To the Editor: May I add a personal anecdote to Professor Terblanche's letter of August 2007 about the late Christiaan Barnard and his treatment by a biographer. (1)

Whenever I am drawn into mentioning that I was a house surgeon under Chris for a few months in 1955, I get sideways glances;

then I have to elaborate on my experiences at that time. This was of course before Chris went to Minnesota and well before the fame which came from his pioneering transplant surgery. Not only do I remember the helpful and encouraging way he treated his house surgeons, but I also always mention how I admired the way he looked after his patients in D4. As I saw it, his approach was kindly and supportive, and he was quite willing to get into a fight in their interests. I remember one illustrative case well.

A middle-aged woman of little sophistication was sent down from the country by a district surgeon, carrying the diagnosis of a lump in a breast, probably cancer. Initial screening showed that this patient was diabetic, and the nurses had an impossible battle trying to teach her to manage insulin. She was put on the list of the professor of surgery at the time for a mastectomy. Once she had been anaesthetised, Chris spoke up: 'Sir, I think that you should cut into the lump'. As you can imagine, a row broke out in the theatre. The professor eventually wearied of Chris's stance in the argument and said, 'We'll ask Joc!' (Talk about appealing to the ignorant.) My answer was, 'I thought this lump fluctuated, sir.' With ill grace, the professor cut into the lump--and pus poured out; it turned out to be a tubercular abscess. So Chris's determination saved the patient from an unnecessary mastectomy and allowed more rational therapy to be instituted.

This action, I feel, typified Chris, for all his surface roughness, and I really admired him for it. I imagine that there are probably many more such stories.

(1.) Terblanche J. Chris Barnard--a personal tribute to a gifted heart surgeon and a great intellect (Briewe). S Afr Med J 2007; 97: 550.

J ('Joc') R L Forsyth

10 Ferrier Court

Rosanna, Victoria

Australia 3084

forsythjr@optusnet.com.au