It seems strange that this soft-spoken, calm and graceful man should astonish the medical world with his speed in the operating room. But speed is only one of the things that San Francisco cardiologist Dr. Elias S. Hanna is known for.
"I visualize my moves very quickly, and I have simplified the procedures of cardiac surgery. That is where the speed comes from," he explains. "I don't look very fast, but there is no wasted motion. I have a gift: What some surgeons take hours to do, I do in 45 minutes."
Hanna, born in Syria, was trained at Texas's Baylor University School of Medicine by Michael DeBakey (See Aramco World, January-February 1995) and Denton Cooley. In 1969, he was drafted into the US Army and sent to Vietnam, where he eventually became the chief cardiac and thoracic surgeon in the theater.
In 1970, at a field hospital in Saigon, Hanna removed a machine-gun bullet from the heart of a wounded soldier—a medical first. The operation was performed without the machinery used today to recirculate a patient's blood. A quarter-century later, the precision and speed of Hanna's procedure, completed in just over an hour, still takes other physicians' breath away.
"There wasn't much of an exterior wound, just a little hole in the chest. We didn't know until we opened him up that the bullet had actually hit the heart," Hanna says. "He had holes in the right and the left [ventricles]. I made an incision in the right ventricle, took the bullet out and closed it. You have to do it within three minutes."
It was during "slow times" in the Mekong Delta that Hanna launched what became the focus of his career: the training, without charge, of physicians in open-heart surgery techniques, many of which he has greatly refined.
"I would bring in Vietnamese kids with congenital heart disease and help them if I could. The hospital allowed me to use its facilities, and medical-supply companies in the US sent me a lot of equipment free."
Hanna later set up training programs in heart surgery for Vietnamese physicians. Today, his nonprofit Hanna Cardiovascular Foundation sends volunteer teams of cardiac surgeons to teach the latest open-heart techniques to physicians around the world. Hanna is credited with organizing cardiac surgery units in Syria, Iraq, China, Sri Lanka, Taiwan and the Philippines.
In 1973, Hanna led an 11-person medical team in open-heart surgery on a patient who could not accept blood transfusions. His team successfully replaced three blocked coronary arteries in only 75 minutes, avoiding the need for transfusion. Hanna was hailed as "the fastest hands in the West." Now, since the appearance of aids, his transfusion-free techniques are increasingly in demand.
A farmer's son, Hanna grew up on the terraced slopes of al-Metin al-Sahel, a village above the Syrian port of Tartus. Today, he still delights in the outdoors, and spends his free time on his farm in Sonoma County.
"You can't do things the same way twice, because every heart is different," he says. "You have to have a feeling both for the patient and for the beauty of the operation. When I operate, I feel a certain sense of artistry because, each time, I create something new."
San Francisco photojoumalist George Baramki Azar is a frequent contributor toAramco World.