Mysteries in Fetal surgery | Oluyinka Olutoye MD PhD | TEDxRVA

[Applause]

[Applause] for generations the womb has been a

for generations the womb has been a

for generations the womb has been a sacred environment where the fetus grows

sacred environment where the fetus grows

sacred environment where the fetus grows and develops and the dark quiet sanctity

and develops and the dark quiet sanctity

and develops and the dark quiet sanctity of the womb the child grows from a

of the womb the child grows from a

of the womb the child grows from a cluster of cells into a full-grown baby

cluster of cells into a full-grown baby

cluster of cells into a full-grown baby organs develop structures are needed

organs develop structures are needed

organs develop structures are needed together as the fetus is fearfully and

together as the fetus is fearfully and

together as the fetus is fearfully and wonderfully made far from the riches of

wonderfully made far from the riches of

wonderfully made far from the riches of man with advances in technology we can

man with advances in technology we can

man with advances in technology we can now look into the womb and see as the

now look into the womb and see as the

now look into the womb and see as the fetus develops and grows with ultrasound

fetus develops and grows with ultrasound

fetus develops and grows with ultrasound and MRI but in addition we can now

and MRI but in addition we can now

and MRI but in addition we can now actually go into the womb to interact

actually go into the womb to interact

actually go into the womb to interact with the fetus to provide treatment and

with the fetus to provide treatment and

with the fetus to provide treatment and even surgery this has opened up the

even surgery this has opened up the

even surgery this has opened up the world of fetal surgery the world that

world of fetal surgery the world that

world of fetal surgery the world that I’m privileged and blessed to be part of

I’m privileged and blessed to be part of

I’m privileged and blessed to be part of the very few things really that gets

the very few things really that gets

the very few things really that gets many women more excited than the

many women more excited than the

many women more excited than the realization that they’re pregnant but

realization that they’re pregnant but

realization that they’re pregnant but the excitement and joy that comes where

the excitement and joy that comes where

the excitement and joy that comes where the pregnancy can easily be caught

the pregnancy can easily be caught

the pregnancy can easily be caught strong by realization that that fetus

strong by realization that that fetus

strong by realization that that fetus may have an anomaly the hopes

may have an anomaly the hopes

may have an anomaly the hopes expectations and dreams for our child

expectations and dreams for our child

expectations and dreams for our child have put into question several questions

have put into question several questions

have put into question several questions arise will this anomaly result in the

arise will this anomaly result in the

arise will this anomaly result in the fetus not even making it through

fetus not even making it through

fetus not even making it through pregnancy is this an anomaly that can be

pregnancy is this an anomaly that can be

pregnancy is this an anomaly that can be corrected after birth

corrected after birth

corrected after birth what personnel or facilities need to be

what personnel or facilities need to be

what personnel or facilities need to be present at the time of delivery where

present at the time of delivery where

present at the time of delivery where should this job be delivered can this be

should this job be delivered can this be

should this job be delivered can this be collected at all can it be corrected

collected at all can it be corrected

collected at all can it be corrected before birth

before birth

before birth now with fetal surgery were able to

now with fetal surgery were able to

now with fetal surgery were able to provide answers that did not used to

provide answers that did not used to

provide answers that did not used to exist answers that we could hope that we

exist answers that we could hope that we

exist answers that we could hope that we can offer for many of these families

can offer for many of these families

can offer for many of these families that are faced with this condition my

that are faced with this condition my

that are faced with this condition my journey into this world started halfway

journey into this world started halfway

journey into this world started halfway around the globe in Nigeria where I was

around the globe in Nigeria where I was

around the globe in Nigeria where I was born and raised

born and raised

born and raised the other

as a young boy growing up in Lagos while

as a young boy growing up in Lagos while the student at King’s College Lagos I

the student at King’s College Lagos I

the student at King’s College Lagos I had a very strong interest in science

had a very strong interest in science

had a very strong interest in science and medicine in particular I was

and medicine in particular I was

and medicine in particular I was fascinated by how the human body

fascinated by how the human body

fascinated by how the human body developed I came across the biography of

developed I came across the biography of

developed I came across the biography of a surgeon

a surgeon

a surgeon Christian Barnard he’s renowned the

Christian Barnard he’s renowned the

Christian Barnard he’s renowned the known for having performed the first

known for having performed the first

known for having performed the first human to human heart transplant in the

human to human heart transplant in the

human to human heart transplant in the world in 1967 in Cape Town South Africa

world in 1967 in Cape Town South Africa

world in 1967 in Cape Town South Africa interestingly Christiaan Barnard

interestingly Christiaan Barnard

interestingly Christiaan Barnard actually spent some time here in

actually spent some time here in

actually spent some time here in Richmond at the Medical College of

Richmond at the Medical College of

Richmond at the Medical College of Virginia where he learned some of the

Virginia where he learned some of the

Virginia where he learned some of the skills that ended up you know leading to

skills that ended up you know leading to

skills that ended up you know leading to his ability to accomplish this feat but

his ability to accomplish this feat but

his ability to accomplish this feat but while reading his biography what really

while reading his biography what really

while reading his biography what really interested me the most wasn’t just the

interested me the most wasn’t just the

interested me the most wasn’t just the accomplishments that he did in the field

accomplishments that he did in the field

accomplishments that he did in the field of transplantation and heart surgery but

of transplantation and heart surgery but

of transplantation and heart surgery but buried within the text was some work he

buried within the text was some work he

buried within the text was some work he had done as a young surgeon walking on

had done as a young surgeon walking on

had done as a young surgeon walking on fiddle animals to improve our

fiddle animals to improve our

fiddle animals to improve our understanding of how some anomalies

understanding of how some anomalies

understanding of how some anomalies develop in the fetus you see some babies

develop in the fetus you see some babies

develop in the fetus you see some babies are born with blockages to their

are born with blockages to their

are born with blockages to their intestines or we call intestinal atresia

intestines or we call intestinal atresia

intestines or we call intestinal atresia and dr. Bernard and his colleagues at

and dr. Bernard and his colleagues at

and dr. Bernard and his colleagues at that time had been able to perform some

that time had been able to perform some

that time had been able to perform some surgery on fetal animals to reproduce

surgery on fetal animals to reproduce

surgery on fetal animals to reproduce those anomalies improving understanding

those anomalies improving understanding

those anomalies improving understanding of how this occurs and helping us

of how this occurs and helping us

of how this occurs and helping us therefore better understand how to treat

therefore better understand how to treat

therefore better understand how to treat them but what I need what I really took

them but what I need what I really took

them but what I need what I really took out of that whole biography was the

out of that whole biography was the

out of that whole biography was the realization back then in 1980 that wow

realization back then in 1980 that wow

realization back then in 1980 that wow it’s actually possible to go into the

it’s actually possible to go into the

it’s actually possible to go into the uterus perform surgery and have the

uterus perform surgery and have the

uterus perform surgery and have the pregnancy continued who knew I had no

pregnancy continued who knew I had no

pregnancy continued who knew I had no idea that was possible I was intrigued I

idea that was possible I was intrigued I

idea that was possible I was intrigued I was fascinated as I proceeded to medical

was fascinated as I proceeded to medical

was fascinated as I proceeded to medical school still in I drew out above a mural

school still in I drew out above a mural

school still in I drew out above a mural or university alayan idea I developed a

or university alayan idea I developed a

or university alayan idea I developed a strong interest in in embryology that is

strong interest in in embryology that is

strong interest in in embryology that is the study of how the fetus goes from

the study of how the fetus goes from

the study of how the fetus goes from sperm and an egg all the way to a field

sperm and an egg all the way to a field

sperm and an egg all the way to a field learn human but the intrigued from the

learn human but the intrigued from the

learn human but the intrigued from the work of dr. Barnard and his colleagues

work of dr. Barnard and his colleagues

work of dr. Barnard and his colleagues really pushed into me this sense of

really pushed into me this sense of

really pushed into me this sense of wanting to engage in the research and

wanting to engage in the research and

wanting to engage in the research and the discovery that could actually help

the discovery that could actually help

the discovery that could actually help shape the outcomes now I knew how the

shape the outcomes now I knew how the

shape the outcomes now I knew how the fetus was formed what about when things

fetus was formed what about when things

fetus was formed what about when things don’t go right how can we correct those

don’t go right how can we correct those

don’t go right how can we correct those anomalies so really had a very strong

anomalies so really had a very strong

anomalies so really had a very strong interest in research and I knew I wanted

interest in research and I knew I wanted

interest in research and I knew I wanted to be a surgeon

to be a surgeon

to be a surgeon well I found my way here to Richmond

well I found my way here to Richmond

well I found my way here to Richmond Virginia I was privileged to be in the

Virginia I was privileged to be in the

Virginia I was privileged to be in the surgical residency program at the

surgical residency program at the

surgical residency program at the Medical College of Virginia this was one

Medical College of Virginia this was one

Medical College of Virginia this was one of the top surgical programs in the

of the top surgical programs in the

of the top surgical programs in the country and I was honored to be mentored

country and I was honored to be mentored

country and I was honored to be mentored by pediatric surgeons like uh Knoll

by pediatric surgeons like uh Knoll

by pediatric surgeons like uh Knoll Salzburg who prepared me for a career

Salzburg who prepared me for a career

Salzburg who prepared me for a career for the future in pediatric surgery but

for the future in pediatric surgery but

for the future in pediatric surgery but in addition part of the fascination for

in addition part of the fascination for

in addition part of the fascination for MCD then was the fact that I had the

MCD then was the fact that I had the

MCD then was the fact that I had the opportunity to engage in research

opportunity to engage in research

opportunity to engage in research research that led to a PhD at Virginia

research that led to a PhD at Virginia

research that led to a PhD at Virginia Commonwealth University research in

Commonwealth University research in

Commonwealth University research in fatal wound healing you see many of us

fatal wound healing you see many of us

fatal wound healing you see many of us here probably have bruises and cuts that

here probably have bruises and cuts that

here probably have bruises and cuts that were sustained along the way I just

were sustained along the way I just

were sustained along the way I just sustained one this morning while shaving

sustained one this morning while shaving

sustained one this morning while shaving but those cuts and bruises heal with a

but those cuts and bruises heal with a

but those cuts and bruises heal with a scar a telltale sign of the encounter

scar a telltale sign of the encounter

scar a telltale sign of the encounter that we’ve had are the from disease or

that we’ve had are the from disease or

that we’ve had are the from disease or injuries or accidents many of the scars

injuries or accidents many of the scars

injuries or accidents many of the scars would consider really inconsequential

would consider really inconsequential

would consider really inconsequential but severe scars can form especially

but severe scars can form especially

but severe scars can form especially from those who had burns with quite

from those who had burns with quite

from those who had burns with quite deforming and disfiguring scars that

deforming and disfiguring scars that

deforming and disfiguring scars that could be life-changing and also when

could be life-changing and also when

could be life-changing and also when scars forming are internal organs from

scars forming are internal organs from

scars forming are internal organs from disease and infection it can reduce

disease and infection it can reduce

disease and infection it can reduce their function and reduce our life

their function and reduce our life

their function and reduce our life expectancy is that what’s really unique

expectancy is that what’s really unique

expectancy is that what’s really unique is that the fetus has an ability to heal

is that the fetus has an ability to heal

is that the fetus has an ability to heal without score and turn the laboratory

without score and turn the laboratory

without score and turn the laboratory then at MCV with my mentors Robert

then at MCV with my mentors Robert

then at MCV with my mentors Robert Digman and Calvin Cohen who are actually

Digman and Calvin Cohen who are actually

Digman and Calvin Cohen who are actually able to look into ways to help unravel

able to look into ways to help unravel

able to look into ways to help unravel the mysteries of how the fetus is able

the mysteries of how the fetus is able

the mysteries of how the fetus is able to heal for the outscore you see each

to heal for the outscore you see each

to heal for the outscore you see each and every one of us at one point in our

and every one of us at one point in our

and every one of us at one point in our development had the ability to heal

development had the ability to heal

development had the ability to heal without scarring how nice would it be if

without scarring how nice would it be if

without scarring how nice would it be if you could bring that back and apply and

you could bring that back and apply and

you could bring that back and apply and help prevent the scars that we all

help prevent the scars that we all

help prevent the scars that we all develop

develop

develop so here I was in Richmond Virginia now

so here I was in Richmond Virginia now

so here I was in Richmond Virginia now having the opportunity to study wound

having the opportunity to study wound

having the opportunity to study wound healing in the fetus here was doing

healing in the fetus here was doing

healing in the fetus here was doing fetal surgery in animal models the

fetal surgery in animal models the

fetal surgery in animal models the science advanced and things improved

science advanced and things improved

science advanced and things improved realized that not only now we’ll be able

realized that not only now we’ll be able

realized that not only now we’ll be able to do surgery in in animal models but

to do surgery in in animal models but

to do surgery in in animal models but fetal surgery could now actually be

fetal surgery could now actually be

fetal surgery could now actually be performed in humans for life-threatening

performed in humans for life-threatening

performed in humans for life-threatening conditions the time I spent here led now

conditions the time I spent here led now

conditions the time I spent here led now to some work that I was able to do

to some work that I was able to do

to some work that I was able to do additional training in Philadelphia

additional training in Philadelphia

additional training in Philadelphia before finding myself in Houston in

before finding myself in Houston in

before finding myself in Houston in Houston Texas at Texas Children’s

Houston Texas at Texas Children’s

Houston Texas at Texas Children’s Hospital they are was fortunate to be

Hospital they are was fortunate to be

Hospital they are was fortunate to be surrounded by a team of talented

surrounded by a team of talented

surrounded by a team of talented surgeons obstetricians anesthesiologists

surgeons obstetricians anesthesiologists

surgeons obstetricians anesthesiologists neonatologists cardiologists nurses and

neonatologists cardiologists nurses and

neonatologists cardiologists nurses and many more as we set up a federal team

many more as we set up a federal team

many more as we set up a federal team that could care for patients with some

that could care for patients with some

that could care for patients with some of those complex conditions patients

of those complex conditions patients

of those complex conditions patients like Lindley beamer he say I first met

like Lindley beamer he say I first met

like Lindley beamer he say I first met Lindley when she well I first met

Lindley when she well I first met

Lindley when she well I first met Lindley where she was just five months

Lindley where she was just five months

Lindley where she was just five months pregnant within her mother weren’t well

pregnant within her mother weren’t well

pregnant within her mother weren’t well her mother was not Mantegna within

so nearly was just 35 months into her

so nearly was just 35 months into her gestation when her mother presented to

gestation when her mother presented to

gestation when her mother presented to Texas Children’s Hospital if they Lindy

Texas Children’s Hospital if they Lindy

Texas Children’s Hospital if they Lindy had a tumor growing off her tailbone

had a tumor growing off her tailbone

had a tumor growing off her tailbone this was a sacral coccygeal teratoma his

this was a sacral coccygeal teratoma his

this was a sacral coccygeal teratoma his tumors can be quite huge they can grow

tumors can be quite huge they can grow

tumors can be quite huge they can grow to huge sizes off the tailbone at times

to huge sizes off the tailbone at times

to huge sizes off the tailbone at times even as big as the fetus itself you can

even as big as the fetus itself you can

even as big as the fetus itself you can imagine the fetal heart now has to pump

imagine the fetal heart now has to pump

imagine the fetal heart now has to pump blood not just to the tumor but also to

blood not just to the tumor but also to

blood not just to the tumor but also to the rest of the body this could provide

the rest of the body this could provide

the rest of the body this could provide this could really put a tremendous

this could really put a tremendous

this could really put a tremendous strain on the heart and at times the

strain on the heart and at times the

strain on the heart and at times the heart fails just overwhelmed by the

heart fails just overwhelmed by the

heart fails just overwhelmed by the amount of work he has to do you see over

amount of work he has to do you see over

amount of work he has to do you see over the years we’ve been able to figure out

the years we’ve been able to figure out

the years we’ve been able to figure out which fetuses are likely to get in

which fetuses are likely to get in

which fetuses are likely to get in trouble as the tumor gets bigger Lindy

trouble as the tumor gets bigger Lindy

trouble as the tumor gets bigger Lindy was one of those fetuses we had to do

was one of those fetuses we had to do

was one of those fetuses we had to do something if we didn’t intervene we knew

something if we didn’t intervene we knew

something if we didn’t intervene we knew surely she was gonna die in her mother’s

surely she was gonna die in her mother’s

surely she was gonna die in her mother’s womb bravely her mother Margaret agreed

womb bravely her mother Margaret agreed

womb bravely her mother Margaret agreed to undergo fetal surgery

so Margaret one underwent fetal surgery

so Margaret one underwent fetal surgery procedure actually that required us to

procedure actually that required us to

procedure actually that required us to open her abdomen open her uterus gain

open her abdomen open her uterus gain

open her abdomen open her uterus gain access to the fetus bring out Linley’s

access to the fetus bring out Linley’s

access to the fetus bring out Linley’s hind side and look at the tumor my hands

hind side and look at the tumor my hands

hind side and look at the tumor my hands are not small and it gives you a scale

are not small and it gives you a scale

are not small and it gives you a scale just in the picture behind me how big

just in the picture behind me how big

just in the picture behind me how big that mass was and again looking at the

that mass was and again looking at the

that mass was and again looking at the little foot right next to it you can

little foot right next to it you can

little foot right next to it you can imagine how big this tumor was

imagine how big this tumor was

imagine how big this tumor was essentially sucking the life out of this

essentially sucking the life out of this

essentially sucking the life out of this Navy were able to partially resect that

Navy were able to partially resect that

Navy were able to partially resect that tumor

tumor

tumor close back the uterus clothes back

close back the uterus clothes back

close back the uterus clothes back Margaret’s abdomen and allow the

Margaret’s abdomen and allow the

Margaret’s abdomen and allow the pregnancy to continue briefly Margaret

pregnancy to continue briefly Margaret

pregnancy to continue briefly Margaret continued the pregnancy or another 13

continued the pregnancy or another 13

continued the pregnancy or another 13 weeks on tissues deliver by cesarean

weeks on tissues deliver by cesarean

weeks on tissues deliver by cesarean section up close to 37 weeks gestation

section up close to 37 weeks gestation

section up close to 37 weeks gestation Laney had been rescued from this huge

Laney had been rescued from this huge

Laney had been rescued from this huge tumor that was taking her life she was

tumor that was taking her life she was

tumor that was taking her life she was not able to live a normal vibrant life

not able to live a normal vibrant life

not able to live a normal vibrant life as we see her here when she was a year

as we see her here when she was a year

as we see her here when she was a year older

older

older [Applause]

but fellow soldiers will not without

but fellow soldiers will not without risks this is one of the few situations

risks this is one of the few situations

risks this is one of the few situations where you can perform one procedure and

where you can perform one procedure and

where you can perform one procedure and lose two patients

lose two patients

lose two patients you see brave patients like Margaret

you see brave patients like Margaret

you see brave patients like Margaret Lane Lee’s mother are the ones that make

Lane Lee’s mother are the ones that make

Lane Lee’s mother are the ones that make this possible you can imagine we operate

this possible you can imagine we operate

this possible you can imagine we operate on these fetuses at about the fifth

on these fetuses at about the fifth

on these fetuses at about the fifth month of gestation from tumors like

month of gestation from tumors like

month of gestation from tumors like lamely we have to make a huge incision

lamely we have to make a huge incision

lamely we have to make a huge incision on the uterus just to get that mass out

on the uterus just to get that mass out

on the uterus just to get that mass out we then have to close this in a very

we then have to close this in a very

we then have to close this in a very meticulous manner and have the uterus

meticulous manner and have the uterus

meticulous manner and have the uterus continue to stay closed as the pregnancy

continue to stay closed as the pregnancy

continue to stay closed as the pregnancy continues now think about it for those

continues now think about it for those

continues now think about it for those of you who have been pregnant at five

of you who have been pregnant at five

of you who have been pregnant at five months the uterus is only so big it

months the uterus is only so big it

months the uterus is only so big it continues to grow all the way to nine

continues to grow all the way to nine

continues to grow all the way to nine months put in tremendous tension and

months put in tremendous tension and

months put in tremendous tension and strain on the killing wound again if

strain on the killing wound again if

strain on the killing wound again if we’re dealing here with a wound that’s

we’re dealing here with a wound that’s

we’re dealing here with a wound that’s struggling to contain the stresses and

struggling to contain the stresses and

struggling to contain the stresses and tension around it we’d never have to

tension around it we’d never have to

tension around it we’d never have to balance the risk to the mother with a

balance the risk to the mother with a

balance the risk to the mother with a potential benefit to the fetus because

potential benefit to the fetus because

potential benefit to the fetus because these mothers have that risk not only

these mothers have that risk not only

these mothers have that risk not only for that pregnancy but for all

for that pregnancy but for all

for that pregnancy but for all subsequent pregnancies the risk is easy

subsequent pregnancies the risk is easy

subsequent pregnancies the risk is easy to understand for life-threatening

to understand for life-threatening

to understand for life-threatening conditions like Linley’s but now we’re

conditions like Linley’s but now we’re

conditions like Linley’s but now we’re doing fado sorry for all the non

doing fado sorry for all the non

doing fado sorry for all the non life-threatening conditions like spina

life-threatening conditions like spina

life-threatening conditions like spina bifida these are conditions in which the

bifida these are conditions in which the

bifida these are conditions in which the fetus has the spine exposed the spinal

fetus has the spine exposed the spinal

fetus has the spine exposed the spinal cord exposed and over time there is

cord exposed and over time there is

cord exposed and over time there is progressive injury to the nerves that

progressive injury to the nerves that

progressive injury to the nerves that will result in loss of function loss of

will result in loss of function loss of

will result in loss of function loss of ability to walk poor control of the

ability to walk poor control of the

ability to walk poor control of the earring poor control also of stool an

earring poor control also of stool an

earring poor control also of stool an accumulation of fluid within the brain

accumulation of fluid within the brain

accumulation of fluid within the brain we know that if we can do the surgery

we know that if we can do the surgery

we know that if we can do the surgery before birth and preserve the ongoing

before birth and preserve the ongoing

before birth and preserve the ongoing injury we can restore function but now

injury we can restore function but now

injury we can restore function but now performing more of this service for non

performing more of this service for non

performing more of this service for non life-threatening conditions means we

life-threatening conditions means we

life-threatening conditions means we need to weigh the risks and benefit to

need to weigh the risks and benefit to

need to weigh the risks and benefit to the fetus and the mother we need to see

the fetus and the mother we need to see

the fetus and the mother we need to see how we can improve the outcome for the

how we can improve the outcome for the

how we can improve the outcome for the fetus while still limiting the risk to

fetus while still limiting the risk to

fetus while still limiting the risk to the mother

the mother

the mother we knew we have to do better so one of

we knew we have to do better so one of

we knew we have to do better so one of the ways to find out from our knowledge

the ways to find out from our knowledge

the ways to find out from our knowledge of wound healing

of wound healing

of wound healing we know that the fetus not even in the

we know that the fetus not even in the

we know that the fetus not even in the fetus

fetus

fetus smaller wounds heal better than larger

smaller wounds heal better than larger

smaller wounds heal better than larger ones so we had to find ways to avoid the

ones so we had to find ways to avoid the

ones so we had to find ways to avoid the big incisions that we’re making on the

big incisions that we’re making on the

big incisions that we’re making on the uterus of this women one thought was

uterus of this women one thought was

uterus of this women one thought was actually to find a way that we could go

actually to find a way that we could go

actually to find a way that we could go in again what we generally do in the

in again what we generally do in the

in again what we generally do in the abdomen for those of had surgery or you

abdomen for those of had surgery or you

abdomen for those of had surgery or you know of their gallbladder or different

know of their gallbladder or different

know of their gallbladder or different things but to put little cameras but

things but to put little cameras but

things but to put little cameras but this time into the uterus so this had to

this time into the uterus so this had to

this time into the uterus so this had to be really small tiny cameras to

be really small tiny cameras to

be really small tiny cameras to straw-like instruments into the uterus

straw-like instruments into the uterus

straw-like instruments into the uterus that we can visualize the fetus but then

that we can visualize the fetus but then

that we can visualize the fetus but then also perform this delicate surgeries

also perform this delicate surgeries

also perform this delicate surgeries with time finding tiny firing

with time finding tiny firing

with time finding tiny firing instruments to be able to perform the

instruments to be able to perform the

instruments to be able to perform the surgery in the mothers to provide the

surgery in the mothers to provide the

surgery in the mothers to provide the optimum result and benefit for the fetus

optimum result and benefit for the fetus

optimum result and benefit for the fetus while still reducing the risk to the

while still reducing the risk to the

while still reducing the risk to the mother you see my journey in the world

mother you see my journey in the world

mother you see my journey in the world of fetal surgery has been a journey of

of fetal surgery has been a journey of

of fetal surgery has been a journey of faith he started with a hidden

faith he started with a hidden

faith he started with a hidden information buried in the text of the

information buried in the text of the

information buried in the text of the biography of Christian Barnard about his

biography of Christian Barnard about his

biography of Christian Barnard about his work on the fetus he started with the

work on the fetus he started with the

work on the fetus he started with the hidden mysteries of fiddle wound healing

hidden mysteries of fiddle wound healing

hidden mysteries of fiddle wound healing of unraveling the issues related to

of unraveling the issues related to

of unraveling the issues related to wound healing and applying those to

wound healing and applying those to

wound healing and applying those to other aspects of life of the work that

other aspects of life of the work that

other aspects of life of the work that we do in him we know that the future of

we do in him we know that the future of

we do in him we know that the future of fetal surgery is gonna be based on

fetal surgery is gonna be based on

fetal surgery is gonna be based on research discovery and innovation as

research discovery and innovation as

research discovery and innovation as that field continues to move forward

that field continues to move forward

that field continues to move forward well for every one of you if you just

well for every one of you if you just

well for every one of you if you just take a step back in your daily lives and

take a step back in your daily lives and

take a step back in your daily lives and look at your career encounters your

look at your career encounters your

look at your career encounters your interactions the things that you do on

interactions the things that you do on

interactions the things that you do on everyday on on a daily basis things that

everyday on on a daily basis things that

everyday on on a daily basis things that you interact with people you interact

you interact with people you interact

you interact with people you interact with things you get to do that if you

with things you get to do that if you

with things you get to do that if you just take a step back you can find some

just take a step back you can find some

just take a step back you can find some hidden information in there that will

hidden information in there that will

hidden information in there that will serve as the nidus to give solution to

serve as the nidus to give solution to

serve as the nidus to give solution to the problems of tomorrow again I thank

the problems of tomorrow again I thank

the problems of tomorrow again I thank you for your time

you for your time

you for your time [Applause]