In Memoriam
James Barrett Jones, MD
By Powell Dillard
The many accomplishments of Dr. James Barrett Jones have been well catalogued in memorials attesting to his achievements in the field of orthopedic medicine. But the man and his personality extended far beyond his achievements in medicine and the field of orthopedics.
J.B. attended the college of Arts & Sciences of the University of Virginia in September of 1941. He was a handsome and charming young man with a winning smile. J.B. and I became fast friends when we lived beside each other on the Lawn of the University.
In 1947, our senior year of medical school, several of us took part in a school show called "Men in Tattle-Tale Gray.” J.B. gave an encore performance as a hospital urologist. Upon the occasion of our 50th medical school reunion, J.B. organized a rendition of the show and sang to the tune of the VMI Spirit song:
When the arch starts to weaken
The back fails again
The limbs are so crippled
To walk seems in vain
We'll call for the plaster
And slap up a cast
Orthopedics will see you through.
Lasting friends were made in our medical school years with numerous trips to Lynchburg for dates with Randolph Macon and Sweetbriar girls.
After medical school, J.B. traveled to New York state for his residency program. There he met his lovely wife, Joan Shepherd. In a visit to Lynchburg, he called on Joe Platt, who was looking for a partner in his orthopedic practice. J.B. and Joan settled in Lynchburg and raised their family.
They both became very active in many facets of the community. J.B. was passionate about his hobbies, including old cars and the Hunt Club, and was a diligent supporter of the nonprofits with which he became involved.
Dr. “Cully” Lippard invited several Lynchburg doctors at different times and in different specialties to accompany him to Puerto Cabecus, Nicaragua. This program was sponsored by the Moravian Church and one of the missions was to set up a clinic on "Corn Island"--Isla Grande Del Mais. J.B. was one of the doctors to give his time and talent to this program.
J.B. as a wonderful friend, devoted to his family and dedicated to his profession. I will miss him.
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Second Presbyterian Church
Roanoke, VA
John W. Mann III, MD
For many of us here in Virginia, the Dominican Republic brings to mind beautiful Caribbean beaches, but each year for the last seven years a group from Second Presbyterian Church in Roanoke, VA has visited the town of San Juan de la Maguana as medical missionaries. The Christian Clinic was founded by Solid Rock Missions twenty years ago to improve the health of the poor inhabitants of San Juan. The Ohio-based mission built a medical clinic which is now headed by local physician, Dr. Osvaldo Canerio. The mission quickly expanded its outreach and built the Jim Smith School which now feeds and educates 1000 students per year from kindergarten through high school. The mission hosts medical, construction and education teams from churches across the United States and Canada in dormitory style rooms which are spartan but comfortable. Our hosts this year, Joe and Shannon Zimmerman, left Indianapolis for a three- year stint of feeding, housing and transporting mission groups.
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Guesthouse Hosts Shannon and Joe Zimmerman |
On our most recent visit we took a team of 35 physician, nurses, construction workers, and translators to San Juan. Our surgical team was comprised of orthopaedics, urology and gynecology. Two anesthesiologists and one nurse anesthetist provided anesthesia for 37 cases. These surgical cases were done in two operating rooms which look much like our operating rooms back home. Some orthopaedic instruments have been donated and left at the clinic, but we transport most of our surgical equipment, drapes and medications with us. All of us are required to improvise and use our creativity to take care of our patients. The nursing staff spend long hours cleaning, organizing and sterilizing our limited instruments for the cases that we do. Our nurses are the real heroes of the surgical teams. All the surgeons become keenly aware of how important their work is for us to do our job.
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Dominican Republic Mission Team 2009 |
For the first time this year, we were able to have Doug Call and Charlie Coulter from Virginia Prosthetics join our team. They had prepared to fit primarily below knee amputation prostheses on the trip and completed four during the week. It was amazing to see the happy smile on a 16 year old girl’s face as she was able to walk again for the first time in several years. Above knee amputations are common due to a large number of infected, femoral nonunions. Amputation is often the only way to adequately rid the patients of infection. Twenty-three patients were measured for above knee prosthetics which will be fabricated and fit on a later visit.
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| Doug Call and Charlie Coulter of Virginia Prosthetics fitting a below knee amputation prosthesis. |
During our visit, internists and pediatricians saw 1322 patients in outlying medical clinics set up at local village schools or churches. Parasitic infestation, malnutrition, hypertension, and uncontrolled diabetes were frequently encountered. The medical teams have prepared medical treatment bags with anti-parasitic drugs, antibiotics, anti-hypertensives and vitamins as needed. High school and college students fluent in Spanish become indispensable in allowing the medical teams to communicate. The patients will wait in long lines to be seen by a physician. They come dressed in their best clothes to be examined by medical providers from a foreign land who speak another tongue. Their trust and faith in our abilities is remarkable and sometimes sobering as they hand over their small child for medical care.
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One of our pediatricians, Dr. Billl Keagy, with a Dominican boy and his mother. |
Our construction team completed a new classroom last year at the small community school of El Rosario. This year a kitchen was completed which will provide hot meals for the first time to the 200 children of this school each day. Construction work is hot and tedious with limited machinery, but the construction teams have excellent help from Dominican locals who work all week for $30.
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Construction crew inside the new El Rosario School kitchen. |
I have made long-term friends at the clinic, and after seven years, have some long-term patients. This year I saw a sixty year old man for the fourth time. I first met him 6 years ago and found that he had a nonunion of a Supracondylar – intercondylar distal femur fracture. It had been fixed with interfragmentary screws by a local surgeon, but had never healed. Despite this, he has walked on a severely deformed and painful knee with little complaint. Each time I have seen him, I have offered him a knee fusion. Doing a total joint replacement is not really an option in this setting. He still wants to work as a laborer. This year he decided to proceed with a knee fusion. I adapted two Kuntchner nails to become a telescoping fusion nail in the shop prior to the case and pre-bent a Synthes plate. The osteotomy of the tibia and femur were done with multiple drill holes and an osteotome with the assistance of my orthopaedic partner, Dr. Hugh Hagan. Other Orthopaedic cases included: tibial osteotomies, repair of nonunions, correction of fracture malunions, hardware removals, and amputation revisions.
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Pre-op X-rays: Subpracondylar fracture Nonunion in a 60 year old Dominican farmer 6 years following his moped He had significant varus deformity, but walked |
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Pre-op exam prior to knee fusion. |
Using an osteotome to perform the knee fusion osteotomy. |
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| Post-op day #1 outside of the Clinic. | Post-op X-ray. |
Dr. Hagan found ample opportunity to use his valuable skills in hand surgery. He operated on a woman with hand deformities due to Leprosy. He performed wrist osteotomies, Dupytrens contracture releases, burn eschar excisions (below), synovectomies, carpal tunnel releases and ganglion cyst removals.
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| Pre-op exam of a 1 year old child with a severe palmar burn contracture. | Intra-op view after contracture release and full thickness skin grafting. |
Each year we go to the Dominican Republic to offer those less fortunate our medical skills. We usually come away with more than we give to the wonderfully beautiful people of this lovely country. We are able to reconnect with what medicine is really about away from the bureaucracy of our typical medical practices. The stoicism and faith the Dominicans reveal is really a ministry all in itself.
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| Anesthesiologist, Dr. Judy Gustafson, with her sponsored student. |
For more information regarding Solid Rock Missions go to their website: solidrockmissions.org.
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