Pioneering surgeon leaves a legacy of healed hearts
Nicholas Kouchoukos, MD, has retired. But his long, remarkable career ensures his presence still will be felt for a long time to come — not only at Missouri Baptist Medical Center, where he’s been based since 1996, or across BJC, but also throughout the field of cardiac surgery.
Dr. Kouchoukos recently took time to reflect on what he called “an extraordinarily rewarding career,” performing more than 13,000 open-heart surgeries. In addition, he was mentored by and worked alongside some of the pioneers of the “golden age” of open-heart surgery; he literally wrote the book on heart surgery; and he held leadership roles and earned honors from national professional organizations.
Dr. Kouchoukos’ interest in medicine was piqued when, as a 9-year-old in Grand Rapids, Michigan, his father’s friend, a town doctor, removed his appendix.
Later, as an undergrad at the University of Michigan, he worked waiting tables at a sorority house with a friend from Chester, Illinois. The friend suggested he check out Washington University School of Medicine. Dr. Kouchoukos liked what he found.
He earned his medical degree at WUSM, then began his general surgery residency in 1961 under chief of surgery Harvey Butcher, MD, an active proponent of innovation and excellence in his staff and residents.
Dr. Kouchoukos’ training coincided with the “golden age of cardiac surgery,” ushered in by the development of heart-lung machines in the late 1950s. The machines were mechanical pumps that took over the patient’s heart and lung function, allowing surgeons to open the chest, access the heart and address problems that previously had been deemed untreatable.
Pioneering surgeons worked to improve heart-lung bypass technology and perfect the surgical procedures made possible by that technology. It was a time of great risk and great advancement, says Dr. Kouchoukos.
On the WUSM faculty and on staff at Barnes, Jewish and St. Louis Children’s hospitals then were surgeons Thomas Ferguson, MD; Charles Roper, MD; and pediatric cardiologist David Goldring, MD. They brought the first heart-lung bypass machines to St. Louis in 1958, making WUSM one of a handful of places in the country performing open heart surgeries. Each doctor became nationally renowned for their expertise.
“I was lucky to receive the best training from the best people,” he says.
Meanwhile, the University of Alabama-Birmingham (UAB) asked John Kirklin, MD, the Mayo Clinic heart surgeon who had refined the heart-lung bypass machine and was among the first to use it successfully, to build a world-class heart surgery program there. Dr. Kirklin accepted the position and began recruiting talented heart surgeons from across the U.S.
With a dedicated heart hospital, the latest technology, laboratories and top faculty under the leadership of a surgical pioneer, “people flocked to train there,” Dr. Kouchoukos included.
A member of the second UAB cardiac surgery resident class, Dr. Kouchoukos eventually joined the UAB faculty and remained on staff until 1984, when he returned to St. Louis to become chief of surgery at the former Jewish Hospital of St. Louis.
“I knew this place. It was the perfect place to move,” he says. “It was like returning home.” Along with him were his wife, Judith, and their three teenage sons.
Dr. Kouchoukos remained surgeon-in-chief at Jewish Hospital and vice-chairman of the WUSM department of surgery through the 1996 Barnes and Jewish hospital merger. He then moved to private practice at Missouri Baptist Medical Center.
Along with a busy surgery schedule, Dr. Kouchoukos found time to publish articles and co-author “Cardiac Surgery.” The book, considered the definitive text on the subject, has been used in medical schools around the world. “Operating is the most enjoyable part of any surgeon’s day,” he says, but teaching the physicians who will follow him is a “very important, gratifying” part of his career.
As the heart-lung machine changed cardiac surgery at the beginning of his career, so has the use of catheters and other minimally invasive tools changed it more recently. Thanks to these innovations, treatment options are available to more high-risk patients with life-threatening conditions.
But the trend toward minimally and non-invasive treatment doesn’t mean that open-heart surgery is going away. “There will always be a role for it,” says Dr. Kouchoukos. For instance, he notes, heart transplant and some aortic repairs depend on the surgeon opening the patient’s chest.
He’s more concerned about the decreasing number of young people becoming and remaining doctors. The phenomenon of burnout, now a common problem among physicians, was uncommon — if not unheard of — earlier in his career. “It puzzles me,” he says.
He speculates that today’s tighter regulatory environment, maze of Medicare and insurance paperwork, and time spent using electronic health records have made practicing medicine less enjoyable.
In retirement, Dr. Kouchoukos plans to remain active. He plans to travel with his wife and spend time with his family. He also hopes to stay involved with medicine — writing, mentoring and consulting.
However, he’ll miss his practice, patients, colleagues and staff at MBMC.
“There’s a culture of care here. No matter what, the patient comes first,” he says. “It’s easier to care for your patients in a place like that. And I don’t want that to change. Missouri Baptist has been a great place to work.”
"My relationship with patients, staff and other physicians has brought me a great amount of satisfaction and pleasure,” he says. “I have had the privilege of meeting many wonderful people, and I am forever grateful for the trust they have placed in me. I now look forward to spending more time with my family and remaining active in the community.”Cardiologist Robert Lehman, MD, provided cardiology services to patients at Missouri Baptist Sullivan Hospital and the MBSH Specialty Clinic for 28 years. He retired at the end of the 2019.
Dr. Lehman says it’s important that his patients continue to receive quality cardiology care, and he’s confident in the care his colleague Bradly Witbrodt, MD, will provide for patients at the Specialty Clinic.
“We are sad for Dr. Lehman to leave, but we thank him for his dedicated service for our community at the Specialty Clinic and wish him well in his retirement,” says Lisa Lochner, MBSH vice president of operations.
Adds Dr. Lehman, “I have truly cherished our special bonding throughout the years. May the future bring you much happiness and good health.”