The biography of Evarts A. Graham, MD, by C. Barber Mueller, MD, is an incredible work of scholarship. The author provides a detailed and wonderful story of Graham's life and the immense contributions to surgery that truly earn Graham the title from the book: the Surgical Spirit of St Louis. Graham ranks in surgery as Charles Lindbergh does in aviation. Mueller, who has a distinguished career as an academic surgeon and department chairman, was a student, intern, surgical resident, and faculty member of Graham's. He brings his personal experiences to this book. In addition, he spent more than 10 years studying Graham's life and career and interviewing his family, friends, and colleagues. From this work comes a comprehensive, intriguing picture of the man who helped develop the treatment of empyema during World War I, who first removed a lung in one stage for cancer, who was a pioneer in thoracic surgery, whose research led to cholecystography (known as the Graham-Cole test), whose research indicated that smoking causes lung cancer, but who continued to smoke and died of this disease. The surgical residency at Barnes Hospital–Washington University in St Louis, Mo, as well as the legacy of its residents were among his many accomplishments.