An open heart

Heart surgeon Prof. Bernard Vidne offers advice to both doctors and the general public in his moving autobiography.

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September 25, 2010 22:56
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Vidne 311. (photo credit: PROF. BERNARDO VIDNE, on the job at the Rabin Medi)

 
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Born in Argentina to a poor family and having little interest in school, Prof. Bernardo Vidne’s becoming a world-famous Israeli heart surgeon who performed more than 40,000 operations (a quarter on children) in 35 years is close to miraculous. The recently retired director of cardiothoracic surgery at the Rabin Medical Center-Beilinson Campus and Schneider Children’s Medical Center in Petah Tikva, who recently turned 70, recalls his amazing and charmed life in a new autobiography.

The 188-page, Hebrew-language, NIS 78 hard-cover book, titled Gilui Lev (which could be translated as open heart), was written with help from Yaffa Shir-Raz and released by Focus Publishing (www.focus.co.il). It offers physicians a lesson in devotion, professionalism, persistence and modesty and inspiration to the rest of us.

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“This tale is almost a Cinderella story,” writes Shir-Raz in her introduction. “But in his case, the magic wand that touched him was not that of a fairy. It was his own hand, a hand to which numerous patients owe their lives.”

Vidne begins by calling December 31, 2006 a turning point in his life that began like any other day. After performing two routine operations until 10 p.m., he thanked the staff and exited to speak to one patient’s family. Without warning, he felt and looked unwell. His colleagues asked if he wanted to sit down. He soon found himself on a stretcher in an ambulance, being rushed for a CT scan of his brain to determine whether he had suffered a stroke. He had.

Fortunately, it was the ischemic type with a blood clot blocking blood and oxygen from part of his brain and not a blood hemorrhage, which can be even harder to treat and more deadly. As catheterization of the brain to scoop out the clot was relatively new here and there were only a handful of experts able to do it, Vidne was taken to Tel Aviv’s Ichilov Hospital (now Sourasky Medical Center), where neuroradiologist Dr. Shimon Maimon was called in to do the minimally invasive surgery. Performed within a few hours of the initial symptoms, it was successful, and within a month, Vidne was back operating on his own patients.

“How ironic life can be,” Vidne recalled. “I found myself lying on the catheterization table... In a moment, the tables were turned.

Instead of looking down at the patient, suddenly I was the patient looking up at the doctors.”

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As Vidne regained consciousness in the intensive care unit, then-director-general of Beilinson, Prof. Dan Oppenheim, gave him a thin cord. “Take it. Make a knot,” he commanded to see if the surgeon’s brain function was unharmed. Vidne obeyed and succeeded.

Two days later, he shaved himself. “I am always very pedantic about that, because just the shave and freshening up are part of recovery.

When I see a patient after surgery looking neglected and stubbled, I send him immediately to shave,” he declared.

“Without doubt, this event created a very big change in the way I looked at life and those around me,” writes Vidne. “The...

warmth that surrounded me from the moment I collapsed surprised me greatly, touched my heart and without doubt saved me. I didn’t expect such immense caring from people with whom my main connection was work. While previously, I had not made emotional contact with most people around me, afterward I started to take interest in them. Suddenly, I cared about these people. I had personally experienced how thin the line between life and death – a border that I had known so well from a different angle. How quickly one can move from a condition of full control to one of complete loss of control, from one who dictates treatment to the patient to being a helpless patient in others’ hands.”

Vidne confesses that before his stroke, due to lack of time or motivation, he was often curt with patients and colleagues. This changed after his own brush with death. He said he learned that “as doctors rise in the hierarchy and become professors and department heads, they distance themselves from the simple person inside them. I admit that for many years, I too made that mistake. I didn’t do this with evil intentions, but despite that, I am sorry that I didn’t devote my energies to this important connection between the man and the doctor that I am.

After all, to be a man and help other people is the first mission of everyone who studies medicine. It doesn’t matter how far you reach; try always to preserve the connection between the doctor and the person that you are,” Vidne advises readers.

“Good as they are, doctors don’t know everything,” he advises patients. “Don’t regard their recommendations as set in stone, and it’s worthwhile always to seek a second opinion, not because he knows more or to make sure that the first opinion was correct, but to examine the disease from another angle – which the temperament, knowledge and experience granted him. Always try to obtain information, but at the same time, believe that your doctor aims to do his best for you. He doesn’t always succeed, but I have no doubt that he wants this with all his might.”

Retelling his life story, Vidne says that as a child he never dreamed of being a heart surgeon, at least consciously. Only much later did he understand how important one’s studies are. He never liked to learn, and when he graduated from high school, he didn’t dream of continuing for higher education.

“The first time I thought I must study and almost simultaneously to be a doctor was in the middle of a lunch in a wine warehouse in Concordia,” Vidne recalls.

He was there to earn some money, after his parents’ modest home burned down when a kerosene stove was left lit. No property survived, forcing him to move in with his grandparents, while his three brothers lived with uncles. Despite their poverty, his parents hired a private teacher so he could skip a grade of school.

As an enthusiastic Zionist, he decided to join a Jewish youth movement at 12 and later was sent to Israel for a year as a potential leader. “For me, it was like reaching the moon,” he writes, but he had unforgettable experiences and upon his return to Argentina, decided to build up local Zionist youth activities. To survive, he found work in the wine warehouse, loaded a truck and distributed heavy crates to restaurants and bars.

One day, the truck driver told him: “Bernardo, because I didn’t study, I am forced to distribute wine and drag heavy crates like a donkey all my life.”

Hearing that one sentence changed his life.

Vidne decided then and there to study.

Returning home, he told his parents he was doing to medical school at the University of Cordoba; they were overjoyed. Many decades later, a well-known surgeon, Vidne returned for a visit and was awarded an honorary doctorate from his alma mater.

Vidne is not sure why he decided to be a doctor, but the main influence apparently was the fact that shortly before, one of his young cousins underwent heart surgery and was saved. “I will never know the real reason,” he writes.

In January 1959, public college education was free, and he was accepted to medical school. Required to study histology and anatomy, he paid a dropout medical student to examine his large collection of tissue slides, devoted himself to reading anatomy books on his own, passed the tests and went directly to the second year. “If you really invest and devote yourself to studies, there is nothing that you can’t overcome.” He also did odd jobs to pay his expenses and lived largely on one meal a day for five years.

Entering his fourth year, he was drafted by the Argentinean army and sent to a closed base for basic training. Reluctant to waste a whole year of medical school, he studied in the bathroom after the lights were turned off. Vidne was discovered with his books by a very tough sergeant major who didn’t like students. Fortunately, the young man approached the sympathetic base commander, who invited him to study at night in his personal office. When Vidne had to attend some mandatory classes, the commander sent him on imaginary assignments outside the base so he would not be questioned at the gate. Vidne clearly had a good fairy watching over him.

Poor people generally have an advantage, writes Vidne, as they are more modest than the rich and hungry for advancement.

Earning his diploma at 24, Vidne married his wife Naomi and sailed to Israel in 1964.

Aliya and working as a doctor were his two fondest dreams. He met Prof. Haim Doron, who later became director-general and chairman of Kupat Holim Clalit (now Clalit Health Services) and was a founder of the Health Sciences Faculty at Ben-Gurion University.

Doron was then in charge of the health fund’s Negev district and desperate to bring more doctors to the developing South.

Turning down his offer of a post in a Dimona clinic, Vidne insisted on doing his residency at Soroka Hospital in Beersheba and for two years studied general surgery. Well received, he was fortunate in having nimble, pianist’s hands and the determination of a long-distance runner.

He was offered a place at Beilinson with Prof. Morris Levy, head of cardiothoracic surgery, who was Israel’s pioneer in open-heart operations and performed the first Israeli heart transplant in 1968. As it turned out, Vidne assisted Levy in that historic operation on a 42-year-old critically ill patient who died a few weeks later because heart surgeons had not discovered then how to cope with the body’s rejection of a foreign organ. Vidne knew he was participating in an important and historic event that opened a new era in Israeli medicine. Today, with anti-rejection drugs and better technologies, heart transplantation is a routine procedure.

Vidne’s rise at Beilinson was temporarily halted one day when the head of the heart institute came to the operating theater to consult with him over the case of a child he was treating. Levy, with whom Vidne had a close father-and-son relationship, suddenly entered. “He boiled with anger and said that he himself should have been consulted rather than I.” Given the cold shoulder, Vidne realized he had to leave. In 1980, he joined Ichilov to head a new cardiac surgery department that the Health Ministry was persuaded to open with help from prime minister Menachem Begin. He transferred even though the salary was much lower than at Beilinson, and he had a wife and four children to support. A decade later, he moved back to Beilinson and (with no ill will) replaced Levy, who had just retired, as department head.

Although he performed many operations on adults with degenerative heart disease, he was drawn to treat children with congenital heart problems, which he calls “production defects.” Thus repairing them was “the closest man could get to creation.” Vidne improved on and developed new techniques.

While for decades babies with heart problems had to be sent abroad for surgery, Israeli surgeons gradually learned abroad and brought know-how back with them so that today, their expertise is equal to that in the world’s best centers. At Beilinson, he persuaded the director-general to allow him to save a desperately ill patient in his 40s by implanting a temporary artificial heart – an Israeli first. He also saved the lives of premature babies as young as two days old.

Vidne does not hide medical errors and misjudgments, which every surgeon recalls vividly. While tragic, these occurrences always pushed him to make improvements in his techniques. Often, he was able to save such patients at the last minute by using a different one. He admits that he found the death of any patient heartbreaking and traumatic. “Whoever doesn’t suffer when he loses a patient isn’t fit to work in medicine. I have always demanded of my students and department doctors to be critical of themselves... Recognizing errors is not simple, and there is no doubt that they are wrapped in a heavy emotional burden, but if you learn to turn this into a rational process of thinking, checking and learning, you’ll be able to gain and lead yourself to higher and more efficient levels of implementation.”

Today, in retirement, Vidne notes that many cardiothoracic surgery directors are his former students, and “60 percent to 80% of all heart operations today are supervised by surgeons who grew up in my department.

Each of them reflects our years of joint work.

If they were angry at me or bore a grudge when they studied with me, I know that in their subconscious they recognized the fact that it would lead to success.”

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