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t m c » p u l s e | m a r c h 2 0 1 9 25 Bryant Boutwell reads an excerpt from his book at a UTHealth event. button]. His belly was full of green stuff. I honestly believe that guy had eaten a quart of guacamole. And it hit the vena cava and his duodenum and pancreas— bad injury. So, hell, what do you do? And then when you have a pancreas and duo- denum that messed up, and you take that out—you take out the duodenum, the head of the pancreas, and then you're supposed to put it all back together so that the bile drains into the jejunum. . . . And because he was so contaminated, I decided to remove his entire pancreas which is not that hard to do, [but] if that connection between the pancreas and the jejunum leaks, you got a mess. In telling the story Red was lost in the moment, describing intricate details of the epic procedure while simultaneously sketch- ing on a napkin his approach and multiple complications along the way. Clearly he was not going to give up on his patient and did not (the patient survived, as best he remembered). Why attempt such a long procedure? "Yes, that's crazy, but there wasn't anybody else to do it." For many procedures, improvisation and bucking the status quo were not out of the question. Afghanistan, the army, and the Boy Scouts had taught him that if you don't have what you need, you make do. For years Red's surgical residents would hear him preaching during surgery on the value of leeches and maggots for cleaning wounds and brown sugar to promote healing. One surprised resident was sent from the operating room to the gro- cery store during a long surgical procedure to buy additional brown sugar. "Brown sugar, not white sugar," Red yelled out the door as his stu- dent headed for the store scratching his head. It worked time after time, and Red rejoiced in proving his point. He also pointed to support in the medical literature for the position that alternative medicine should not necessarily be dismissed out of hand. Looking back, Red summed up his teaching career with satisfaction. "I've had some really great students over the years, and I can proudly say not a one was taught to do half a surgery or to think of anything beyond the patient as the focus of everything we do." Left: Tank commander Lt. James Duke, Jr., Texas A&M University. Middle: Duke and his first wife, Betty, on their wedding day in 1953. Right: Duke in surgery. Dwight C. Andrews, McGovern Medical School at UTHealth