Acta chir belg, 2006, 106, 267-274

“Bruges possesses many treasures of art from previouscenturies, but the living treasure of Bruges is certainlyProfessor Sebrechts” (1). With these words, QueenElisabeth honoured the surgeon with whom she hadclosely worked with the Belgian Red Cross (Fig. 1). A few weeks later, on Easter morning, March 28th

1948, Joseph Sebrechts passed away due to bleedingoesophageal varicose veins, as a consequence of cirrho-sis caused by hepatitis. At the age of 63, after a hecticyet ascetic life, he stopped working on the eve of PalmSunday, said goodbye to patients and collaborators,returned home, asked for the last rites after a massivehaemorrhage, and died after being treated by his assis-tants and nurses during the entire Holy Week. His deathwas unexpected : in between operations, he was knownto vomit blood now and then, but he hid everything fromhis nearest and dearest right up to the very end in orderto not upset them needlessly. He died as he had lived :calm, only concerned about his patients, brave, full ofconfidence, and deeply faithful.

On April 2nd 1948, he was honoured with a princelyfuneral procession. His coffin was carried by six assis-tants from his house to St. Salvator cathedral, with thousands from all strata of society mourning in the rain along the route, hearing the chimes of the triumphal

bell in the Halletoren. After all, the term “zeebrechten”had become synonymous in West-Flanders with“surgery” (2), and in the eyes of the people he hadbecome a legend.

Bruges had lost its most famous citizen. The clock inthe front of the Minnewater clinic was stopped on theday of his passing, and has never operated since.

After his death, the city changed the name of‘Gasthuisstraat’ at the Minnewater into the ‘Prof. Dr.J. Sebrechtsstraat’, “in recognition of the exceptionalmerits of the late Professor Sebrechts, whose great com-passion will live on in the appreciative memory of thepeople of Bruges”. The beautiful garden of his patricianhouse, which was visited by Queen Elisabeth and byPrincess Josephine-Charlotte, became the city park “HofSebrechts”, with a memorial plaque as a gift from thefamily to remind passers-by of their famous fellow citi-zen. A bronze bust in his likeness (Fig. 2) was placed in

Prof. Dr. Joseph Sebrechts : “primus inter pares”

E. Sebrechts

Dienst Heelkunde, A.Z. Jan Portaels, Vilvoorde, Belgium.

Surgical history

Fig. 1Queen Elisabeth of Belgium with Dr. J. Sebrechts duringinspection of Red Cross divisions in Bruges (September 1939).The gentleman on the left is Henry Baels, Governor of WestFlanders, father of the future second wife of King Leopold III.

Fig. 2Bronze bust of Dr. Sebrechts in the hall of St. John’s Hospital.

1 See PANNIER, 1985.2 See DE WOLF, 1942.

268 E. Sebrechts

the hall of St. John’s general hospital, and a woodendoor on which the assistants, which numbered thirteen at the time of his death, had burned their names for years (Fig. 3) was preserved as a precious reminder ofthe “school of Sebrechts”(3).

The Life of Joseph Sebrechts.

Joseph Sebrechts was born on February 11th 1885 inWillebroek as the youngest of six children. His fatherwas a notary in Mechelen, but became hemiplegic whenhis little son was only five years old, and passed away in1895, leaving his wife alone with the burden of raisingthe family, more so since her eldest daughter joined a convent. His great-grandfather Corneille Sebrechtsreceived a gold medal for obstetrics in 1793, and another great-grandfather was a physician as well.Joseph was raised in a very religious family : one sisterand four aunts were members of the Sisters of Mercy,taking care of orphans, lunatics and incurables.

Joseph grew up amid the fascinating years at the turnof the century, with the discovery or introduction ofelectricity, radioactivity, X-rays, radio, motorbikes, cars,airplanes, helicopters, metro, trams, atom, relativity theory, neon, incandescent bulbs, aluminium, Kodak,film, gramophone, air-filled tyres, ballpoint pen, vacuumcleaner, sewing machine and, last but not least, theBelgian Congo. He had been an enthusiastic guide forhis family during the World Fair of 1900 in Brussels.

As a child he stood out due to his pleasant disposi-tion, sacrificing spirit, and his technical ingenuity. For

example, he surprised everyone by equipping the parentalhome with electrically operated roller shutters using ahomemade induction coil, and also by making qualityphotographs using a camera of his own design. This talent would later prove to be of exceptional value forhis surgical techniques and also for the ultramodern furnishings of his home and hospital practice (4). The‘frame of Sebrechts’ to facilitate exposure of the intra-abdominal organs during surgical procedures is still inuse.

He was educated at French-speaking schools (5) inMechelen, Ghent (St. Barbara) and Aalst, where hemaintained excellent grades. At the age of thirteen, heapproached the Fathers of the Congregation of Scheut,but was rejected because he seemed too weak for thedemanding mission to China. At the age of fifteen, hetravelled to Rome with two comrades to see the Pope.With a Motosacoche (a precursor to the motorcycle),bought with money wheedled out from his sister, hewould later make the trip via back roads to Leuven(Louvain), where in 1908 he was promoted magna cumlaude to doctor of medicine. He remained assistant forone more year in the department of surgery to ProfessorThéophile Debaisieux, before taking a study-trip toGermany, Austria and France.

At the end of 1909, at the age of 24, Joseph moved toBruges with his sister Eulalie, after a debate between hisbeloved Professor Debaisieux and the AugustinianSisters of Meaux, who had fled France to Bruges in1905 due to Combes’ law, imposing the separationbetween church and state. Doctor Sebrechts, as a youngwell-trained surgeon came to Bruges only to find him-self being the right man in the right place at the righttime.

After the bloom of the “Venice of the North” underthe rule of the Burgundians, around 1850 after the firstfood riots of the young Belgian nation, Bruges decayedto the point where it received the title of ‘poorest city ofFlanders’. For the first time since the middle ages therewas famine, paired with cholera and typhoid fever,caused by the economic and agrarian crisis. In Bruges,moreover, it was compounded by the loss of the lace

3 One of his last assistants was his son Paul, the late U.S. NavyCaptain, who specialized at the Mayo Clinic in Rochester, Minn.,served as Chief of colorectal surgery at the U.S. Naval Hospital in SanDiego, then the world’s largest hospital, and became Professor ofSurgery at the University of California.4 Examples of these furnishings include central heating, electricity,the first cold-warm mixing tap (from his own design, to the surprise of the local plumber), a water mains delivering groundwater, and anautoclave remodelled to serve as a pressure pump for car tyres. 5 In those days French was the official language and the only oneallowed by law in Flanders’s secondary schools and universities, eventhough in the Dutch-speaking part of Belgium ! The ruling waschanged in the 1930s.

Fig. 3Sister Angele, chief staff nurse, presenting the burned woodendoor, Sister Dominique, and Dr. Sebrechts.

Prof. Dr. Joseph Sebrechts : “primus inter pares” 269

industry. Baudelaire spoke of the “ghost town, mummytown”. However, in 1892, when Georges Rodenbachbrought the city back into international notoriety withhis novel “Bruges la morte”, the standard of living hadalready sharply risen. At that time, restoration works inneo-gothic style were commonplace for public build-ings, and construction of the port of Zeebrugge and thesea canal had just begun. It was a lively provincial citywith 40,000 proud inhabitants, amongst which animportant English colony had introduced tennis andfootball. Public life had gradually become moreFlemish-orientated after the death of the local famouspoet Guido Gezelle. Tourism industry extended its firsttendrils, thanks to the exceptional preservation of thecity’s medieval character (6).

Meanwhile, modern surgery became possible due tothe advances of anaesthesia and asepsis, and wentthrough a period of explosive growth at the end of the19th century. The first successful operation for a perfo-rated appendix was performed in 1885, the year ofSebrechts’ birth (7). After the creation of the BelgianSociety of Surgery in 1892, the elevation of status andfresh recognition of the surgeon in society could finallybe seen. Finally, after the turn of the century, the‘quacks’ that had operated on the market square gradu-ally disappeared from the scene.

Joseph Sebrechts had to wait more than six monthsbefore receiving his first patient, since he would onlyaccept surgical pathology. Meanwhile the sisters builtSt. Joseph’s clinic, later known as ‘the clinic ofSebrechts’, which opened in 1910. It became rapidlyclear that the premises were too small for the hugedemand of patients upon it. According to her eldest son,his exasperated single mother said : “Louis, it is incred-ible how much money our Jefke is costing me. I shouldsell a forest. You’re an adult now, what do you think ofthis ?”

In 1912, Sebrechts was also appointed assistant-sur-geon to St. John’s hospital (8), where five years later hebecame head of the department of surgery. Fifteen yearslater, he was appointed chief physician, after he hadincreased the yearly number of surgeries in Bruges ten-fold, together with Sister Angele, his chief staff nurse.One local newspaper mentions an astonishing number of1430 operations in 139 consecutive days (9). Perhaps heneeded as little sleep as Napoleon ? Within a few years,he had turned the dated provincial hospital, which wasfurnished with world-famous Memling paintings that heloved to show to foreign visitors, into a post-universitycentre of excellence. The surgical results were spectacu-lar : in 1930, he presented a series of 243 laparotomiesfor ruptured extra-uterine pregnancy with auto-transfu-sion of blood, without a single mortality (10).

Meanwhile, both the hospital and the clinic were con-tinuously expanded and modernised, according to his

detailed instructions. In 1935, feeling most unhappybecause he could not get a new building, he moved thesurgical department to the renovated Minnewater Clinic,which was later used as a military hospital in 1940. Formany years, the board of the hospital could only bereluctantly convinced to fund these activities, since inthe previous century, they had been continuously oblig-ed to save up for the next possible disaster. Now, theyattributed the reason for the explosive growth of the hos-pital mainly to one single person, claiming that thisgrowth was disproportionate to the needs of the localpopulation (11). In his quest for perfection, Dr. Sebrechtshimself expended fortunes on surgical instruments.Those, which remained unused, were donated after hisdeath, to the University of Lovanium in the BelgianCongo. Professor Paul Hennebert would later report thecase of a young girl whose leg was extended by 17 cmusing one of these instruments (12).

In 1911 he married Jeanne Van Caillie, the daughterof a justice of the peace from Ostend, who was, in accor-dance with the usual customs of the day, solely raised forpurposes of matrimony and motherhood. She would givehim eight children. Maurice, Frans and Joseph wereborn in 1912, 1913 and 1914 respectively. At the out-break of the First World War, Jeanne was sent toEngland with the three infants. The first months of theirexile were very trying, until the parishioners of St Paul’sAnglican Church at Ramsbottom, Lancashire got wordof her situation, and organized collections to pay forhouse rental and food until she could establish contactwith Belgium via Holland to finance her further stay.During the First World War, the new “Bruges at sea”(Zeebrugge) was a U-boat harbour of strategic impor-tance for the Germans, and bombs were dropped onBruges regularly. Nevertheless, Joseph remained on thescene working as a young surgeon and being a tempo-rary bachelor. He gained valuable experience treatingcivilian victims, while his elder colleagues workedbehind the front lines in field hospitals led by A. Depage (13). In 1920, what the Belgian people hadsuffered during the war became internationally acknowl-edged when Antwerp was allowed to organise theOlympic games. Our national athletes, even though they

6 See VAN DEN ABEELE, s.d. 7 Three years earlier, the 44-year-old French statesman LeonGambetta had passed away on New Year’s Eve due to acute appen-dicitis, not having received an appendectomy. 8 A Visit to the Sisters of this hospital inspired Florence Nightingaleto start her admirable crusade.9 See Anonymous, 1925.

10 See DESBARAX, 1990.11 See Anonymous, 1934.12 See HENNEBERT, s.d.13 For detailed biography of Depage, see VAN HEE, 2002.

270 E. Sebrechts

were exhausted from war and Spanish’ flu, managed towin 36 medals, amongst which were 14 gold medals.

Jeanne came back home after the war, having beenseparated from her husband for more than half their mar-ried life to date, after which she gave birth to Paul,Etienne, Marie-Jeanne and Ignace in 1919, 1920, 1922and 1924 respectively. Fate struck when their youngestbaby died in 1924, and subsequently, when her husbandbecame severely ill in 1926 with hepatitis. He barelyrecovered from this disease, which supposedly had beencaused by a puncture accident. When the beloved doctorwas in danger of dying, thousands were mobilised forthree pilgrimages to ‘Our Lady of Assebroek’, and fortwo ‘Ommegang’s of the Holy Blood’. Joseph wasadministered the last sacraments in the presence of 25doctors, almost the entire compliment of those availablein the region (14). In spite of a poor prognosis, as con-firmed by the experts of the University of Leuven,Joseph recovered thanks to the determination and exper-tise of his assistant Dr. Andre Goffaerts. (Fig. 4) (15).As gratitude for his unexpected recovery, JosephSebrechts financed the construction of an art-decochapel with a statue of St. Therese of Lisieux inSt. Salvator Cathedral (16, 17).

Soon after the war, and particularly after the devalua-tion of the Belgian Franc, the economy revived fully fora few years. Just before the great depression, Dr.Sebrechts went on a boat trip to North America in 1929to attend a congress on hospital management, and toresearch medical infrastructure. Within two weeks, hemanaged to visit many centres, thanks to a special train,and the constant company of special motorcycle police-men for the members of the First International Congressof the Hospitals. This study trip inspired him to furthermodernisation of infrastructure and medical care inBruges, even though he considered the American system

much too expensive : daily cost for one patient equalled140% of the average workers daily wage whereas inBruges it amounted to only 35%. Even so, he was mostimpressed by the great degree of tolerance between theclergyman and the laymen, at the service of the patient.

Back home, after the stock market crash, not havinginvested in shares, he managed to buy the 730 hectares“Domain De Lint” in Oud-Turnhout, with moorland,swamp, sand dunes, pinewoods and bird reservation. Onrare occasions, he enjoyed some well-deserved, butalways too brief breaks with his family. His love ofnature was an inherited gift from his father (18).

Jeanne was very proud of her famous husband, “legrand patron”, for whom his career was the top priorityleaving little time for his wife and children. She tookcare of all the rest, single-handedly and dutifully, alwayscourageous, but sometimes despairing, since she wasseverely disabled by rheumatoid arthritis and varicoseveins (19).

Apart from having been in most European nations,Dr. Sebrechts also visited Lebanon and Egypt on theoccasion of the International Congress of Surgery in1936. He returned from Egypt with mementos of the dis-covery of the tomb of Tutankhamen in 1923, which lefta deep impression on his children.

But then the Second World War broke out. Duringthose frightening days of May 1940, he remained at hispost, while all military doctors were sent to France for afruitless stay during the short Belgian campaign. Brugeslay right behind the front lines, and Dr. Sebrechts,together with his assistants, provided shelter for tens ofthousands of refugees, and for the many wounded alliedand German soldiers. At one time, 1200 injured arrivedby train in a single night. He mobilised everyone, and setup 3200 beds in a few days, while surgical operationswere performed around the clock. Eight ambulancesunceasingly carried the wounded across the front lines,and when they were disallowed passage, Dr. Sebrechtsrelied on the King to convince the military commanders

Fig. 4Dr. J. Sebrechts (4th from the left) with his assistants (1925).Dr. A. Goffaerts is 2nd from the left.

14 See D’YDEWALLE, 2000.15 Dr. Goffaerts later had an impressive career in Aalst, but unfortu-nately died at the age of 48 from a horse-riding accident.16 See D’YDEWALLE, 2000.17 Two years later, his youngest daughter was also named Thereseafter this recently canonised and very popular saint. Her birth wasquite a surprise to the already 45-year-old mother.18 His father had written a book entitled ‘The rustic conifers ofBelgium’.19 She was living in a golden cage, and secretly used his commodiousincome for all kinds of charity. Nevertheless, she had the reputation ofbeing a rigid and tough lady, even in the opinion of the numeroushouse staff. She suffered her first heart attack only a few months afterJoseph passed away. Fortunately, she was looked after, until her deathin 1961, by her youngest daughter, who, following the example of pastgenerations, ended up sacrificing her youth.

Prof. Dr. Joseph Sebrechts : “primus inter pares” 271

with a simple statement ‘par ordre du Roi’! (20) (Fig. 5).After the capitulation, when the German military com-manders realised that their soldiers had received thesame treatment as the allied forces, they expressed theirthanks.

In 1945, he coordinated aid to the many farmers whohad been driven from their land by artificially createdfloods, and at the end of the war he and his son Frans,using his own vehicle, led the re-supply convoys thattravelled to Zealand Flanders to bring food and clothing,and to transport the sick to safety. He broke many civiland military regulations, and recklessly endangered hisown life, but in the end, he brought salvation in the midstof despair. In 1946, Queen Wilhelmina of TheNetherlands nominated him ‘Commander of the Orderof Orange-Nassau’ with the words, “I thank you, doctor,for all you have done for my people”.

Reputation and Character of Joseph Sebrechts.

Joseph Sebrechts dominated surgery in our country during the interbellum, and, together with other eminentsurgeons, ensured that surgical developments kept pacewith foreign centres. The names of Antoine Depage,Albert Hustin, Albin Lambotte, Fritz De Beule, RobertDanis and Albert Lacquet should be remembered forgenerations (21).

Dr. Sebrechts had exceptional technical ingenuity,organisational talent, ethical principles as a surgeon, afeeling for a correct diagnosis, and also as leader ofmany organisations, strong judgment of human charac-ter. Moreover, most outstanding was his love and respectfor his patients, whom he always tried, to the best of hisabilities, to save from stress and pain. This was notalways evident at a time when suffering and pain wereconsidered part of the disease, and were even looked on

by the Church as soul saving. In a calm, humble and loving fashion, he invested the

majority of his time taking care of his patients, alwayssucceeding to give each individual the illusion that hehad all the time in the world for him or her. He followedin the footsteps of Ambroise Paré, of whom KingCharles IX had once asked on his sick bed that he betreated better than patients in the hospital, only toreceive the response “That is not possible, Sire, becauseI treat the poor as kings”. For Dr. Sebrechts, there wasno distinction between paying and non-paying patients,and for the latter, he often bore the costs, including thoseof Vitallium prostheses made in the USA. He also intro-duced metallic hip-replacement in Belgium. When thecity of Bruges refused in 1924 to start an ambulance ser-vice, he did it by himself, with his own car and driver,and with his wife as bookkeeper. The city took over theservice two years later, when it had become profitable.He once told his eldest brother : “Imagine, Louis : it hasoccasionally happened that they’ve brought me afarmer’s wife carried in a horse-drawn carriage, on a bedof hay. How could one possibly save such a poor soul, when she has been shaken about so much on herjourney ?’ Occasionally, patients paid in natura, whichwas not always a bad thing : in 1939, Constant Permeke,later to become a very famous painter, gave Dr. Sebrechtsa painting in repayment for his treatment, with anaccompanying letter, from which can be deduced thatthe surgeon could not find the time to visit the artist’satelier to make a choice from the paintings himself.

At his nomination as a member of the RoyalAcademy of Medicine, surgeons of the ‘school ofSebrechts’, gave him an appropriate souvenir : a bronzebas-relief work of sculptor Octave Rotsaert, bearing alikeness to the Good Samaritan, but modified to have thedoctor’s facial features. We also have a stained glasspane in our possession depicting a similar scene.

Early on, and at his own expense, he introducedradiotherapy for tumour treatment. Several years later,the hospital bought the device in question. This is thereason why the provincial council consequently entrust-ed him with the organisation of cancer control, eventhough the University of Ghent was also a candidate (22).He was convinced, just as his wife, that his days as a sur-geon were numbered : insufficient radioprotection gavehim, like many other pioneers in this field, serious radio-dermatitis of both hands.

Being a capable diplomat, he always remained abovecontroversy. As a result, he was praised by Royalty,

Fig. 5King Leopold III with Dr. Sebrechts visiting the surgicaldepartment during the 18-day campaign in 1940.

20 See LACQUET, 1948, 17.21 See for biographies of these surgeons : R.VAN HEE & P. MENDES DA

COSTA, 1993.22 See Anonymous , 1925.

272 E. Sebrechts

French-speaking upper classes in Flanders, Flemishelite, common people, the Church, not to mention hiscolleagues, who spontaneously relied on him for manyduties. In 1925, he had been named Associate Professorof Surgery of the University of Leuven, and he was alsovice-president of the National Red Cross, led by Princede Merode. He was a member of the High HealthCouncil, and was the driving force behind the White-Yellow Cross and Winter Help, as well as being presi-dent of the Royal Academy of Medicine, of the FrenchSociety of Anaesthesia, the Belgian Society of Surgery,the Provincial Medical Council of West-Flanders, theBelgian Society of Anaesthesia, the Belgian Society forGastro-Enterology, the Belgian Society of Gynaecologyand Obstetrics, the Flemish Society of Medicine andGynaecology, and of the Alumni of the University ofLeuven. He was also a member of many other scientificsocieties and councils, and he was a Honorary Fellow ofthe Royal Society of Medicine and of the Association ofSurgeons of Great Britain and Ireland (23).

His authority remained unaffected throughout thewar. During the liberation in 1945, he helped to free thefather-in-law of his son Etienne, a brewer and Brugesresident, from prison where he had been locked up forone night after false accusations of conspiring with theenemy. He himself, of course, had to explain how it hadbeen possible for German surgeons to witness surgicaloperations in Bruges during the occupation, and why hehad been so involved with the Flemish Winter Help.

That he performed surgery on members of the courtwas fortunately not public knowledge. In 1941, PrincessMarie-José, daughter of Albert I and Elisabeth, wife ofPrince Umberto of Piemont, who would later briefly beking of Italy, made a visit. Due to the special circum-stances brought about by the war, she was admittedanonymously to St. Joseph’s clinic in Bruges as “laMarquise de San Maurizio”. After the operation,Sebrechts gave her some Cuban Havana cigars, whichshe was known to smoke frequently. Despite this vice,she lived to the ripe old age of 94.

Some time later, at the express request of theRoyal House (owing to the house arrest of the King),Dr. Sebrechts, only assisted by Dr. Jules Helleputte,performed surgery in the castle of Laeken on thePrincess of Rethy, Lilian Baels, the second wife of KingLeopold III. He had already treated her youngest sisterSolange for sequels of poliomyelitis. When he returnedhome, he complained that a similar adventure outside ofhis familiar surroundings was not to be repeated. InSeptember 1942, Princess Josephine-Charlotte, later tobecome The Grand Duchess of Luxembourg, underwentan urgent appendectomy at St. Joseph’s clinic. Lookingfor anonymity outside the clinic due to the Germanoccupation of Belgium, she recovered, and even took herfirst steps in Sebrechts’ private house in Bruges.

Dr. Sebrechts was a confirmed Flemish man, in aFrench-speaking and French-minded environment. Hesupported the struggle for Flemish recognition by thestrength of his personality, without ever provoking any-body, which at the time was a very difficult balance tostrike. In this way, he ensured that the aloof Belgian RedCross also became solidly anchored in Flanders after theFirst World War, and ready for new challenges. In 1924,he played an important role in the foundation of the‘Vlaamsche Leergangen’ (24) in Leuven, which providedDutch language teaching at the University of Leuventhrough private financing. After his election as a mem-ber of the just founded ‘Koninklijke Vlaamse Academievoor Geneeskunde’ and being faithful to his Flemishpersuasions, he took his leave from the ‘AcadémieRoyale de Médecine’ (25). It made a big impression whenthe latter French-speaking academy named him hon-orary member after this move, making him the onlyBelgian to be a member of both academies. On the daythat professor Frans Daels was banned from the BelgianSociety of Gynaecology, Dr. Sebrechts did not hesitatefor one moment before founding the Flemish Society ofGynaecology, and becoming its president (26). Even so,that he had not burnt his bridges was demonstrated in1941 when he bowed out from leading the soon to beinstituted National Order of Doctors due to “an exces-sively busy practice.” Dr. Fr. Van Hoof, who wasappointed in his place, was sentenced to 15 years’ prisonby a court martial in 1947 for having accepted the posi-tion (27).

He was devoutly religious, but for him this hadalways been a private matter. There was as yet no socialsecurity, but a widely spread network of charitable aidorganisations. Whilst the needy were treated in hospitalsfor a small yearly fee, the more well-to-do could findtreatment in the private clinics. At the time, the Sisterswere more concerned with the moral and religious guid-ance of their hospitals’ needy, which often had been builtclose to the cemetery for practical reasons. However,attention was moved gradually by the physicianstowards a curative treatment, thanks to recent break-throughs in surgery, and an increase in the overall qual-ity of life. Despite being Flemish, he did not regret thecooperation with the French Augustinian sisters,because they were more pragmatic than the Flemish“Zwartzusters” (Black Sisters), particularly with regardto surgery on men. Dr. Sebrechts became a friend of

23 See LACQUET, 1948.24 See note 5.25 See LACQUET, 1948.26 See Anonymous, 1925.27 See VAN BEVER, s.d.

Prof. Dr. Joseph Sebrechts : “primus inter pares” 273

bishop Waffelaert, after he had cured his brother, a gen-eral, upon his return from the front. He miraculouslymanaged to obtain approval from the bishop for adapt-ing medieval convent habits to the needs of modernmedicine.

Surgical Activities of Joseph Sebrechts.

Apart from his publications, Sebrechts through hiswords and examples gave daily lessons to his assistantsand to many surgeons who came to visit him, so that hisinfluence was larger than might have been expected, notleast abroad. One visitor during the roaring twenties wasWilliam J. Mayo, who was so impressed by theHalletoren (Hall Tower) with his carillon bells, that hewas inspired to build the Mayo Clinic’s PlummerBuilding with the Rochester Carillon atop, intended tobe an expression of the spiritual element of medical care.Being a notary’s son, Dr. Sebrechts kept a meticulouslycomplete archive of all his patients, and he standardisedevery operation to the smallest detail, so that even hisassistants could perform them quickly and easily. Aftera few years, the techniques were always evaluatedaccording to the results, and adapted if necessary, whichkept him abreast of the state of evolution of other med-ical centres. He operated daily, from early in the morn-ing, alternatively in St. Joseph’s clinic and St. John’shospital. In the latter, the doorman would warn every-one, in accordance with an ancient custom, of the doc-tor’s arrival by ringing a loud bell (28). In the evening, hewould pay visits to everyone who had received surgery.On Sundays, he would make a large tour of the variouswards, and would often travel throughout the country toassist colleagues who were at their wits’ end in theirtreatments. His loyal driver, Cyriel Pillen, drove himeverywhere, and sometimes on the way they would eatat the same table, which was quite revolutionary at thattime.

His “catechism”, used as a guide by the assistants,started with the following words : “These days, a goodsurgeon does not have to be skilful and dexterous … heshould be a good doctor above all else...” Science, tech-nique and organisation came second place for him, eventhough he considered them to be very important.

The patients placed a limitless confidence in him per-sonally. As an example of psychogenic death, ProfessorDr. F. Thomas, in the class for Medicine in Law inGhent, gave an example of a patient whose stitchesneeded to be removed, and who refused to let anyone butSebrechts do this. When an assistant removed the firststitch jokingly, the patient had a cardiac arrest and died.

Sixteen of his publications deal with spinal anaesthe-sia, and the hypobaric fractionated technique, of whichhe was a pioneer in Europe, carries his name (29). In1928, he broke through internationally, when, at the con-

gress of the French Society of Surgery in Paris, he pre-sented an unparalleled personal series of 25,000 cases ofspinal anaesthesia, with exceptional results thanks to hismeticulous technique, which is still in use today. Hestarted with this activity in 1910, and applied it progres-sively to 67% of his procedures (30), reaching a total fig-ure of 40,000 by 1934. He also stated that anaesthesiawas better suited for specialised hands. E.g. : C.H. Mayowas 12 years of age when he was allowed to administeranaesthesia for his father W.W. Mayo.

He published nine papers on aortic aneurisms, gall-stones, gastric ulcers, Caesarean sections, bone graftsand hospital management, and nine papers deal withtuberculosis of the lung, spine and kidney. Dr. Louis DeWinter, famed lung specialist, referred to Dr. Sebrechtsas his “secular arm”, recalling the Inquisition. He tookcured patients and lengths of ribs from thoracoplastiesby bus to the Brussels’ meeting of the League againstTuberculosis, where this caused a large commotion (31).During World War II, Dr. Sebrechts also successfullyperformed the first pulmonary resection in Belgium.Only a few months after his death, streptomycin becameavailable, and, thankfully, heroic thoracoplasties becameobsolete.

Due to the many superlatives that were repeated timeand again by all those who knew him personally, wemade intensive enquiries into whether or not this greatman might have had any shortcomings. Apparently hewas too diplomatic, and did not publish as frequently asone would have hoped. His wife and children were rele-gated to the roles characteristic for the time, since “mod-ern man” was still to be invented! Even so, he wasalways available, friendly and competent, in that order,which is still hopefully the goal of any ‘good’ doctor.

One week after his death, the World HealthOrganisation was founded, and shortly after that, theUniversal Declaration of Human Rights was written,heralding a new post-war era, especially for surgery,which was about to witness spectacular changes.

References

1 Anonymous. Van Vlaamsche koppen : Dr. Sebrechts. Ons Volk ontwaakt, 1925 : 200-201.

2 Anonymous. Les constructions de la Commission localed’Assistance Publique. La Flandre Maritime, 24/03/1934.

3 DESBARAX P. M. De ontwikkeling van de anesthesie in onze con-treien. In “In de voetsporen van Yperman. Heelkunde inVlaanderen door de eeuwen heen.” Ed. R. Van Hee. Brussel :Gemeentekrediet, 1990 : 225-237.

28 See VAN DEN BON, 1947, 457.29 See HUBENS, 1990, 247.30 See DESBARAX, s.d.31 See VAN DEN BON, 1974.

274 E. Sebrechts

4 DESBARAX P. M. Joseph Sebrechts and Spinal Anesthesia inBelgium. Antwerp : Anaesthesia Museum Verantare.

5 DE WOLF K. Brugsch Volk. Brugge : Cayman-Seynave, Cultura,1942.

6 D’YDEWALLE S. Theresia van Lisieux en dokter Sebrechts.Parochieblad Kerk en Leven, 9/02/2000.

7 HENNEBERT P. La médecine à Lovanium. www.md.ucl.ac.be/histoire/livre/lovan.pdf

8 HUBENS A. Vooraanstaande chirurgen gedurende de eerste wereld-oorlog en tijdens het interbellum. In “In de voetsporen vanYperman. Heelkunde in Vlaanderen door de eeuwen heen.” Ed.R.Van Hee. Brussel : Gemeentekrediet, 1990 : 238-250.

9 LACQUET A. In memoriam Professor Dr. J. Sebrechts. Jaarboek KonVl Acad Geneeskd Belg, 1948 : 17.

10 PANNIER R. Professor Dr. J. Sebrechts werd 100 jaar geleden gebo-ren. Onze Gazette. Brugge : OCMW, 1985 : 83-85.

11 VAN BEVER J. Historiek van het AVGV 1922-1942. www.vgv.be/pdf/historiek22.pdf.

12 VAN DEN ABEELE A. online publications. users.skynet.be/sb176943/AndriesVandenAbeele.

13 VAN DEN BON A. Het achthonderd jaar oud Sint-Janshospitaal vande stad Brugge. Brugge : Commissie van Openbare Onderstand,1974.

14 VAN HEE R., MENDES DA COSTA P. (Eds.) Société Royale Belge deChirurgie. 1893-1993. Koninklijk Genootschap voor Heelkunde.Wetteren : Universa Press, 1993.

15 VAN HEE R. History of the ISS/SIC. Antoine Depage, one of thefounders of the ISS/SIC. World J Surg, 2002, 26 : 1195-1201.

Bibliography of Joseph Sebrechts

– Opération d’Albee, pour mal de Pott (82 cas). Arch Prov Chir,1922.

– Over Maagzweer. Vl Geneesk Tijdschr, 1922– Césarienne Basse (153 cas). Congr Gynécol, Paris 1924.– Anévrisme disséquant de l’Aorte. Arch Prov Chir, 1925.– Thoracoplastie et tuberculose évolutive. Rev Belge Tuberculose,

1926, 6 : 246-249.– Nieuwe techniek voor de nephrectomie bij Tuberculose. Vl Geneesk

Tijdschr, 1928, 9 : 181-186.– La rachianesthésie (25.000 cas). Congr Franç Chir XXXVII, 1928 :

1055-1084.– De techniek van de rachianaesthesie. Vl Geneesk Tijdschr, 1929,

37 : 749-762.– Opération d’Albee pour tuberculose vertébrale (300 cas). Congr

Franç Chir, 1929 : 461.– Traitement chirurgical de la tuberculose pulmonaire (225 cas).

Congr Franç Chir XXXVIII, 1929, 142-153.– Technique de l’apicolyse avec plombage musculaire vascularisé.

Congr Franç Chir, 1929.– Ce que j’ai vu dans les hôpitaux américains. L’assistance

Hospitalière 5, 1929.

– Quelques faits observés au cours de l’anesthésie rachidienne.Congr Nat Sciences, Bruxelles 1930 : 1047-1055.

– Note au sujet de la rachianaesthesie. Bull Acad Roy Méd BelgV° série, 1930, X : 543-638.

– Modifications de notre technique au sujet de la Rachianesthésie.Bull Acad Roy Méd Belg, 1931.

– Anesthésies rachidiennes. Soc Int Chir IX° Congr, Madrid 1932 :837.

– Discussion au sujet de la Rachianesthésie. Ann Belg Chir, 1932 :292.

– Le collapsus électif et l’apicolyse avec plombage par musclesmunis de leur pédicule vasculaire dans le traitement de la tubercu-lose pulmonaire. Arch Méd-Chir de l’Appareil Resp VII, Paris1932, 5 : 381-502.

– A propos de la Cholépéritoine. Brux Méd, 1933 : 895-927– Over rachianaesthesie. Vl Gen Tijdschr, 1933.– La rachianaesthésie. Ann Bull Soc Roy Méd XII, Gand 1933 : 175-

197.– Het chirurgisch standpunt in de galsteentherapie. Vl Geneesk

Tijdschr, 1934, 15 : 481-490.– La rachianaesthésie. Rev. Belge Sc. Méd, 6 (4) : 312-334.– Quelques facteurs de progrès chirurgical. Le Scalpel, 1934 30 :

1045-1056.– Spinal anaesthesia. Brit. Journ. Anaesth, 1934, 12 (1) : 4-27.– Over chirurgische technieken van collapsotherapie. Vl Gen

Tijdschr, 1935.– Notre technique de Rachianesthésie dosable à la percaine. Anesth

Analg, Paris 1935, 1 (3).– L’Anesthésie en Urologie. J. Belge d’Urol, 1937, 3 : 7-212.– Surgical treatment of Giant Cavities at Bruges. 1938.– Greffes Osseuses. Soc. Intern. Chir., XI° Congr. Bruxelles, 1938.– L’anesthésie en Gynécologie et en Obstétrique. Liége Médical,

1939 33.– In Memoriam Dr. E. F. C. Moons. Jaarboek Kon Vl Acad Gen Belg,

1946, 8.– Moet de lumbaalanaesthesie nog aangewend worden ? Palfijn,

1947, 6 (8) : 314-326.– Meningitis after spinal anesthesia. Brit Med J, 1947 8.

Acknowledgements

My thanks are due to Mrs. Therese Sebrechts Marelle,youngest daughter of Joseph Sebrechts, for the many personalanecdotes listed in this paper, and to Joeri Sebrechts, Joseph’sgreat-grandson for his help in translating my Dutch.

E. Sebrechts, M.D.Zennelaan 62B-1800 Vilvoorde, BelgiumE-mail : erik.sebrechts@advalvas.be