Richard van Praagh

During my early years in pediatric cardiac surgery I had, of course, read many of Drs. Richard and Stella van Praagh's important contributions. I had also heard them present papers at national and international meetings but had never met them personally. Having trained in cardiac surgery in the Department of Surgery of the University of Minnesota, I was influenced early on by the macroscopic pathology of congenital cardiac malformations as described by Jesse Edwards, a pathologist who also made many important contributions to this field. Jesse Edwards, as I am sure Richard van Praagh would agree, was a superb teacher and a much respected and productive investigator. I had learned much from him and we had become good friends. I also knew that Richard van Praagh had spent time with Jesse while at the Mayo Clinic. Therefore, when I was invited to succeed Dr. Robert Gross as Cardiac-Surgeon-in-Chief at the Boston Children's Hospital and Harvard Medical School, I was very much looking forward to meeting and working with this world renowned couple of cardiac pathologists, Richard and Stella van Praagh ([Fig. 1]).

Fig. 1 Stella and Richard Van Praagh.

Coincidentally, it was also in 1972 that Richard had published one of his most important contributions, namely the “Segmental Approach to Diagnosis in Congenital Heart Disease”. Certainly, this contribution influenced the worldwide understanding and classification of congenital heart defects. We surgeons in particular profited immensely from Richard's segmental approach, since it helped us to better understand the morphogenesis of congenital heart defects and to guide us in a more systematic fashion during our attempts at correcting particularly the more complex types of congenital cardiac malformations. Importantly also, this new “language” greatly facilitated communication among all of us involved in the diagnosis and treatment of children born with a cardiac defect.

My first visit to the Cardiac Registry, originally located within the labyrinthian hallways of the Children's Hospital basement, proved both extremely pleasant and productive. To begin with, Stella offered me one of her homemade culinary specialties, baklava, a delicious Greek version of this pastry. This warm reception rapidly developed into a meaningful friendship; the three of us felt very comfortable with each other. Stella and Richard subsequently very graciously accepted my request to organize a weekly pathology teaching session for our cardiac surgery residents and fellows, also including our many foreign visitors. All of them treasured that unique opportunity to examine, hands on, this large and very complete collection of specimens containing essentially all types of congenital heart defects, expertly assembled over many years, mostly by Stella and Richard.

It very soon became clear to me that the van Praaghs were indeed an extraordinary couple. Their symbiotic relationship went much beyond that of husband, wife and children or simple professional collegiality. They depended on and enriched each other in their academic work. Stella was a gifted and enthusiastic teacher, and she excelled at it. She was, as far as I could observe, from an organizational point of view “the original left ventricle” of their conjoined effort.

Richard impressed me very much, as a Renaissance type of individual. He is extremely intelligent and pursues many interests beyond cardiac pathology. His background in philosophy and mathematics, to mention just a few of his many talents, is remarkably broad and deep. His alert and inquisitive mind often races in various directions simultaneously. His attention, therefore, can be distracted from one moment to the other by ever new ideas, which can at times make it difficult to keep a conversation or a teaching session on track. He is brilliant at conceptualizing embryonic, anatomical sequential developments and deducing their anatomical and functional consequences. His interventions during our clinical sessions or postmortem seminars proved invariably stimulating and inspired us to modify or improve our surgical efforts. I must confess that, not infrequently, I failed at first to recognize the essence of his arguments and only after further reflection managed to grasp the importance or validity of his ideas.

It is not the intent of this short essay to enumerate or analyze all of Richard van Praagh's contributions. Suffice it to say that there were many, and all of great importance to the field. His name, accompanied by Stella's, will eternally occupy a central place among the pioneers of congenital cardiac pathology. Richard was passionate about his work and consequently engaged not infrequently in intense arguments with his colleagues in pediatric cardiac pathology. Often these differences spilled over into, what I liked to call, transatlantic taxonomic warfare, mostly with Robert Anderson, a similarly opinionated British pediatric cardiac pathologist. Fortunately, these sometimes heated exchanges never succeeded in affecting their mutual professional respect or their friendship.

Lastly, when I arrived in Boston in 1972, Richard had already mentioned to me his intention to write a book on the “Pathology of Congenital Heart Malformations”. This was 38 years ago and the book has yet to be published. In 2010 we both reached the respectable age of 80 years. I doubt that I will have the pleasure and the privilege of a final copy of this Methuselaian effort in my lifetime. I sincerely wish that Richard nevertheless will persist in giving birth to this long overdue book, even if it takes him another decade. Richard owes it to himself, to the memory of Stella, and also to the many children he has helped to save through his work over these many years. This book, when published, will reveal much additional insight into the fundamental contributions of this multitalented humane man, his wisdom, and his love and lifelong commitment to search for the truth, both in medicine and other subjects of global interest.

It has been a true privilege and an enriching experience to have known and worked with Richard van Praagh for these many years.

P. S. Richard, I will do my best and try to still be around for the publication of your book.