


I just came across a rare photo of James W May Jr. He was my Chief Resident as a Junior surgical resident on the Massachusetts General Hospital plastic surgery service.
Tall, handsome, brilliant, bow tie, Brooks Brothers, consummate gentleman and master technician. Totally unassuming, modest, generous, and an unquenchable thirst for knowledge.
My first day on the plastic service, I was assigned to assist Brad Cannon, a senior master surgeon. We were performing a breast reduction. As the case proceeded, the breast seemed kind of square to me. I asked, “Why does the breast look square?” Brad explained, “when you pull the flaps down, they all come out square”. At that point the scrub nurse fainted and started to fall. I wheeled around and got my gloved hand under her head before it struck the floor. I lifted her legs and she recovered. We had both broken scrub and had to leave the room to re- scrub. Brad continued the surgery as if nothing happened. “Get me a new scrub” he calmly ordered.

I returned immediately, scrubbed, and gowned to finish the case. It was my first reduction. The breasts looked square.
The original scrub nurse returned just as we were finishing. “What happened dear?” asked Brad. “It must have been the square breasts sir,” she smiled behind her mask with a wink to me.
My second case that day was a breast reduction with James. We called him Jim. He was performing an inverted T reduction. I noticed that the breasts came out nice and round. After the case, I inquired, “I just did one of these with Brad and the breasts came out square. Yours came out round. Why?”
Jim came up and put his arm around my shoulders. He was tall and leaned over conspiratorially in a soft whisper as if this was to be a deep dark secret between us, “IF YOU CUT THEM SQUARE, THEY COME OUT SQUARE. IF YOU CUT THEM ROUND, THEY COME OUT ROUND “. He smiled that James May Jr. smile.
This was perhaps my first and most important lesson in plastic surgery!