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- Spencer B. King III, MD, MACC, Editor-in-Chief, JACC: Cardiovascular Interventions∗ ()
- ↵∗Address correspondence to:
Dr. Spencer B. King III, Saint Joseph’s Heart and Vascular Institute, 5665 Peachtree Dunwoody Road NE, Atlanta, Georgia 30342.
At the start of this academic year I was asked by the fellows to relate how Andreas Gruentzig came to America. I opined on that subject and now will continue the story (1). I was moved to do this while listening to candidates for the presidency of the United States rail against immigration to gain political advantage. This struck me as especially ironic considering that a high percentage of our interventional cardiology fellows are indeed immigrants. I also reflected on a political refugee who migrated to West Germany and later to the United States and ultimately became the father of our subspecialty. I have related some of the story of Andreas’s odyssey from Zurich to Atlanta and will pick up the story of this unusual immigrant where I left off.
When Andreas agreed to visit me in January 1980 following the Snowmass meeting, I immediately contacted Dr. J. Willis Hurst, the chief of medicine, and informed him of the visit. Dr. Hurst was skeptical at first, having heard that Andreas was something of a prima donna. He probably heard this from his former fellow, Dr. Hans Peter Kreinbuhl, who was in a less than amiable relationship with Andreas back in Zurich. I told Willis that Andreas was coming for a visit in any case, and I wanted the two of them to meet. Willis was immediately enthralled by Andreas and became a critical supporter of his recruitment effort from the moment of their first encounter.
Huge obstacles to bringing Andreas to the United States appeared. First of all, he had taken no ECFMG or other qualifying exams. Second, his training had been in angiology, biostatistics, and other disciplines, but his cardiology training had been largely informal compared with American standards. The road to a visa seemed extremely complex, as did the opportunity to obtain Georgia licensure should a visa be possible. All this changed with another chance meeting at the Piedmont Driving Club, a highly restrictive men’s club immortalized in Tom Wolfe’s A Man in Full. We were taken to lunch by the chief of surgery, Dr. Charles Hatcher, and the chief of cardiology at Emory Hospital, Dr. Bruce Logue. During the meal, I noticed that among a group of men at an adjoining table was Judge Griffin Bell, who had recently resigned as attorney general of the United Stated under Jimmy Carter. I knew Judge Bell through our activities on the Board of Trustees of Mercer University and invited him to meet Andreas. When I mentioned for the first time that we were trying to recruit Andreas, Judge Bell replied: “Is there anything I can do?” I said: “As a matter of fact, we anticipate problems with his visa.” Judge Bell said: “There is nothing I can do about that; however, I did appoint the chief of immigration and naturalization.” He also mentioned that his law firm had people who were intimately familiar with immigration law. The King & Spalding firm was hired on and, with Andreas’s blessing, began a rather expensive, although ultimately successful, legal proceeding.
The process of obtaining state licensure was also difficult but, with Dr. Hurst urging that Andreas constituted a “national treasure,” the impossible was finally accomplished. In the 6 to 7 months it took Andreas to make up his mind, I felt fairly confident that he would be well served to join our group at Emory. Dr. Hurst remained nervous and finally pressed me to find out if Andreas was coming or not. When I contacted him in September 1980, he told me that he had been asked to meet with Dr. Eugene Braunwald and Dr. Sven Paullin to consider one more time going to Harvard. Andreas called me shortly after and said that he planned to arrive in October 1980 to begin his work with John Douglas and myself in the cath lab at Emory University Hospital.
Andreas was given the position of Director of Cardiovascular Interventional Medicine and the title Professor of Medicine (Cardiology) and Radiology. The Radiology title was a carry over that I had acquired when I first returned to Emory in 1972 because of the insistence by the chief of radiology that all cath activities must be performed by members of the Radiology Department. Not I nor John Douglas nor Andreas had any training specifically in radiology, but we were all knighted radiologists by the department. In retrospect, this turned out to be an excellent relationship, as there were no conflicts whatsoever between interventional cardiovascular medicine and radiology during those years.
The conflicts between our group and cardiac surgery and cardiac anesthesiology, however, were a different story. Despite the warm personal relationships between Andreas and the surgeons, whom he met in Kiawah Island 2 years before, when it came down to selecting patients for angioplasty who could have been surgical candidates, and to needing emergency surgical backup late on Friday afternoons, things became much more difficult. The surgeons were mild mannered compared with some of the cardiac anesthesiologists. Emergency bypass surgery was required not infrequently and did not always happen at a convenient moment for the surgical teams. The chief of cardiothoracic surgery told me that he was going to have a strong talk with Andreas and straighten him out on what he could and could not do. When Andreas returned from his “straightening out” session with Dr. Hatcher, I asked him how things went. Andreas smiled and said that Dr. Hatcher had been completely supportive of his position and that was the end of it. Andreas was most charismatic and persuasive and had the unique talent of extending this quality to relationships with adversaries as well as friends (2).
Could Andreas move to the United States today in the way he did 35 years ago? It is highly unlikely. Perhaps xenophobia is never thought to apply to people like Andreas Gruentzig, but who knows who will create the next revolution in medicine. For a country built on immigration, I can only hope that the political rhetoric recedes soon.
- American College of Cardiology Foundation
- King S.B. III.
- King S.B. III.