The patient had pre-existing cardiomyopathy when he contracted 

COVID19. The patient is said to be doing well recovering in the hospital.

Without a doubt, the common belief among good physicians is just that, i.e.

the most beautiful creation in this universe is human life so that it comes only

natural for those doctors to do everything they can, individually and as a team,

to save as many lives as they can, which often requires selfless dedication and

heroic measures, mobilizing their big heads and big hearts.

Good choice for such simultaneous condition of the lung and heart troubles although it would depend on what kind of pre-existing cardiomyopathy the patient has. But I have no doubt that it would be able to deliver a better outcome than a single organ/lung transplantation because common candidates are the aged patients with chronic cor pulmonale not like viral pneumonitis. Anyhow, the Vanderbilt program has fame with nation-leading cardiac transplant team with top-notch outcomes, as I know of.

BB Lee

P.S. Vanderbilt program reminds me of our days with such notorious (?) reputation for 'nation-lowest salary' for the surgery residency program- $8,000.00 per year for junior residency, $800.00 more than the MCV program (nation second lowest) under David Hume!-.  Indeed, in our days, all the brilliant young men throughout the country to seek to become a surgeon lined up to bet on the position of surgery residency under the legendary William Scott, waiting two to three years even if they wouldn't pay. I still recall David Hume never failed to mention/cite Bill Scott at least once a week whenever he had a chance. I believe Bill Scott took the exact same course to become a surgeon ahead of David Hume including both Harvard Med School and Peter Bent Brigham and Boston Childrens program. But Bill Scott had a further fellowship and residency at the Johns Hopkins under legendary Alfred Blaylock to become a faculty member of prestigious Hopkins and was soon brought down to Vanderbilt as the youngest chief of all throughout the southern USA  to build the nation-top surgery program. David Hume deeply admired Bill Scott, openly admitting Bill Scott established more than he himself even in pheochromocytoma ahead of him - Hume started his career in the endocrine surgery as the chief of surgery lab at Harvard- and took a similar path to accept the invitation at MCV to build a surgery program like Bill Scott but concentrated to the transplant surgery to get the fame as 'mecca' of transplantation in those days. So I vaguely remember a couple of guys from Vanderbilt - I forgot the name but one of them became a nationally leading cardiac transplant surgeon later!- stayed at Richmond to study on the cardiac transplant at the lab of Richard Lauer (David Hume brought Dick Lauer from Norman Shumway of Stanford U to organize the nation-leading cardiac transplant team at MCV, then) and started their own cardiac transplant to become the nation-best cardiac transplant team in these days. 

Thank you very much, Professor, for detailing the origin of Vanderbilt heart transplant program.

That helps a lot in learning how their program became the largest in the nation.

I learned the largest heart transplant program in South Korea is at 현대병원(울산대학교)

through my personal experience involving my 40 year old nephew who underwent heart transplant

there and died of complications 2 months later. Family were told they are doing the largest volume

of heart transplants. Nonetheless, the way the attending MDs are communicating with the patient and

the family was found to be primitively old-fashioned and downright dangerous to the patient

and most frustrating. gather that is nothing new in Korea anyway.

In the late 1970s and '80s, I, as director of the cardiac cath lab, wound up taking care of

quite a few of endstage heart failure patients who were all willing to go for heart transplants.

I was in touch with every heart transplant program in the nation, but every one of them had a long list

so that the patient had to meet their strict criteria.

Perhaps only about ten patients received transplants despite my best efforts.

Glad you enjoyed my lament on the old days- hapless oldie doesn’t have much left to talk but old days as they say- not many people bother to recall. Since you ran the cardiac lab and closely involved in the advanced cardiac case, you might be interested to hear a bit more about the heart transplant program at MCV, especially one well-known saga involved to Christian Barnard of Cape Town/South Africa who performed world-first heart transplant - you could read the memoir by Melville Williams on Google, who was the director of the surgical lab when I arrived at Richmond on late November 1968 and taught me how to do the microsurgery from the scratch-.                    

Indeed, when I checked in the Surgical Lab soon after I arrived at Richmond, all talked about how unethical and further illegal one bastard from South Africa was, who stole all the credit for the heart transplant from Dr. Richard Lauer. Dr. Lauer started the heart transplant experiment at Stanford U with Norman Shumway but Dr. Hume recruited him to come to Richmond to expand the program at MCV with almost unlimited funds.

I had no idea on Christian Barnard whom they talked about but soon I learned the whole story from Dr. HM Lee and also Mel Williams; Christian Barnard stayed at MCV for a few months to learn how to do the heart transplant from Dr. Richard Lauer’s group at his lab and stole all those data/experience and rushed back to Cape Town to perform the cardiac transplant to human being claiming the world-first heart transplant. Barnard later apologized publicly on his unethical behavior but the society eventually expelled him taking away his membership.  

Indeed, Dick Lauer was the first cardiac surgeon along entire Eastern Seaboard to lead the cardiac transplant then and as usual with open policy- Hume insisted ‘there is no such monopoly in the academic knowledge and obliged to share’ – Dick Lauer welcomed all their colleagues to come to visit Richmond to learn how to organize the team especially for the control of immune reaction/rejection.

Anyhow, I am really surprised to hear someone died of complications 2 months after the heart transplant??? Sorry to know for such a tragic outcome to your nephew but it certainly is very strange, indeed. I am sure your family had a chance to go through a detailed review of how it happened on such young 40 years old male with such unexpected(?) result but again it certainly is unusual to happen in 2 months following the surgery, borderline period of technical complication, and immunological complication.

Indeed, cardiac transplant is relatively simple in comparison to the kidney and liver especially the technical point of view-do you know what was the complication? – so that it rarely can go wrong two months later since we learned enough through the painful mistakes we made in the kidney and liver already, then. And also, the postop management of the acute rejection was already well established then. Very interesting!!!! You should let me have some idea, Dr. Lee.

Anyhow, the transplant program at 현대아산 중앙병원(울산대학교) is not only the largest for the heart but also for the kidney as well as liver in South Korea with the excellent outcome I always quote proudly to my colleagues here in the U.S. Indeed, Prof. Min ByongChul who himself was a surgeon and founded this 아산병원 with Prof. 이문호, committed to set up the surgery program based on the transplant program so that I almost decided to come to join to him to 현대 아산- Prof. 민병철 persuaded me, together with Prof. 한용철,  to study the transplant surgery and arranged me to come to Richmond to David Hume after my initial plan to study vascular surgery at Strong Memorial Hospital did not work out (China Medical Board revoked initial selection of me and replaced me with the second candidate, 한만청 선배 to be sent to the U.S. first per request by SNUH based on the seniority).

But soon after I learned 정주용 회장 asked to Prof. 이문호 to accept one of their clan member who practiced in New York, as a staff of the surgery department without my consent against their initial pledge to let me make the final decision to select all the surgery staffs so that I pulled off the pledge to come to 아산 중앙병원.

But I was involved to the last minute on their surgery program so that I know too well how much they committed to this transplant program and further through 삼성병원/성균관 대학, I organized for the surgery program 5 years later, I know how much Prof. 민병철 invested in the transplant surgery he was so proud of.

So, the cardiac transplant program they have should be not only the largest one in Korea but also be of the top quality with no doubts. So there must be some reason why they lost such a young man with minimum preexisting morbidity within 2 months after the successful surgery.

Curiously,

BB Lee

P.S. The attitude/culture/custom between the patients and doctors in Korea is quite different from ours here in the U.S. as you correctly pointed out, Dr. Lee! A bit tricky to explain it through such an open letter so that I don't want to go further but they do practice with different criteria with firm traditional authority. They can't digest or willing to tolerate a liberal American approach to lower the eye level to meet the patients. Indeed, 삼성병원invited a group of American trained physicians including me to set up a new hospital with new culture/custom equivalent to the American value in the early '90 but soon after one bastard kicked out Prof. 한용철 with such noble idea and took over the hospital, he solicited many innocent 한방 to turn against us/양방 like mother fucker Tramp splits the peoples, giving such hardship till we all left to come back to the States.  

I will look for another chance, if I may, to discuss my nephew's case.

All I can say is that the attending physician did not provide the family

one single answer to the pertinent questions I raised through family.

I was kept in the dark for whatever reason.

By the way I was offered the job, Chief of Cardiology, by 민병철 선배님

thru the recommendation by my classmate, 김건언, Chief of Vascular Surgery there and then,

when 이종구 선배님 resigned. I was given 3 days to decide.

I turned it down in less than 3 hours although I sincerely thanked my friend 건언.

After all, it is a small world, Dr. Lee!

건언 was the one I recommended to Dr. Min though he failed to get along with Dr. 홍창기 who was de factor leader of American group at Asan Hospital, then.

He is now back to New York but I lost the contact with him since he was back! Indeed, he was only one among Korean colleagues to have received full vascular surgery training under Tony Imparato at NYU as I know of. He did a good job while in Korea.

BB Lee

Indeed, Prof., it is a small world.

Thought you two would know each other

since both of you are in the same specialty.

I forgot to mention to you about your chance(?) to come back to Korea to work at 아산병원 with 건언 ( by any chance were you Steve's high school classmate?) but I can understand how difficult it was to you than anyone! Indeed, without being pushed by my wife and Prof. 권이혁 I would have chickened out to drop the whole thing to move back to Korea after a quarter-century absence. In a way, I have no regret but I paid more than I expected only to fulfill my sentiment. So the new life at 아산, if you would have accepted their invitation, would have been a 'sweet and bitter' experience to you. Indeed, life is short and I can't believe those 10 years full of agony are way in the remote corner of my memory now making me wondering whether it was a real or a dream/nightmare I can vaguely recall in these days!!

BB Lee

P.S. I love Dr. 홍창기 all my career though he became so controversial among their colleagues at 아산. He was one year ahead of me in high school but two years ahead in college. We worked closely together through the residency at SNU and made an active support to him to get married to Dr. 김상희 and they became the godparents to my second daughter. Because of him, I pledged to come together with him to 아산 at the beginning but subsequently pulled out my pledge to him I still feel guilty to him. I never figured out how and why he has made such controversy- someone blamed him to have learned the Korean way of politicking!- among so many colleagues he took to Korea together. He was very upset to me to keep bypassing him to give advice/recommendations to Prof. Min, then the director directly including 김건언. I tried hard to ease their animosity but sadly it didn't work out till the last. 창기 resettled in San Francisco Bay Area after he retired from 아산 for a while- his two sons, both were at the practice in New York- but he missed the life back in Korea and moved back now- I talked over the phone while I stopped over at Seoul only for three days on way home from Beijing last year/October and failed to visit him to his countryside retirement community. Indeed, he is one of few I miss dearly, such calm, cool, never get volatile like me!!!

Indeed, it is a small world, Professor.

My high school is 경동.

(우리 4 형제들은 경복, 경동, 경기 그리고 포천 고등학교들을 나와 서울대 법대, 의대, 공대 그리고 농대를 나왔음)

홍창기 선배님의 4촌동생 홍강의, my medical school classmate, happens to be my close friend so that

I've known about him quite a bit although he may not remember me.

In 1977 when he was 내과과장, I had a visit with him at 중앙병원.

Because of my personal commitment early on focusing on living one reality, i.e. one life in the USA,

not 2 realities, i.e. two lives both in the USA and Korea, it was not a difficult decision for me to give up

two or three good chances to return to Korea. Looking back, I too have no regrets.

Probably you made the right decision, Dr. Lee, and might have lost more than gain if you should have been back to Korea unless there is a special cause to go back to Korea like me. Indeed, many criticized me NOT to go back to Korea and instead settle in the U.S. against David Hume's wish who waived the rule to accept an FMG like me to give an exception so that I could go back to Korea to return what I owe to him. Hence, I had tremendous guilt not to have kept the pledge/promise so that I would say rather more with 타의반 than 자의반, to be honest, to choose to go back to Korea for 10 years to pay back. Anyhow, many came back to Korea with purely a sentimental cause with substantial disappointment I painfully watched. 

BB

P.S. Oh yes, I know 홍강의 too well. He did a good job to establish pediatric psychiatry after he returned to SNU and his sister 홍경자 got married to 박건춘 who was my most favorite junior resident during my SNUH  days and later he was the first one I recruited for the 아산 team after I pledged to Prof. Min - I brought him to Washington DC to learn the trauma surgery and later he became 의료원장-.