Lawrence Cohn

Abstract

Leading cardiac surgeon renowned for expertise in valve repair and replacement surgery, and for minimally invasive technology

Lawrence H Cohn (b 1937; q Stanford University 1962), died from a stroke on 9 January 2016.

Taufiek Konrad Rajab

Lawrence Cohn had already decided he wanted to be a surgeon when he started his last year of medical studies in the autumn of 1961 at Stanford University in Palo Alto, California. He felt that as a surgeon he could really “do something” to help people.¹ But he was not yet sure which form of surgery to pursue. So he spent time talking with various Stanford surgeons to learn about their work. And then one day he met Norman Shumway.

Shumway and his young colleague, Richard Lower, at the time were conducting heart transplants on dogs, laying a foundation that they hoped would lead to human heart transplants. “He was hot stuff,” Cohn said years later of Shumway. “I sought him out and asked him if I could work on his service.”² Shumway listened to the young aspiring surgeon and invited him to spend time in his laboratory.

“I helped in their lab a couple of times,” Cohn recalled. “And then one spring day in 1962 they said I could be a subintern on their service. I started on a Monday and didn’t leave the hospital for eight straight days. I was mesmerised.” When Cohn finally left the hospital he knew that he would devote the rest of his life to cardiac surgery. At home, he told his young wife: “I’m hooked. I’m hooked. I gotta do this. It’s great.”

Shumway would in January 1968 would perform the first adult heart transplantation in the USA and is now widely regarded as the father of the procedure.³

Cohn in 1971 would leave Stanford for Harvard University, joining the staff of what is now Brigham and Women's Hospital. He transformed cardiac surgery at the hospital, “implementing many of the techniques he had learned at Stanford to dramatically improve the surgical results.”⁴

In subsequent decades Cohn developed his own new surgical techniques, including simplified techniques for mitral valve repair. He was recognized globally for his extraordinary skills in valve repair and replacement surgery and in minimally invasive heart valve surgery.

“He was brilliant, one of the world’s top cardiac surgeons,” says Eugene Braunwald, a pioneer cardiologist who mentored Cohn in the 1960s. Braunwald, a former physician in chief at Brigham and Women's Hospital and founding chairman of the Thrombolysis in Myocardial Infarction (TIMI) study group, adds: “He was devoted to his patients and interacted closely with their families. He trained many of the most outstanding cardiac surgeons around the world. They came to the Brigham to train with him.”

Lawrence Harvey Cohn was born on 11 March 1937 in San Francisco. His father owned a building materials business, and as a teenager Cohn helped in his father’s shop and also made deliveries to customers. His parents wanted him to eventually take over the family business. But he liked the biological sciences and “the idea of being a doctor.” Not sure what to do, he spoke with a family relative who encouraged the teenage boy to follow his heart.

Cohn enrolled at the University of Calfornia, Berkeley, receiving a bachelors degree in American history in 1958. He applied to study medicine at several leading universities and was invited to travel to Boston for an interview at Harvard. The interviewer was a Harvard psychiatrist.

“He was brutal,” Cohn later recalled. “He psychoanalysed me and looked at me with all the psycho tricks. I said to myself, ‘I’m not going here.’”²

Instead Cohn enrolled at Stanford and qualified in medicine in 1962. Shumway urged Cohn to take a non-conformist step by skipping general surgery training and instead immediately beginning cardiac surgery training. Cohn felt it best to follow the traditional route and completed two years of general surgery training at Boston City Hospital at Harvard, which he felt had a better general training program than Stanford. In 1964 Cohn moved to the National Institutes of Health in Bethesda, Maryland, where he was mentored by Andrew Glenn Morrow, chief of cardiac surgery, and by Braunwald, who later would become his colleague at Harvard.

Cohn in 1966 moved to the University of California, San Francisco, to complete general surgery training. In 1969 he returned to Stanford to complete his training in cardiothoracic surgery under Shumway and was named chief resident the next year. In 1971, Harvard made him—as he later said—a job offer he couldn’t refuse, and he left his hometown in sunny California for the frigid and snowy winters of Boston, where he remained for the rest of his life.

Cohn in 1980 was promoted to professor of cardiac surgery at Harvard and in 1987 was named chief of cardiac surgery at Brigham and Women's Hospital. His clinical and research interests included reconstructive valve surgery, minimally invasive technology, adult congenital heart surgery, and thoracic aortic pathology. He was author of more than 500 research papers, 105 book chapters, and 12 books, including the second, third and fourth editions of Cardiac Surgery in the Adult, the most referenced textbook in the discipline.

In 2005 he stepped down as chief of cardiac surgery at Brigham and Women's Hospital, but remained active professionally until shortly before his death. He performed more than 11 000 cardiac surgical operations and trained more than 150 residents and fellows, including nearly 30 who would eventually serve as division chiefs or department heads.

Cohn, who served on the editorial boards of two dozen journals, was founding editor of the Journal of Cardiac Surgery and served as editor for the Journal of Thoracic and Cardiovascular Surgery, Operative Techniques in Cardiac and Thoracic Surgery, and Modern Techniques in Surgery. His honors include an honorary doctorate from the University of Paris and the American Heart Association’s highest award, the Paul Dudley White Award.

In 2008 Cohn and his wife, Roberta, established the Cohn Library, with his wife, Roberta, a collection of some of the earliest editions of books and papers about cardiac surgery and cardiology.⁵

Cohn leaves his wife, Roberta, whom he first met when he was 12 years old; two daughters; and three grandchildren.