By Peter McDermott
Ask Dr. Joseph G. McCarthy to describe his job and he’ll point to a late-16th century quotation framed on his office wall.
Italian surgeon Tagliacozzi wrote in 1597: "We restore, repair and make whole those parts which nature has given but which fortune has taken away, not so much that they may delight the eye, but they may buoy up the spirit and help the mind of the afflicted."
"Four hundred years later, that sums it up," said McCarthy, director of the Institute of Reconstructive Surgery at New York University Medical Center.
McCarthy, author of the standard textbook on plastic surgery, first published in eight volumes in 1977, works entirely with children born with craniofacial abnormalities.
There’s a wide variety of such abnormalities. A separate unit at NYU treats the mildest and most common of them, the cleft lip and palate. McCarthy’s team, however, deals with children born with severe clefts and holes of the head and face.
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"Think of a young couple, recently married, all excited about a pregnancy and then they have a child born with a severe facial deformity; it’s absolutely overwhelming," he said.
"It’s not just the horrendous appearance of the child; often the child has a breathing problem, the eyes are threatened, the brain may be under pressure. So you have the appearance problem and what we call the functional problems.
"The services you have to provide are broad in scope. You need an ophthalmologist for the eyes, a neurosurgeon for the brain, an ear, nose and throat doctor for the breathing problem."
Psychologists and social workers are also usually involved.
This multidisciplinary approach is one cornerstone of the institute’s philosophy. Another is its commitment to take all comers.
"Anyone who gets to that door is taken on; there are very few medical units today who can say that," McCarthy said.
The 16 plastic surgeons and the other specialists attached to the institute regularly devote their services free of charge. The unit, which has approximately 5,000 patients on its books, is supported by the National Foundation for Facial Reconstruction and is sponsored by the Variety Club of New York.
The third part of the institute’s philosophy is its pledge to treat patients over many years.
"When we take on a child, we’re committed to that child until adulthood," McCarthy said. "It’s a very challenging and labor-intensive type care."
One essential aspect of a child’s well-being, though, is largely out of the hands of the professionals.
"The psychology intrigues me: why some kids can handle it and some can’t," McCarthy said. "The attitude of the parents is the key thing
"Each one of these kids desperately needs someone who believes in them, who goes to bat for them. They need constant reinforcement."
McCarthy first became involved with plastic surgery of the face under the guidance of his predecessor at NYU, Dr. John Converse. Later he went to study in Paris under Dr. Paul Tessier, who revolutionized a field that McCarthy has since also made breakthroughs in.
"Tessier showed that if you worked with a neurosurgeon and went in through the cranial cavity, you could take all the bones of the face apart and rearrange them," McCarthy said. "Before him, the eye sockets or orbits and the cranial vault and other parts of the skull were inviolable."
In 1956, Joseph McCarthy, who grew up north of Boston, began his college education at Harvard. In the first half of the 1950s, the university had been a favorite target of the notorious senator who shared his name. He was thus the object of "good-natured teasing" by a lot of the faculty.
By that time many Boston Irish families had long been associated with Harvard, he said. "Ted Kennedy was just a little ahead of me."
McCarthy, whose mother was born into a family of English heritage in Montreal, traces his Irish roots primarily to Mallow in County Cork. "My grandfather’s father came in 1816 when he was just a young boy," he said. That first McCarthy in America became a successful shoe manufacturer. He eventually married in his 60s and had five children.
McCarthy has himself been married for 37 years, and has a daughter and a son and three grandchildren.
His job, which also involves teaching and research, remains the other focus of his life. "It’s a long day and a long week," he said. Like everyone else, he doesn’t like the alarm clock going off. "But when I come in, I don’t feel I’m coming into work," he said. "It’s very exciting."