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Sir Brian Gerald Barratt-Boyes
Sir
Brian Barratt-Boyes was born in Wellington on 13 January 1924. He was an
outstanding person in so many ways; highly talented with flawless dexterity and
skill as a surgeon, innovative and insightful as a scientist, a brilliant
teacher, and a wonderful man. He was held in the highest regard by colleagues
and patients.
His death, following a fourth cardiac bypass operation, has
left colleagues with an overwhelming sense of sadness and of loss, but also
wonderful memories, of times of immense joy, of immense satisfaction, of being
extremely challenged, and memories of a man with enormous determination, with
attention to the finest detail, of a man who had achieved so much, and of a man
living life to the fullest. Sir Brian’s life has affected the life of many others
in innumerable different ways and will continue to do so in the future.
Sir Brian’s academic journey began in Wellington at
Johnsonville Primary and Wellington College and followed on to Otago University
where he graduated MB, ChB in 1946. He was an outstanding pianist and at one
stage considered a concert career. He became a fellow of the Royal Australasian
College of Surgeons in 1952 being the first to not have undergone any training
outside of New Zealand and was awarded a Master of Surgery in 1962. He undertook
a Fellowship at the Mayo Clinic in Cardiovascular Surgery from 1952–1955.
During this time he worked in the Cardiac Catheterization Laboratory and did
seminal work on measurements of normal heart pressures and cardiac outputs. It
was here that he met his friend and colleague, John Kirklin.
In 1956 he held a Nuffield Travelling Scholarship at Bristol
University. In 1957 he returned to New Zealand as a senior thoracic surgeon at
Green Lane Hospital. In 1965 he became the surgeon in charge.
He became a Fellow of the Royal Society in 1970 and was
awarded an Honorary Professor of Surgery at the University of Auckland in 1971.
He was awarded an Honorary Fellowship of the American College of Surgeons in
1977, the Royal College of Surgeons in 1985, and the American College of
Cardiology in 1989. He was awarded an Honorary DSc by Colorado University in
1985. He was President of the Cardiac Society of Australia and New Zealand from
1986–1987.
He received numerous Honours and awards from almost every
country in the world, including from his Holiness the Pope. Last year he was
awarded the Distinguished Alumni Award from the Mayo Clinic for accomplishments
in medical practice, education, and research.
In 1966 he was awarded a CBE, and in 1971 he was knighted at
the age of 47 for his pioneering work on replacing the aortic valve of the heart
with a homograft valve. His original idea was to invert the valve so that the
cusps were not in the way when it was inserted, allowing visibility for the
valve ring to be sown in. His second major achievement was his perfection of the
technique of hypothermia and circulatory arrest. The idea originated from a
Japanese registrar who came to Green Lane Hospital for training.
Sir Brian tested the technique first in the laboratory and
then in babies, allowing surgeons to operate on a still, bloodless heart. This
technique changed the practice of paediatric heart surgery and opened up the
treatment of many congenital heart defects that previously were untreatable.
Again the results of cardiac surgery at Green Lane Hospital were among the best
in the world and the Green Lane Hospital surgical results became the standard by
which other cardiac centres compared their own results.
His third monumental achievement was his book coauthored
with the American surgeon John Kirklin which was simply called
Cardiac Surgery. This book recorded
many of the results of surgery at Green Lane Hospital.
The
American Journal of Cardiology called
it “absolutely magnificent, it is one of the very best medical books ever
published, it is a classic from the beginning”.
The International Journal of Cardiac
Surgery said “This work is phenomenal and almost defies adequate
description”. It is considered the bible for cardiac surgeons worldwide
and is now in its third edition.
Many of Sir Brian’s achievements are not listed on his
curriculum vitae such as training many cardiac surgeons who are now scattered
worldwide saving the lives of 1000s of patients each year; critiquing and
challenging other surgeons’ work; developing new cardiac units throughout
Asia; and teaching junior doctors and nurses.
Sir Brian was extremely hard working, he demanded the
highest standards of medical care without compromise, and he imbued a group of
wonderful people with the same high standards; the surgeons, cardiologists,
anaesthetists, perfusionists, pathologists, and nurses all had enormous respect
for each other and there was an intense focus on teamwork and improving patient
care. Huge strides were made in understanding the anatomical detail of
congenital heart defects and developing new surgical techniques.
His influence worldwide was enormous. His reputation being
so high that doctors at Harvard Medical School, arguably one of the most
prestigious in the US where patients with complex heart disease are referred for
treatment, referred a gravely ill famous patient to have surgery in New Zealand
by Sir Brian, knowing that the patient would receive the very best treatment in
the world.
That Sir Brian chose to live and work in New Zealand in the
face of numerous offers to work overseas deserves the utmost admiration and has
benefited this nation enormously. Sir Brian was indeed one of New
Zealand’s favourite sons.
In 1989 at an American College of Cardiology Convocation, at
which Sir Brian was awarded a very prestigious Honorary Fellowship, this
citation was made using the term physician, and calling him the greatest
physician of the century. The term physician was used not because they had
forgotten that he was a surgeon, but because they wanted to acknowledge his
enormous contributions to medicine in general as well as his humanistic and
caring attributes.
Sir Brian lived the history of cardiology and cardiac
surgery, to which he had contributed so much, with himself undergoing four
cardiac operations and left main coronary artery stenting. He pioneered the
first use of cardiopulmonary bypass in New Zealand in 1958. The first coronary
artery bypass at Green Lane Hospital was performed in 1969 and in 1974 he
underwent the same operation.
In the early 1980s internal mammary artery grafting was
introduced. In 1983 he underwent repeat bypass grafting using a left internal
mammary graft. In the 1990s complete arterial grafting was developed and in 1997
he underwent his third bypass operation using a free right internal mammary
artery graft. Recently left main artery stenting has been introduced, and in
2004 his left main coronary artery was stented. Two weeks before his death he
underwent aortic and mitral valve replacement.
Sir Brian was revered by his patients and, up until his
death, Sir Brian was still receiving letters from grateful former patients and
he always wrote back thanking them for their kind words and wishing them all the
best in the future.
Sir Brian retired from surgical practice in 1989 to his
beloved farm “Green Hills” near Waiwera. He grew grapes, played
tennis, worked on his book, and spent time with his family.
Sir Brian continued his research on the long-term results of
valve replacement right up until he went to Cleveland for his fourth heart
operation. This was not a retirement project but important, original work that
would influence the care of future patients He also continued to lecture
throughout the world and to give advice about the design of new heart
valves.
Sir Brian wanted to be remembered as a surgeon who helped
both the young and the old. There is no doubt that he will be remembered for
that, as well as for the wonderful legacy of surgeons that he has trained
throughout the world; but he will also be remembered as a lovely man who had a
wonderful journey and who enriched many lives. Sir Brian’s impact on young
surgeons and their careers will be an ongoing legacy.
Sir Brian’s life demands respect and admiration, but
it was his gentleness, his love of life, and his compassion that made colleagues
and patients love him.
Sir Brian is survived by five sons (David, Mark, John,
Stephen, and Simon) and his wife Sara whom he married in 1986.
Rārangi
maunga, tū tonu, tū
tonu
Rārangi tangata, ngaro noa, ngaro noa You have
gone,
but your mountain is everlasting Professor Harvey White
(Director of the Coronary Care and Green Lane Cardiovascular Research Unit,
Green Lane Cardiovascular Service, Auckland City Hospital, Auckland) wrote this
obituary.
The photograph is courtesy of
Remembering
and appears at their interactive memorial site entitled
Always in our hearts:
http://www.remembering.co.nz/tribute2.asp?REMID=102
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