Prof. Joseph Borman’s open heart

One of Israel’s leading cardiothoracic surgeons for decades, who pioneered in open-heart surgery and performed Israel’s first heart transplant, writes a fascinating new autobiography.

PROF. JOSEPH BORMAN (photo credit: courtesy)
(photo credit: courtesy)
What an exquisite life! Prof. Joseph Borman has not only been happily married to Ruth for almost 56 years and produced three successful children and grandchildren. The one-time South African immigrant to Jerusalem and cardiothoracic surgeon also saved many thousands of lives, trained generations of young surgeons, conducted and published research, pioneered and perfected openheart surgery at Hadassah University Medical Center and performed Israel’s first successful heart transplant.
Borman, still contentedly living with Ruth in Jerusalem and almost 85 years old, tells his life story in a new, 175- page, English-language autobiography. Called Open Hearts: Memoirs of a Cardiac Surgeon and issued for $18 by the Gefen Publishing House, the book presents his experiences and accomplishments in a professional and family context that includes visits to some 60 countries around the world.
“I wish to be remembered as an individual who carried out his allotted time on this earth to the best of his ability in the most humane fashion,” goes his epilogue on the final page. Not every physician could honestly say the same. Known as the “gentleman of the medical profession,” Borman was loved by patients and their families for his humane and respectful attitude to them.
“Most of us oldies develop odd pains and sometimes even more serious problems. Yet Ruth and I, while these words are being written, still attempt to lead a much toneddown culture and social life, enjoying theater, movies, and, best of all, just being together.”
Three years ago, he developed choking attacks and recurrent episodes of severe double pneumonia. His doctors concluded that they came from problems related to radiotherapy of his larynx following the diagnoses of a tumor on his vocal cords (although he had never smoked). It was decided that he should stop eating and instead temporarily receive most of his calories directly to his intestines, in the hope that eventually his pulmonary complications would disappear, allowing him to ingest nearly everything normally again.
“Maybe it would be better,” Borman philosophizes, “as the bit often attributed to comedian George Carlin goes, if our life cycle went backward. You should die first – get it out of the way. Then you are old and decrepit and live in an old-age home. You get kicked out when you’re too young.
You get a gold watch; you go to work. You work for 40 years until you’re young enough to enjoy your retirement. You go to college – you do drugs and alcohol, you party, you prepare for high school. You enter grade school, you become a kid, you play, and you have no responsibilities.
You become a baby; you go back into the womb. You spend our last nine months floating; you finish off as an orgasm.”
THE GREAT heart surgeon was “conceived and born [in July 1929 to Leah and Zalman Boruchman] in the same little bedroom in Krugersdorp, a gold-mining town not far from Johannesburg. I was a first-generation child of immigrants to South Africa from Lithuania and Latvia,” he begins his volume. Before his father got married, he spent 1924 building roads in Mandatory Palestine, but then boarded a ship to Cape Town where he arrived penniless.
Starting by selling used bottles, Zalman prospered and established a general store and then sold furniture. Most of his family were massacred by the Nazis. Joe and his older sister Hannah enjoyed a pleasant childhood.
His bar mitzvah was observed when Hitler’s armies conquered much of Western Europe and North Africa. Joe had thought of studying business administration but when his sister completed her physiotherapy degree at Witwatersrand University and gave him her textbooks it piqued his interest in medicine. He managed to be admitted to medical school. Their mother died of cancer at the age of 47. In 1951, Joe received his MD at Witwatersrand, conducted animal research and decided on a surgical specialty.
To pass the surgical exams of the Royal College of Surgeons of England, Borman went to London to study.
Well-prepared and lucky, he was one of 20 percent of those to pass the exams, and at the age of 27 he became a certified fellow of the eminent Royal College, giving him entry to a surgical career.
In 1956, Borman made his first visit to the fledgling Jewish state when his father and stepmother Sonia invited him to come along on their trip. He was offered a date with a “lovely girl, an officer in the Israel Defense Forces,” and thought she would be an “Amazonian who would flip me over her shoulder if she thought I was getting out of line.”
He turned down the idea, instead going on a tour of Haifa at night. He returned to Woolwich Memorial Hospital on the outskirts of London and progressed in his skills. One day he received a call from “an Israeli girl who said that she had a letter for personal delivery to him” from a friend in Haifa. When they finally met, it turned out to be the IDF officer whom he had declined to meet in Israel.
But Ruth Lichter of Haifa turned out to be “a most attractive, blonde, blue-eyed beauty, soft-spoken and shy.”
Although he had been going with a non-Jewish girl from New Zealand, Joe was smitten with the Israeli teacher, but Ruth was rather cool. After a short romance, they decided to marry and did so in a London synagogue.
They moved to Canterbury where Joe received a hospital position and found an old house in the nearby village of Bridge. Joe read aloud to Ruth in English, while she taught him conversational Hebrew. They were “deliriously happy.” When she informed him that she was pregnant, Borman was overjoyed. They decided to move to Johannesburg to settle down, and he planned to open a general surgery practice. But as fate would have it, they decided to see European cities, and instead of going to Athens from Rome, they ended up in Israel and visited Ruth’s parents in Haifa.
Visiting Jerusalem to see a 10th anniversary of Independence exhibition, Joe went to Hadassah Hospital, where he met deputy director-general Dr. Jack Karpas, a former South African. On the spot, he offered Joe a job as assistant to the director of cardiothoracic surgery, Prof. Hanoch Milwidsky.
Ruth urged him to accept it. They never looked back, even though the staff knew little English and his Hebrew was not yet very good. Surgical services were located in the center of town, opposite Bikur Cholim Hospital.
Ruth gave birth in Jerusalem to a daughter, Margalit (who is married today to Prof. Amitai Ziv, a former Israel Air Force fighter pilot who studied medicine and is now deputy director of Sheba Medical Center and world renowned for his expertise in simulation for teaching medical students).
In 1962, Hadassah moved into its “magnificent new campus in Ein Kerem,” replacing the cramped old-fashioned conditions Borman had experienced in Straus Street, but the Borman family moved to Los Angeles for a postgraduate year at a research lab, where he leaned the basics of open-heart surgery and clinical work at St. Vincent’s Hospital.
Recalling the development of heart surgery since 1896, when a German surgeon carried out the first successful cardiac operation, on a man who was stabbed in the heart, Borman noted that in the 1920s, surgeons tried to widen narrowed heart valves blindly by poking a finger in. In the 1960s, after techniques were developed to treat “blue babies” with congenital defects that routed oxygenated blood out the wrong way, bypasses were developed, using blood vessels from other parts of the body to replace defective ones.
ARMED WITH expertise in the latest openheart surgery techniques, Borman and his team set about to perform the operation – stopping the heartbeat to operate while the blood flow was continued with a heartlung machine, followed by the heart being restarted with an electric shock.
Open-heart surgery in those early days was very risky compared to today, when it is routine. Among the pioneers here were Prof. Danny Gur (Sheba Medical Center), Prof.
Morris Levy (Beilinson Hospital) and Borman, who headed Hadassah’s cardiothoracic surgery department for 25 years.
When some patients attached to the mechanical pump for hours suffered damage to the brain, heart and kidneys because of air bubbles forming in the circulating blood, Borman flew to Denmark. Thee he learned from a cardiothoracic surgeon who had developed a cheap, disposable bubble oxygenator that eliminated the problem; Borman had a supply dispatched by air express to Jerusalem, and the problem was solved.
When the Six Day War broke out in June, 1967, the cardiothoracic surgeon was “lent” to Soroka Hospital in Beersheba to operate on wounded soldiers as his family remained in Jerusalem. “You know,” he told Ruth by phone, “if I have never before understood exactly why I am in Israel, today I have the answer. I feel so much a part of the country. I feel I am contributing in the most meaningful way I can to the care of the wounded and to the welfare of Israel as a whole. I shall never again have doubts about our decision to settle in this small, developing land – which is our own and which is so dear to Jews all over the world.”
Borman recalls being called in the middle of closing up the chest of a wounded soldier only to see another soldier, the 19-year-old son of a gynecologist colleague named Prof. Lancet, who had no pulse or heartbeat following a bullet wound to his groin.
With no time even to scrub up, he cut into the leg and managed to find the main artery that had been damaged and gushed with blood. Several precious minutes had passed before Borman could get the heart beating and the hemorrhage stopped, and the soldier faced the risk of severe brain damage. But two hours later, he walked to the recovery room and asked where the soldier named Lancet was lying.
A young man with a bandaged arm sat up in bed said he was the one. Borman couldn’t believe it and looked for the wound in the groin. But he was the one. Today, the “soldier named Lancet” is Prof. Doron Lancet, a brilliant senior geneticist at the Weizmann Institute of Science who made a major contribution in maping the human genome.
The world was astounded in 1967 when Dr. Christiaan at Groote Schuur Hospital in Cape Town performed the first human heart transplant. Louis Washkansky lived for 18 days, but died of pneumonia; his heart had beaten strongly until he died. But because of the problem of organ rejection by the patient’s immune system, the breakthrough surgery had to wait years until it could become safe thanks to the anti-rejection drug cyclosporine.
Borman prepared to bring heart transplantation to Hadassah with Dr. Mervyn Gotsman, a brilliant cardiologist from South Africa who joined the hospital in 1973 (and later became the chief of cardiology and personal physician of Menachem Begin and himself retired several years ago).
After they became immersed in learning the technique, the main problems were lack of donor organs and ultra-Orthodox opposition – including street posters – to the recognition of lower-brain death as a prelude for removing the heart. But in August 1987, a donor organ became available at Rambam Medical Center and Borman and his team performed Israel’s first successful heart transplant at Hadassah.
“The pale, limp heart gradually becomes pink. The muscle begins to tremble – ventricular fibrillation – at first weakly and then stronger and strong fibrillation... ‘Shock,’ I command, and the pump technician presses the illuminated red button on the defibrillator... And then a faint beat, a pause, a stronger beat, a few more random beats – the heart is beating faster and now it is beating regularly, strongly, beautifully.”
The patient survived for some 30 months until he succumbed to a stroke. His second heart transplant patient was still alive when the book was published and continues to call Borman before Rosh Hashana and Passover to wish him well every year. He is one of the longest-surviving heart-transplant patients in the world.