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INTRODUCTION
Prof. Dr. Isidor Papo was one of the most respected doctors in
the former Yugoslavia. He was born on December 13th 1913 in a small
town in Herzegovina, Ljubiško. He was the third child of municipal
clerk Jozef Papo, a Sephardic Jew, and his wife Klara, born Levy.
[1,2,3] When he was fit for school, his family moved to Mostar,
where young Isidor finished high school. According to the testimony
of prof. Papo, his childhood in Mostar will remain in his fondest
memory, and he will cherish the friendships he made in that city for
the rest of his life [5]. In December 1932, he went to study at the
University of Zagreb. He passed all his exams in record time and
with the best grades- all tens. During his studies, the young Papo
was most influenced by prof. Dr. Drago Perović (one of the most
famous anatomists of that time) and prof. of surgery, Dr. Julije
Budisavljević, who fueld in him the desire to practice surgery. Papo
was "obsessed" with the perfect surgical technique, which in periods
of imperfect anesthesia was the decisive factor in the patient's
survival. After college, he completed his mandatory internship and
military service in Sarajevo. In 1939, a strong fascist influence
was already felt in the Kingdom of Yugoslavia and it was difficult
to get a job. For Jews, "numerus clausus" was implemented when
vacant positions were available in public institutions. When a
vacant position for a doctor in the Sarajevo hospital was announced,
the Minister of Health from that period, Budisavljević, chose young
Papo over the candidate that Prince Pavle himself had exhorted.
[1,2] Thus begins Papo's career as a surgeon, which lasted 42 years.
He was granted a specialization for gynecology, but soon the war
started, which interrupted all of that. Papo is mobilized into the
surgical team of the Zeta Division. After the signing of the
capitulation, there was a general disunity among the soldiers and he
was captured by the Italians in Nikšić. He manages to persuade them
to let him go and flees to Sarajevo. Thanks to Home-guard colonel
Dr. Dinko Cvitanović, he got a temporary job at the Sarajevo
Hospital, where he also lived in the attic. At that time, Sarajevo
was under the administration of the NDH and the Ustaše demanded that
all Jews be identified with a yellow ribbon, which Papo refused.
Raids begin in Sarajevo and the Gestapo sends an invitation to the
Papo to come forward. It is then when he decides to flee to Mostar,
where Dr. Koporoc employs him in the hospital there. Mostar was then
under the occupation of the Italians, who did not persecute the
Jews. Jews could move freely in Mostar and its surroundings. Dr.
Dinko Cvitanović does not forget him and invites him to flee with
him via Split to Abyssinia, but Papo still decides to stay in the
captured country. Through his friend Salko Fejić, he came into
contact with the communists on September 26th 1941 and becomes a
doctor-surgeon of the Mostar battalion. Dr. Gojko Nikoliš, who at
that time was the head of the medical department of the Supreme
Headquarters of the Partisan Army, transferred him to his surgical
team. [1,2] Together with Dr. Mešterović, they form a team that will
take care of tens of thousands of wounded over the next three years.
There were a lot of improvisations at that time: sewing was done
with parachute thread, there was a lack of medical equipment,
instruments, anesthetics, medical personnel... When they took over a
settlement, the most important thing for Papo would be to collect
food and medical equipment so that they could help wounded soldiers
and civilians. He operated tirelessly, sometimes continuously for 72
hours. That war surgery regime left its mark on young Papo. Namely,
he begins suffering from insomnia, which will follow him throughout
his life. In Jajce, where the Supreme Headquarters was, he carried
out operations even during the bombing. Papo did not leave the
patients on the table even during the fiercest forays of "Stukas" in
order to hide. He participated in both the battle on the Neretva and
the battle on the Sutjeska, during which he treated wounded and sick
civilians from typhus, and carried some to the nearby hospital on
his back. Papo was in the column of wounded that was protected by
the 3rd proletarian division under the command of Sava Kovačević.
Durring the battle on the Sutjeska, he escaped death and wandered
for two weeks, surviving, as he used to say, by "emasculating young
boars in villages". During the war, he also experienced a personal
tragedy when the Ustaše killed over 50 members of his family,
including his brother and sister. [1,2,3,4,5]
In 1944, he was sent to Bari as a member of a delegation with Dr.
Nikoliš in charge with intent of cooperation and training with
allied English and American doctors. There, he will meet his
lifelong companion, a surgical nurse, Anastasija, Asja Salakin. He
also gained a lifelong friend, Lord Rodney Smith, who in 1969
proposed him for a member of the Royal College of Surgeons. After
returning from Italy, he went to Novi Sad, and then to the Srem
Front, where he treated the wounded. After the end of the war, from
1945 to 1948, he stayed at the University Clinics in Moscow and
Leningrad, where he acquired knowledge from prominent surgeons A. N.
Bakunyev, A. A. Visnyevski, B. V. Petrovski and S. S. Judyn. [1,2]
He passed the specialist exam for surgery in 1947. Prof. Dr. Papo
gained significant experience in esophagus reconstruction, he later
modified his professor's method, which is still called Judyn- Papo's
method in the literature. Back then, caustic injuries to the
esophagus caused by household cleaners such as baking soda and
hydrochloric acid were common. According to Medical Military
Accadamy (VMA) data, until 1967, Professor Papo performed 425
reconstructive procedures with a mortality rate below 4%. He
received numerous international awards for this technique. [2,5] He
returned to Yugoslavia in 1948, where he became the head of the
Second Surgical Department of the Main Military Hospital in
Belgrade, which later grew into the Surgical Clinic of the VMA. He
will spend the next 30 years in that position. In 1950 he was
elected assistant professor, in 1953 he became an associate
professor, and in 1956 he became a full professor of surgery, head
of the department and chief surgeon in the Yugoslav National Army (JNA).
In 1950, he spent his training in the USA, at clinics in New
Orleans, Baltimore and Houston, where he collaborated with Dr.
Cooley, gaining knowledge in heart, lung and blood vessel surgery.
In 1951, he became the first surgeon in Yugoslavia to perform heart
surgery.
Picture 1. Prof. Dr Isidor Papo
In the 1950s, "closed heart" operations were performed. In most
cases, these were procedures on patients with congenital heart
defects, such as closure of the residual aortopulmonary canal in
children, bridging of congenital narrowing of the aorta,
arteriopulmonary bypasses, as well as closed commissurotomies of the
pulmonary artery valve in children with congenital cyanotic defects.
In addition, closed mitral valve commissurotomies and
pericardiectomies are regularly performed in adults with acquired
heart diseases. Prof. Papo and his team at VMA from 1960-1961 begin
to perform new, exciting operations on the "stopped and open heart"
in extracorporeal blood flow and hypothermia, using extracorporeal
circulation.
From 1962, catheterization and angiography become a regular part of
diagnostics. [2,4]
He manages to surgically treat more and more complex congenital
heart defects. Thus, in 1965, he performed the first operation to
replace a heart valve with an artificial prosthesis. The professor
was proud of that, because those operations were performed a few
years after they were performed in the USA, successfully, with few
complications and with better equipment than in some European
countries. Patients did not have to go abroad for expensive
operations. The period from 1960-1981 was the most dynamic for prof.
Papo. He did 5 surgeries a day. By his own admission, he had
performed 20.000 operations, of which about 10.000 were heart
operations, 3.500 congenital heart defects and 3.500 contracted
ones. 1.850 people received two or three artificial valves each.
[2,4,5]
During the earthquake in Skopje, he organized an "air corridor". The
seriously injured were flown to the VMA for surgery. At that time,
the professor, together with his team, worked tirelessly for over 20
hours to take care of all the patients. [4,5]
He was Comrade Tito's personal physician, to whom he was bound by
war camaraderie. During the three-month trip on the "Seagull", they
visited Tunisia, Libya, Morocco and Egypt together. During the trip,
prof. Dr. Papo operated on a sailor in the ship's operating room. He
was invited to many countries to operate and give lectures, to name
just a few: Washington 1973, Barcelona 1973, Los Angeles 1973,
Chicago 1974, Buenos Aires 1974, Lima 1974, La Paz 1979, Gothenburg
1983, Houston 1987, etc., as well as great number of lectures in
SFRY. [4,5]
At the same time, he progressed in military service. He was promoted
to the rank of general-colonel of the medical service in 1975. He
was a member of many medical associations such as: Association of
Surgeons of Yugoslavia, Austrian Society of Traumatologists,
International Society of Hydatologists, American Society of
Cardiologists, American Society of Military Physicians (honorary
member), Los Angeles Surgical Society, International Society of
Surgeons, English Society of Surgeons, British Society of Chest
Physicians, Royal College of Surgeons of England (Honorary Member),
German Society of Surgeons, Thoracic Surgery Society of Bolivia,
Society of Surgeons of Paris (Honorary Member), International
Society of Digestive Surgery, Member of the Academy of Surgery of
Paris, Honorary Member of the Academy of Medical Sciences of Peru,
Honorary Member of the Academy of medical sciences SLD,
corresponding member of ANU in Sarajevo, corresponding member of
JAZU in Zagreb, regular member of SANU in Belgrade, member of the
Federation Council in Belgrade, honorary doctor of the University of
Mostar. In the period from 1963 to 1966, he was president of the
Surgical Section of the SLD. He was the winner of numerous awards
and high recognitions. Some of them are the AVNOJ Award, the
Zavnobiha Award, the "22. December JNA" Award, October Award of the
City of Belgrade, Seventh of July Award of the Republic of Serbia,
Award of the City of Mostar, Vishnevsky Award in Moscow. [2,4,5]
He wrote over 218 professional papers, 13 of which were published in
foreign journals. The papers were cited 285 times. His first paper
was published in 1939 in "Physician's courier" no. 11 under the
title "Haemangioma medullae spinalis", and the last one was
"Experience in heart valvulae replacement" printed in 1995 in the
SANU bulletin No.14; pp1-7. Bibliographically, professional papers
can be divided into: a group of papers related to the issues of war
surgery, a group of papers from the domain of surgical treatment of
the esophagus, a group of papers in which all aspects of
cardiovascular surgery are discussed, as well as the problems that
have arisen and their improvement, and a heterogeneous group of
works with rare clinical cases of various diseases in human
medicine. He became a corresponding member of the Serbian Academy of
Sciences and Arts in 1961, and a regular member in 1968. He was one
of the main editors of the Military textbook "Wartime Surgery" from
1953. [3,4,5]
He was well informed about international matters and even wrote a
book about the knowledges from the Korean War he had gatherd. He
encouraged his students to engage in experimental surgery. It is
known that 4 associates of Dr. Papo wrote dissertations in that
field. Their findings were incorporated into the doctrine of
treatment of war injuries in our army's medical system. Prof. Papo
was diligent in following international medical literature, he
noticed the shortcomings of the methods and would modify them in
order to have a better survival of the patients. He had a special
interest in postoperative complications. Friends and associates
state that he was hardworking, disciplined, honest and
conscientious. If 500 operations were successful and one was not, he
would be deeply sad about that one failed operation. Although he
advised patients to take a break from work and rest more, he himself
never had that balance. He was at the Clinic every day from 5:30 am
to 2 pm, and in the evening he would visit his patients. He also
loved philately, collected rare birds, was engaged in beekeeping,
but he would often be found in the operating room helping his
colleagues in demanding parts of operations even during his breaks.
He had a beautiful marriage with his wife Asja, but unfortunately,
no children. In his free time, he would go to his native Mostar, and
his greatest satisfaction would be when a villager would thank him
with "Thank you General, may God give you health". [4,5] He himself
underwent major heart and aortic surgery, performed by his friend
Dr. Cooley in Houston. Although he wanted to, after the operation he
could no longer work. He retired in 1981. He spent his retirement
days peacefully, engaged in scientific work. He died on October 14,
1996 at the age of 83. He was buried at the Jewish cemetery in
Belgrade.
Picture 2. - Professor Dr. Isidor Papo with his
wife Asija in 1946
LITERATURE:
- Jokanović VT, Novaković M, Đuknić M, i ostali. Isidor Papo:
život i delo: [1913-1996]. Beograd: Akademija medicinskih nauka
- SLD; 2013. COBISS.SR-ID – 276573959.
- Papo I. Slobodan Kostić: (1902-1986). Beograd: [b. i.];
1987. COBISS.SR-ID 60425996.
- Almuli J, Аlmuli Ј. Živi i mrtvi: razgovori sa Jevrejima.
Beograd: S. Mašić; 2002.COBISS.SR-ID 102895628.
- Vučinić M.Životna priča jednog hirurga. Novi Sad: Prometej;
2007. COBISS.SR-ID 223516167.
- Gregorić DP. I lekari su ljudi. Beograd: D.P. Gregorić;
2014.COBISS.SR-ID 207553804.
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