Farewell, Gentle Giant: Francis Robicsek (4.7.1925–3.4.2020)

Francis (Ferenc) Robicsek died peacefully at home in Charlotte, North Carolina, USA, on April 3rd, 2020. His name will forever be associated with various aspects of thoracic and cardiac surgery. Many obituaries have already been published, listing his countless contributions, one of them on the website of the German Society for Thoracic and Cardiovascular Surgery and reprinted in the Blue Pages of this issue.[1] This Editorial will be another, yet very personal one, because I am happy and proud to have had Francis as a fatherly friend for a very long time.

Francis Robicsek (born July 4^th 1925 in Miskolc, Hungary; died April 3^rd 2020 in Charlotte, NC, USA) with permission of the Robicsek family.

We first met at Hannover Medical School in the 1980s. In our department the lore about the famous Dr Robicsek and his rafting trip with Hans Borst down the Usumacinta River between Guatemala and Mexico to visit the hidden Maya ruins of Bonampak and Yaxchilán, ending in an interrogation by the police, had become legendary. Francis was intrigued by my last name and decided we should talk. At first I felt somewhat frightened that a living myth should take an interest in me, a resident at that time, but that was dispersed during the first minutes when we had several laughs sharing a particular sense of humor. A mutual friend later called him “strangely accessible for a giant” - well phrased indeed. Francis was a bit disappointed that we did not live in the Heinemanhof in Hannover Kirchrode, the impressive brick building designed by Henry van-de-Velde for the Minnie-James-Heineman Foundation. This retirement home (!) was originally financed by the same benefactor Dannie N Heineman, with a single “n,” who had also founded the Heineman Medical Research Center in his town of birth: Charlotte, North Carolina. As the Hannover group published a lot on aortic dissection and as this was part of my own scientific work at that time, I ended up with an invitation to give a presentation in Charlotte and to visit the almost-namesake institution.

Throughout the years we had many encounters and I got to know Francis quite well, both personally and professionally. When he realized that I was drifting into surgery for congenital heart disease he eagerly told me that the first cavo-pulmonary anastomosis had, of course, actually been done by him when still in Hungary and two years before William Glenn's first clinical effort in 1958.[2] [3] He proceeded to give me detailed tips how to do it best without extracorporeal circulation.

Two of his most constant surgical interests remained the correction of pectus excavatum and the reconstruction of the aortic root and ascending aorta. For manuscripts on these topics an editor could not find a more diligent and knowledgeable reviewer, and “The Thoracic and Cardiovascular Surgeon” and its authors profited immensely for decades right until 2020. It is therefore a great honor for this journal to have published two of the last original manuscripts by Francis Robicsek electronically in 2019 (!) and in print in this very issue, which is thus sort of dedicated to him.[4] [5] Overall, ThCVS alone lists 34 publications bearing his name. The real Robicsek operation, however, will always be the rewiring technique for postoperative sternal instability.[6] “I'll be remembered for complications,” he used to mumble in his distinctive gravelly voice and Hungarian accent.

But normally, modesty was certainly not one of his strengths. Francis sent out signed copies of Walter Isaacson's biography “Leonardo da Vinci” to his friends, proudly hinting at page 419. There a certain “Francis Robicsek of the Carolina Heart Institute” was mentioned in connection with Leonardo's experiments regarding the flow dynamics within the aortic root.[7] Mind you: the books were signed by Francis, not by the author. I call this a very pronounced self-confidence.

On a personal level there are two characteristic events which should be shared. First: he became allegedly the only man who ever gave my mother a “baisemain,” addressing her as “Gnädige Frau” with true Hungarian grandeur. Second: Francis was very fond of my dear wife Eveline. During one of his visits to Mainz she had to take him to Eberbach Abbey because he wanted to see where Umberto Eco's “The Name of the Rose” had been turned into a movie. From there he made her drive on into the woods to the village of Katzenelnbogen. He adored that name (“cat's elbow”) in connection with his collection of cat figurines. When he left us, he dug deep into his famous battered, voluminous briefcase and handed Eveline a beautiful amber rose, fitted in a silver stem and leaves which is with us every day in our living room. He presumably had found it when plundering a flea market, an additional favorite pastime.

When not corresponding on difficult manuscripts concerning chest wall anomalies and the like, we exchanged ideas for Yucatan travels or on airsickness bags (yet another idiosyncratic collection), debated about the New Orleans music scene or European history. He also shared the humorous videos which he seemed to have become so fond of lately. Like his permanent jokes not all of them were funny, but he still always made you laugh. Independent of him, although he adamantly refused to believe it, my eldest grandchild was named Charlotte. One day I shall take her there and we shall visit his grave. For the time being let me close this memory like Francis Robicsek did always finish his reviews:

“Yours very respectfully,”

Markus

• References

• 1 In memoriam. Available at: https://www.dgthg.de/de/nachruf_robicsek . Accessed April 28, 2020.
• 2 Robicsek F, Temesvari A, Kadar RL. A new method for the treatment of congenital heart disease associated with impaired pulmonary circulation; an experimental study. Acta Med Scand 1956; 154 (02) 151-161
• 3 Glenn WWL. Circulatory bypass of the right side of the heart. IV. Shunt between superior vena cava and distal right pulmonary artery; report of clinical application. N Engl J Med 1958; 259 (03) 117-120
• 4 Robicsek F, Madjarov JM, Padera Jr RF. Cause of ascending aortic dilatation in patients with bicuspid aortic valves: the final link. Thorac Cardiovasc Surg 2020; 68 (04) 277-280
• 5 Robicsek F. Should we move up the clock on preventive intervention in Marfan's disease?. Thorac Cardiovasc Surg 2020; 68 (04) 328-329
• 6 Robicsek F, Daugherty HK, Cook JW. The prevention and treatment of sternum separation following open-heart surgery. J Thorac Cardiovasc Surg 1977; 73 (02) 267-268
• 7 Isaacson W. Leonardo da Vinci. Simon and Schuster; New York: 2017: 419