Q&A: Ellsworth Wareham

A: I assist the surgeon. When you do a heart operation, you have to have somebody of equal competence with you working at the table. And usually there are two. There's a first and second assistant, and I'm either the first or second assistant. And one does minor parts of the operation, like bypass grafts on a heart.

Q: I'm sure, with your experience, that your advice during operations is useful.

A: There isn't much of that. I'll tell you, these modern surgeons, you know that's like saying a fella who was a pilot in World War II is going to give some advice to a fella these days, you know what I mean? These fellas that are doing cardiac surgery these days have come out of a program and they're just as sharp as they can be. People often tell me, like you suggested, do you give them some counsel? Well, very rarely. That's a rare occasion. They're just so sharp.

Q: How has health-care practice and training changed over the time you've been operating?

A: These days, if a fella says he wants to be a cardiac surgeon, he'll have to take medical school and his internship, and he'll have to take about seven years beyond that in training. Now during this training period, he has to be exposed to various operations and has to have done a certain number himself. This is controlled by qualifying bodies. In my day, we took residency training and so forth, but it wasn't so carefully monitored. A fella could get through his training and only do maybe two or three operations in any certain time, but that no longer holds true. As an example, at Loma Linda University Medical Center, where I was chief of cardiac surgery for 22 years, a fella going out into practice will have done 500 heart operations himself, as the surgeon. So you see it's closely monitored, and that's why these fellas are so good.

Q: What have you noticed about our approach to treating medical problems that you think should be changed?