Crudup Maneuvers
Surgeons who trained under James Crudup reflect on the things he taught them — everything from stitches to spirituality.
The thing about surgery that Jimmy taught me — and I learned from other great surgeons I’ve had the good fortune to work with — is that if you have a problem and you correct it, you have to reestablish the course of the operation from before that problem occurred. If an adverse event occurs and you have to drop everything to fix that adverse event, you then quickly reset your mind to pretend like it didn’t happen. Jimmy taught me that.
Jimmy often operated by himself so he developed ways to put the retractor in and hold the tissue back such that he could do what he needed to do and not rely on somebody else. That was another lesson: to set the field up to be self-contained so you weren’t struggling against the anatomy. He taught me to be very gentle with the tissues. He was very meticulous and stopped all bleeding when it occurred. So much of the way I operate is from him.
— Bruce Gewertz, M.D. (Residency 1977)
He had a way of setting up the field so that there was never a wasted move. And he always did the procedure in his head, first. You hear about athletes, how they run the race, or shoot the basketball, or go up to bat and they do it first in their heads. That’s what he did. And that’s how we try and approach surgery — having it planned out.
Jimmy had a wonderful philosophy of life. He was very respectful of God and knew his place in the grand scheme of things. You picked up on that and realized that this guy had the right perspective.
— Thomas Wakefield, M.D. (Residency 1984)
He worked very strongly on the basics. I had a shake in my hand and it scared me, but he pointed out that the skill is not in your hand and muscles, but in your brain. He taught me to follow the curve of the needle as you put it into the tissue — you can traumatize the vessels when you’re sewing them together by not exactly following the curve of the needle. I learned to make sure every knot comes down flat, how to free up vessels and to avoid tension on the suture line and to be gentle. I’ve been operating on my own now for 35 years and I can tell you that patients have less post-op pain, less infection and faster healing if you treat the tissues gently.
I learned not to be in a hurry. Generally, the fastest surgeries are the ones that go slowly and with an economy of motions. If you get a bleeder, you are calm about it and control it without getting frustrated or upset.
— Sherman Silber (M.D. 1966, Residency 1973)
I remember once I asked him, ‘Jimmy, if you had to have surgery, who would you have do it?’ And he just laughed and said, ‘I’d get a mirror!’ I think that was a nice thing about him. He was proud (of what he knew and what he could do), but was a very humble man. He was confident without having any arrogance at all.
I think about him all the time. Sometimes I’m putting in a stitch the way he taught me and I think to myself, “This is the Crudup Maneuver…”
— Linda Graham (M.D. 1975, Residency 1981)