Page 12 - Peter Munk Toronto Star

M12⎮TORONTO STAR SATURDAY, JANUARY 31, 2015
PETER MUNK CARDIAC CENTRE
> SURGERY
Heartfelt commitment spans a generation
Tirone David, 70, shares
a similar life-saving passion
with Mitesh Badiwala, 36
JONATHAN FORANI
SPECIAL TO THE STAR
The past and future are members of
the same team at Peter Munk Cardi-
ac Centre, and their names are doc-
tors Tirone David and Mitesh Badi-
wala.
They are of different generations
and medical upbringings — David,
70, is a veteran in the field, while
Badiwala, 36, is one of the hospital’s Usually, you have go away and learn
newest recruits — but as part of the
same expert team of surgeons, the
decades that separate them in age
could bolster the future of cardiac
surgery in the city and around the
world.
From pigs in Toronto labs to beat-
ing human hearts on Chicago oper-
ating tables, Badiwala, has circled
back home again to the team that
gave him his start. After a year as a
travelling fellow at Northwestern
University and a “taste of the Amer-
ican health-care system,” it was time
to come home.
“They tried to keep me at North-
western, but I was too proud a Cana-
dian to stay,” Badiwala says. “It’s a
very collegial group here.”
He wasn’t always so sure-footed,
though. When he started medical
school in 2000 at the University of
Toronto, he had no idea where he
wanted to go in the field. But soon,
one of his earliest mentors, Dr.
Heather Ross, introduced him to car-
diology. The first summer he had off
during med school, he worked in a
lab and watched some of his now-
partners in the operating room and
that was that.
“I got hooked. It was almost like a
drug,” he recalls. “I was totally ad-
dicted to cardiac surgery. I loved the
intensity of it, the technical detail
that was required. The fact that pa-
tients can get really sick in a mo-
ment’s notice and you’re there to al-
most rescue them at times.”
During work on his PhD, he assisted
on more than 100 organ retrievals
and transplants. He says that time
Dr. Tirone David, left, is considered a “legend” by his peers; Dr. Mitesh Badiwala could be the one filling his shoes.
was a kind of “informal fellowship”
in the practice of heart transplants, a he was really sick. We couldn’t get a
procedure near the end of spectrum
of cardiac surgery. For a young stu-
dent who hadn’t completed the rest
of his cardiac surgical training, this
was uncommon.
“Ironically, the first cardiac surgery the young man had to walk around
operation that I learned and was
comfortable doing was heart trans-
plantation — not coronary bypass,
not valve repair — not all the other
common stuff,” he says. “Not all car-
diac surgeons do transplantation.
how to do it, but I kind of learned it
up front.”
This cemented his ambitions and
transplantation became his passion.
When a young man in his 20s land-
ed on Badiwala’s operating table, he
knew even more that this was the
practice for him. “His skin was grey,
heart for him, because he was too
sick to wait,” he recalls. “We put a
pump into him. And that in and of
itself transformed him.”
At the time, about eight years ago,
with a backpack controlling the loud
pump. Since then the technology has
“totally evolved twice over,” says Ba-
diwala, but still, it worked. “Seeing
him get better with the pump was an
eye-opener for me — a guy who was
almost dead being kept alive with a
pump,” he says, recalling the amaze-
ment he felt as a trainee at the hospi-
tal.
Called a left ventricular assist devic- same sack that the heart is normally
es, or LVAD, the pump substitutes as
the left side of the heart where the
problem typically is, Badiwala says.
ON ON1
STEVE RUSSELL/TORONTO STAR of cardiac surgery: minimally inva-
sive operation. But more than that
for the doctors at Peter Munk, the
key is as simple as teamwork. Multi-
They drain blood from the left side of disciplinary practice and collabora-
the heart and use the LVAD to pump tion is one of the primary goals for
it to the rest of the body through the the centre’s future as it strives to
aorta. become the “valve centre of excel-
lence” globally, says Badiwala. “We
Badiwala says the man would have have all these pockets of expertise
likely been using a first or second and we’re slowly kind of merging
generation pump then. Today, they them within our institution.”
are already on to the fourth genera-
tion of pumps. Instrumental to that team is Tirone
David, the “legend,” as more than
“Like so much in the world of tech- one fellow doctor at Peter Munk calls
nology, it’s constantly evolving. Like him.
the size of cellphones and MP3 play-
ers over the last several years, these “Everyone knows him,” says Badi-
heart pumps too are shrinking in wala. “To this day, he operates very
size,” he says. “They used to be so big frequently. He does a better job than
that we’d have to put them in the most of us do on a bad day for him,”
belly. But now the pumps are so he laughs. “For me to have a mentor
small that we can just fit them in the like that to help me as I start my
practice is an incredible experience.”
in. The operations are becoming less
and less invasive.” In some ways, Badiwala is tasked
with filling David’s shoes.
That’s one of the keys to the future
“Dr. David is a legend, he really is,”
says Heather Ross, one of Badiwala’s
first mentors. “Those are rather gi-
normous shoes to fill. Mitesh prob-
ably doesn’t look at trying to fill those
shoes as to make his own footprint. I
think that is a brilliant way of think-
ing about it.”
Indeed, David’s curriculum vitae is
extraordinary. Perhaps his crowning
achievement is having an operation
named after him: the “David Proce-
dure.” In the ’80s, David operated on
young patients with a genetic abnor-
mality that caused their aorta to ex-
pand. These patients were dying by
the age of 40, he says. But in 1989 he
developed a procedure in which the
aortic root is replaced without re-
placing the aortic valve. Now, people
with the abnormality live normal
lives.
Despite his age, David has no plans
to retire. “I’m 70 years old, however
my clinical performance is no differ-
ent than when I was 40,” he says,
decrying human perception of time.
“My degree of productivity hasn’t
stopped yet. But eventually I’m sure.
Like any aged professional, we al-
ways slow down. I don’t know when
it’s going to be. I think I am in the
twilight years of my productive life.”