cope had successfully treated 30 patients with hyperparathyroidism operatively. Cope, also described primary hyperplasia
Hyperplasia
Hyperplasia means increase in number of cells/proliferation of cells. It may result in the gross enlargement of an organ and the term is sometimes mixed with benign neoplasia/ benign tumor....

 of the parathyroid glands as a cause for hyperparathyroidism, as distinct from parathyroid adenoma.

During this time Cope also became the senior surgeon at the Thyroid clinic at Massachusetts General, and wrote 20 papers on thyroid
Thyroid
The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage...

 surgery.

Treatment of burns

By the early 1940s Cope's interest had turned to the management of patients with burns, particularly the fluid resuscitation
Fluid replacement
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced via oral administration , intravenous administration, rectally, or hypodermoclysis, the direct injection...

 of these patients. In November 1942 the Cocoanut Grove fire
Cocoanut Grove fire
The Cocoanut Grove was Boston's premier nightclub during the post-Prohibition 1930s and 40s. On November 28, 1942, occurred the scene of what remains the deadliest nightclub fire, killing 492 people and injuring hundreds more...

 occurred, with nearly 200 patients from the fire admitted to Massachusetts General. This event led to advances in burns care due to the research carried out in the months after the fire, led by Churchill and Cope with Benjamin Castleman
Benjamin Castleman
Benjamin Castleman was an American pathologist best known for the eponymous disease which is named after him, Castleman's disease....

, Tracy B. Mallory and Richard Schatzki
Richard Schatzki
Richard Schatzki was a German-American radiologist.Richard Schatzki trained in radiology in Berlin with Hans Heinrich Berg who was the leading diagnostic radiologist in Germany at that time. He immigrated to the USA in 1933 and subsequently worked as a radiologist in Boston...

. This work included the nature of pulmonary damage caused by smoke inhalation, and the "soft" technique of surface burn management, using boric petroleum-impregnated gauze dressings to allow healing instead of tanning
Tanning
Tanning is the making of leather from the skins of animals which does not easily decompose. Traditionally, tanning used tannin, an acidic chemical compound from which the tanning process draws its name . Coloring may occur during tanning...

 with tannic acid
Tannic acid
Tannic acid is a specific commercial form of tannin, a type of polyphenol. Its weak acidity is due to the numerous phenol groups in the structure...

. This work was published in 1943. Work carried out by Cope and Francis Moore
Francis Daniels Moore
Francis Daniels Moore was an American surgeon who was a pioneer in numerous experimental surgical treatments...

 led to methods of estimating fluid replacement needs in burns patients. This research into burns management, which continued with the support of the United States Army
United States Army
The United States Army is the main branch of the United States Armed Forces responsible for land-based military operations. It is the largest and oldest established branch of the U.S. military, and is one of seven U.S. uniformed services...

 and Navy
United States Navy
The United States Navy is the naval warfare service branch of the United States Armed Forces and one of the seven uniformed services of the United States. The U.S. Navy is the largest in the world; its battle fleet tonnage is greater than that of the next 13 largest navies combined. The U.S...

, led to the establishment of the Shriner's Burns Institute at Massachusetts General.

Treatment of cancer

In 1962 Cope was elected President of the American Surgical Association. He turned his attention to the surgical treatment of cancer, particularly breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

. He warned against reliance on radical surgery, and advocated less invasive surgery and more use of radiotherapy and chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....

. He also drew attention to the consideration of psychological and emotional aspects of disease in medical education. He promoted these ideas widely, publishing Man, Mind & Medicine - The Doctor's Education in 1968, and The Breast: Its Problems, Benign and Malignant: And How to Deal With Them in 1977.

Cope became Emeritus Professor of surgery at Harvard Medical School in 1969. He died on 30 April 1994 at his son's home in Woodsville, New Hampshire
Woodsville, New Hampshire
Woodsville is a census-designated place in the town of Haverhill in Grafton County, New Hampshire, U.S., along the Connecticut River at the mouth of the Ammonoosuc River. The population was 1,126 at the 2010 census...

, the day after his wife of 62 years.

Legacy

Parathyroidectomy
Parathyroidectomy
Also known as "Parathyroid gland removal", Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove primary tumors or hyperplasia of the glands, especially when they produce excessive parathyroid hormone. As drugs such as Fosamax do not treat the...

 is now a part of the standard management of cases of primary hyperparathyroidism
Primary hyperparathyroidism
Primary hyperparathyroidism causes hypercalcemia through the excessive secretion of parathyroid hormone , usually by an adenoma of the parathyroid glands.-Epidemiology:...

. The management of burns, including fluid replacement, surface management and respiratory management, is based on the work carried out by Cope and his colleagues at Massachusetts General. Cancer treatment now is focused on limited surgery and adjuvant chemoradiotherapy rather than radical surgery, and medical education now takes psychosocial considerations into account.
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