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Profound Connection  

An unintentional poke solidified my long-standing admiration of my uncle Ralph into a profound connection. Asking him the same question, “how did you do this work?” had over the years led to many divertive but insightful and educational conversations with my uncle. During these eleven years, he occasionally told me, “You learn to not talk.” These conversations, general surgeon to pioneering open heart surgeon, whetted my desire to know more and ask him my question again. 

That day in the fall of 2006, my uncle Ralph was irritated by my attempt to nominate him for an award. Wanting to acknowledge and honor him and his work, I had instead poked the bear. What uncle Ralph did after that poke was to let his guard down. He spoke to me, about his career, his accomplishments and his struggles parenting his blue baby Jason. Then he made an amazing change. After not talking about how he did his work. After his long-held decision to take his story to his grave. He agreed to let me tell this story with this one condition. Tracy, he said, “tell it in a positive way.” 

Complex version of transposition of the great vessels, was rare and remained without a repair for many reasons. My uncle did not speak directly about his emotions, they were still too raw in 2006. Instead, he told me the timeline of all the blue baby repairs. Of course, the reader must understand, Ralph and Mary did not know their blue baby was coming. Nor did they know Jason would have this defect without a repair in 1969. This defect is a combination of all the blue baby defects. Its repair was hindered by a lack of imaging of the complex valve defects, hindered by needing to create defects, rather than repair them to allow the child to live, and by not being able to create a model in the research lab.

In fits and starts the blue baby surgical repairs timeline began in the late 1920’s. In 1944, with the Blalock-Taussig-Thomas shunt and the winding down, with a win, of WWII, the blue baby timeline took off and was completed by the mid 1960’s. A forty-year surgical accomplishment, that was significantly assisted by the development of the heart lung machine in the mid 1950’s with Dr. John Kirklin, the clear master in its use. 

From Ralph, there was no time to slow down or grieve. Everyday Ralph worked. Dr. Ralph Berg knew the heart. His medical career started in 1941. His surgical career started in 1945. He was entrenched in the blue baby surgical repairs. Then when the blue babies were thankfully becoming rarer in the mid 1960’s and when they did present, a repair was available, acquired heart disease took over. Acquired heart disease is the term used before they knew what coronary artery disease and occlusion was.

The launch of the pivotal decade, 1970 to 1980 where the radical and unique protocol of Drs. Everhart and Berg led to the knowledge of what is a heart attack, and how to treat a heart attack was influenced by the blue babies. Dr. Ralph Berg knew to preserve the myocardium while he struggled with the initial rejection of acute coronary revascularization. Whether from stretching out due to the shunts overworking a ventricle or from lack of blood flow from the coronary artery shutting down a ventricle, the name of the game is preserving the myocardium. Internationally known and recognized for the acute coronary revascularization, Dr. Ralph Berg’s personal story with his blue baby Jason is not known, until now. Entwined into the pivotal decade, Jason and Ralph Berg’s story and their relationship should become well known. 

From the Berg family, going way back, the willingness to try hard, to assist, to learn, to respect and preserve life logically led to the pursuit of knowledge, a medical and surgical career, preserve the myocardium and in fact preserve all the organs. Into their old age, Ralph and my Grandfather Thoralf were well preserved, both active and engaged their entire lives. It is this gift, to preserve what you have. 

For me 1980 is the year. First, in May of that year, Dr. Ralph Berg presented his research paper showing acute coronary revascularization is the treatment for a heart attack, which published the following year. Then, in July, Ralph and Mary took Jason, aged ten with fevers and heart infection, to Dr. John Kirklin who repaired Jason’s complex transposition in a harrowing operation. And then, in October, the landmark paper was published showing what a heart attack is, how the various combination of the three coronary arteries lead to the differing types of a heart attack. In that year, the end of the pivotal decade, acute coronary revascularization and Jason’s heart repair were completed. Uncle Ralph remains boss. He managed Jason and Jason outlived his life expectancy twice, living to the ripe age of twenty-two. Any and everyone who suffers a myocardial infarction has a treatment, acute coronary revascularization, available. 

Below is a quote from the book, “Blue Baby and Acute Coronary Revascularization” with presales, and voting on the two cover designs coming in September, and publication on December 16th.  

A heritage of Spokane, Washington, of physicians both academic and non-academics, of immigrants, of the American dream, and of family. A surgical master, Dr. Ralph Berg facing rejection, despite knowing he would be validated, continued to do what was right and saved lives. He continued to live his life. He struggled. He achieved both the correction of his blue baby Jason and validation of his acute coronary revascularization work. 

My favorite sentence in the whole book is, “With insight into what is frivolous and what is important and profound connection, I threw out the nomination and we continued.” This is the moment my friend Tracy Berg, also the book’s author, with her uncle who was never going to tell this story and this book began. Dr. Linda Harrison, Family Practitioner, PEO Chapter 

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