Tuesday, September 20, 2005

Bypassing Thousands

Where can a medical pioneer, a caring physician, and an avid fly-fisherman all happily dwell? Right here in the heart of Maine.

Heart surgeon Robert Clough has a sizeable fan club in these parts. Here’s a recent encounter: Dr. Clough is in Calais, on his way to Canada to go fly-fishing. A local gentleman approaches him. “You’re Dr. Clough, aren’t you?” he says. “You gave me five bypasses!” The man lifts up his shirt to show his scarred chest as proof. Dr. Clough shakes his patient’s hand and asks him how he’s feeling. “Well, I just put up 16 cord of wood this weekend,” he replies. “What does that tell you?”

With 10,100-plus heart surgeries since Eastern Maine Medical Center’s cardiac surgery program debuted in 1987, Dr. Clough is hailed by appreciative patients often. And he loves every minute of it. “This kind of thing would never happen if I’d ended up in Boston,” he says. “It’s one reason why it’s so nice to be in Bangor, Maine.”

When Clough was recruited to help found the area’s first cardiac surgery program, about 200 area patients a year needed heart surgery. “The closest place to have it done was Portland, although patients were sometimes sent to Boston and Cleveland,” he says. Clough, who had been living in Texas, jumped at the chance to help design the new operating facility, write the protocols, and even train the operating room staff. “With all the support I had, there was no excuse for failure.” He performed EMMC’s first cardiac surgery, a triple bypass, on July 22, 1987, on a man named Lee Turner, from Shirley Mills. “Someone asked Lee if he was nervous about being the first patient,” Clough remembers, “and Lee said, ‘No—if they really thought I was going to die, they wouldn’t operate on me first.’” EMMC’s first cardiac surgery patient not only recovered nicely from his triple bypass, but he’s still doing well, 18 years later.

The long-term success of Eastern Maine’s cardiac program has been as healthy as Lee Turner’s surgery. Clough believes this is due, in part, to a groundbreaking organization called the Northern New England Cardiovascular Disease Study Group. Comprised of all eight heart centers throughout Maine, New Hampshire, and Vermont, the members have been pooling data, designing improvements, and visiting each other's facilities since ‘87.

“When we started out, the places with poorer outcomes thought it was because their patients were sicker,” he says. But as the group continued to share best practices, they all became equally successful. “Today, there’s no difference statistically between any of the members,” Clough says. These same NNECDSG hospitals, he says, are also “the best places in the United States to have bypass surgery.” The experience taught him that “competition might be good for bringing down the price of shoes or cars or plasma TVs, but in medicine, cooperation is what is good for patients.”

So is gratitude. For the vast majority of cardiac patients who come through their surgeries successfully, life is no longer something they take for granted. Over the years, many have shared their gratitude with Clough. The office waiting room shows off a cross-country skiing trophy won by a patient after her EMMC bypass surgery. Other patients have given Clough paintings, handmade heirlooms, a Passamaquoddy good luck charm. But the best rewards are intrinsic. “If I had gone to Milwaukee, I would have been the 49th cardiac surgeon on staff,” he says. “Here, I feel I’ve made a difference. I feel very lucky.”

So do his patients.