The End of an Era. In Memoriam Hans Georg Borst (17.10.1927–8.9.2022)

Hans Georg Borst (17.10.1927–8.9.2022) (source: private, with permission).

“Y'know – this is incompatible with my life expectancy”[a] said Prof Borst and turned away from the dawdling lift, leading the team up five flights of stairs with his bad hip to continue with the day's planning. Little did he know that fate had reserved almost a complete century for him, rendering one of his favorite expressions relatively void: “I'm perishing!”[b] This did not become true until September 8, 2022–the day which also claimed Queen Elizabeth II. And if that was not coincidence enough, Hans Borst's “Hands across the ocean”[1] were shaken one last time - with his long-time friend and fellow aortic surgeon Randall B Griepp also dying that very day in New York, aged 82, 12 years his junior.

Apart from the well-known and often repeated fact that he was one of the true pioneers and most influential developers of cardiac surgery, Hans Borst will always be remembered for his charisma. He simply was charisma personified. Even my wife, who is not easily impressed with people, fell in awe the first time she met him. When he entered a room, everybody present got the feeling that now something was about to happen, that a problem was about to be solved for good. He wasn't a man of many words, but the ones he spoke were valid, even if disguised in subtle irony and often humor: “We are doing complex procedures all day long, only for some tired neurologist to take the money and buy himself a new EEG.”[c]

Patience was definitely not one of his strengths, in and out of the OR. And contradiction was only accepted if it was really well-founded. Priceless the scene when the head of cardiology, Prof Paul Lichtlen, looked over the drapes during an emergency CABG following a botched early PTCA, suggesting in his Swiss idiom: “Hans, whilst you're at it, just put one on that distal PLA also, will you?” Borst briefly looked up, gnarling: “Come on then, Paul! Scrub in!”[d]

The main secret of his success, both as a surgeon as well as a leader, was his ability to let others do what they could best. He would rather operate on a complicated acute type A dissection while in the other OR an expert and dedicated staff member would take care of the private coronary patient originally scheduled for that day. He did not particularly like that “doll's stuff”[e] anyway. This was also true for the surgery of congenital heart disease for which he had a deep respect. When it came down to the tiny ones, he was glad that he had sent colleagues to be trained at Great Ormond Street or Boston Children's, whose abilities he officially admired in his typical, slightly sarcastic way: “Watch out that one day you won't start operating on protoplasm.”[f] Comments like this were often accompanied by a chuckle when he had made a particularly apt one. „I could have started an advertising agency instead. I always come up with these good slogans.”[g]

In this inimitably firm but in the end good-natured way he guided, led, and protected his department as a whole, wisely investing venture capital in his staff where it seemed promising. He knew by whom he would be paid back - and he seldom erred. An early fan of Post-it notes, decades before emails were invented, Borst immortalized his thoughts on countless examples. If you received one, you knew exactly what to do and better did it as soon as possible ([Fig. 1]). Accordingly, as a Borst disciple one was under a lot of pressure, but in general enjoyed it, because it was fairly obvious that delivering would lead to a win-win situation. The resulting number of leaders from the Hannover School is legion.

Fig. 1 Post-it note. “Heinemann: Have a brief look at this act of an Editor's brutality! Borst” (source: M. Heinemann, private, with permission).

Last, but not least, Hans Borst was the Editor-in-Chief of this very journal from 1978 until 1986. He turned it into an English publication and gave it the distinctive title it still bears today. Soon, on December 12, 1978, The Thoracic and Cardiovascular Surgeon became listed in the “Current Contents of Medicine” and the “Science Citation Index,” the harbinger of the “Journal Impact Factor”. Those were the days of typewritten and photocopied manuscripts with glossy print illustrations which had to be numbered and labeled on the back. The editorial office prepared the bulky envelopes for the reviewers and mailed them. Large folders had to be systematically filled, and index cards helped to keep track of in- and outgoing manuscripts. As a matter of course interested residents suddenly found themselves in the middle of these tedious tasks. I can definitely claim that I learned an Editor's job literally from scratch.

For one's own scientific output, Hans Borst with his electric pencil sharpener was the most important and remorseless reviewer and advisor. One had to sit right next to him, and then the effort of many hours was cruelly analyzed word by word, at the same time being turned into something publishable. An occasional grunt of “bollocks!”[h] was not meant to discourage but usually justified. After all, one knew that “Y'know – a chief can't be nice all the time.”[i] When, weeks later, the reward came in the form of a letter of acceptance, Hans Borst would be all smiles and prouder than the first author.[2]

Now he is no more, and we as his disciples can no longer resort to him for advice. This gap cannot be filled. We must be grateful that we were allowed to have Hans Georg Borst for so long - charismatic, alert, and an inexhaustible support to the end. We shall always remember him in and with our hearts.

Publication History

Article published online:
19 December 2022

• References

• 1 Borst HG. Hands across the ocean. German-American relations in thoracic surgery. J Thorac Cardiovasc Surg 1985; 90 (04) 477-489
• 2 Heinemann MK, Buehner B, Jurmann MJ, Borst HG. Use of the “elephant trunk technique” in aortic surgery. Ann Thorac Surg 1995; 60 (01) 2-6 , discussion 7