Acclaim for
Solving the Mysteries of Heart Disease
Get ready for a fascinating journey into the realm of scientific discovery in that most complex and storied human organ; The Heart. The Voyage is led by a truly remarkable tour guide; an icon of modern scientific investigation, a scientist versed in art, architecture, dance, and literature with an almost magical command of story-telling.
Herbert I. Machleder, M.D.
Emeritus Professor of Surgery, UCLA
Past Chief of Staff, The UCLA Hospital and Medical Center
“Thinking outside the box” barely skims the surface of his brilliant mind…. Dr. Buckberg’s theories have changed the way we practice cardiac surgery.
Marc R. Moon, M.D.
Chief, Cardiac Surgery
Director, Center for Diseases of the Thoracic Aorta
Washington University School of Medicine
…a real “page turner” …a fascinating cross between a high-end spy novel and a scientific treatise on the causes of heart disease. Buckberg leaves nothing on the table... and we feel his pain as he explains why some of his most transformative ideas have not yet become mainstream.
Dr. Alan Russell
Highmark Distinguished Career Professor
Director, Disruptive Health Technology Institute
Carnegie Mellon University
At some point, nearly every person or someone they love is touched by heart disease. It occurred with me when my father needed a quadruple bypass and mitral valve repair. As it happens, I married one of my father’s heart surgeons, Brad Allen, who I discovered was also a medical researcher and has collaborated with Dr. Buckberg for over 35 years. He would often tell me of these amazing discoveries coming from this research, but I never truly understood until I read this book. Written in understandable language, it shows how many beliefs we have (and even our doctors have) about different heart diseases may actually not be true, and explains how these remarkable discoveries could literally save thousands of lives.
Jaclyn Smith
American Actress and Businesswoman
Solving the Mysteries of Heart Disease is a memoir, a detective story, and a love affair with the heart. These adventures of Dr. Buckberg are entertaining, but also carry an important message about modern medicine.
Paul Micevych, Ph.D.
Chair, Dept of Neurobiology
Director, Lab of Neuroendocrinology of the Brain Research Institute
David Geffen School of Medicine at UCLA
…a fascinating journey…. Getting a wide acceptance of new concepts and innovative treatments is probably as difficult as climbing the Everest Mountain. Courage and tenacity are, among others, the key characteristics of Gerald Buckberg.
Daniel Loisance, M.D.
Professor Emeritus
Former Head of the Cardiac Surgery Department at Henri Mondor Hospital Paris XII
Member of the Académie Nationale de Médecine
This remarkable work chronicles the scholarly and yet deeply personal account of the research achievements of one of our most respected cardiac surgeons. Although written for the general public, practicing physicians would gain a great deal by reading it.
Ralph B. Dilley, M.D.
Surgeon-in-Chief, Scripps Green Hospital, Retired
Clinical Professor of Surgery
UCSD School of Medicine
SOLVING THE MYSTERIES
of
HEART DISEASE
Life-Saving Answers Ignored
By The Medical Establishment
GERALD D. BUCKBERG, M.D., D.SC.
A special thanks to Jim Novack, a wonderful wordsmith whose contributions helped make this book possible.
www.jamesnovack.com
Copyrighted Material
Solving the Mysteries of Heart Disease
Copyright © 2018 by Health House Press. All Rights Reserved.
No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means — electronic, mechanical, photocopying, recording or otherwise — without prior written permission from the publisher, except for the inclusion of brief quotations in a review.
For information about this title, contact the publisher:
Health House Press
[email protected]
ISBNs: 978-0-9998472-0-6 (hardcover)
978-0-9998472-3-7 (softcover)
978-0-9998472-2-0 (eBook)
Printed in the United States of America
NOTE TO READERS
This memoir defines my career as a cardiovascular surgeon and researcher, and uses this background to explain my conviction that answers to major cardiac illnesses exist now, but are not currently used.
The basis of this belief is widely documented by reports of my work published in major cardiovascular journals with worldwide distribution. The stepwise progress from experimental to clinical application has been validated by national and international studies in patients. Each conclusion is carefully reported with clear-cut references. This information is attainable by all physicians, but not appreciated or used due to the rigidity of conventional thinking.
I bring this information to the non-medical public. My stimulus for this action came from the mother of a surgical colleague who watched television news to become aware of an innovative, but little-known treatment. She asked her son (who had never heard of this approach), “Why don’t you consider this?” He was not confined by convention… and pursued learning about it.
I hope that readers will ask their doctors to look at this book’s solutions, whose supportive evidence is furnished by included references. The book does not provide answers for the reader’s individual treatments, but rather encourages them to bring these concepts to their physicians, whose medical knowledge and professional judgment will guide their response.
This book is independently authored, without being affiliated with or endorsed by the David Geffen School of Medicine at UCLA, where I am a faculty member and cardiac surgeon. Its opinions are mine, and do not necessarily reflect the views of my mentors, teachers, or colleagues that conduct research and cardiac surgery.
Patients’ stories are authentic, though such individuals have been given fictional names to avoid identifying any real person, living or dead.
FOREWORD
BY JAMES L. COX
Note: James Cox is a distinguished scientist who found a treatment that offsets atrial fibrillation in most patients. He is internationally heralded, since this disease affects over 3 million patients in the United States alone, and is a major cause of strokes worldwide. Dr. Cox is unique in his creativity, and his innovative work has had an astounding impact.
In 2015, Dr. Cox was the recipient of the Scientific Achievement Award from the American Association for Thoracic Surgery. Similar to a Nobel Prize for the profession, this is the association’s highest award, and has honored the legends of cardiac surgery, such as Drs. Kirklin, Shumway, DeBakey, Cooley, and Carpentier. Dr. Buckberg was the sixth person to receive this award, in 2007.
Gerry Buckberg is a “Level One.” Let me explain. Many years ago when my cardiology colleagues at Washington University in St. Louis had successfully created the world’s first and only computerized system capable of digitally mapping the complex cardiac rhythm abnormality called Atrial Fibrillation, our initial data output consisted of a hodge-podge of numbers that made no sense to anybody. During that time, I happened to meet the Emeritus Professor and Chairman of the Department of Pure Mathematics at Cambridge University. During the course of our conversation, he asked me to describe my current research interests and I made the seemingly inno
cuous statement that I was studying a “chaotic” rhythm of the heart. With the mere mention of the word “chaotic,” the old man’s ears perked up and his eyes suddenly began to sparkle. He said, “Well, you know, my people at Cambridge are the world’s experts on the Chaos Theory!” He began to quiz me relentlessly about what I meant by a “chaotic rhythm” because his group had proven that there is nothing in all of nature that is truly chaotic … everything in nature has a pattern to it and anything that appears to be chaotic is simply the result of our own ignorance and inability to discern its underlying pattern.
After several hours of discussion, my new friend proposed that I come to Cambridge with a stack of our raw data so that his “people” could examine it for nature’s underlying organized activity, which he was certain was there. So… I had the unexpected privilege of giving an hour lecture to the members of the Department of Pure Mathematics at Cambridge University! While I was there, I met the new Departmental Chairman of Pure Mathematics, who informed me that all members of his profession know and accept the fact that there are three levels of mathematicians in the world and that the intellectual level of each mathematician is based solely on pure brain power. Apparently, mathematicians are less “politically correct” than cardiac surgeons!
The vast majority of accomplished mathematicians are “Level Threes” and they address the solution of “Level Three Problems” because, while brilliant, they are intellectually incapable of solving more complex mathematical problems. There are usually 20–40 “Level Two” mathematicians in the world at any given time and they spend their time trying to solve “Level Two Problems.” However, they don’t bother with the simpler “Level Three Problems” and they accept the fact that they are intellectually incapable of solving “Level One Problems.” Throughout history, there has usually been only one “Level One” mathematician alive in the world at any given time. The only exception that the Cambridge Professor could recall was in the early 20th century when two “Level One” mathematicians were alive at the same time … Albert Einstein and Niels Bohr.
I’m sure that there have been a few “Level One” scientists in the history of cardiac surgery but there is only one that I know of for sure … Gerry Buckberg. His ability to tackle problems that the rest of us see but cannot solve has been nothing short of astounding. Because of his scientific contributions in the field of myocardial preservation alone, he has probably saved more lives than any cardiac surgeon of our generation. He converted cardiac surgery from being the most dangerous of all surgeries into routine and safe procedures for the rest of us to perform. I have repeatedly referred to him as “The only true genius of our generation of heart surgeons,” and I stand by that statement.
This is a particularly interesting statement to come from me because when we were young, Gerry Buckberg and I were serious antagonists … I thought he was wrong in practically everything he said and I don’t think he even bothered to think about me at all. When I was only 29 years old, we locked horns for the first time at the Surgical Forum of the American College of Surgeons meeting in San Francisco. The next year, we got serious about our differences. I presented a 10-minute talk “disproving” his paper from the previous year in San Francisco and we were supposed to have a 5-minute discussion period following my presentation. The session was chaired by Dr. Gerald Austin of Harvard, one of the most powerful surgeons in the world. Nevertheless, Dr. Austin allowed our post-presentation “discussion” to go on for a full 25 minutes in front of a standing-room-only crowd. It was a defining moment for my relationship with Gerry Buckberg because it cemented my disdain for him. Again, I don’t think he even knew my name.
An interesting thing happened over the ensuing 30 years or so. I slowly developed first, a kind of neutrality regarding his ideas, then an acceptance of them, then an ardent respect and admiration for them that resulted in my ultimately becoming an avowed “Buckberg Groupie.” I became convinced that he was the most brilliant man I’d ever met and I remain certain that is true. Over the years, we have become collaborators on multiple projects, co-authors on multiple publications, and the dearest of friends. When I was President of the American Association for Thoracic Surgery in 2001, I asked Gerry Buckberg to be my “Guest Scientific Lecturer” at our annual meeting in San Diego. As expected, his lecture was groundbreaking and breathtaking, weaving together all of nature, from the spiral DNA helix to the spiral helix of the galaxies, into a mind-blowing elucidation of how the ventricles of the heart perform their vital function.
Late in our lives, I learned that Gerry Buckberg is the epitome of the Renaissance Man. Not only is he one of the most important cardiac surgeons of our generation, but he is also an accomplished and talented painter and creator of a ballet in which he integrates classical music with modern dance into a visual spectrum of the normal and abnormal rhythms and heart motions. His mind’s capacity and his inherent talent are apparently limitless, the sine qua non of a “Level One.” This book is his story, told in layman’s prose. It is a story that everyone who is interested in how revolutionary ideas evolve should read, for there are few people in life who have something of general importance to teach all other people, regardless of their chosen profession. Gerry Buckberg is that person for our time.
James L. Cox, MD
Department of Cardiac Surgery
Northwestern University
Chicago, Illinois
April 2018
INTRODUCTION
Exploring Uncharted Territories
Before you is the lifelong adventure of a heart surgeon and cardiac researcher whose mission has been the solving of mysteries. Discovering solutions that will evolve into new treatments that improve and save lives — possibly including yours or those of your loved ones. This journey will introduce you to a range of seemingly impenetrable riddles… of your heart. Many of these puzzles — the solutions to which have the potential to impact millions of people all over the world — were long thought unsolvable. For while our country directs immense attention toward cancer, the reality is that diseases of the heart claim more lives every year, at enormous personal and financial costs.
This story reveals how the solutions to many of these major cardiac issues have been uncovered by our efforts at UCLA’s David Geffen School of Medicine and around the globe, and explains how this new knowledge can bring about a surprising “revolution” in health care.
Yet today, the progress made possible by this knowledge has not happened.
While the general public reasonably expects the medical profession to welcome changes that can transform healthcare… that is frequently not the case. A fundamental, powerful, and ageless barrier prevents the embracing of new techniques and technologies. This obstacle is a rigidity of thinking.
I did not anticipate this when I first became a cardiac surgeon / researcher. My commitment was to care for my patients and set off upon the challenging investigations needed to find long-sought answers. I would make rounds to visit patients at five in the morning and often not complete my surgical procedures and research until ten at night. This lifestyle made others ask, “Why was I so steadfast in my dedication?”
The answer springs from my childhood.
I grew up as “a kid in the Bronx.” My family didn’t have much money or socio-economic status. Yet my mother and grandmother were absolutely regal in this environment. Their presence elicited from others a deep respect, gratitude, and devotion for a simple reason. Their lives were built upon giving and helping others. Their smiles, grace, and positive attitudes were palpable to me as a child, as I observed their lack of interest in taking anything back (short of knowing that what they did was useful). Their joy came from giving. My hope was to someday experience this splendor that characterized my mom and grandmother.
As it turned out, the opportunity arrived fairly early on.
A heart attack claimed my grandfather when I was 14 years old. This sudden end to my grandparents’ 54 years together created a great loneliness for my
grandmother. Suddenly, she lived alone. Though she would never complain, a glance at her eyes and the absence of her customary smile told the true story.
Their house was only a block away from ours. I decided to stay with my grandmother, sleeping in the room next to hers. She spoke only Yiddish, but this lack of communication did not prevent me from being there with her every night for a year and a half. I still recall Grandma coming into my room and singing lovely Russian lullabies and folk songs to me as I drifted off to sleep.
It was my first profound experience of giving without expecting anything in return. Yet I received much: the lovely smile returned to her face, and I felt my being there helped bring the light back to her eyes. While I didn’t recognize it then, that experience would set the stage for building a life of devoting my energies to helping others.
As I entered the field of medicine, I soon realized that the mentors and role models I most admired were just like my mother and grandmother. They mirrored their generous qualities by dedicating themselves to improving the health of their patients.
I became a cardiac surgeon / researcher because of my need to better understand my grandfather’s sudden illness, coupled with my desire to heal ailments centered around the organ most central to our being — our heart. I was excited to learn the latest techniques in open-heart surgery, since we could solve many underlying problems. But I was deeply troubled to see that many hearts were damaged during the operations, even when each of the surgeons performed the procedure with perfect technique. Was this simply, as many believed, the best that could be expected when operating on such a fragile organ? That attitude was unacceptable to me and I was driven to find an answer — one that could be shared with others in medicine, and used to improve outcomes for our patients and their families.
I had astounding success at my start, as I uncovered why an area inside the heart would die after a perfect operation, and I then developed a method to protect the heart from this damage during the procedure. My introduction of “blood cardioplegia” (a way to safely stop the heart’s beating movement, so that surgeons can precisely correct the heart problem) is now used by 85% of cardiac surgeons in the United States and nearly that many worldwide, and has benefited over 25 million people.
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