On the Shoulders of Giants

A personal tribute to Dr. Harold E. Kleinert by Suzanne Caragianis

Harold Kleinert, my mentor and dear friend, died on 28th September, 2013, at the age of 91. Dr. Kleinert was a pioneer who developed many aspects of hand surgery over his 55 years in medicine before he retired at age 86. But he also made another significant contribution which I would like to recognise and to encourage in others – his mentoring.

I’ve said he was my mentor – but what is a mentor? The Oxford Dictionary defines it as ‘an experienced and trusted adviser’. While its modern usage goes back to the 18th century, the word derives from the Greek Mentor, an adviser to Telemachus in Homer’s Odyssey. Perhaps we should also look upon it as kindly guidance.

Dr. Kleinert established his private hand surgery clinic in Louisville, Kentucky, Louisville Hand Surgery in l960 and mentored and trained over 1200 hand surgeons from over 50 countries during his working life. He summed up his mentoring and training commitment in these words “If you do something well, develop new procedures, instruments etc., you are obligated to share them and teach others.” Once, he said to me “The sign of a good teacher is if you choose good students and make them better than you in one way or another.

Dr. Kleinert was born on a ranch in Montana in l921. He attained his medical degree at Temple University in Philadelphia and completed a residency in Detroit. He became interested in hands – and particularly tendons – early on and felt they should be repaired rather than left. He wanted to improve the outcomes of hand surgery to improve function for his patients.

A full list of his achievements would be long indeed, but here is a summary of some of the most profound:

  • 1953 – Began investigating repair of small vessels using the smallest nylon available resulting in vascular repair in severe injuries. Was also working on flexor tendon operating techniques and post-operative protocols
  • 1961 – Published the first successful use of axillary blocks in upper limb surgery
  • 1962 – The first repair of digital vessels
  • 1963 – Developed Double Headed Operating Microscope and designed better microsurgical instruments and finer suture materials
  • 1963 – Performed the first revascularisation of a partial digital amputation
  • 1973 – Performed first Vascularised Epipyhseal Transfer in right forearm at 7-and-a-half years.
  • 1973 – National consultant in hand surgery to Surgeon General of US Air Force
  • 1976 – President of the American Society for Surgery of the Hand
  • 1977 – Performed the first Bilateral Forearm Replantation
  • 1980 – Received Scientific Achievement Award from American Medical Association for his significant contribution to medical science
  • 1986 – Founding lecturer for the American Society for Reconstructive Surgery.

Dr. Kleinert is perhaps most well known for his early primary flexor tendon repair work. When he presented to the American Society for Surgery of the Hand in l967 his results were so superior they accused him of being a liar. He invited them to Louisville where he presented his results. On his return, Dr James Littler – an eminent surgeon from New York – told the Society “If I injure a flexor tendon in a finger, I am getting on a plane and flying to Louisville.”

In l999 LHS completed the world’s first successful hand transplantation.

In 2001 Dr. Kleinert and partners opened what is believed to be the first 24 hour emergency hand care centre in the world where the dedicated and immediate hand surgery could be undertaken outside the main emergency room leading to faster evaluation and surgery – and hopefully recovery.

His hand surgery fellowship programme began in l960 and grew to one of the largest in the world. Some of the Australian hand surgeons who trained in Louisville include, Dr. Ian Leitch, Dr Jim Katsaros, Dr. Philip Griffin, Dr. Michael McCleave, Dr. E. Mah, Dr. Michael Tonkin, Dr. Mark Ross, Dr, Phillip Slattery, Dr. Tony Burger and Dr, Craig Smith to name a few.

Dr. Kleinert would always say “Doctors shouldn’t have egos. It’s about the patient.” He said “Try and learn something new every day; you can learn from anyone”. The ‘anyone’ included students and patients. He led by example, demonstrating generosity and compassion to each and every patient. He encouraged all his students (or children as he once said) to give entirely of themselves.

It is in part because of Dr. Kleinert I feel such a profound responsibility to teach and take on university students, to volunteer and undertake my medical missionary work and to treat patients, especially our chronic rheumatoid patients, as friends.

For me to have a mentor such as Dr. Kleinert has given me courage and strength to push the limits and give all I can to my patients, students and training therapists. What I would like to ask colleagues around the country is “Are you willing and able to take on, and carry forward, some of this mentoring and training so progressively undertaken by Dr. Kleinert?” Giving generously of your knowledge and experience as many of you are already doing and find fulfilment in is all of our responsibility and one of the objectives of the AHTA.

Unquestionably, our professional sphere has benefited hugely from Dr. Kleinert’s example and something would be sadly missing if too few others here, in Australia, could not find the time to give to the up-and-coming of this and future generations of keen professionals.

A quote from 'Mentoring Demystified' goes to the heart of the matter. Mentoring is “a synergistic relationship – two or more people engaged in a process that achieves more than each could alone. The purpose of mentoring is development. It is about learning not teaching and both mentors and those mentored grow from the experience.”

Thank you to my mentor, Dr. Harold E. Kleinert for the increased experience and wisdom you demonstrated, you certainly left the world a better place.


"Providing hand care and rehabilitation to our patients for over 25 years."