Some lead by example. Some lead by suggestion. It is the rare individual who does both. This unique duality was epitomized by Basil A. Pruitt Jr, MD, FACS, MCCM. Dr. Pruitt was a Clinical Professor of Surgery at The University of Texas Health Science Center at San Antonio and a visionary in the field of trauma and burn care.
Curiously, he studied geology at Harvard. When asked why geology he responded: “it is always best to understand the foundations on which you stand before trying to reach for the horizon.” Clearly, he was a man of many dimensions and directions. Conversations with Dr. Pruitt were at once predictable and inspiring: he would first ask himself “why,” and then ask his colleagues “why not”? Early inquiries into the “why’s” of burn care, acute injury management, and critical care established foundations on which current standards and practices rest. Dr. Pruitt’s unwavering search for new knowledge and better care survives him, both in the research institute he led and within the investigators he mentored. In this way, he inspired generations of physicians.
A fixture at major scientific meetings, he balanced formality with friendliness—always using your title—while eschewing his own. Be it basic science, clinical trials, or a pro/con debate, Basil Pruitt guided his audiences with clear ideas expressed in simple words. He explained, “if I don’t make it plain, how will everyone understand what I mean for them to know?” And he meant for everyone to know.
My first encounter with Dr. Pruitt was especially memorable, as it occurred the first time I attended the annual meeting of Eastern Association of the Surgery of Trauma. The year was 1995, and he patiently listened to my presentation on shock and hypoperfusion. My soon-to-be-mentor, Phil Barie, made the introduction. He rumbled, “Dr. Kaplan, what are your next steps?” Dr. Pruitt listened patiently as I justified my plans. He thought for a moment and then began “Why not look at this…” An hour later, I began revising my career plans from cardiac to trauma surgery.
I persisted and so did he: over the next 2 decades—through service on his Editorial Board, to the National Institutes of Health, to the Department of Defense, and to the Society of Critical Care Medicine—he kept asking me “why not?” I was not the only person who was asked that question by Dr. Pruitt.
Nearly every contemporary leader in critical care owes some of their success to Dr. Pruitt.
Career guidance, appointment letters, promotion letters, and grant reviews were addressed with solemnity, rapidity, and honesty. I was one who called upon Basil for all of those and was rewarded with crisp insight and wisdom. I never trained with or under Dr. Pruitt, yet I benefitted. He melded a keen intellect with humility and an appreciation of camaraderie—often over superbly crafted margaritas! Dr. Pruitt was my mentor, confidante, peer, and friend.
He gave of his time and his heart. Driven by what was needed but more by what was right, Basil Pruitt set a polestar by which others steered their careers. He changed military and civilian medicine in a global fashion. Basil Pruitt Jr, MD, never accepted contemporary care as “good enough.” His signature questions—why? and why not?—improved practice and outcomes. His greatest legacy may be his professional progeny, so many of whom have adopted his signature questions as their own.