A vocation for being a doctor

It was my destiny, (some would say God's Favour) to live close to Dr. GianCarlo Rastelli in the last two years of his life. These were the years of his greatest scientific successes, but they were also those of his battle against the illness to which he finally had to surrender.

It was my destiny (God's Favour) to share with him the final moments of his life, the early hours of 2 February 1970 in a room in the Methodist Hospital of Rochester, Minnesota, seat of the Mayo Clinic.

To have known this extraordinary person and to have received his teaching in the fields of science and humanity is a moral legacy for me. It is now my duty to make this exemplary figure of the researcher and scientist known to students, young doctors and all other people.

He was my teacher during my years in the Faculty of Medicine. Then, when he had already moved to the United States, he helped me to choose where I should go to specialize, and in the end I too opted for Rochester and the Mayo Clinic.

Like today, in those years it was not so easy to cross the Ocean to study. We met in that very special environment of the Mayo Clinic, which attracted doctors and specialists from all countries and continents, drawn by the fame of this unique Institute. He was some years older than me, working in surgery and experimental heart surgery, I was working in infantile cardiology.

But in addition to our contacts through our scientific activity, there were our common roots. His family was from the Bassa Parmense, from the banks of the river Po, whereas my roots were in the Appennines. We both had attended the "Romagnosi" High School, and the same Faculty of Medicine. And we had many other interests in common.

It was easy to establish a fellowship with common objectives, something which perhaps only happens in particular conditions. Gian was a person blessed with many talents.

He became a world famous scientist. " The name of GianCarlo Rastelli is permanently established in the daily vocabulary of Cardiologists and heart surgeons all over the world", wrote Dr. D. McGoon, his teacher and one of the most authoritative international figures in heart surgery.

This is the particular characteristic of Gian that I wish to remember.

He could have been a great musician.

He had had musical education, (his uncle, Lino Rastelli, was a famous pianist), and had a great sensitivity and knowledge of libretti and musical scores.

I remember the atmosphere of the evenings in his house at Rochester, where there was always background music that he had carefully prepared. Usually we listened to the notes of Verdi which recalled the arias of the Bassa Parmense, but there was also the baroque music of Vivaldi and Palestrina, or Purcell's sonatas with their trumpets which from those days have always fascinated me.

He could have been a writer or a poet.

A writer like his father, who was a freelance journalist and editor of newspapers. And as we know the writing gift was also passed on to his sister Rosangela.

He could have been an actor, because of his presence and the charm with which he communicated.

Kirklin, the head of heart surgery at the Mayo Clinic, and one of the international pioneers in heart surgery, wrote that what most struck him when he first met Gian, were his rare handsomeness, indicator of equilibrium, harmony and interior beauty. Gian also had an extraordinary ability as a raconteur which always created a aura of charm around him. At parties he was always the focal point. I remember a Christening party for my first child, Giorgio John, born at Rochester with Gian as his Godfather, with colleagues from every continent and language and religion, Gian was radiant and often came to tell me that the party was a great success!

He was no lover of presumption or cheap publicity. I believe that it was only ever once that I saw him to be irritated and upset. This was when he learned that an article had been published in our local paper that spoke of him in "journalistic" terms.

As a scientist he did not like to be written about in newspapers. He said that it was the scientific journals that should report the results of his research, not daily and weekly newspapers.

Knowing this aspect of his character, so reserved and private, the fact that he did not like to be spoken about, I ask myself today, as I did at the meeting at Palazzo San Vitale, what Gian would say on seeing so many of us here speaking about him. He had so many talents. He could have followed many paths.

Gian decided to be a doctor when he was very young. It was an intimate vocation, a choice in which there was a perfect fusion between his desire to give to others and his innate love of knowledge. Even during the years at the Faculty of Medicine and then as Assistant at our University he felt the attraction of scientific research, and with a Nato scholarship he realized his dream of becoming a researcher in one of the most important Temples of Research, the Mayo Clinic.

In the world of international medicine Gian Rastelli is mainly linked with 2 conquests that bear his name: the classification of the common Atrio-Ventricular Canal, a congenital malformation which involves the structures of the Crux Cordis, the centre of the heart, the region where the interatrial and interventricular septa mitral and tricuspid A-V valves meet.

This is a spectrum of multiple alterations of various degree, a precise anatomical knowledge of which (in accordance with the Rastelli Classification) has made it possible to set out various corrective operating techniques depending on the type of Canal, with a drastic reduction in mortality.

This new classification brought Dr. Rastelli a special prize (Golden Award) from the American Medical Association.

The second conquest is the operation which bears his name, The Rastelli Procedure, for the correction of a complex cardiopathy, the Transposition of the Great Vessels with IVD and Pulmonary Stenosis.

For this discovery too he received the maximum recognition (Golden Award) of the American Medical Association.

In medicine as in other fields, especially in the rapidly changing modern times, innovations are soon overtaken and replaced by new discoveries. The Rastelli Classification of the A-V Canal, and the Rastelli Operation for TGV, are still in the vocabulary and in the everyday clinical practice of cardiologists and heart surgeons all over the world, today as in the past when, more than 35 years ago, McGoon wrote these words.

What is really extraordinary, singular and stupefying is the fact that these results were obtained in a short period of time and while Gian was fighting a battle for his own health against an illness for which up until then there was no hope.

Gian had great trust in the Mayo Clinic, he knew that it was the best place to receive treatment, he had a great desire and hope for a recovery, together with a great joy of life.

He continued to work until the very end, without revealing the personal drama that he bore. Always showing a great serenity, and an extraordinary amiability with patients and colleagues. I learned of his illness only when he was hospitalized for the last time.

Dr. John Kirklin, Gian's teacher and the surgeon who Gian had wanted to work with at the Mayo Clinic, a few days before 2 February 1970 wrote in the Mayo Clinic journal: " … Dr. Rastelli was too intelligent not to realize that his disease was fatal. Yet he worked happily and vigorously and productively with apparently never a thought to the sure fact that his life would end prematurely. Characteristically 2 weeks before his death he wrote me a letter announcing with pride his receipt of several honours. In this letter there was no hint of what he must have known, the disease had progressed greatly. It contained only enthusiasm for the work that lay ahead and warmth for his friends. The serenity and confidence with which Dr. Rastelli faced life and death, literally, is the greatest of the many things he taught me."

Gian was a person of Faith, it was Faith that gave him the guide lines of his life, and it was Faith that enabled him to find the enormous strength and dignity with which he faced illness and death, continuing to work at his research projects until the very end.

With coherence, with heroism, Gian lived his Faith as a Marian devotee.

In these days I have often pondered on the problem posed by Torelli, in his most recent wonderful book, "The Eternal Father and Montanelli", with regard to the gift of Faith which Montanelli says that he never received.

Gian was a great scientist, he made great discoveries, but even at the peak of scientific success he remained, one might say, simple, susceptible to stupor and wonder at the beauty of nature, and he always felt a joy for life, despite the tribulations of the illness.

He remained small because, as Jesus says in the Gospel of Luke with those words that are so disconcerting and hard for us, "You preferred it this way, Father. You have hidden these things from the learned and the wise and you have revealed them to the small."

"How beautiful is the sun" were the words he uttered with sweetness the day before 2 February, with his gaze turned to the window. The words of a young man who "knowing that everything had been completed" died without a single complaint.

Umberto Squarcia MD

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