When Michael DeBakey passed away on July 11, 2008, it was a sad day for the world and for mankind, and it was a shock to those of us who had always loved him and admired him, for we considered him immortal. It was difficult to believe that the power of his mind and body could be conquered by disease and death, as for he had always been their conqueror. Since his passing much has been said and written about Michael DeBakey, the foremost heart surgeon, the pioneering researcher, the innovator, the gifted medical educator, the international medical statesman, and, above all, the genius, but little has been said about the man behind the genius. Indeed very few people have had the privilege to know the real man. I feel profoundly privileged to have been one of his close friends and one of who had come to know the essence of man behind the genius. For many years I had the honor of having lunch with him at least biweekly, and I have travelled with him to Lebanon and throughout the world many times. It was not medicine that bonded us, it was Lebanon; our beautiful ancestral country that we both loved so deeply. We were also both reared in the Orthodox Christian faith, and we both adored and revered our parents. Michael DeBakey loved Lebanon, and the Lebanese people reciprocated with affection, pride and admiration. To the Lebanese his name was redolent of a young Lebanese poet Gibran Khalil Gebran who some 100 years ago stood before the towers of New York and said “I’m the descendant of the people who built Damascus, Byblos, Tyre, Sydon, and Antioch, and I am now here in America to build with you and with a will”. In an address he made to young Americans of Syrian origin, Gebran said “I believe that even as your fathers came to this land to produce material riches, you are born here to produce riches by intelligence and labor”. Michael DeBakey, who himself was the American born son of Lebanese immigrants did, indeed, “build and with a will”; did indeed produce “riches by intelligence and labor”; riches that shaped the future of American medicine and defined the greatness of America. No American contributed more to modern medicine, and no surgeon is more deserving of the label “Greatest Surgeon of all time”. How fortunate to be a contemporary of this man, and what even greater honor to be his friend.
Both Gebran and DeBakey were universal in their messages. The message of Khalil Gebran was the power of love; the message of Michael DeBakey was the power of knowledge. Bertrand Russell, the renowned British philosopher and Nobel Laureate, described the combination of love and knowledge as “the greatest force in the world”. It is this combined force, and not physical force, that is needed to save the world and mankind.
Having been raised in a warm and loving Lebanese family, Michael DeBakey had a penchant for Lebanese food, and my office staff, over the years, learned the routine. The Lebanese lunches were served by my staff mainly in his office in the Alkek Tower of the Fondren/Brown Building, and occasionally in my office at St. Luke’s Medical Tower. Sometimes we had a few guests, but usually we were alone. The last time we had lunch together was a week before he died. During that time, he said “Philip, I do not have a lot of time, and I have very few close friends like you. Can we make this lunch regularly every week, when you return from Italy?” “With great pleasure, we certainly will” I answered. Seven days later, I heard the shattering news when I was in my hotel in Rome, Italy. I was stunned and I kept switching channels just to confirm that it was indeed, my friend, Michael DeBakey, who had passed away. I was frozen in disbelief for a few hours, immersed in deep thought about the man I loved deeply who was a father figure as well as a treasured friend to me. He is no longer here. There are no more lunches. That great privilege is gone. Somehow, Houston appeared so distant and so empty.
What do I know about this international icon that the world didn’t? What was real and what was mythical? There is indeed a myth that surrounds every great man, and almost always the myth is larger than the real man, but with Michael DeBakey, the reverse was true. The man towered over the myth.
Unlike most doctors who devote their lives entirely to their work and know little of the outside world, Dr. DeBakey had a panoramic mind with an endless landscape of knowledge. His knowledge was far from limited to medicine, but reached into history, politics, philosophy, religion, music, and literature. He was a Renaissance intellectual in the true sense of the word. There was no field or area of knowledge he was not versed in. With the little time he had for nonmedical adventures, he read extensively, and this mind memorized almost everything he read. What an enhancing memory he had, and what an enormous intellect that not only absorbed knowledge, but assimilated, expanded, and refined it. In politics and history, the Middle East was his favorite. We talked endlessly about the plight of Lebanon and the conflict in the Middle East. Although I lived more than half of my life in Lebanon and have always been a political activist in Lebanese and Arabic affairs, I never left his office without learning something new from him. One thing we never discussed at these sessions was medicine.
Although he was a great scientist, he had a strong and profound faith. I have never known of any man who revered more Christianity and its message. He was a strong symbol of love and forgiveness. He never questioned the reality of Jesus Christ, he always admired His example. He was ever thankful to the Lord for granting him that great mind, that great body, that long life, and his unparalleled achievements. He studied and mastered the human body in all its complexity and wonder, and was puzzled by those who were not in awe of the Creator when faced with the ingenious mechanisms of the human body and mind. He reminded me of the great Arabic Persian, physician and philosopher, Avicenna (Ibn Sina), who said “I studied medicine to understand and appreciate God. Didn’t God create man in His image?”
Few people understood the innocence deep in Michael DeBakey’s heart. To me that innocence was clearly visible and palpable. When he was comfortable and contented, he always gravitated to talking about the young Michael DeBakey who lived in Lake Charles and, at the age of 10, visited with his parents their hometown of Marjayoun, Lebanon, known at that time as the Paradise of the Middle East. His favorite subject of conversation was his father and mother, and he spoke endlessly and lovingly of them and of their enviable qualities. The father was a highly intelligent and prosperous entrepreneur who indoctrinated in his children the highest human and Christian values and who emphasized the importance of education and diligence. His mother whom everyone called a queen, read the Bible daily and radiated love in the home, and he learned from her the art he applied to sewing Dacron grafts. Both of his parents were extremely charitable, but almost always silently. His favorite food was Lebanese, the food his mother prepared when he was a child, and his favorite dish was kibbee, his parents and siblings favorite as well. More than any other human being, his mother was the center of his love and life. He repeatedly told me how fortunate he was to have such model Lebanese parents, who cherished family love, high principles and education. He knew that I was listening and heard his words and that I understood. That bond with his parents and with his siblings was what bonded the two of us.
He was not only fortunate to have model parents, but siblings as well. Anyone who knew Dr. Michael DeBakey as well as I do is aware of how devoted to, and proud he was of, his late brother Ernest, a superb thoracic surgeon of Mobile, Alabama. They were extremely close throughout their lives, and called each other often, whether they were at home or traveling. He was also exceptionally close, personally and professionally to his sisters Selma and Lois, both internationally recognized Professors at Baylor College of Medicine, with whom he shared his office suite and who acted as his colleagues/aides, involved in and supporting every aspect of his spectacular career. They were ever present to help him, support him, and advance his efforts. Colleagues around the country told of his unfailing tributes to them for their support of his efforts and for their pioneering contributions in their own discipline. They dedicated their lives to him; he was their world. He respected their intellect and their integrity, which his parents had instilled in all of them, and he considered it a blessing to have not one, but two such treasures, whom he called his “angels,” in whom he confided his innermost thoughts and ideas, and whom he entrusted his most valuable honors and archives objects. It was a mutually fulfilling and productive triumvitrate. Working with their brother cannot be better described than in the apt words of Khalil Gebran: “Work is love made visible.” And: “You give little when you give of your possessions. It is when you give of yourself that you truly give.” Michael DeBakey could not have reached the peaks he did without them; they are inarguably a part of his legacy.
The real man was neither harsh nor arrogant, as many people thought. He was very humble and loving. Indeed, this was the only side I ever saw of him. All I saw was love and tenderness, but I can understand the façade of severity and harshness, the product of his total commitment to excellence and his unyielding devotion to his patients. He was certainly a great researcher, innovator, and educator, but beyond any shred of doubt, he was a greater physician. Nothing came before the patient, not his ego, his name, his prestige, or his interests. He was invariably intolerant of mediocrity and could never accept anything less than the best. When it came to the patient’s life, niceties did not count, and he always cut through to the heart of the matter. He was the strongest patient’s advocate, and he never compromised on their lives. That was what made him the great doctor he was.
He exuded confidence, but he was indeed humble. He was a man of integrity - solid integrity. In an era when we witness the assault of bureaucracy, government, and insurance companies on the quality of medical care and on the very essence of the humanitarianism of medicine, none had the courage to challenge those forces more than Michael DeBakey. Of all the “products” of America, the very best in my opinion has been American medicine. Dr. DeBakey was instrumental not only in making this excellent product, but also in preserving its sanctity. In this era of materialism, mechanization, and decline in human values, Michael DeBakey stood as a monument of character, integrity, courage, and above all, humaneness. Despite his giant stature; however, this man was in constant awe of new and expanded knowledge, of the wonder and complexity of the human body, and above all the Creator.
With his death, a part of me has also died. I will miss the lunches, I will miss the dialogues, I will miss the endless hours talking about Lebanon and our parents, I will miss our pure and mutual friendship, I will miss his love and tenderness. I will always miss him deeply. My only solace is that part of him is still alive and still with us. That part is in Selma and Lois. Every time I hug them, I feel he has not died.
May the Lord bless him in heaven, as He blessed him on earth.
Every morning, I close my eyes and embrace the Lord and thank him. I thank him everyday, and I will continue to thank him everyday until my last day. I thank him for everything because if it were not for him, I would not be here. In particular, I thank him for the opportunity he has given me to treat cancer patients.
And, every morning, when I drive to my office in the city of Houston, I ask myself three questions: Is there any work greater than that of treating people threatened by death from cancer? The answer is no. Is there any work which is more noble than saving the life of a human? The answer is no. Is there any work I love more than mine? The answer is no. At this moment I am filled with joy and I am soothed with warm inner peace,
When I arrive in my clinic, and I see my patients, I feel I am as close to God as possible. My clinic is my church. Here I pray, during the day, all day. My prayer is in sharing with my patients their pain and their suffering, and also in sharing with them the joy of hope and the glory of resurrection of life. Here in my clinic I feel the awe of responsibility; the responsibility of life and death. Also, here I feel the awe of nobility and sacredness. A cancer doctor’s work and his relationship with his patient are sacred. To achieve sacredness, the doctor should rise above himself. He should forget who he is and what his interests are and should only work for others not for himself. To achieve sacredness, the “I” should melt away and become “you”. Giving life is God’s work, and although God alone is capable of giving life, He has bestowed upon man the human mind. This mind is the ultimate miracle of his creation. Without it, there is no being. God has created the mind for man to acquire knowledge. Knowledge is a must to control disease and alleviate suffering and pain. Knowledge is what defines medicine and its greatness. Without it there is no medicine. In medicine there is nothing outside knowledge, and in my 41 years of experience as a cancer physician, researcher and educator, I have never seen one patient who was cured without scientific knowledge, and I have never seen a single miracle beyond the miracle of the human mind.
This is all about knowledge, but the secret that many people, patients and doctors may not know is that knowledge alone is not enough. To cure the cancer patient a lot more than knowledge is needed. The four most important things you need are: love, hope, courage and perseverance.
My motto has always been, and will forever remain, the doctor who does not love his patient, cannot cure him. The patient, in particular the cancer patient, needs a doctor who loves him. Love is the power that bonds the patient and the doctor in an eternal embrace. Without love and compassion, the doctor will never know the human behind the disease, and will not be able to shepherd the patient through his journey with his disease and its treatment. “Love never fails”
Also, hope, I believe is essential for the conquest of disease. I do not think that a doctor has the right to strip the patient completely of hope, even though he may believe that he knows the truth, the whole truth. Khalil Gibran said “who saw the truth coming down from heaven?” Also I say, what might be true today may not be true tomorrow. Science and knowledge grow and expand everyday. Recently, I had lunch with a woman whom I treated 35 years ago. When I started her treatment, I did not believe she had any chance for cure, but during her treatment new drugs emerged and she eventually achieved a cure.
Also, the road to cure needs a lot of courage and perseverance. It is not only the patient who should have courage and perseverance but also the doctor. Many patients lose the courage and perseverance needed to continue treatment because the doctor gives up too early. The road to cure is long and brutal. There are many roadblocks and many big holes. There are countless failures and multiple frustrations. Should the doctor or the patient retreat, every time there is a failure or the patient slides into a hole, they will never reach the end of the road. To reach the end of the road you have to accept failure. You have to accept sliding into the hole and persevering to get out of it and to continue forward with determination. This scenario may happen many times before you reach the end, and achieve cure. Only those who have courage and perseverance reach the end of the road. Only those who go to war and fight it with all their power win the war.
Giving in all its forms is great, but the highest of all of them is giving a human back his life. The life of the doctor is the lives of others, the lives of his patients. There is a great verse in the Quran, "The one who cures one human, cures all mankind".
Today is the 62nd commemoration day for the Universal Declaration of Human Rights which constitutes one of the major achievements of the United Nations. This Declaration was born at the end of the Second World War and is considered the first attempt by an international organization to focus on the human individual and his rights. It was the beginning of the Cold War between the East and the West and there was then a conflict between two divergent ideologies: the first maintained that the individual must work, and even be sacrificed for the sake of the state, and the second believed that the state must work for the sake of the individual.
How proud, we, the Lebanese, are when we remember that a man from our land was the primary mover behind this Declaration, and if it were not for him, this Declaration would not have seen the light. This man was Charles Malik, one of the distinguished men who elevatedLebanon to the world. Also, he was one of the great philosophers who spoke on the uniqueness and the greatness of the individual person and the significance of freedom. Although I think this historical document is extremely important for the protection of human rights and for their promotion all over the world, I believe it failed to address in a clear and unequivocal way what I consider the most important issue relating to the future of man and his right to life. This issue is the right to health.
Article 3 of the Declaration states: “Everyone has the right to life, liberty and security of person”. But I would like to ask, what does the “right to life” in this article mean? Evidently, it does not mean the right to health as Article 25 stipulates: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family including food, clothing, housing and medical care, necessary social services and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control”. It is clear from the above two articles that those who authored the Charter of Human Rights [John Peters Humphrey (Canada), René Cassin (France), P.C. Chang (China), and Charles Malik (Lebanon)], failed to define the basic and organic relationship between the right to life and the right to health. Accordingly, the right to health was not a central issue in the Charter. This is where I differ. I believe there is no human right more important than the right to health, as health is necessary for life. Without health, there is no life and without life, there are no human rights. For this reason I recommended to the United Nations in the past to revise Article 3 and now I look forward to working with those serving on its Human Rights Committee to change this Article to read as follows: “The most important and sacred human right is the right to life, but this right is not possible without the right to health, as life depends on health. Consequently, all governments and societies are urged to consider healthcare a priority and should strive to provide medical care to all citizens”. What does this revision mean and what is its impact? This revision heralds a revolution in our commitment to Human Rights as the right to health becomes a priority in the policies and strategies of governments all over the world, contrary to the present situation, where healthcare is treated as a low priority. Also, one of the important indices to assess the commitment of a country to human rights will be its commitment to healthcare.
What does the right to health mean? It means three things: first, the right to prevention of disease. Second, the right to early detection. Third, the right to medical care when needed. To achieve these objectives, new health policies need to be established and civil society needs to be mobilized. Healthcare is not only the responsibility of governments as people may think, but is also the responsibility of society at large. The tragedy today is that most health policies around the world remain in the hands of traditional politicians, but it is my conviction that such policies should be above politics in its’ traditional sense, as health relates to every person irrespective of his political, religious or societal affiliation. Health should be apolitical. Take for example, the debate that lasted for many months this year in the United States Congress which revolved around one point, and one point only, and that is how to reduce healthcare costs. I cannot help but ask why not one single Congressman had the courage to speak on prevention of disease as the most effective way of reducing cost? Reduction of cost at the expense of the quality of medical care is a very expensive mistake. In my opinion the most efficient way of reducing cost without the risk of reducing quality of medical care is to establish comprehensive policies for the prevention and early detection of disease. What politicians do not know is that prevention of disease not only reduces financial costs, but reduces what is by far more important, human suffering. After the strategy of prevention comes the strategy of early detection. The latter demands health policies that provide the right of every person to undergo an annual check up. My motto in this regard is, “if consulting the doctor is necessary when you are sick, consulting him when you are healthy is even more important”. The chances of cure from any disease are extremely high when the disease is discovered early and these chances decrease as the disease advances. In regard to the right to good medical care when one falls ill, I do not know of a more threatening enemy to man than disease, or a more brutal power that could strip him of his dignity. Isn’t it a shame that people do not realize the significance of health and the sacredness of the right to health until they become sick? What about patients who need medical care for a prolonged period of time and who combat disease everyday? These people painfully know the meaning of humiliation and disgrace. Also, what about those patients who have no access to a doctor or medication? What do human rights mean to those people if they do not have the right to health? And what does the right to freedom or the right to education mean to a person who is battling death? This is why I am recommending that the right to health be the first and most sacred right of the human rights. I would also like to emphasize that the real index for measuring the status of civilization in a country, should not be the military power it possesses, or the social and financial prosperity of its citizens. It should be the commitment of that country to the health of its people. How shameful that there are great nations like the United States of America which claim to not have adequate financial resources to provide health care to their citizens, but at the same time have all the resources to launch the most expensive wars in history. Indeed, how ironic it is that people, who are considered heroes in the world today and in the past, are heroes of wars and heroes of death and destruction.
Life is a gift from God. It was given to man. Man is not capable of conceiving it or earning it. Only God is capable of creating it and giving it, but health is a necessary condition for the maintenance of life, as without health life may disintegrate. To glorify God, we should also glorify His gift and consequently acknowledge the role of health in preserving it.
May the believers amongst you, please come, and let us all glorify Him.
This article was originally published in Arabic in the Annahar newspaper of Beirut Lebanon as a front page editorial on Friday December 10, 2010
اقامت جمعية متخرجي الجامعة الاميركية احتفال يوم المؤسسين الـ144 للجامعة الاميركية في بيروت في اوتيل البريستول. وكرمت بالتعاون مع "دار نلسن للنشر" وجوهاً نيرة في الجامعة الاميركية في بيروت"، وذلك من خلال المؤلف الذي وضعه الدكتور ميشال خليل جحا بهذا العنوان. ويضم الكتاب 25 شخصية اكاديمية ممن درسوا او تولوا مهمات بارزة في الجامعة منذ ما يقارب القرن. نخبة من كبار الرجال منهم من تولى مسؤوليات كبيرة في لبنان والخارج.
والكتاب يضم الاساتذة الذين علَّموا في الجامعة: انيس الخوري المقدسي، يوسف اسعد داغر، فؤاد صروف جبرائيل جبور، متى عقراوي، انيس فريحة، نبيه امين فارس، شارل مالك، نقولا زيادة، زين نور الدين زين، عفيف مفرج، قسطنطين زريق، وديع ديب، فؤاد طرزي، خليل حاوي، ابرهيم مفرج، احسان عباس، انطون غطاس كرم، محمد يوسف نجم، خليل سالم، سليم الحص، كمال الصليبي، ايلي سالم، طريف الخالدي، وفيليب سالم.
بداية النشيد الوطني ثم نشيد الجامعة الاميركية في بيروت، ثم قدم ابرهيم خوري الاحتفال محيياً الحضور ومقدماً رئيس جمعية متخرجي الجامعة الاميركية فواز المرعبي الذي رحب بالحضور وخصوصاً الرئيس سليم الحص، وتوقف عند الالتزام المادي والمعنوي للمتخرجين لدعم الجامعة ومساعدتها. وحيا ذكرى المؤسسين الذين عملوا لتبقى قيم الجامعة وتستمر وتنتشر.
ثم كانت كلمة لمدير "دار نلسن للنشر" الزميل سليمان بختي الذي قال: "تمنيت، وانا في سبيلي الى هذه الكلمة، لو اننا نستعيد زمن وجوه نيرة في الجامعة الاميركية في بيروت"، وما احلى النعم لو تدوم. ولكن الزمن الجميل لا يستعاد الا بروح التأسيس". واضاف: "يؤتى الكبار الغائبون والحاضرون كما تؤتى رؤوس الينابيع لاستعادة العافية البكر. وكم نحن في حاجة اليها في زمن الحيرة والقلق والتردي". واشار "الى ان هذا الوقت يشير الى معنيين وكتاب وصورة.
المعنى الأول يوم المؤسسين، والمعنى الثاني ان نكرم ونتذكر كوكبة من الاساتذة العلماء الذين اخذوا الرسالة من يد المؤسسين وسكبوا فيها ضوء العين وجذوة الروح وشغف العمر. وصنعوا نهضة تربوية وثقافية في الجامعة والمجتمع. والكتاب هو ثمرة الحب والوفاء. وان ما يبقى حياً في الوجدان هو العطاء الذي يدفع بالانسان نحو قيم اعلى. اما الصورة فهي في التعاون بين جمعية متخرجي الجامعة ودار نلسن للنشر لأجل لقاء حول معنى له طعم التأسيس ونكهة العطاء. انها صورة مشرقة للمجتمع المدني في ابهى تجلياته".
ثم كلمة لنقيب الصحافة محمد بعلبكي الذي حيا "يوم المؤسسين" الذين لولاهم، لخسرنا الكثير. تذكر النقيب انه تابع دراسته بمنحة من المقاصد ومنحة من الجامعة الاميركية. وتذكر "زمن الحرب الاهلية البربرية والدعوات التي طالبت بترحيل الجامعة وأقفالها، وكيف تصدى الرئيس الحص ورفاقه لذلك من خلال المؤتمر الدائم لدعم الجامعة الاميركية". وتذكر يوم دمر مبنى الكولدج هول. وقال ان "هذه الجامعة هي أمنا وبها ومعها ننهض نحو العلى". وختم محيياً الجامعة والمتخرجين وذكرى المؤسسين وتوقف عند الاساتذة في الكتاب الذين لهم الفضل الكبير على اجيال، ولأجل نهضة التربية والتعليم والثقافة. ثم كان توقيع للكتاب وسط حشد لافت من الحضور ترأسه الرئيس الحص والنائب تمام سلام، والوزراء والنواب السابقون محمد يوسف بيضون وعصام نعمان وبيار دكاش واحمد سويد وجبران طوق وبهاء عيتاني وصلاح الحركة والسفير المغربي علي اومليل. وكان مؤثرا حضور ابناء، واحفاد المكرمين الذين فتشوا حثوا في الكتاب عن صورة او فكرة تقول جديداً عن عطاء لا ينفد ولا يخبو لانه بناء للانسان
By Philip A. Salem, M.D.2
One of the distinctive features of our Lebanon, which is geographically crucified in the Orient between Israel, Syria, and the Mediterranean Sea, is its permeating presence in the world and the impact of this presence on world civilization. There are very few countries that could boast about the impact they made on world science, culture, and economics as much as Lebanon, and there is no other country of its size that has contributed as much to mankind.
It is generally believed, for example, that the Phoenicians invented the alphabet, but there are some history scholars who question the alphabet being the work of the Phoenicians alone, but irrespective whether it was the work of the Phoenicians or whether Egyptian hieroglyphics and Mesopotamian Cunieform contributed to its evolution; it is a historical fact that it was the Phoenicians who introduced the alphabet to the Mediterranean world.
The ancient Greeks adopted the Phoenician alphabet and modified it. The new alphabet enabled the philosophy of Socrates and the great works of the Greeks to survive. Later, the Etruscans in Italy became familiar with the Phoenician alphabet. They modified the Greek version and, in turn, passed it along to Rome. The Romans made their own refinements and this led to the modern alphabet that we use today. From the beginning of recorded history, the Phoenicians were the masters of the Mediterranean Sea and they established colonies on its’ shores. Carthage was only one of those colonies. By doing so, not only did the Phoenicians trade goods, but also culture and civilization. From the time of the Phoenicians to the present time, the Lebanese had ambitions far beyond their own geography. They immigrated to the various corners of the world, not only to accumulate material wealth, but also to share in the making of other civilizations. Wherever you travel, you meet people of Lebanese origin. They are in all segments of life. Because of war and turbulence in Lebanon in the last half century, many Lebanese immigrated to the Gulf countries, Africa, Canada, Australia, the United States, and Latin America. Industrious and tenacious, they worked hard to succeed and prosper. In spite of immense economic difficulties, you would never find a single Lebanese refugee living in a tent at the expense of the United Nations, or see a single Lebanese beggar in the streets of Paris, London, or New York. This is a question of pride and dignity for them. A rough estimate is that there are 4-5 million Lebanese residing in Lebanon, itself; and there are approximately 20 million residing outside.
The story of the Lebanese doctor in Diaspora began in the Americas. The first wave of immigration from Lebanon was in the middle of the 19th century, and most of the immigrants went to the United States and soon thereafter to Brazil and other Latin American countries, like Argentina and Mexico. These immigrants had no skills and were not educated. The only language they spoke was Arabic, but they worked hard to make a living in their new adopted countries. They all had something in common: the determination to build a new life, and the determination to provide their children with a good education. Not themselves the product of education, they realized its importance and ensured that their children had that of which they were deprived. Many of these children became doctors, and at least two made it to global fame: Peter Medawar of Brazil, and Michael DeBakey of the United States.
Medawar was born in Brazil on February 28, 1915. His mother was British but his father was Lebanese. The name of his father was Nicholas Medawar. He was a Maronite Catholic. Although Peter Medawar was born in Brazil, he was educated and lived most of his life in England. He was Professor of Zoology and Biology at the University of Burmingham and University College of London. In 1960, he was awarded the Nobel Prize in Physiology and Medicine with Sir Frank MacFarlane Burnet. The prize was given in recognition of his work on the immune system, including graft rejection and the discovery of acquired immune tolerance. His research in immunology was fundamental to the understanding and practice of tissue and organ transplants. Soon after he was awarded the Nobel Prize, he was appointed Director of the National Institute for Medical Research and became Professor of Experimental Medicine at the Royal Institute, and President of the Royal Post-Graduate Medical School. Medawar was knighted in 1965 and was appointed to the Order of Merit in 1981. At the relatively young age of 54 years, he was partially disabled by a stroke and died on October 2, 1987. Medawar’s mind was very inquisitive and even a stroke could not stop his inquiries and research. His knowledge was not limited to science, but he applied the knowledge he acquired in science to other areas of learning. He was an established author and a first-class scientific writer. Like most men with great minds, his interest and curiosity extended far beyond science to art and philosophy.
The other Lebanese doctor who made it to the world stage and who stands as a monument of pride to all Lebanese doctors around the world is Dr. Michael DeBakey.
This man undoubtedly represents the peak of fame and achievement in the world of medicine, and I feel profoundly privileged to have been one of his closest friends. Michael Elis DeBakey was born on September 7, 1908 in Lake Charles, Louisiana. Both parents were Lebanese immigrants. His father’s name was Shaker and his mother was Raheeja. The family’s real name was Dabaghi, but was later anglicized to DeBakey. He was known to his family and friends as Michel. When he was 10 years of age, he visited his parent’s hometown of Jdaidat Marjayoun in Lebanon, and he lived there for 10 months. In our personal conversations, his favorite subject was his parents. He spoke endlessly and lovingly of them, and of their great qualities. His father was a highly intelligent and prosperous entrepreneur who instilled in his children the highest human values and emphasized the importance of education and diligence. His mother, whom everyone called “the queen,” radiated love at home. More than any other human being, his mother was the center of his life. He repeatedly told me how fortunate he was to have such model Lebanese parents who cherished family, high principles, and education.
Dr. DeBakey received his M.D. degree from Tulane University School of Medicine and he served on the faculty of surgery in Tulane until 1948. At age 23, while he was still a student at the medical school, DeBakey invented the roller pump, which provides continuous blood flow during surgery. It is because of this pump that open heart surgery became possible 20 years later. Although most of his professional life revolved around heart surgery, in 1939 he and his mentor Alton Oshner of Tulane, postulated that there is a strong link between smoking and cancer of the lung. This postulate became a milestone in the history of medicine. From 1942 to 1946, Dr. DeBakey was on military leave as a member of the Surgical Consultants Division of the Office of the Surgeon General of the Army and, in 1945, he became the Director and received the Legion of Merit. Dr. DeBakey significantly contributed to the development of the concept of Mobile Army Surgical Hospitals (MASH), and later helped establish the Veterans Administration Medical Research System. For this reason, the Veterans Affairs Hospital in Houston was recently named after him. He came to Houston and joined the Faculty of Baylor University College (now known as the Baylor College of Medicine) in 1948. From 1969 to 1979, he was President of the College, after which he was promoted to Chancellor.
DeBakey’s contributions to heart surgery were immense. He was one of the first surgeons to perform coronary artery bypass and, in 1953, he was the first to perform a successful carotid endarterectomy. He is known all over the world as a pioneer in the development of the artificial heart and was the first to use an external heart pump successfully in a patient. He repeatedly told me that his pioneering use of the Dacron graft to repair blood vessels stemmed from his learning the art of sewing from his mother. DeBakey was the boss of Denton Cooley while they both practiced at Baylor College of Medicine, but they had a feud associated with Cooley’s implantation of the first artificial heart in a human. There are several versions of this story. The one I know is that Debakey had initially scheduled the surgery for Friday, April 4, 1969. However, because of a conflict in schedule relating to a speech he was giving in Corpus Christi, Texas, DeBakey rescheduled the surgery for the following Monday. While DeBakey was in Corpus Christi, Cooley performed the surgery without the consent of DeBakey. The actual sequence of events that preceded Dr. Cooley's September 1969 resignation from Baylor College of Medicine and censure by the American College of surgeons is presented in this brief 2012 Houston Chronicle Op-ed article published by Dr. DeBakey's son, Denis DeBakey. Cooley's memoir conflicts with study of events - Houston Chronicle. The press covered the event and Cooley gained much publicity and fame. DeBakey was very angry at Cooley for his actions. As a result, Cooley left the Methodist Hospital and joined St. Luke’s Episcopal Hospital across the street and established the Texas Heart Institute. Their disagreement about this incident turned into a bitter feud. I personally lived that feud as I was a friend of both. The two men reconciled in 2007. I have known Dr. Cooley for more than 22 years since I joined the St. Luke’s Episcopal Hospital staff. He is a great surgeon, teacher, and innovator. DeBakey had a panoramic and unique mind. Not only was he versed in medicine, but he was also versed in many other areas like history, philosophy, music and literature.
Dr. DeBakey received the Presidential Medal of Freedom in 1969. In 1987, President Ronald Reagan awarded him the National Medal of Science, and on April 23, 2008, he received the highest honor, the Congressional Gold Medal of Honor from President George W. Bush. Dr. DeBakey continued to practice medicine into an age well after most others had retired. He used to tell me that most of his students had already died. He was fortunate that one of those students, Dr. George Noon, was still alive. On December 31, 2005, when Dr. DeBakey was 97 and suffering from an aortic dissection, Dr. Noon successfully operated on his former teacher.
During the last 20 years of his life, Dr. DeBakey was one of my closest friends, and he was a father figure to me. We used to have lunch every other week. The feast had to be Lebanese and the conversation always gravitated to Lebanon and our Lebanese parents and families. Although he had lived in Lebanon for less than a year, he was very Lebanese. After his death on July 11, 2010, I wrote an article depicting our friendship, “The Real Man Behind the Genius.”3 Michael DeBakey was a world-renowned Lebanese-American heart surgeon, a first class scientist and innovator, but par excellence, he was a medical educator. He also had an incredible ability to bring his professional knowledge in medicine to bear on public policy, an ability which earned him the reputation of a medical statesman. He will probably go down in history as the greatest surgeon of the 20th century.
Successive generations of doctors of Lebanese descent led to the establishment of great medical institutions abroad. Two of which are in Latin America: the Syrian-Lebanese Hospital of Buenos Aires, and the Syrian-Lebanese Hospital of Sao Paolo. In 1978, while attending an international cancer conference in Buenos Aires, I was invited to speak at the Lebanese-Syrian Hospital on advances in cancer therapy. This hospital is one of the best community hospitals in Buenos Aires and the bulk of the staff, doctors, and nurses are of Lebanese origin. My own paternal grandfather died in this city in 1928. Before I gave my lecture, there was a reception in my honor, during which I met the Director of the hospital. She turned out to be a childhood friend from my village of Bterram. We had not seen each other for 25 years.
The Syrian-Lebanese hospital in Sao Paolo (Portuguese: Hospital Sírio-Libanês) is one of the most famous hospitals in Brazil. It was established in 1931 by major contributions from wealthy Lebanese families, most notably the Jafet family. One of the best cancer treatment and research programs in Latin America is now at this hospital. Both the former President of Brazil, Lula Da Silva, and the current President, Dilma Rousseff, have received cancer therapy there. I have personally visited it many times and have given lectures there on several occasions. I know some of the cancer physicians who work there from the time they spent as trainees or faculty at M.D. Anderson Cancer Center in Houston.
The largest Syrian-Lebanese communities in Brazil and Argentina are predominantly comprised of Christian families who fled the Middle East after the Turkish occupation. Because they came from countries which were under the Ottoman Empire, they were referred to as Turcos. The word “Turco” did not distinguish Turks from Lebanese, Syrians, Palestinians, or other Middle Eastern nationals. However, the overwhelming majority of these immigrants were Lebanese. Also, at that time, Lebanon was part of Greater Syria and Latin-Americans could not distinguish those who came from Lebanon proper from those who came from Syria; thus, they were all called Syrian-Lebanese. It is now estimated that Brazilians of Lebanese descent number between 8-9 million. In Sao Paolo itself, there are 5 million. Also, it is estimated that Argentinians of Lebanese descent number between 4-5 million.
In Mexico, the Lebanese presence is very palpable, but mostly in the business sector. Carlos Slim Helu, the richest man in the world, is of Lebanese descent. Both his father and mother were Lebanese. There are no Lebanese hospitals in Mexico, but there are two Lebanese clubs which are among the most prestigious in the country. There is the Central Club in downtown Mexico, and the Freddy Attalah’s Lebanese Club in the suburbs. One of the Presidents of Mexico, Gustavo Diaz Ordaz, once said “if you don’t have a Lebanese friend, make sure you find one”. Not only are the Lebanese influential there, but they are very well liked. In regard to medicine, there is a medical society for Mexican doctors of Lebanese descent. This society is very active and I have been to Mexico on many occasions to contribute to conferences sponsored by it.
In the United States, one of the biggest achievements the Lebanese have made in medicine is the establishment of St. Jude’s Children’s Research Hospital in Memphis, Tennessee. The hospital was established by the Lebanese entertainer, Danny Thomas, who made a vow to St. Jude that, should He make him a rich man, he would establish a hospital in His name. In 1962, he delivered on his promise, and St. Jude’s has now become the best cancer research and treatment center for children in the world. In 1996, Peter C. Doherty of St. Jude’s was co-recipient of the Nobel Prize in Physiology and Medicine for his work on the immune system and how this system can kill virus-infected cells. Acute leukemia in children is now curable in 90% of patients mainly due to the scientific discoveries and advances made at St. Jude’s. This hospital is not only a shrine to St. Jude but also to cancer research in children all over the world. Although the hospital was named after Thomas’ patron saint, it is not a Catholic hospital and is not affiliated with any religious organization. Any child of any color, religion, or geographical origin can be admitted to it. Also, St. Jude’s has an international outreach program to improve the survival rates of children with cancer diseases all over the world, and consequently it has established many satellite programs. One of these programs is in Beirut at the American University of Beirut. It was established on April 12, 2002. There are now active negotiations to explore the possibility of establishing another such program in Jordan. Danny Thomas, himself, was not a doctor, but he has contributed immensely to the field of medicine. The Board of Trustees of St. Jude’s has always been composed of business people of Lebanese and Syrian descent. A unique feature of St. Jude’s is that all medically eligible patients who are admitted to its facilities are treated without regard to their ability to pay. Families never pay for treatments which are not covered by insurance, and those families without insurance are never asked to pay. The treatments of these patients are supported by charitable donations.
The three examples of Lebanese-Syrian institutions in Buenos Aires, Sao Paolo, and Memphis, Tennessee are monuments for what the Lebanese and Syrians can do when they work together. This is in contrast to recent political conflict and hostilities between their two respective countries. Like the Phoenicians who migrated along the Mediterranean shores to build new civilizations, the Lebanese and Syrians immigrated to share in the making of the future of their new countries. The Lebanese and Syrians who currently live in the Middle East should learn from the model of the great work their brothers and sisters established in the Americas.
Although the major impact of the Lebanese doctor in Diaspora was in the Americas, one Lebanese doctor made it to fame in China. He was Shafick George Hatem who was born on September 26, 1910 to a Lebanese-American family in Buffalo, New York. His father, Nahoum Salaama Hatem immigrated to the United States from the village of Hammana in the Metn Mountains of Lebanon in 1902. Dr. Hatem attended pre-med classes at the University of North Carolina and studied medicine at the American University of Beirut and the University of Geneva. While he was living in Geneva, he made the acquaintance of some students from China. On August 3, 1933, he and a few friends boarded a ship in Trieste, Italy that took them to several ports in Asia, including Singapore and Hong Kong. Eventually, the three young doctors landed in Shanghai. Hatem established his medical practice in Shanghai and he changed his name to Ma Hai-te (Ma Haide). It was in Shanghai where he was introduced to communism and he eventually joined the Communist Party of China. At some point in his life, he became the personal physician of Mao Tse Tung. Hatem remained a doctor with the communists until their victory in 1949. Thereafter, he became a public health official. He was the first foreigner to be granted citizenship in the People’s Republic of China, and many Chinese credit him with helping to eliminate leprosy and many venereal diseases in post-war China. He received the Lasker Medical Award in 1986. He died in China in 1988 and was buried at the Babaoshan Revolutionary Cemetery. During his lifetime, he was honored in his town, Hammana, Lebanon, where the main square of the city was named after him.
This was the story of the Lebanese doctor who was the son of an immigrant. Now is the story of the Lebanese doctor who was born in Lebanon and who subsequently immigrated. Most of these doctors came to the United States. I do not know of any other country that has contributed more to American medicine than Lebanon. Currently, there are a few hundred Lebanese doctors who are leaders in the fields of cancer, heart disease, and other specialties. There is hardly a university or hospital in America where you do not find a medical leader who is of Lebanese descent.
Many of these doctors are now members of the National Arab-American Medical Association (NAAMA). This is an organization of medical professionals of Arab descent. NAAMA was incorporated in California in 1975 and became a national organization in 1980. Currently, there are 27 chapters in the United States and Canada. This organization sponsors national and international medical conventions annually and it produces two publications, Al Hakeem and NAAMA News. The journal, Al Hakeem, covers a broad range of association events and educational as well as cultural topics in English and Arabic. More recently, the American Lebanese Medical Association (ALMA) was established as a non-profit corporation in the state of Massachusetts on January 13, 1994. ALMA was conceived to develop a society through which physicians and other health care professionals of Lebanese heritage may come together and undertake projects to improve the health and well-being of all of Lebanon’s diverse religious and cultural communities in America and in the homeland. Also, ALMA holds annual medical conventions in Lebanon to promote advanced training and scientific exchange between America and Lebanon. I am proud to say that I have been part of the story of NAAMA as well as of ALMA.
Most of the Lebanese doctors who are leaders in medicine and research live in the United States. A few live in France, England and Canada; but you can find them anywhere you go in the world. Even in Australia there are some Lebanese doctors who rose to prominence. Marie Bashir, Governor of New South Wales, is of Lebanese descent. She was Professor of Psychiatry at the University of Sydney before she was appointed Governor.
In Diaspora, the Lebanese doctor has always had an edge over others as he is culturally more attuned to treat the sick. In addition to tenacity and discipline, he has compassion, love, and mercy. These qualities are part of his culture and they are crucial to the practice of good medicine. Our great challenge is to use the knowledge and skills acquired by these doctors abroad for the enhancement of medical education and health care in our beloved homeland. A more important challenge is to learn from the success story of the Lebanese doctor in Diaspora, and translate it into a great success story at home. For that, we must provide the Lebanese doctor at home with all the elements necessary for success. To accomplish this, a courageous revolution must take place to radically change our current views on the role of education, science and research in the making of the New Lebanon.
1 This article was written at the invitation of the Lebanese Order of Physicians. To be published as a chapter in a book which will be compiled by the Order.
2 Philip A. Salem M.D. is Professor of Cancer Treatment and Research and the holder of the Philip Salem Cancer Research Chair at St. Luke’s Episcopal Hospital, Houston, Texas. Also, he is the President of Salem Oncology Centre.
3 “The Real Man Behind the Genius” authored by Dr. Philip A. Salem, M.D., published in the Methodist DeBakey Cardiovascular Journal, Volume 6, Number 1, 2010, Pg. 42-44.