Nicaragua's doctor of mercy
Heart surgeon Edward Lefrak, '65, uses his language skills and humanities education to make a difference in Central American medical care.
You'd think that by now Edward A. Lefrak, M.D., would have settled down a little.
He's 56 years old, for one thing, a time of life when a lot of people are looking out the window and thinking wistfully of retirement. He runs a hugely successful heart surgery program at the Inova Heart Center at Fairfax Hospital in Falls Church, Virginia. He became the doctor he dreamed of being-starting at the University at Buffalo, where he defied conventional wisdom by dabbling broadly in the humanities and graduating with a sociology major in 1965 on his way to medical school at Indiana University.
Yes, all things considered, Ed Lefrak is pretty well set. Which is why, a decade ago, he started studying Spanish. He went back to school-George Mason University-and took a bunch of courses there; went through Berlitz; even traveled to Latin America from time to time to live with families there and immerse himself in the language.
"It was just something I got into for something new and different to do," he says. "It wasn't done for any specific goal other than learning."
What he couldn't have anticipated was that the hobby would lead him to confront a world of suffering people-and galvanize him to take on some small part in alleviating that suffering.
It was October 1998, and Lefrak had flown to Miami on his way to another home-stay in Nicaragua. But his flight to Granada, one of that nation's chief cities, had been canceled: something about bad weather.
That was the first flight canceled, Lefrak says, because of Hurricane Mitch, a devastating storm that tore through Honduras and Nicaragua. The storm killed at least 11,000 people and forced 3 million from their homes. In a massive mudslide in northwest Nicaragua, nearly 2,000 people died when the side of a volcano gave way after days of torrential rains. The human misery was almost beyond comprehension.
Unable to get into Granada, Lefrak went instead to Ecuador and stayed for a week, "watching CNN in Spanish during the peak of the hurricane time in Nicaragua and Honduras. I saw all the faces, and it seemed like for once in my life I wanted to do something more than just watch [the event] on television."
Through a nurse at Fairfax Hospital, he connected with Mercy Ships, an international medical charity organization, and traveled to Leon, Nicaragua. "There were volunteers there from all over the world," he says, "but I turned out to be the only doctor there that week. We had information from the university in Leon about where the people in need were, and we just packed up a bunch of donated medicines in pickup trucks and went out into the countryside." Hours away from big-city amenities, they set up impromptu clinics in the open air and treated 150 to 160 people every day.
"I wasn't doing any cardiac work, of course," Lefrak says, "just general practice, which I hadn't done since medical school. Nearly everyone suffered from depression-they had lost everything they owned. And there were a number of diseases from contaminated water-all the wells had been contaminated because of the flooding. We saw a lot of tropical diseases, including malaria.
"These were people who were poor and on the edge already. Nicaragua had gone through so many things in the past 20 years-a civil war, other hurricanes and a devastating earthquake in 1972. This hurricane was kind of the final straw."
How does one person make a difference in the face of such misery? Lefrak and his colleagues knew that their assembly-line patients, their immediate ailments addressed, would have to return to homes and villages still suffering the ravages of poverty and natural disaster. But there was one Nicaraguan girl, at least, whose life he knew he could make better.
Lefrak met Maria Eliset Centeno Hernandez, 14, at a clinic in Corinto in northwest Nicaragua. She lived with her brother and grandmother in a tin-roofed shack, and she was so debilitated by a childhood attack of rheumatic fever that she struggled to walk even two blocks. Lefrak knew that replacing the mitral valve that connects two chambers of Maria's heart would stop its chronic leakage and prevent blood from backing up into her lungs.
One girl with a heart problem, one cardiac surgeon who showed up when her country was most in need. Lefrak couldn't cure Nicaragua, but by god, he could cure Maria. So he set out to do just that.
She and her grandmother were flown to Washington, D.C., and took up residence with Lefrak and his family at their house. In a three-hour operation at Inova Heart Center, the surgeon replaced Maria's balky heart valve with an artificial one donated by a medical company; she tolerated the surgery well, spent a few weeks recuperating at home with the Lefraks, and then the tiny Nicaraguan family went home. They're still poor, their city is still hurting from Hurricane Mitch, but Maria is regaining her strength and her breath, she should be able to play her beloved basketball and soccer, and she should live a full, long life.
"It felt good to have an opportunity to reach out and do a little bit," Lefrak says now, looking back on the experience. "It was a drop in the bucket, but it was one drop rather than nothing. There are thousands of Marias down there, but I can only do what I can do."
Maria's odyssey was chronicled in photos and two articles by the Washington Post, which made Lefrak a front-page celebrity for a time. It was a long way from his days at UB, where his determination to pursue a liberal arts education was unusual among his science-intensive pre-med classmates.
"There were 89 or 90 med schools in the country at that time," he says, "and at about half of them one couldn't apply without more science than I had. I just tried to take as much sociology and English and history as I could. I didn't want to take just science courses.
"Now I think that more medical schools actually encourage something like that, and as it turns out, for me personally it was the right thing to do. It made things more difficult that first year in medical school-I had to learn a whole new terminology and take a lot of science classes. But I always encourage people, when they go to college, to try to get as much out of the experience as possible."
The Inova Heart Center, whose cardiac surgery program Lefrak established in 1977, has attracted national attention, and its patients' survival rates for heart transplants-among the riskiest transplants in medicine-are above the U.S. average. Lefrak himself has been ranked among the nation's best heart surgeons by Good Housekeeping magazine. And he does get a chance to use that Spanish locally, Lefrak says: "500,000 people in this area speak Spanish. It's kind of a [northern] cradle for Salvadorans."
Scott Thomas is features copy desk chief at the Buffalo News.