October 20, 2016
Barbara Sobko, left, and Karen Buckner October 20, 2016 | by Amy Bickers

“Cats and dogs working together.”

That is how Robert C. Bourge, MD, describes his three-decade professional relationship with James K. Kirklin, MD.

Bourge, former Director of the Division of Cardiovascular Disease and the E.A. and Abbie Drummond Endowed Chair in Cardiovascular Medicine, has a well-earned reputation for cutting up. He has a fake beating heart in a cooler in his office that he’ll be happy to show you while he tells you about the times he used it to freak out colleagues.

Kirklin, former Director of the UAB Division of Cardiothoracic Surgery and the John W. Kirklin Endowed Chair in Cardiovascular Surgery, is more fastidious. Ask him if his surgeries resemble a scene from Grey’s Anatomy, i.e. cool background music and dramatic conversations about personal lives. The answer: Not even a little. He treats that space like a library. He is The Odd Couple’s Felix to Bourge’s Oscar.

“In 1986, Jim talked me into working with him in heart transplantation, and it turned out to be the best thing I ever did in my medical career,” Bourge says. “He’s largely responsible for kickstarting my academic career.”

It turns out that cats (cardiothoracic surgeons) and dogs (cardiovascular physicians) working together can lead to great things.

Milestones include the Bourge-Kirklin partnership with David C. Naftel, PhD, professor in the Division of Cardiothoracic Surgery at UAB and professor of biostatistics in the UAB School of Public Health, to develop the idea of a multi-institutional national database for heart transplantation in adults. In 1990, the Cardiac Transplant Research Database was established, generating the first multi-institutional collaborative research in heart transplantation which encompassed over 40 of the larger institutions in the United States.

Another “major event along the way,” Kirklin says, was when he and Bourge pitched the idea for an intensive care unit dedicated to heart transplant patients. Opened in 1992, the Heart Transplant Intensive Care Unit is a state-of-the-art 23-bed unit – one of only a few of its kind in the nation – staffed with a skilled critical care team dedicated to caring for heart transplant and lung transplant recipients as well as patients requiring mechanical circulatory support devices to survive.

In fall 2013, Bourge and Kirklin collaborated on another medical project, this time through philanthropy. The two established the Bourge-Kirklin Endowed Research Fund in Mechanical Circulatory Support in the Division of Cardiovascular Disease. Mechanical circulatory support is a life-saving treatment option for critically ill patients with advanced heart failure. The fund provides support for a faculty member known as the Bourge-Kirklin Scholar.

Earlier this year, Bourge asked Kirklin if he would join him in giving additional funding to enhance the research fund to the level of a professorship.

“Both of us share a commitment to recruiting the best faculty possible and to promoting scientific endeavors,” Kirklin says. “Philanthropy is an important way to facilitate that.”

Recently, the friends and colleagues sat down to discuss 30 years of professional collaboration and their shared commitment to giving to UAB.

Bourge: Jim, did you ever think when we started working together in 1986 that we’d still be working together today?

Kirklin: Well, you know, it’s incredible. There were many people in those early days who said there’s no way these guys can work together. This is cardiology and cardiac surgery and one of the two of them is going to be too controlling.

Bourge: I think it worked because we’re both too controlling.

Kirklin: We’re both laid back in our own ways. Do you remember in those early days of transplantation, having so much difficulty with some of these complications, we had an agreement that whoever was the most aggressive, we were going to go with that? That ended up with some people getting operations that others were afraid to do, instead of medical therapeutic interventions. We just said “Hey, Bob, you have the more aggressive idea, we’ll go with it.” And vice versa.

Bourge: And it worked.

Kirklin: Absolutely.

Bourge: Remember the first 2½ to three years we worked together, we had 100 percent survival after heart transplantation.

Then we started the mechanical circulatory support program, which was a wonderful thing to me, because we had far fewer patients dying while waiting for heart transplantation. As you remember, we started it as a bridge to transplantation. Now, for patients from around the country and around the world, it has become destination therapy.

Kirklin: In those early days, the devices were very rudimentary. These large pumps were coming out of the chest cavity and sitting on the abdominal wall, and patients were trying to walk around with these big machines acting as consoles.

Bourge: Like a refrigerator.

Kirklin: That gradually evolved into a totally implantable device, but still very large. Currently we have much smaller rotary pumps that are more durable, potentially functioning for years.

Bourge: We’ve saved a lot of lives throughout our careers together. A lot of happy people. We even had patients that got married in the heart transplant ICU. And we were witnesses to those marriages. Very happy times.

Jim, as you remember, when we both started advancing in our careers, we decided that we were going to support research and the growth of UAB through philanthropy. I’m glad to say that we were able to do it both independently in our own way but uniquely – I believe at UAB at least – together. Please describe what we did.

Kirklin: Well, I remember poignantly the day you came over to my office and wanted to discuss a philanthropic project that you were thinking about. And this is after we had both had a long track record of philanthropy. You began this conversation and I thought, as usual, Bob Bourge has done something very few people have done before. Not only did you make a commitment yourself, but you came to another close friend and colleague and said, “Listen, we share in a mission. It’s very important to push forward this ideal of mechanical circulatory support. We have a perfect faculty member who deserves this honor, so will you partner with me in making this happen?”

I must say I was overwhelmed with your vision and the opportunity to partner with you. And then when you came again and said, “Listen, let’s ramp this up to the next level and make it a professorship,” that also was a great opportunity, and I was very excited to partner with you. Bourge: Thank you for working with me on this and for our many years of collaboration.

To support UAB’s cardiovascular programs: Megann Cain, 205.934.7408; mbcain@uab.edu; or Leon H. Ryan III, 205.996.0127; leonryan@uab.edu.