Following is a list of Dr. Ephraim McDowell’s personal qualities described as “C” words along with evidence corroborating each of the characteristics.

Courageous: When he agreed to attempt an operation that his teachers had stated was doomed to result in death, he, as well as his patient, showed great courage.

Compassionate:  He was concerned for his patient and responded to Mrs. Crawford’s pleas for help.

Communicative: He explained to his patient the details of her condition and her chances of survival so that she could make an informed choice.

Committed: He promised his patient that if she traveled to Danville, he would do the operation. He made a commitment to her care.

Confident: He assured the patient that he would do his best, and she expressed confidence in him by traveling 60 miles by horseback to his home.

Competent: Although lacking a formal medical degree, he had served an apprenticeship in medicine for 2 years in Staunton, Virginia, and he had spent 2 years in the study of medicine at the University of Edinburgh, an excellent medical school. In addition, he had taken private lessons from John Bell, one of the best surgeons in Europe. By 1809 he was an experienced surgeon.

Carefull: Despite the fact that 2 physicians had pronounced Mrs. Crawford as pregnant, he did a careful physical examination and diagnosed that she was not pregnant but had an ovarian tumor. He also carefully planned each operative procedure with a review of the pertinent anatomic details. As a devout Presbyterian, he wrote special prayers for especially difficult cases and performed many of these operations on Sundays.

Courteous: He was humble and courteous in his dealings with others. Even when he was publicly and privately criticized after the publication of his case reports, he did not react with vitriol. The qualities of character demonstrated by Dr. Ephraim McDowell 200 years ago are still essential for surgeons today.

Dr. Ephraim McDowell exemplified the essential qualities that define a great surgeon. His courage was evident when he accepted to perform an operation deemed fatal by his mentors, facing the unknown with determination. His compassion shone through in his genuine concern for the well-being of his patients, responding to cries for help with sensitivity and empathy. He was communicative, ensuring that his patients were well-informed about their conditions and the risks involved, enabling decisions based on knowledge. Additionally, Dr. McDowell demonstrated unwavering commitment to his patients, keeping promises and ensuring that each received the best possible care.

His confidence in his abilities, even without a formal degree, was supported by a robust education and a continuous dedication to learning. Dr. McDowell was competent, the result of years of study and practice, conducting meticulous physical examinations and planning each procedure with precision. His courtesy and humility in interactions, even in the face of criticism, showed a character that valued respect and integrity. These qualities, demonstrated two centuries ago, are timeless and continue to define ethical practice in modern surgery. As William Osler aptly stated, “The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.”