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Philip K Caves

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Among the highest awards our Society bestows for best presentation by a junior member at the Annual Meeting is The Philip K. Caves Award. Who was this man, a figure from before the founding of the ISHLT?

philip k cavesJohn Wallwork, as a young resident, met this dynamic senior lecturer in Edinburgh. It was instantly apparent Philip Caves was a man on the move, bringing vitality and energy that sustained him throughout his short life.

Born in Northern Ireland in 1940, Caves received his medical education in Belfast, where he also started his general surgical and subsequent cardiothoracic training.

A move to the Brompton Hospital in London followed in 1970. But Caves blossomed when, in 1971, he was awarded the British-American research fellowship to Stanford University School of Medicine, California, funded by the British and American Heart Associations. In the stimulating atmosphere under the supervision of Norman Shumway, he rose from Senior Resident in 1972 to Staff in 1973.

Working closely with the late ISHLT President Margaret Billingham, he developed the cardiac bioptome and endocardial biopsy technique. Access to tissue from the transplanted heart enabled the Stanford group to define cardiac rejection which later evolved into the ISHLT grading system. The opportunity to fine-tune immunosuppression for their recipients improved survival at a stroke still 7 or 8 years before the introduction of cyclosporin. The whole episode stands out as an example of a curious mind taking a clinical problem and methodically developing, in a scientific fashion, an ingenious and completely novel solution. The end result is a technique that has stood the test of time.

His training attitude was taken directly from Shumway at Stanford, transforming operative training in Edinburgh in 1974. He moved to the newly created Chair of Cardiac Surgery in Glasgow a year later. Many of the junior staff from Edinburgh, including John Wallwork, followed-a step which was to have a huge bearing on their subsequent careers.

Caves hit Glasgow like a whirlwind-transforming both adult and congenital cardiac surgery-while motivating others with his tireless and engaging manner. He particularly changed attitudes at the Children's Hospital in Glasgow when he began operating on neonates who were previously denied surgery. Undoubtedly had he had lived, he would have started the UK's first heart transplant program in Glasgow.

As a left handed surgeon, many of the moves Caves taught remain a combination of left- and right-hand. He was, however, the first surgeon Dr Wallwork met who had proper left sided instruments. Then and, indeed sadly now, some trainers insist that left-handers function handicapped with right-handed instruments.

At age 38, Caves collapsed and died on the morning of July 23rd 1978, whilst playing squash with the father of a patient for whom he had tried to remove a large left ventricular tumor. A man of firm Christian beliefs, he was a source of spiritual help to many and a loyal supporter of his local church, to which he devoted much of his time and energy.

His death had a huge impact on his colleagues and the medical fraternity across the country. In the same way as we remember JF Kennedy, or Martin Luther King, everybody who knew him can recollect what they were doing when they heard that Philip Caves had died.

Dr Wallwork reflects on a very important lesson learned from his untimely death. Although our career paths inevitably differ from what they would have been, professional life continues and none of us are indispensable for the future. Succession planning is important for any team or organization.

An obituary in the British Medical Journal summarized the man:

"Philip Caves had great personal charm, allied to a seemingly inexhaustible dynamism. He had a prodigious appetite for work, whether physical or intellectual. He was a superb technical surgeon with exceedingly high personal standards of Surgical practice."

He serves as a role model for all of us-hard working, imaginative, and demanding high standards of himself in the interests of his patients. So when, in 1983, the ISHLT wished to name their highest award recognising the efforts of young trainees, it was almost automatic that Philip Caves was chosen. Since then, there have been nearly 30 recipients, spread across 4 continents with all specialities represented by the Society. It is entirely appropriate that the name of such a major and inspiring figure lives on.

John Dark, FRCS
Freeman Hospital

John Wallwork, CBE, FRCS
Papworth Hospital