Willem Kolff Interview (page: 8 / 9) Pioneer of Artificial Organs	Print Interview

Dr. DeVries, during all of this time, with this skyrocketing career, have ever had any doubts about your abilities?

William DeVries: No. I never had doubts about my abilities. I was trained to be a heart surgeon. I was trained with my hands. I was trained to practice medicine and I went to one of the best medical schools, and the best training program for surgery. For nine years I learned about surgery. We worked with some of the best people in the world. I always had confidence in myself that I could do it. I was shocked sometimes that the circumstances in which you work were not the best. At times it looked like everything was kind of going against you. But when you do in the work that I do, you deal with people. People come to you, and they are sick, they hurt, and they are in pain, and you get them better. And they look you in the eyes and they say, "You've done something for me." There is nothing in the world that can top that for you. When you get that contact, the only people that can evaluate your work are your peers or yourself. When you know you've done a good job, and you have confidence in your work, and the patient tells you that, and you know that's true, it's a reward in itself.

With the artificial hearts, some patients had strokes, and people started saying "This is a stroke machine. It ought to be stopped!" People would criticize you, and sometimes you would say to yourself, "I don't know. Maybe this isn't working." All you had to do was walk down the hall into a room where there was a patient with the artificial heart in place and he would look up at you and say, "Thank you for keeping me alive. Thank you for this day that I've had." From then on, it didn't matter what anybody said. It was worth it to us.

When you go into something like heart surgery, you come up to the patient, and you say, "I'm going to do the best job that I can do and the best job that I think can be done." The patient trusts you. He puts his heart in your hands, so to speak, and he doesn't want you to say, " Maybe the guy next door can do it better than me, but if you just give me a chance, maybe it will work out okay somehow."

Get the Flash Player to see this video. You can't work with life and death situations, coming out of a table when a patient has died in your hands and say to yourself, "Gee, you know, maybe someone could have done it better." You've got to know that you did the very best you can, and the people around you did the best you can, and the guy just died. You know, sometimes people die. We as physicians have people -- we fail all the time, because ultimately, people are going to die regardless of whatever we do. With the artificial heart, we may have kept someone alive a little bit longer, but they are going to die sooner or later. You know? And, you've got to be able to say when they die that you had done the best that you could do, and you accept the consequences of what went on. And, then you go back after it's over and look and say, "Is there something that could have been done differently?" or assess it, and then learn from that and move on to the next step. That's the important thing. You learn from your failures and your mistakes, but you move on.

Dr. Kolff, what part of your work do you think will most benefit the world?

Willem Kolff: I've worked on so many different subjects, it's hard to compare. Each is important for an entirely different set of the population. 540,000 people have been treated with dialysis worldwide, over half a million. If you realize that all these people have families too, you see how many people are involved.

There are 33,000 people that need artificial hearts in the USA. Our artificial heart has been applied so far in only 260 people. There is so much work to be done that there is little time to be glorious about the things we've done.

Dr. Kolff, why do you think many people seem unwilling to donate organs in this culture?

Willem Kolff: In the first place, I'm not sure that that is so. I think the main reason is that they're not properly asked. Some people are better at asking than others. I recall once, I was walking through the halls of the Cleveland Clinic and...

Get the Flash Player to see this video. I heard desperate crying coming from a room. I went in and saw that a husband had just died, and it was the woman that was crying. So, I went to see the doctor who was in charge and said, "May I ask her for the man's kidneys?" And, while she was still crying she said, "Oh, please, please, take them, let something good come out of this." I had one Turkish assistant. He could get an organ from anybody, nobody refused him.

Do you think organs are going to become more available?

Willem Kolff: Yes, but not enough. We have two kidneys, so we can give one away. The number of patients on dialysis is leveling off because there are so many kidney transplants, and the results are so much improved. But for hearts it's different. There are at least 35,000 people in the United States that have irreparable heart disease and could be helped with an artificial heart. There are definitely no more than 2,000 heart donors. So that leaves 33,000 people per year that die for lack of an artificial heart.

The FDA has stopped the use of artificial hearts because the paperwork was less than optimal. So now you know for certain that these patients are going to die. The regulatory system -- the FDA, against which there is no appeal -- is so difficult and so expensive for manufacturers that they don't undertake new projects. It's the danger of lawsuits.

You've all seen, in the newspapers and television, the lawsuits about breast implants. Nobody knows what causes multiple sclerosis, but some people with multiple sclerosis are suing Dow Corning because they had silicon leaking from these artificial breasts. Well, 1.2 million women get these breasts, but now the company will not manufacture them anymore. Dow Corning may well decide to get out of the medical business. Medical sales account for 3% of their total sales. Why should they risk all the trouble and bad publicity by manufacturing medical equipment?

FDA regulations are making it impossible to come out with new products. And we should definitely put a cap on liability suits, of any kind, because we cannot afford this. I'm sending artificial hearts to eleven different countries in the world, where surgeons are willing to implant them in animals, and do the experiments I cannot finance here. These are very exciting things, but it makes me very worried about the position the United States will have in this kind of work.

I would like to have them made here. If I cannot have it made here, should I accept a contract from Japan? Of course I must, because it must be made. Later on we in the United States will have to buy these things from the Japanese, as we buy Japanese cars. We will not be defeated on the battlefield, but defeated because we're not educating our people, we're not doing long-term research for industry,

What are some of the challenges you see for the next century in the field of medicine, or in any field?

Willem Kolff: I feel very strongly that our priorities are wrong. Our priorities have been defense, killing people, more bombs when they were not needed. The military industrial complex has a momentum of its own. So many people depend on it. So many of our representatives try to keep it alive because there's a factory in their district, and jobs are dependent on it and therefore they have to support it. But finally we should have the sense and the courage to see that we may be the strongest nation militarily, but we are becoming weaker every day commercially.

Do you work out of a sense of duty?

Willem Kolff: I have a great sense of responsibility towards patients. I have a responsibility to bring the things I have invented to the marketplace. I have a new artificial heart here now. I've worked on these artificial hearts very hard. If they're not produced, I might as well not have done it.

How do you see the responsibility of someone in your field to our society in general?

Willem Kolff: I think we should use our influence to make society a better place for all of us to live in. A favorite phrase of my mine has to do with the atomic bomb. "What good does an artificial heart do you when we are all pulverized?"

Those of us who are not dependent for a paycheck on the military industrial complex should use whatever influence we have to steer us away from this enormous, unjustified expense on defense. Our present administration, with Russia out of the picture, still wants to spend $3 billion on Star Wars! I think this is criminal. We need these $3 billion for education, we need them to help the poor, we need them to retrain the unemployed. 35 million people are uninsured! We need a health system.

In the Netherlands, everybody is insured. The government saw that it was less expensive to pay insurance fees for the poor than to set up a welfare program. You still have private insurance companies, so there is competition, but they're both guaranteed by the government.

The other thing we need in this country is a better control system in the application of medicine, and the spending of our funds. We need to end the stealing of money from the government. They finally closed the dialysis center in Ogden, and we were asked to take care of these patients for a few days to bridge them over. Eleven patients died because they were under-dialyzed, and a large number of patients had been treated with dialysis who did not need it, only for the financial gain of the physician and the dialysis center.

Another point that I would like to make is about the war on drugs. I just saw in the newspaper that 73,000 Colombians have been arrested for trafficking cocaine. They are mainly mules carrying the cocaine from one place to another. And we don't have the courage to say that we're losing the war on drugs! We'll never win that war. We don't need a war on drugs, we need a drug program.

We need to take the profit out of the drug business, because the drug lords have a hundred times as much money as the police. But if we take the profit out of it, and use that money to rehabilitate drug addicts, then we have a program. Then we can re-educate our children. There are some addicts that are lost, so make the drug available to them, so they don't have to steal or murder to get it. Cocaine costs almost nothing to grow; marijuana even less. Make it available, do it the way the Dutch do.

When somebody says, "We're winning the war on drugs," that means that fewer children of well-to-do families in suburbia are taking drugs. But you know that in the inner cities it's getting worse and worse. The number of murders that we've had in the last year (1991) is larger than it has ever been.

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