Dr Klaus T. Kallmayer, is chairman/senior consultant of German Heart Centre Bremen at Dubai Healthcare City.
Do to a patient only what is in his best interests. Administer only what you know and is to the best of your knowledge. If in doubt, do not hesitate to refer him to another doctor.
My interest in medical ethics began when as a medical student in Germany, we had to do a thesis that was mandatory for our graduation.
I did mine on Medical Ethics as I was inspired by the work of Thomas Percival, a British doctor and 18th-century philosopher who is said to have coined the term "Medical Ethics".
I believe that medicine is not a pure science though it relies heavily on scientific methods. It is both a science and an art. Experience and compassion are key factors in this profession, and the former, for instance, has nothing to do with science.
No one outside the medical profession can judge what is right or wrong about this profession. Therefore, physicians must regulate themselves to ensure that their practice is based on certain ethical standards.
A patient relies completely on the implicit trust he places on the physician. Indeed, trust is the basis on which we practise medicine. And if we do not gain that trust, we cannot heal.
Technological progress ...
... has increased our knowledge of diseases but technological devices can only be as good as the doctor who uses them.
A good example to illustrate this is a flashlight. If you aim it in the wrong direction you will not see what you are looking for. You should know where to aim. The same is true with the use of diagnostic machinery. Its success and efficient operation depends on the doctor's knowledge.
Here too, the physician should be guided by his knowledge and should not, for instance, advise invasive procedures when the case is only a low risk category. The more choices you have in terms of technical devices the more you must discriminate against what you must not do.
Marrying science and art
I did a Master of Arts in history along with a degree in medicine at the Tuebingen University in Germany in 1978. Some people believe that history is not important because what has happened will never come back. But I think history is necessary because it is the memory of a society. A person without memory is disoriented and people who do not know where they come from will not know where they are heading.
History is also in many ways related to medicine as treatment begins with unravelling the history of the patient who on his first visit is a complete stranger to the doctor. It is this that often unmasks the diagnosis. The symptoms do not always tell the full story.
The turning point in my life
I headed to the USA to do my Fellowship in Cardiology (1985-87) under the guidance of eminent cardiologist Professor Bernard Lown at the Brigham and Women's Hospital, Harvard Medical School, Boston.
Working with him was a great privilege. In him you could find the unique combination of clear scientific thinking and sound clinical judgment.
"Feel, listen and touch," he always emphasised. "Feel the patient's pulse, listen to his heartbeat and touch his chest; do not ignore the signs the patient is giving you. Let your technical prowess be guided by what your clinical examination tells you." He stressed the importance of taking a thorough history and carrying out a competent physical examination before turning to laboratory tests or complex machinery.
"As physicians, we have to acknowledge our shortcomings," he always reminded us. "If you do not admit your mistakes, how will you learn from them?" he would ask. He also encouraged utmost sincerity not only to the patient but also to oneself.
Dr Bernard Lown is a gifted teacher and is a living example of what medical ethics theoretically teaches you. He brought me back to the roots of my foundation and for this, I am truly indebted to him.
Memorable moment
The organisation that Dr Lown set up at the height of the arms race in the eighties – International Physicians for the Prevention of Nuclear War (IPPNW) – received a Nobel Peace Prize in 1985. He believed that as physicians we ought to have a particularly sensitive conscience and that should not stop at the borders of our profession but extend to the world.
Together with Dr Yevgeny Chazov of the USSR Cardiological Institute, the IPPNW was formed and true to the spirit of the Hippocratic Oath, this organisation dedicated itself to preventing nuclear war and abolishing nuclear weapons.
The exhilaration we felt when the Peace Award was announced is still fresh in my memory. I remember the red carpet events, the paparazzi and the endless interviews and speeches.
But more gratifying was to be with this great person who selflessly championed the cause that made the world a better place.
I returned to Germany in 1987 after my fellowship at Harvard and became Director of Cardiology at Klinikum Bremen-Mitte in Bremen. Two years later, I founded my own Cardiology Clinic in Bremen.
Over the past 18 years, I have done around 12,000 cases of interventional surgery alone. We have a very high caseload of 8,000 interventional patients per year in our Bremen catheterisation laboratories. In addition to these cases, we see more than 25,000 patients a year in our outpatient clinic. Handling such large numbers means that there is a tremendous amount that you can learn as you possibly see everything under the sun in one year alone.
Dubai calling
The Arab Health Conference brought me to the UAE in 2003. I was impressed with the pace of development in this country but discovered that more could be done in the field of cardiology. We therefore, set up the German Heart Centre Bremen at the Dubai Healthcare City, with the aim of providing cardiac care of world-class standards at an affordable price and to develop a cardiac care programme for an emergency situation that is not currently available in the country.
Our clinic here is staffed with German cardiologists, all on senior consultant level, from our group in Bremen. Currently four of our partners share the duty on rotation.
The German Heart Centre Bremen has entered into a tie-up with Welcare Hospital to create a sophisticated heart centre of its kind. This unit will be at the City Hospital within the Dubai Healthcare City and will open in early 2008. We will lend our professional expertise in conducting all the invasive cardiac procedures at the hospital. Currently we are affiliated to the International Modern Hospital in Dubai.
