Pediatric surgeon Douglas McKay finished the delicate 90-minute operation, straightened up from the table and gave an “okay” sign to people anxiously watching through the operating room door. Then, gently tickling Josh, his 9-month-old patient, the doctor said fondly, “He’s a cute little guy, isn’t he?”
McKay, 52, is head of orthopedics at Children’s Hospital National Medical Center in Washington, D.C., but this particular afternoon he was moonlighting in an extraordinary way. The operation was taking place at the National Zoo and Josh was a spider monkey. For nearly two years McKay has been treating animals in addition to children; he has acquired a considerable reputation with both.
His unusual avocation began when the zoo’s prize orangutan Azy came down with infectious arthritis in one elbow. It was an unfamiliar problem to chief veterinarian Dr. Mitchell Bush. Because McKay had examined Bush’s infant daughter for a defective thumb, Bush asked him to consult on Azy’s case.
For McKay, who specializes in reconstructing children’s club feet, dislocated hips and malformed spines, Azy presented a new challenge. “Orangutans,” he explains, “use their arms much more than humans do, for swinging from tree limbs, for example.”
Two operations were required, one to treat the elbow joint, the second to repair damage caused when Azy pulled a drainage tube from his arm. “We left his incision open to heal,” says McKay. “That’s something we do more and more with humans, but vets would be hesitant because animals have a tendency to worry their wounds. In this case, it worked.”
Since that first surgery, McKay has operated on a tiger’s ankle, a lion’s paw, a crane’s ankle tendon, an antelope’s hip and Josh’s thigh, broken when an older male attacked him. “The zoo,” McKay says, “has become my hobby. Some of the names for the anatomy are different, but I don’t get lost, and that’s a surprise. All I do is pick up the knife and go to work.” (Sometimes there are special problems, however, such as operating on Aghbala the lioness. “When she moved,” McKay laughs, “I said, ‘Keep that thing asleep or I’m getting out.’ “)
McKay is best known to other orthopedists for originating an operation to straighten the spines of children with kyphosis. It is a condition caused by a birth defect, injury or illness that produces a humped back and paralysis of the legs. To eliminate the hump, McKay designed a steel plate which is inserted through the abdomen and fitted to the spine. Installing the “McKay plate” takes eight hours by a specially trained surgical team. The plate literally pulls the backbone into line. Although the legs remain paralyzed, the operation does relieve pressure on the lungs and intestines and enables patients to lead a far more normal life. “The greatest improvement,” says McKay, “has been in social problems. One of my patients had dropped out of school because of her deformity. Now she has returned and is doing well.”
McKay has performed the operation 15 times, with 90 percent success, but he has not yet submitted the procedure to medical journals. “I want to refine the technique before publishing a paper that would open it up to other doctors,” he explains.
A native of Maine and son of a doctor, McKay planned to study engineering, as his two brothers did. While he was at the University of Maine, however, his father died. “I was impressed at the outpouring of people at his funeral,” McKay recalls. “I began to think, ‘Maybe I will go into medicine.’ ”
After earning his M.D. at Tufts, McKay interned in surgery. “I liked surgery,” he says, “because you did something. You didn’t just watch. If you’re wrong, of course, you’ve got a mistake on your hands that you can’t forget.”
He practiced in New Mexico and in Louisiana, where he chaired the orthopedics department at LSU Medical School. In 1972 he was hired to build up the orthopedics department at Children’s, the newest pediatric center in the U.S. He operates 200 times a year, 40 or so by invitation from other hospitals. “McKay’s a superman. We’re lucky to have him,” says Children’s chief surgeon, Judson Randolph.
McKay has enlisted Randolph and another colleague at the hospital to help at the zoo. But sick children remain the great challenge. “You’re creating something for 60 years, their whole lifetime,” he says. “You’re not just trying to make them comfortable until something else happens to them. Your surgery has to stand up for a long time. And it’s so rewarding. At Christmas they send me cards.” Now, he adds, he’s even more popular with his young patients: “They say, ‘That’s my doctor. He takes care of animals too.’ ”