Bernie Goldman: Saving Children’s Hearts

Bernie Goldman and Steve Fremes

Bernie Goldman preceded Stephen Fremes as the Chief at Sunnybrook. Steve trained in Toronto under Richard Weisel. Bernie gave Steve his first job, operated on Steve’s father, and, with Steve, they were the first 2 cardiac surgeons at Sunnybrook. Steve succeeded Bernie who fostered Steve’s career and allowed him to grow. There was a synergistic succession strategy. “He allowed, encouraged, and fostered my success. George Christakis and I have had very successful research careers here under Bernie’s leadership.”

Bernie Goldman stopped operating at age 73, after 40+ years of cardiac surgery. “I found myself going between 3 hospitals (Sunnybrook, St. Michaels and East General) teaching cardiology fellows implantation of pacemaker/ defibrillators – and that brought the old question to mind: “am I hanging in, or hanging on”? Having spent his career at both TGH and as Head of Cardiac Surgery at Sunnybrook, he knew that surgeons who “hang on” too long block young surgeons’ access to precious OR time – and so he stopped. Fortunately, the College of Physicians and Surgeons was then expanding its Complaints and Review Committee (ICRC) and Bernie joined the surgical panel, evaluating public concerns and physician performance. It was a stimulating, challenging and satisfying experience. He retired completely from the CPSO and all clinical matters once he reached 80 in early 2016.

Bernie maintained his passionate commitment to the Save a Childs Heart Foundation (SACH) based in Israel at the Edith Wolfson Medical Center (WMC) outside Tel Aviv. He became interested in a young American cardiac surgical fellow at Sick Kids (Ami Cohen) who had presented at University Rounds about his experience as a captain in the US Army, setting up a modern MASH Unit in the Saudi desert (wearing a kippah) during the first Gulf War in 1991. Ami was a fully trained adult cardiothoracic surgeon who experienced an epiphany after operating on local children with heart defects while stationed in Korea, hence the pediatric fellowship. Bernie was later delighted to learn he had joined an Israeli colleague and friend who had opened a new cardiac unit at WMC. Ami Cohen’s first pediatric heart cases were referred by and old army colleague. The patient came from Ethiopia (and later from Gaza via a Christian missionary). In 2001 Cohen published his seminal article in Annals of Thoracic Surgery “Saving Children’s Hearts - we can and we should” (1) - describing the methods and outcomes of the SACH project in its first 5 years. Shortly after publication, Ami Cohen tragically died after a mission to Tanzania, but the program carried on in his memory.

A local philanthropist encouraged the formal establishment of SACH Canada to promote awareness and funding support and asked Bernie to be the first Chairman. In the 15 years that have followed, SACH has had significant growth and accomplishment: SACH is a UN sponsored NGO and global surgical humanitarian initiative with specific goals – to repair hearts of children from the less developed world and to teach and train others to establish their own independent centres in those countries. After 20 years, the SACH team (all working voluntarily) has operated on >4,000 children from 51 countries around the globe. Fully 50% come from the neighbouring Arab regions (Gaza, West Bank, Iraq, Jordan, Syrian refugee camps, Azerbaijan and recently from Afghanistan).There are 16 “partner sites” for diagnosis, referral and follow-up in Africa, the Middle East and Eastern Europe and 6 independent surgical sites (China, Tanzania, Moldova, Romania with 2 in training in Israel for Ramallah and Addis Abba). The WMC is the centre of excellence for pediatric heart disease and the network hub connected by spokes to its partner and surgical sites, as well as to other charitable affiliates in different countries. SACH and the WMC will soon begin construction of a new Children’s Hospital and International Children’s Heart Center.

Bernie’s intimate involvement with SACH has brought his career now full circle with regard to teaching, mentoring, operating and academic pursuits. His recent book “Mending Hearts, Building Bridges” (2) details the history of SACH with beautiful photographs of children before, during and after their operative experience. He regularly scrubs in on visits to SACH where he states they let him snip sutures (it has been a long time since he trained with Bill Mustard at Sick Kids!). He has published and presented this past year, along with a McMaster medical student, on the SACH program: providing tertiary care on a global level at no cost to the children’s family and providing cardiac care in regions of political tension and conflict. Bernie is a member of the Department’s Global Surgery Section ably chaired by Lee Errett. For the past few years, he has sponsored 2nd year Canadian medical students for 2 week summer “internships” at SACH. Bernie has recently sought and obtained approval from Chairman James Rutka, with support from Dr. Eric Hoskins and the Ministry of Health, to send residents in Ontario training programs (pediatrics, intensive care or cardiac surgery) for short term exposure to the SACH global humanitarian effort, working with the team in Israel or abroad on a mission. As “Chair Emeritus” Bernie has secured funding support for this unique educational experience from a donor to SACH Canada.

MM

1) Cohen, A., Tamir, A., Houri, S., et al. Saving Children’s Hearts - we can and we should. Annals of Thoracic Surgery 2001:71:462-8

2) Mending Hearts and Building Bridges: The Save a Childs Heart Foundation: J. Public Health Management and Practice: (22)1,89-98(2016)