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Q&A with Dr Erich Schürmann


What is a cardiothoracic surgeon?

The cardiothoracic surgeon is a surgeon who specializes in the surgical procedures of the heart, lungs and other organs in the chest. Congenital cardiothoracic surgeons subspecialize in the surgical procedures required in the correction of congenital defects in babies and young children.

How long does it take to become a cardiothoracic surgeon in South Africa?

Cardiothoracic surgeons take a minimum of 12 years to qualify. Congenital cardiothoracic surgeons require an additional 2-5 years of training.

What does a typical day involve as a cardiothoracic surgeon?

Long days, with exhilarating highs and soul destroying lows. The average day starts with ICU rounds at 7am, followed by two surgical cases on average daily. Each case averages 5 hours. In between cases new patients are consulted, or old patients are followed up, and any emergencies are attended to. Once surgeries for the day are complete ICU patients are reviewed. One surgeon remains on call for any ICU problems or emergencies during the night. Patients undergoing surgery the next day are seen and the family members or parents are counseled. If you’re not on call your day usually ends by 8pm. The surgeon on call returns to ICU during the night for routine rounds and is on call till the following morning. Weekends are similar but surgical cases are on an emergency basis only.

What do you love about your job?

I love been at the cutting edge of a physically and intellectually demanding occupation. I love being part of a team of people who each in his or her own way is putting all their effort, skill, blood, sweat and tears into saving lives and improving quality of life. The skill of each and every member of our team is a very rare commodity and it’s a privilege to stand shoulder to shoulder with them. Congenital cardiac surgery is especially rewarding. These kids present with little or no long term survival, but in the vast majority of cases they end up having a normal quality of life and normal life expectancy following surgery. In other words spending resources on babies with congenital heart disease outstrip any other procedure in medicine due to the fact that successful procedures can add seventy or more years of life.

The diversity of surgical procedures performed is vast. From an open heart procedure on a 2.5 kg baby’s strawberry heart to a lung resection in a 75 year old smoker or a coronary artery bypass operation on a 100 kg man. This is rare in any other speciality

Anything you dislike about your job?

I hate losing. I hate the odd complication or loss. The peak of a successful operation is addictive but the valley of a loss is a dark hole with slippery walls… I feel the weight of every parent and family member on my shoulders with every skin incision. I have the utmost respect for the parent that willingly hands over his or her child to the masked stranger on the other side of the red line; handing over that child or loved one’s future into our hands. Parents and family members are the true heroes.

Surgeries are average 5 hours long? Do you take meal or tea breaks?

Ha. No time flies when you are having fun. Most of the surgeries we perform are open heart surgeries. This means the aorta is clamped and the heart isn’t receiving any nutrient or oxygen rich blood. We use the saying, “time is muscle”. The shorter the period the heart muscle is without blood flow, the better for the patient. Heart surgery is about connecting the patient to the heart lung machine, stopping the heart, repairing the defect, removing all air from the heart, restarting the heart and weaning the heart from bypass. This should all be done expeditiously and accurately. The heart can’t be rested like a broken bone or an inflamed intestine. It has to start working immediately and efficiently to sustain the blood flow required by the organs and body tissues.

Any outstanding memories?

Hundreds, some good, some bad. The first time I saw the beating heart as an intern. My first solo heart surgery. My first operation on a new born baby. My first death. Seeing babies who were blue and dying now going to school and playing sport. New memories are created every day.

 

© Maboneng Heart and Lung Institute 2017 | Featured Image: Maboneng Heart and Lung Institute

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