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Leaders in Innovation

Charles Kelman: The Saxophone-Playing Surgeon Who Changed Medicine

The steady hands of a surgeon are critical to performing a successful operation. With confidence and skill, they carry out the kinds of procedures that transform lives.

NIHF Inductee Charles “Charlie” Kelman had the skillful hands of both a surgeon and a talented musician. Kelman was a pioneer in the field of cataract surgery, dedicating his career to improving the field of ophthalmology even when others tried to dissuade him. As much time as he spent improving his professional work, he never neglected his other passion: music.

Eager to change medicine while still following his musical dreams, Kelman proved that sometimes boundaries were meant to be broken.

 

Becoming Dr. Kelman

Kelman was born in Brooklyn, New York, in 1930. From a young age, he was fascinated by music. At 3 years old, he began playing the harmonica. Within a few years, he took up the saxophone and clarinet as well. The 1930s were the era of big band music and more than anything, Kelman wanted to become a musical great along the lines of his idols Benny Goodman and Artie Shaw.

His father was an immigrant from Greece who had experimented with invention but never saw recognition for his work. This dissatisfaction was often used by the older Kelman as a prompt for his son to pursue a successful career in medicine. Despite being pushed toward a different path than he desired, he continued to play and compose music throughout high school and college.

Although his grades were not outstanding, Kelman was accepted to Tufts University. Shortly after beginning college, his family received news that his father had cancer. This information drastically changed the way Kelman viewed his future. He accelerated his studies and graduated from Tufts within two years. He then went off to medical school at the University of Geneva in Switzerland, hoping to complete his studies in time for his father to see him graduate. Sadly, Kelman’s father passed away just six months before his son graduated.

When he returned to the United States to begin a residency program, Kelman brought with him his enduring love for music. While in Geneva, he continued to play whenever he could and even co-composed a song, “Le Petit Déjeuner,” that was recorded by French singer Jean Sablon. For his residency, Kelman chose ophthalmology, which he had heard provided the most flexible hours and therefore would be conducive to practicing music. Soon enough, he found himself enthralled by his medical work.

 

A Groundbreaking Discovery

Kelman applied to Wills Eye Hospital in Philadelphia, one of the top ophthalmology programs in the country. Though initially denied entrance, he showed up to the school in person and persuaded his way into acceptance.

By 1960, Kelman began his private practice. Within the first few years, he took note of the publicity surrounding Irving Cooper, an American neurosurgeon experimenting with a cryoprobe to treat Parkinson’s disease. Kelman wondered if the device could be useful in ophthalmology. His investigations led him to develop a means to remove cataracts using the freezing technique, though his ideas were circumvented by a Polish physician who had published similar research.

Kelman returned to the drawing board frustrated and determined. He recognized that the inefficiencies of cataract surgery were a major drawback in the profession. At the time, the standard extracapsular cataract extraction involved large incisions and around 10 days in the hospital. From there, patient recovery continued to be a slow process.

Kelman began hypothesizing cataract removal through a smaller incision and avoiding the hospital altogether. He managed to secure a three-year grant to study this objective, and he spent the entirety of his allotted time and money testing different devices. By the end of the three years, Kelman believed he had come up short until a visit to the dentist struck inspiration. The dentist used a Cavitron® cleaning device that vibrated at ultrasonic frequencies to remove plaque. Kelman made an immediate connection. He believed a similar device could penetrate eye lens tissue and engrave lines on a cataract without it moving.

Kelman was able to then design a new device that developed phacoemulsification – a technique that involves emulsifying (liquifying) the eye’s internal lens and then drawing it out through suction.

 

Making His Case

Kelman’s revolutionary discovery was not readily accepted by mainstream ophthalmology. By 1970, he began training other surgeons in his new technique despite the criticisms of academic institutions. Phacoemulsification cataract surgery was deemed dangerous and even declared as merely “experimental” by the National Eye Institute.

With few institutions behind him and even fewer ophthalmologists willing to take the risk on a new procedure, Kelman felt his next step was to convince the public. He promoted his work through a public relations campaign that featured him entertaining on “The Tonight Show Starring Johnny Carson” and entering new business partnerships with the manufacturer of his phaco devices. The unconventional surgeon shook the establishment to its core when he appeared joking with Carson on national television and even playing his saxophone.

 

Triumph in Persistence

Kelman’s fearlessness and belief in what he created eventually overcame any doubts leveled at him. Today, the majority of cataract surgeries are outpatient procedures completed within five to seven minutes using small incisions, and Kelman’s techniques are most widely used. His concept for cataract removal even preceded the trend of minimally invasive surgery that became popular among other medical specialties. He was always interested in advancing ophthalmology, even when he was faced with opposition from his peers and the institutions of his field.

Kelman also loved science and art, and he found both to be integral to his success and happiness. He made use of the senses of sight and sound, never regarding either as mutually exclusive or one as more valuable than the other. In the end, Kelman’s capacity for harnessing the best of both senses made him the unforgettable person he was.

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