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Rene Favaloro: 1923-2000: Heart surgeon

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Argentine heart surgeon Rene Favaloro made his name in America where, in 1967, he performed the world's first documented heart bypass surgery. Favaloro was a rural doctor in his native Argentina, but became a pioneer of coronary surgery in the United States before returning to his homeland. During his career, he would claim to have performed some 18,000 heart bypass operations. In the end, the state of the Argentinean health system would prove too much for Favaloro. The doctor devoted his life to the provision of free, quality health services there. Increasing frustration and financial desperation led him to take his own life in 2000.

Interest in Medicine Began Early

Rene Geronimo Favaloro was born July 14, 1923, and raised in a modest home in La Plata, Argentina. His mother, Ida Y. Raffaelli, was a dressmaker, and his father, Juan B. Favaloro, was a carpenter. Favaloro's uncle was the only person in the family to have earned a university education, and he had become a doctor. Favaloro was convinced even as a boy that his own destiny lay in medicine, as well. He studied medicine at La Plata University, graduating in 1948. In 1950 he took a temporary post working as a country doctor in Jacinto Arauz, a small, impoverished town in the province of La Pampa, 300 miles west of Buenos Aires. He ended up staying in Jacinto Arauz for 12 years. "The lessons of his rural practice were never lost on him," Pearce Wright wrote in a London Guardian obituary, "and he maintained that all doctors in Latin America should be required to work among the poor."

Favaloro left Jacinto Arauz for America to begin his post-graduate studies. When Favaloro arrived at the Department of Thoracic and Cardiovascular Surgery at the Cleveland Clinic in 1962, he spoke very little English. However, the language barrier did not hold him back. Favaloro soon established himself as a pioneer in his field, although he was prone to breaking into a string of Spanish expletives when things were not going his way in the operating room.

In 1967 Favaloro performed the world's first documented coronary bypass surgery. Eugene Pottenger, a 54-year-old produce wholesaler from Illinois, had been given just three months to live because of the severe blockage of an artery to his heart. Pottenger was hooked up to an artificial heart-lung machine, and Favaloro "harvested" a vein from the patient's leg to use as a replacement for the clogged coronary artery. The procedure has become "a mainstay of modern medicine," according to the London Times, and boasts survival rates of 20 years or more.

Others would claim to have already performed the procedure. In the world of medical achievement, however, nothing is accomplished until it is documented in a medical journal. Favaloro and the Cleveland Clinic were the first to appear in print, in the Journal of Thoracic and Cardiovascular Surgery in August of 1969. Favaloro maintained the procedure was nothing more than a logical next step from the work he and his team had been doing. "Medicine is only evolution and it doesn't matter who is first," he was quoted as saying in the London Times. Still, he added, "in this case there is no doubt that the Cleveland Clinic was first."

Returned to Argentina

The pioneering heart surgeon turned his back on a lucrative medical career in the United States in order to bring his expertise back to his homeland. "Although he could have had a brilliant medical career at one of the most prestigious and well-endowed medical centers in the United States—which would have made him very rich—Favaloro resigned," according to the London Guardian. He returned to Argentina in 1972 to create a top-level teaching clinic and performed the nation's first heart-transplant operations. Favaloro raised the $55 million it took to found his heart clinic, the Favaloro Foundation, which opened its doors in 1992. There, he treated thousands of patients, often at no charge, and trained hundreds of surgeons.

The 25th anniversary of Favaloro's first bypass surgery was celebrated at the Cleveland Clinic in 1992. Pottenger, the first patient, was still alive at 79 and attended the event. Favaloro constantly downplayed his achievements. "I'm still a simple country doctor," he said in 1992, according to the London Times. "De-spite the technology, the most important thing is to talk to the patient and make contact with the patient. The patient is not only the illness, he has a soul."

Favaloro was author of more than 300 scientific papers and wrote the study Surgical Treatment of Arteriosclerosis in 1970. He also wrote an autobiography, The Challenging Dream of Heart Surgery: From the Pampas to Cleveland, in 1994. While Favaloro was known and honored the world over for his achievements, he was disenchanted with this level of international success. Truth be told, his international renown contrasted sharply with the lack of recognition—and practical support—he received in Argentina.

Clinic Struggled With Financial Difficulty

Argentina has struggled with financial depression since the 1990s when, like many other Latin American countries, it instituted free-market reforms. Millions of Argentines lost their health-care coverage while the government slashed subsidies to Favaloro's clinic. The Favaloro Foundation was often the only hope for chronic patients, and the doctor refused to turn away those who could not pay. After years of championing the cause of universal health care, Favaloro was growing distraught. According to the national newspaper La Nacion, as quoted by the Guardian, the Favaloro Foundation was reportedly owed $18 million by state-owned medical centers and hospitals. His dream was on the brink of financial ruin. He pled for help from the government and private investors to no avail. Accord-ingtothe Seattle Times he wrote in a letter to a friend, "I am going through one of the worst moments of my life. I have become a servant knocking on doors looking for money to keep the foundation alive."

Favaloro died July 29, 2000, at age 77. He was found by his secretary in the bathroom of his Buenos Aires apartment. From the gunshot wound to his chest, the gun lying nearby, and letters of farewell found in the apartment, police attributed the death to suicide. Favaloro's wife, Maria, had died in 1998. Though they had no children of their own, they raised four children of one of Favaloro's brothers, who died young. Argentine President Fernando de la Rúa, acknowledged Favaloro's "deep love and attachment to his country," according to the Lancet, and declared July 31 a day of national mourning.

Favaloro was honored in Europe for his work just weeks before his death. He attended the opening of the Georges Pompidou European Hospital in Paris on June 26 and 27, 2000. While there, he confided his troubles to fellow Argentine heart surgeon Juan Carlos Chachques, who is director of the Paris hospital. "I have no doubt that this tragedy is a direct consequence of the financial situation in which Argentina's health system is embroiled, Chachques is quoted as saying in Lancet. "Dr. Favaloro faced the appalling prospect that everything he had worked to achieve … was on the point of disintegration."

Selected writings

Surgical Treatment of Arteriosclerosis, (study) 1970.

The Challenging Dream of Heart Surgery: From The Pampas to Cleveland, (autobiography) 1994.

Sources

Guardian (London, England), August 3, 2000, p. 22.

Lancet, August 5, 2000, p. 492.

Seattle Times, August 27, 2000, p. A25.

Times (London, England), July 31, 2000, p. 19.

—Brenna Sanchez