Stanley J. Dudrick, whose research into hospital nutrition transformed modern surgery, helping save millions of malnourished and critically ill patients who relied on his intravenous feeding technique to eat, died Jan. 18 at his home in Eaton, New Hampshire. He was 84.

The cause was complications from kidney failure and other health problems, said his son Stanley Dudrick.

Dudrick was among America’s most accomplished surgeons, known for almost single-handedly pioneering a way to nurse starving infants back to health, feed adults who are unable to eat normally and nourish patients after major surgeries.

Over a half-century career in medicine, he also taught tens of thousands of medical students and chaired surgery departments at the University of Texas Medical School at Houston, the University of Pennsylvania and two Yale-affiliated hospitals.

But he was best known for developing the feeding method known as total parenteral nutrition (TPN), a once-unthinkable breakthrough in which patients obtain all the nutrients they need – including proteins, carbohydrates, fats, minerals and vitamins – through a vein near the heart.

The technique, also known as intravenous hyperalimentation, bypasses the gut and has proved indispensable to newborns and adults suffering from severe burns or struggling with chronic bowel disorders. “I think it was one of the most dramatic advances in medicine ever,” said Walter Longo, chief of colon and rectal surgery at Yale School of Medicine. “I’m very surprised he didn’t win the Nobel Prize.”

Echoing those comments, retired physician and University of Illinois College of Medicine professor Barry A. Mizock ranked TPN alongside more “glamorous” achievements like open-heart surgery. “There are people with short bowel syndrome, who have lost a large portion of their small intestine, who would otherwise die,” he said.

Dudrick’s invention was all the more remarkable given that it came at the outset of his career. Raised in a Pennsylvania coal-mining family, he had turned toward medicine at age 7, after a doctor cured his mother’s life-threatening fever, and graduated from Penn’s medical school with top marks, remaining there for his surgical residency.

During one trying weekend in 1961, he lost three patients and came close to abandoning surgery altogether. “When they died, a piece of me died,” he told a Misericordia University interviewer in 2012. “In addition to my feeling inadequate personally, I got to thinking that there’s something deficient in the way we take care of seriously ill or injured patients surgically. You could do great operations, but many of the patients still died.”

His mentor, Jonathan E. Rhoads, had been obsessed with the issue of surgical nutrition, and encouraged Dudrick to pursue a comprehensive intravenous feeding technique, then considered little more than a pipe dream. “Even if it were possible, it would be impractical; and even if it were practical, it would be unaffordable,” Dudrick once said, recalling the skepticism of his peers.

Among other problems, a high concentration of nutrients could cause a vein to collapse or become infected, and the dosage could lead to blood sugar issues, according to Longo. But after five years of work, Dudrick found a way to feed beagle puppies entirely by vein, resulting in six grown dogs – including a beloved pup known as Stinky – that were comparable in size to those fed normally.

That success was followed by a 1968 article in which Dudrick and his team reported that they had used TPN to support a human baby with a fatal bowel deformity, after testing the procedure on adult patients. Hospitals began adopting the method, albeit slowly at first, with heavy skepticism from some physicians who objected to its use in ailing infants who risked spending their lives in a sickbed.

A 1983 report in The New York Times described one baby receiving TPN as “a hostage to medicine,” and quoted a Columbia University pediatrician who called the procedure “a horrible experiment.”

“We’re dealing with an evolving medical science,” Dudrick said in response to the criticism. “As we go along, we modify things and learn. But to deny TPN to a child unless there is absolutely no hope is simply unethical. It is letting a child starve to death.”

In time, the flood gates opened. According to a 2015 article in the American Surgeon, a monthly medical journal, the mortality rate in post-surgical cases dropped to nearly 5% – from 40% to 60% – as a result of TPN. A 2015 newsletter from the American College of Surgeons credited the technique with having “saved well over ten million patients from succumbing to their disease.”

Like Jonas Salk with the polio vaccine, Dudrick never patented his technique or sought to make money from it. Instead, he told People magazine, he wanted simply “to leave something better behind when I go, rather than just practice medicine the way it has always been done.”

The first of four children, Stanley John Dudrick was born in Nanticoke, Pennsylvania, on April 9, 1935. His grandfather was a Polish immigrant who found mining work only after agreeing to an exacting condition: that all of his sons, including Dudrick’s father, “work at the mines for free until age 18,” according to the American College of Surgeons.

Dudrick’s father later worked as an insurance agent, in addition to assembling B-29 bomber wings during World War II and enlisting his eldest son’s help in building houses and repairing cars – technical work that may have contributed to Dudrick’s decision to become a surgeon.

He received a bachelor’s degree in biology from Franklin & Marshall College in 1957 and graduated from medical school at the University of Pennsylvania in 1961, later joining the faculty at what is now the Perelman School of Medicine.

Dudrick spent most of the 1970s in Houston, at what is now McGovern Medical School, and went on to teach at Yale University, the Geisinger Commonwealth School of Medicine in Pennsylvania and Misericordia, a Catholic university in Dallas, Pennsylvania, where he served as founding medical director of a physician assistant program. He also co-founded the American Society for Parenteral and Enteral Nutrition (ASPEN) in 1975 and was its first president.

Survivors include his wife of 61 years, the former Theresa Keen; six children; a brother and sister; 16 grandchildren; and five great-grandchildren.

Dudrick stepped away from daily surgery in recent years but remained involved in medicine as a teacher, mentor and researcher, to the surprise of some colleagues.

“I get frustrated at times by the attitude among many of my fellow human beings who question why I am still pushing,” he said in the 2012 Misericordia interview. ” ‘What you did was great. Wasn’t that enough?’ They have a hard time understanding that I am not happy enough with the way things are.

“I would like to see health care and education continue to progress and advance,” he continued. “What drives me is the philosophy of Benjamin Franklin, which is to work every day to discover and produce new, useful knowledge. I’m addicted to the basic concept of producing new knowledge overall, but especially if we can make it useful and relevant to maximally improve the human condition.”

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