We Call them HEROES: An American Heart Team in Ukraine…

“Pensiveness best describes the scene, as we swirl our glasses watching the foam tumble down the side of the glass and picking at a cold piece of pizza. We all know what is coming but none of us know what to expect.”

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Editor’s Note:

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This needs to be written, but it sucks to write it.

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It sucks to write about this, because basically it’s a man versus inhumanity to man thing.

As cardiovascular perfusionists I’m pretty sure we agree that designed killing is antithetical to all the precepts that brought us into this profession to begin with. We save lives based on the premise that for whatever reason our patients have been delivered to us, it was due to natural circumstances or lifestyle issues, but the concept of compassionless predation is something that is difficult for most of us to wrap our heads around. But it’s called war for reason. This really is not the time to render judgment on indiscriminate killing, but it is the moment where we all need to step up and take a position to stop it.

That pretty much sums it up… Just Stop it.

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There is no reason to sugar coat killing. Time to stand up-

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The Story… An American Heart Team in Ukraine

by Brian Forsberg, CCP

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March 10th, 2022

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07:30 EST

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I was at Broward Health Medical Center in Ft. Lauderdale, FL prepping a room for a TAVR when I received a call from Dr. No. I swiped my phone and took the call where he calmly said “I need a team to travel to Lviv this Saturday, can you GO?” Immediately, memories of my many trips to Ukraine as a volunteer Perfusionist collided with the recent acts of war and pictures of destruction. I experienced a visceral reaction that triggered my mind, body and soul to make the immediate decision. My mouth just pushed the words out.

Yes.

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17:00 EST

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Second call from Dr. No, “It’s a GO; can you get perfusion supplies for 4 cases?”

The hunt for supplies was on, as I was to be wheels up in less than 48 hours from Miami, FL. A few phone calls, texts, and emails, and boom! Oxys and packs were confirmed by team members, but I still needed cannulas.

Jill Cohen, CCP & VP of Clinical Ops for Comprehensive Care Services (CCS), who has pumped for Dr. No in a past trip, filled those cannula requests and we were set. (Special thanks to CCS Directors Mike Casares, CCP, at Joe Dimaggio Children’s & Vicki Kilpack, CCP at Holtz Children’s) 😊

I left work after backing up heart at BG and returned to my hotel to pack, knowing I was checking out early the next Morning.

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March 11th, 2022

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06:30 EST

As a national traveler for CCS, I was sitting in the Marriott in Ft. Lauderdale enjoying a double espresso planning out my next 36 hours in the USA before heading to a war zone to pump cases. Here was my list:

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13:00 EST

I finished my case and immediately drove down to Joe Dimaggio Children’s Hospital in Hollywood, FL to gather the cannulas. While in Hollywood I stopped at Target to pick up some travel essentials, while in line to checkout I received my ticket confirmation from Jean Towne at Novick Cardiac Alliance. I paused as I read the itinerary. The same physiology that had overcome me earlier again raced through my body as I read, fly to Krakow, Poland, meet the team, and then travel by bus to Lviv, Ukraine.

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It’s GO time!

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17:00 EST

Ty , CCP and his wife Meghan opened their home to me, providing lodging, laundry, home cooked dinner and most importantly a comfortable, loving space to enjoy fellowship before my departure.

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13:00 EST

Hugs, Goodbyes and prayers as I departed my friends home and headed South on I-75 to Miami International Airport (MIA). A quick drop off of my rental car and I was off to Terminal J, one that I know well traveling internationally out of MIA since 2010. COVID has caused numerous issues regarding international travel and the rules change everyday so I planned on getting to the airport early to check-in and be sure I had appropriate docs to fly.

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15:00 EST

Greeted by the friendly SWISS Air Ticket Agent she took my passport and asked for my COVID Vax card and I obliged. She then starts counting on her fingers and says my vaccine is over 270 days and I am not permitted to transit through Zurich. She tells me I will need a booster before I am allowed to travel. Somewhat dazed, I wondered maybe I am not supposed to GO and a minor sense of apprehension peaked and waned in quick order. Dazed but focused, I briskly walked to the Uber pickup zone while making an appointment for a booster shot at the nearest Walgreens in Little Havana, Miami.

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15:45 EST

Upon arrival the Pharmacy explained that the computers were down and might not be up for 30 minutes. Damn, maybe I really am not supposed to GO. I pleaded with the Nurse and told her my plight, but there was nothing she could do. We were at the mercy of technology.

However, Divine intervention powered up the computers and 10min later they tossed me into a chair rolled up my sleeve and slammed some more Pfizer mRNA into me so that I would be eligible to travel. Vax card updated, hailed another Uber and hustled back to MIA once again.

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19:15 EST

Boarded SWISS Air flight 0065 settled into my seat and quickly fell asleep before take off. I woke up when we hit cruising altitude and the lights came up for dinner service. The Flight Attendants began the all too familiar “beef or pasta” and drinks when the peaceful flight was thrown into complete chaos.

1 row in front of me a young female passenger un buckled her seat belt stood up and started dancing and wildly yelling about how she wanted to continue her party in Miami. Clearly, on drugs she had peaked as we hit causing altitude.

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Physicians were summoned by the Captain overhead to help but she resisted and continued to dance, spin, climb over seats and remove articles of clothing. After 30 minutes of this they finally got her back to her seat where they ripped into the onboard medical bag and started pulling out drugs, oxygen, and a pulse ox to treat the distressed passenger.

At this point I heard the airlines crew talking about a diversion to land at the nearest airport as we were already 2 hrs over the Atlantic at this point. Again I found myself thinking, am I supposed to GO?

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22:00 EST

The physicians gave her multiple rounds of oral valium and she slowly begins to calm down. They have another meeting with the cabin crew and the Captain makes an announcement that we are continuing on to Zurich and apologies for the inconvenience and stressful beginning of the flight this caused.

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I am a GO again…

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March 13th, 2022

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14:00 CET

Now having over-nighted on my way over the Atlantic, jumping a few time zones, transiting Zurich, I finally touch down in Krakow, Poland. The team filters in as each connecting flight brings another group and more bags filled with supplies. Medical professionals from across the US, Canada, and Belgrade share a snack and a beer in the airport cafe as we await Dr. No on the final arriving flight from Amsterdam. Everyone is tired and nervously excited for what is to come next. Pensiveness best describes the scene, as we swirl our glasses watching the foam tumble down the side of the glass and picking at a cold piece of pizza. We all know what is coming but none of us know what to expect.

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19:00 CET

Climbing aboard the massive transport but I sit in the front row with an unobstructed view of the road and landscape ahead of me. The drivers are below us as well as all of our luggage teeming with medical supplies. They have packed the bus with not only food and water for our journey but also cases of water, paper towels, hand-soap and other humanitarian aid to bring into Lviv with us. The air breaks hiss as they release and we lurch forward…

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1st stop

The Poland / Ukraine Border.

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LET’s GO ON BYPASS!

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I don’t think- “Are we Going to Survive being Bombed?” Is part of any check list I have ever signed off on- Pretty Sure that in this case- THERE is no TIMEOUT…

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21:30 CET

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The bus begins to decrease speed as flashing lights in the distance draw our gaze. We pull up in a multi lane line with buses on one side and cars on the other. This is our pen while we wait. There are stoplights that are directing when vehicles are permitted to take a 90 degree right turn to approach the border facility but for now we wait. The straight ahead is completely blocked by barricades and Polish Border patrol. In peaceful times there is no hard right turn. Just a document check and straight on through. But not now.

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23:30 CET

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The bus is silent. The team is exhausted and the adrenaline has long burned off. We keep waiting. Suddenly a car pulls up shouts at the Polish Border Police and immediately they make way and open a route straight through the border continuing along the highway. A uniformed man with a red laser light flashes and directs the way as 10 semi-trucks blow by us headed straight into Ukraine. A trailing vehicle collects the man and they are gone into the night. We wish we could follow them but then realize a military convoy was hit earlier that day and we think otherwise.

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00:00 CET

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Our light turns green for GO. We pull into the far left bay and are promptly boarded by Polish authorities. They ask for our passports and flip open to the face page and confirm our identities while asking us why we are traveling to a war zone. No one said anything. They then departed the bus and we were told to wait.

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00:30 CET

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Passports returned and stamped out of Schengen zone, we are permitted to pass through an intermediary zone where we will have to repeat the process with Ukrainian Border Patrol to be admitted into their country. At this point we start to see the humanitarian crisis before us. A sobering sight happening live on the other side of the bus window glass, not the glass of iPhones or TV’s. This is the reality of what is happening at borders of all the friendly countries that are taking Ukrainians fleeing Russia’s attacks. We park, disembark the bus and physically present ourselves and passports to the station and allowed to use the facilities. We are sharing these with Ukrainians, fellow humans, that have only 1 or 2 shopping bags carrying their possessions. They are drinking coffee, having a dinner prepared by world kitchen., they all have a story, and most do not know what chapter is next.

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01:00 CET

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The US & Canadiens, receive entry stamps and approval to enter Ukraine but one team member from Serbia and they have not condemned Russia, therefore her passport was held and not allowed to cross. Dr. No argues on her behalf that she was just in Lviv in early February helping NCA with the previous surgical trip. The Border Guards finally relent after 30 minutes of calling multiple Deputies and Ministers of Health in Lviv. She can GO.

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01:30 CET

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The bus lurches forward once again and we almost forget what it feel like to move forward on the bus. The gates go up and we pass through multiple sets. Down a ramp and back onto the highway with the flashing lights fading behind us we press on forward. Unlike Poland the road was perfectly flat asphalt lit with lights the entire way. The Ukrainian side of the highway was an entirely different story.

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Perched in my seat panning the roadway I begin to notice orange flickering spaced apart off of the road and expanding in number deeper into the dark I look. It reminded me of a movie where they lit fires to keep grapes from freezing during cold weather. It has the same lighting effect as this and I tumbled within my thoughts trying to reconcile what I was witnessing. We then came to a bridge which was covered in sandbags at both entrances and there what I saw cut through my ever aggressive sleepiness.

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The soldiers guarding the bridge had a small metal stove burning wood to keep warm and it was throwing off that same fiery glow that was unmistakable. Off the road were troop encampments and what I saw were all of their fires. It was mesmerizing and I never felt so safe and happy knowing they were all there to protect Ukraine’s border and it’s constant attack from Russian aggressors.

I let sleep take me knowing God and my Ukrainian brothers were watching over and we tumbled down the road towards Lviv.

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04:00 CET

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WE THANK YOU!

The WORLD Shall Too 🙂

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March 13th, 2022

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Remarkable Images of Perceptual Changes with How We See Things when under stress…

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In the worst of times we have become the best. Prior to Covid and prior to the calamity in the Ukraine, perfusionists all of the world have one common goal and that was to save lives regardless of race, culture, or religious, belief.

We are now faced with uncertain times that I believe will draw us together as opposed to apart.

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A Job WELL DONE!!!

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ACKNOWLEDGEMENTS

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Dr. William Novick

A renowned pediatric heart surgeon, talks openly about the challenges of delivering life-saving heart surgery to children in War torn Countries. He is the pioneering founder of the Novick Cardiac Alliance, an international team of doctors, nurses and clinicians that operate in conflict zones worldwide. He also shares his origin story: at age nine, during the civil rights uprising in Montgomery, Alabama his family experienced racial injustice firsthand. Dr. Novick poignantly explains how the experience led him to champion those marginalized in society and how it ultimately forged a global vision to serve children regardless of their race, color or religion.

“Am I arrogant enough to say that we are the Biggest Baddest Group- to do this in the World? 

YEP!  You Bet I am… Because I am extremely PROUD of what we have done.”

We DON’T make empty promises.  If we say we are going to be somewhere- we are there…  If we say we are going to operate on someone- we do…”

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Brian C Forsberg- CCP

Brian Forsberg is in my opinion a perfusion force to be reckoned with. I’ve met many great individuals in our perfusion community, but I must say there are very few that make me feel humbled because their passion and courage is so outrageously evident.

Brian and I crossed paths several years ago when I first began this blog for the perfusion community. I don’t consider what I have accomplished as anything more than my effort to improve the quality of communication and insight that we need at times when considering the impact we have us perfusionists in our community.

While I was criticized by many, Brian encouraged me to continue with this endeavor. This is one of many perfect examples of Brian not only being a man of courage, a man of exceptional integrity, but what he did in my estimation, is what truly epitomizes the cornerstone of what being a perfusionist is. He is creative, innovative, and pretty much a Raiders of the lost Ark sort of individual that gosh, I have no idea anyone could not admire.

In his latest endeavor- what is laudable to note, is that Brian has set aside his own personal safety to further the cause of what I think makes medicine great. This is not the Hippocratic Oath “moment” where the premium quote is: “do no harm”.  This is the moment where you have to consider the Tidal Wave of personal risk assembled when measured against the lives that may or not be saved in the process – and accepting that risk. To save one life is majestic considering the surroundings of this sort of calamity, but what impresses me more is that in the face of the fact that no congenital cardiac defect is an assured victory, to ignore that implied handicap and still go risk your life in order to give another life a chance – that is in my opinion heroic.

Brian is currently a National Traveler for Comprehensive Care Services in the US. He is also the Chief Perfusionist & Co-Founder of The Novick Cardiac Alliance and travels worldwide to support the mission of treating children with congenital heart disease.

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Keeping it Fair & Honest… The People I Need to Thank 🙂

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I wish to recognize a few individuals in our perfusion community that have clearly stepped up to the plate and are making a difference in our effort by the example of their own action – thus personifying what is best about us in this profession.

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Bryan Lich CCP, President and CEO of perfusion.com has united us as the largest perfusion forum both nationally and internationally and in my opinion has given his heart and soul to what we do as a profession. I am grateful to be his associate and friend. He has supported the CircuitSurfers.com blog and the message behind it- for which I am grateful.

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–Chet Czaplicka CCP, President and CEO of Comprehensive Care Services. 

I have known and worked with Chet for many years, going back to 1994. Back then, I admired him greatly for his passion not only for the profession, but for the great care and compassion he clearly demonstrated by action to the heart programs that he contributed to, as well as a staff he hired to maintain an unparalleled level of professionalism. He has courage few people may recognize, because typically people don’t recognize that kind of stuff. But trust me, it’s unquestionably there.

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Dennis Brancato CCP, Northwest Regional Director- Specialty Care

Not only do I respect this guy, but one day when I was feeling sorry for myself and made a self-serving comment about the amount of sacrifice, I had made for God knows what reason – he looked at me straight in the eye with great passion – reminded me that yes- he too had made an incredible sacrifice to continue doing what he does. There’s a time and moment when you stare someone in the face  and you realize that every single thing you are hearing is the brutal truth. I respected it.

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Why MENTION these 3 Perfusion Groups?

Because I have worked for ALL OF THEM… And we have all been measured. The best of the best.

These are 3 of the biggest perfusion contract groups in the world- and SHOULD be recognized for the contributions they are making in order to help keep us all safe.  They have no hidden -agenda and are the best in the world IMO.

Let’s Help Ukraine!