Remembering a Renaissance Man
In the halls of Jefferson there hangs a portrait of Gerald “Jerry” Marks, MD ’49, painted by the artist Dean Paules. Nearby hangs one of Marks’ own watercolors from a series titled “Changes Along the Way: A Surgeon’s International Journey.”
One depicts the surgeon as others saw him: distinguished, authoritative, a leader in his field. The other reflects how he may have seen himself: a traveler, an observer, a man attentive to light, to color, to possibility.
Between them lies not one extraordinary story but several — each complete, each remarkable, and each somehow woven together by the same animating spirit.
Marks, who often was at once the oldest and the youngest presence in the room, died this year at the age of 100.
He was a surgeon who transformed the treatment of rectal cancer and improved countless lives. He was a founding father of a society that would become the largest general surgery organization in the United States. He was an accomplished watercolorist who painted his way around the globe and, remarkably, produced some of his finest work after the age of 90. He was a veteran of two wars, a devoted husband for 63 years, a father, and, by every account, a man of irrepressible wit, elegance, and warmth.
To take full measure of the man, ponder a riddle. Is surgery a form of art or is art a kind of medicine?
Left: Mother and Daughter at the Shore No. 1, at age 93. Right: Philadelphia City Hall Viewed from the Benjamin Franklin Parkway, at age 91.
BORN IN BROOKLYN in 1925 and raised in Philadelphia, Marks came of age in a world shaped first by the Depression and then by war. Even as a child, art stirred his imagination. After watching a family friend work as a commercial artist, a 5-year old Marks produced a graphite drawing of a little girl in a garden that was recognized in a citywide art show.
A self-described “independent cuss,” Marks began working at a young age to help support his family. Whether helping his grandfather at a hot dog stand or his uncle in a candy store, or working as a soda jerk, an ice cream truck driver, or as a busboy, he saved whatever he could toward college tuition.
He was 16 when Pearl Harbor changed everything.
Like many of his generation, Marks felt the pull of national service. After a semester at Villanova, he enlisted in the U.S. Navy and was accepted into the Navy’s V-12 program, an initiative created to accelerate the training of future physicians for military service. That path brought him to Jefferson, where he completed his medical degree in 1949 and was elected to the Alpha Omega Alpha honor society.
Years later, Marks observed that had he been born a year earlier or a year later he might never have become a physician at all. The war, with all its upheaval, had opened the door to a life in medicine.
MARKS’ MEDICAL EDUCATION coincided with a remarkable period in the evolution of surgery.
He began a rotating internship and entered surgical residency at Jefferson under the formidable Thomas A. Shallow, MD 1911, the second Samuel D. Gross Professor of Surgery. Shallow’s influence on the young physician was profound.
Marks’ workload as a resident was enormous by modern standards. Surgical teams managed dozens of hospitalized patients at a time, making rounds multiple times each day.
It was during this period that he met Barbara Ann Hendershot, a Jefferson nursing alumna who worked in the operating room. She was the great-grandniece of J. Parsons Schaeffer, MD, PhD, a Jefferson professor and renowned anatomist whose “Morris’ Human Anatomy” served generations of physicians much as “Gray’s Anatomy” later would.
Marks described her as “stunning.”
The couple married in 1950 and went on to raise three sons, Richard, Jim, and John. Richard and John would earn their MDs at Jefferson as well, classes of 1988 and 1989, respectively.
Marks’ surgical training was interrupted by military service with the U.S. Air Force during the Korean War. He served as a project engineer, conducting research on high-altitude physiology and pulmonary decompression that resulted in several scientific publications.
When he returned to Jefferson to complete his residency, the department was entering another historic chapter. John H. Gibbon Jr., MD ’27, who had succeeded Shallow as the third Gross Professor, performed the first successful open-heart surgery using the heart-lung machine in 1953.
Marks’ wife briefly scrubbed in on that landmark operation.
Following an American Cancer Society fellowship in proctologic surgery, Marks trained under William T. Lemmon, MD 1921, the inventor of continuous spinal anesthesia. Impressed by Marks work in pulmonology, Gibbon asked him to become Jefferson’s inaugural chair of anesthesia. It was “tough to say no to Dr. Gibbon,” Marks later recalled. But he did.
He wanted to become a colorectal surgeon.
Left: Pranzo da Mantova, at age 94. Right: San Francisco Chinatown No. 5, at age 98.
IN THE MID-20TH century, the outlook for patients with rectal cancer was grim.
There were only 13 physicians in the United States who were double boarded in both general surgery and colorectal surgery. Surgical options were limited, and the standard operation for rectal cancer often required a permanent colostomy, leaving patients dependent on an external bag for the rest of their lives.
For many patients, the psychological burden of that prospect was overwhelming. Some delayed seeking treatment altogether.
Marks noticed this early in his career, and it troubled him deeply.
“The dominant issue for rectal cancer patients is psychological,” he later explained. “The fear of having a permanent colostomy.”
Some physicians might have accepted that reality as inevitable. Marks did not.
Instead, he began asking a different question: Was it possible to remove the cancer while preserving normal bodily function?
Driven by that challenge, Marks began developing surgical approaches designed to preserve the anal sphincter while still achieving effective cancer removal. In 1960 he introduced the combined abdominal trans-sacral resection of the rectum, known as the CATS procedure.
More than two decades later, in 1984, he advanced the concept further with another innovative operation: the transabdominal/transanal radical proctosigmoidectomy with coloanal anastomosis, known as TATA.
These procedures allowed many patients to avoid permanent colostomies while improving both survival and quality of life.
8 on the 18th Green, at age 94
Marks’ innovations were born not from abstract intellectual exercise, but from empathy for a human problem he had witnessed firsthand.
He also championed the use of high-dose radiation therapy before surgery, an approach that many physicians at the time believed to be dangerous.
When Simon Kramer, MD, founding chair of Jefferson’s Department of Radiation Oncology, arrived from London with the idea that high-dose radiation could halt rectal cancer’s growth, Marks saw an opportunity. The two physicians worked closely together, studying outcomes and refining surgical techniques.
The results were, in Marks’ understated phrasing, “striking.” Survival rates improved dramatically.
Today, multimodal treatment combining surgery, radiation, and careful staging is the standard of care for rectal cancer patients around the world.
The Quiet Sailboats of Aruba at Dusk, at age 97
MARKS ALWAYS HAD an instinct for innovation.
In 1969, intrigued by a new instrument that allowed physicians to look directly inside the colon, he spent most of his personal savings to purchase one of the first flexible fiber-optic colonoscopes in the United States.
Where few surgeons recognized the potential of the technology, Marks immediately grasped it. For the first time, physicians could directly visualize the colon and remove polyps during the examination, opening new possibilities for early detection and prevention of colorectal cancer.
The instrument, Marks later said, “changed my life.”
Recognizing that this emerging technology required collaboration across specialties, Marks organized one of the first international colonoscopy symposia at Jefferson in 1974.
From that meeting grew the Society of American Gastrointestinal and Endoscopic Surgeons. He served as its first president.
Marks also helped establish the International Federation of Societies of Endoscopic Surgeons, extending his influence to a global community of more than 100,000 surgeons.
Time and again, he had a willingness not only to challenge established assumptions, but to build institutions that could carry new ideas forward.
EVEN AS HIS reputation grew internationally, Marks remained deeply committed to Jefferson.
Over the years he rose to the rank of full professor and worked with dean Joseph Gonnella, MD, to establish the Division of Colorectal Surgery. In 1984 he launched Jefferson’s colorectal surgery residency program and founded its Comprehensive Rectal Cancer Center, bringing together surgeons, radiation oncologists, pathologists, and researchers. In 1992, Jefferson established the Gerald J. Marks Professorship of Colorectal Surgery in his honor.
The Hunter at age 93
In 1998, he and his son John H. Marks, MD ’89 — himself a pioneering colorectal surgeon and expert in minimally invasive surgery — established Marks Colorectal Surgical Associates at Lankenau Hospital in Wynnewood, Pennsylvania. Together they led the Marks Colorectal Surgical Foundation, supporting research and education for decades. The elder Marks continued performing colonoscopies until nearly the age of 90.
Marks remained closely connected to Jefferson throughout his life, donating generously, earning about every award the University bestows, and serving for many years as Class Ambassador for the medical school Class of 1949.
Even in his 90s, Marks remained engaged in evaluating patients, mentoring younger physicians, and offering counsel to colleagues. Charles J. Yeo, MD, the eighth Gross Professor and Chair of Surgery, called Marks a mentor and a friend. “He was dedicated to the surgical history of Jefferson,” Yeo said. “He often charmed us with his stories of Dr. Shallow.”
Some people never quite retire from the things they love.
MARKS WAS, in the deepest sense, always an artist.
His eye for color, light, gradation, and spatial relationship was not incidental to his surgical skill; it was inseparable from it. He possessed an unusual ability to discern subtle variations in tissue color and texture, clues that guided his dissections with a precision others struggled to match.
“When driving to work,” Marks once said, “most people see the road and the traffic. Me? I see the sun, the sky, and the ever-changing forms and contrasts of color and light.”
In his 50s, during a vacation in the Caribbean, he returned to watercolor painting after decades away, and he never stopped.
His international travels became the subject matter for his art: the canals of Venice, the beaches of Marco Island, the boulevards of Rome, and the waterways of a dozen other countries.
Beginning in 1999 he produced an annual calendar of his paintings as a fundraiser for the Marks Colorectal Surgical Foundation. He personally inscribed each copy, a cherished tradition that continued for almost 30 years. In his tenth decade of life, he produced more than 100 watercolors, publishing them at age 99 in a book titled “Ageless Art: The Special Joy of Watercolor Painting After 90.”
In keeping with that same spirit, he co-founded with fellow Jefferson alumnus Geoffrey Dunn, MD ’79, the Surgeon Artists League, a society dedicated to fostering creative expression among surgeons and exploring the connections between art and surgical practice.
TO THE END, Marks remained physically active, playing tennis and golf into his 90s and even competing alongside his son Richard in national senior father-and-son tennis championships.
Yet what perhaps distinguished him most was the persistence of his curiosity.
Even as he approached 100, Marks remained engaged with the world around him, evaluating patients, supporting research, mentoring physicians, and painting luminous watercolors.
His true legacy, however, lies in the lives he changed.
“My dad loved the phrase, ‘shake the tree of tradition,’ and that’s what he did,” said his son John. “He truly did what others said was undoable, routinely saving people who were told they were inoperable.”
Marks’ surgical innovations allowed thousands of patients with rectal cancer to survive without sacrificing dignity or function. His leadership helped bring endoscopic technology into the mainstream of surgical practice. And the surgeons he trained carried forward the principles he embodied: curiosity, discipline, and devotion to patients.
Late in life, Marks once described his journey as having taken him “beyond the moon and back.”
He spent a century proving that medicine, at its best, is both science and art, and that, in steady hands like his, the two become one.
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