Likely bored with cardiology, he moved on to a field more suited to his brilliance: vasculitis. In the 1960s, not everyone believed in thromboangiitis obliterans. Some argued that it was simply a form of polyarteritis nodosa, not deserving of its own name. Victor McKusick conducted his own meticulous study of the disease and was able to demonstrate, through both angiography and histopathology, that it was a diagnosis sui generis. This was no small feat—in the days before video recorders and CT angiograms, it was Victor himself who physically moved film after film under the patient, trying to capture the pathognomic image as the dye ran through the diseased artery.9
There probably is no such thing as a gifted teacher.
Such is the brilliance of Victor McKusick that he isn’t really known for either contribution. Instead, his most lasting contribution to medicine was made as a geneticist. When he was an intern, he encountered a patient who had required multiple surgeries for hamartomatous polyps in the gastrointestinal tract. The patient also had spots on his lips and in the inside of his mouth. As a resident, he encountered three more patients with a similar syndrome, all from the same family. He reached out to Harold Jeghers, who had encountered patients with a similar syndrome. Eventually, it became clear that this was the same syndrome described by a Dutch physician, J.L.A. Peutz. Today, Peutz-Jeghers syndrome is considered a classic example of an autosomal dominant genetic disorder, and is taught in medical school curricula every year, across the country.10
Now that I’ve said all this, I feel comfortable saying one more thing: Victor McKusick was an awful teacher. I joined Johns Hopkins toward the end of his career, and not knowing when he might retire, I made a special effort to attend every lecture he gave. His lectures were a mess. There’s an old story from the pre-PowerPoint days: The projectionist dropped Victor’s slide carousel just before a lecture and all of the slides ended up on the floor. Not knowing what to do, the projectionist rapidly collected the slides and put them back into the carousel, albeit in some gravity-determined order. Victor apparently didn’t notice. According to the story, members of the audience came up to him afterward to compliment him on what they thought was one of his best lectures. After having spent many hours listening to him speak, I have no doubt the story is true.
