04 January 2010


It has been the holiday season in Prague and, as in most northern European cities, numerous small log-cabin-type buildings have been erected at most major plazas, and merchants have been selling crafts and Christmas goods. Originally, I thought this was the purpose of the markets, but I now know better. The real reason for the markets is to drink beer, grog and mulled wine and to eat pastries and sausage. The shopping is just for entertainment during eating and drinking rest breaks.

Recently, I visited an interesting specialty hospital in Prague. This hospital specializes in adult cardiac, neurosurgical and planned abdominal, vascular, orthopedic and GYN surgery. They have no conventional emergency department and they don’t accept trauma cases. The hospital is also heavily involved in surgical research.

My intent was to quickly view the outpatient diagnostic departments and perhaps see a med/surg floor, but the executive office, which had advance notice of my visit, arranged a presentation in the cardiac catheterization lab. Specifically, I was ushered into the electrophysiology lab, where a patient was undergoing right-atrial mapping for prospective ablation therapy.

I had atrial ablation in 2005, so I was interested in comparing the facility in Prague with the U.S. facility that treated me. The Prague lab is super high-tech with robotics and a magnetic catheter-guidance system that has just become available in the United States. I do believe my electrophysiologist in Memphis would be drooling over this lab set up.

The opposite end of this scale would be the National Cardiothoracic Centre in Accra, Ghana. It was my privilege to meet the founder of this, the first cardiac surgery program in all of West Africa, while I was posted to Ghana. Frimpong Boateng, MD, left his native Ghana in the 1970s to study surgery in Germany. After 10 years abroad, he returned to his home country to offer life-saving cardiac surgery where there had been none and, in 1989, with considerable support from members of the German medical establishment, opened the National Cardiothoracic Centre in Accra. For 20 years, he has struggled to keep his life’s work moving forward and has survived insufficient facilities, a dearth of funding and even occasional loss of electrical backup during surgery. The center regularly accepts patients from neighboring countries and primarily repairs valvular and congenital heart disorders for persons who would have no options if the center didn’t exist.

I have not been to this hospital in many years but I am confident that Boateng and his group of dedicated colleagues continue to provide valuable health care under the most difficult of circumstances and without all the fancy bells and whistles I saw this week. Don’t misunderstand. I am as impressed by the potential of the high-tech interventions and the practitioners who advance our knowledge through research as I am by the surgeon who is saving lives under stringent circumstances. Ultimately, in both cases, the practice of medicine benefits and lives are bettered. I think we call this win-win.

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

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