Diary of Trip to Belgium November 26-December 3, 1960
Michael E. DeBakey, M.D.
This trip was made through the kind invitation of H. R. H. Princess Liliane of Belgium, who is President of the "Cardiological
Foundation Princess Liliane." The purpose of my visit was to hold a "Colloquium" at the Royal Palace on Cardiovascular
Surgery and to present a series of conferences and lectures on various aspects of this field of surgery at several of the
Belgian University Medical Schools and Hospitals. I was deeply honored to be asked to participate in this way and to have
an opportunity to help Princess Liliane, the Belgium Royal Family, and the medical community of that nation, for all of whom
I have lasting esteem, admiration and affection.
Saturday, November 26, 1960: I left Houston on schedule at 9 a.m. on EAL Flight #508 (DC-8B Jet) and after a smooth flight
arrived at Idlewild, New York, at 1:04 p.m. Dr. Sigmund Wesolowski was on the plane and we had a nice visit. He had been working
in our Department during the previous week completing the final phases of a manuscript on his extensive experiments on vascular
grafts in the pig. To supplement this excellent experimental study we had provided him with some of our clinical material
on the long term fate of various types of vascular grafts in the human. It was reassuring to find that his studies in the
pig supported our own observations in man, adding further evidence to the long held belief that in certain respects man is
not far removed from the pig. On the previous day I had mailed the completed manuscript to Charles C. Thomas for publication
as a monograph and the completion of this gratifying task allowed us to enjoy a relaxing visit and discuss further research
approaches to this problem. I spent a few hours shopping in the city and then returned to Idlewild to check in at Sabena
Left Idlewild on schedule at 8:30 p.m. on Flight #548 (Boeing Jet 707). Shortly after take-off they began serving dinner,
full course with aperitif, pate de foie gras, delicious tender steaks, dessert, cheese, fruit, coffee, liqueur, with champagne
and several wines. This required about three hours.
The flight was very smooth. There was little sensation of speed, yet we were traveling at an altitude of 38,000 feet and at
a speed of 560 miles per hour. The outside temperature at this height was -68 degrees Fahrenheit.
About three hours after take-off from New York, we were able to lean back in our seats and get some sleep. Two hours later
we were awakened for breakfast. It was dawn and one could see the sun rising ahead.
With the entire flight from New York to Brussels now requiring only six hours and twenty minutes, it should be obvious that
one can get little rest if the old custom of taking such a long time to serve a full course dinner is maintained. In this
modern jet age, there is need to modify accordingly our eating habits.
Sunday, November 27, 1960: Arrived in Brussels on schedule at 9:30 a.m. and was met at the airport by Professor Lequime who
took me directly to the Chateau de Laeken, which is the Royal Palace. My apartment is at the end of the hallway on the left
side and consists of a bedroom, sitting room, dressing room, and bathroom. It is, of course, beautifully appointed, simple
but tasteful and very comfortable.
After a refreshing bath and a change of clothes, I went with Prof. Lequime to pick up his wife, a beautiful and charming lady,
and then we drove out into the country about twenty minutes from the city to the beautiful and historic Chateau de Bois St.
Jean, Boisy-Thy., where we had lunch as the guests of the gracious Countess de Vaux. She is also a physician, an otolaryngologist.
In addition, the other guests included Professor von den Branden, who is the Professor of Otorhinolaryngology at the University
of Brussels, and His Highness, the Prince of Croy. It was a most enjoyable lunch.
At 8 o'clock in the evening, we had dinner at the Royal Palace with King Baudouin, his father, ex-King Leopold, and his
wife, Princess Liliane. In addition to myself, Professor Lequime and his wife were there.
King Baudouin was somewhat ill disposed from an ear infection and excused himself immediately after dinner. He is quite attractive,
rather slight in build, shy and quiet, participating very little in the conversation. King Leopold is also attractive, rather
slim, taller than his son, and somewhat more engaging. His wife, Princess Liliane, is one of the most charming and attractive
ladies I have ever met. She actually sparkles with a highly engaging personality. She is obviously well read with a keen intelligence
and is both widely and deeply knowledgeable. Socially conscious and highly motivated, she spoke of the various needs of her
country, particularly in matters of health. She referred to these needs both broadly and specifically and particularly in
relation to cardiovascular surgery. Appreciating, for example, the necessity to combine a good research program with clinical
activities, she also recognized the need for better organization as well as properly trained personnel and adequate facilities
in order to attain a high quality of work. She emphasized the pitifully small amount of money, less than $250,000, which the
appropriates annually for all medical research in the country. She particularly deplored the fact that many able young physicians
are sent to the United States
for training in experimental as well as clinical investigation only to return home
to find that they are unable to utilize their training and talents because of lack
of proper support and facilities. Her understanding of these problems and her sincerity of purpose in trying to find their
solution was most impressive.
I came away from this dinner with the feeling that this was one of the most pleasant experiences I have had, owing primarily
to the engaging personality and sincerity of purpose of Princess Liliane, who is truly a wonderfully charming and gracious
lady. I find myself wishing so much that I could offer some real help to this lady who has given so much toward helping her
people. Such projects as this one of Princess Liliane's is meaningful to us not only from the human standpoint but also
because it provides a means for bettering our relationships on a very basic level of human understanding. When a hopelessly
sick child is operated on and given a new life, everyone understands. Communication of this kind with other countries is respected
and creates a responsiveness that no amount of money can create. It is one of the most effective ways we can possibly develop
to improve our relationships with our neighbors. This is one thing we have to offer because our developments in surgery are
so far in advance of those in other countries. These reflections have consumed my thoughts this evening after dinner, and
I intend to do whatever I can upon my return home to help these people who are so assiduously helping themselves.
Monday, November 28, 1960: I awoke early after a good night's sleep and had an opportunity to collect my thoughts and
organize my schedule. At 8 o'clock I rang for breakfast, which was brought to my room and consisted of fresh fruit, toast
and jams, bacon and eggs, and cafe au lait.
At 9:45 I was taken to Hospital Brugmann where I held a dry clinic and discussed patients with aortic insufficiency (one of
the patients was Mr. De Vos who only recently returned from Houston), ventricular aneurysm, and aneurysm of the aorta. One
of the latter is a white woman, 67 years of age, with a syphilitic aneurysm of the upper part of the descending thoracic aorta.
Arrangements were made for me to operate on this patient on Wednesday morning.
After the conference we had lunch with Professor Govaerts, who is chief of the surgical service. Dr. Van Wien and his wife
(the anesthetist) were also there.
In the afternoon I went to Hospital St. Pierre for a conference on vascular grafts. This was a question and answer period
regarding indications, technic, and complications. The audience was so enthusiastically and intensively interested that the
Chairman finally had to call time.
Then to dinner as guest of the Van der Strichts at a very nice restaurant in the city. The party included Professor and Mme.
Lequime, Professor Morelle, and Dr. and Mme. Guissart.
Tuesday, November 29, 1960: This morning to Ghent to the University Hospital and met Professor Delorme, Chief of the Surgical
Service, and saw his son perform closure of an atrial septal defect (septum secundum) under hypothermia - nicely done. Then
made rounds with Princess Liliane and saw a number of patients, including ones with mitral stenosis, patent ductus, and tetrology
of Fallot. Two of the latter were recovering well from complete correction under cardiopulmonary bypass, the first done in
This is a relatively new hospital, well-constructed and well organized. It is said to be the most modern hospital in Belgium
and when completed will have about 900 beds. The pediatric service had 150 beds and is excellent with individual small rooms,
airy and nicely appointed.
I delivered my lecture on Renovascular Hypertension and then showed the film. Although it was narrated in French, the sound
on the projector did not work and I was forced to narrate the film. Actually this may have been better. They seemed to understand
English well and were most gracious in their response.
We then had a most delightful lunch with Princess Liliane. After lunch I was taken by Professor Pannier to Bruges where we
visited some antiquities, including the cathedral and the museum of Byloke, saw one of Van Eyck's famous paintings, and
saw St. John's Hospital which is still being used after almost 900 years. In this connection it was interesting to hear
them say that they believed the pharmacy in this hospital to be the oldest in continuous operation despite the claims of Yugoslavia.
When I was in Yugoslavia they told me the same thing about their pharmacy, claiming it to be the oldest despite the belief
of the Belgians. The realization that in both instances these institutions had been in operation even for centuries before
our own country was discovered gave me a deep sense of humility.
Then to dinner with the Panniers at their home. They are a wonderful family with five girls, one boy, and another child on
the way. Dr. Pannier's brother, who is a lung specialist, and his wife were also there.
After a delicious dinner, I was driven back to the Palace in a Mercedes-Benz, a car from the Palace.
Wednesday, November 30, 1960: Up very early with breakfast in my room and left for the Hospital Brugmann at 7:45 a.m. to operate
on the patient with syphilitic aneurysm of the descending thoracic aorta (WF, 67 yrs., BP 180/90, previous myocardial infarct).
[Diagram = Diagrammatic Drawing of Findings and Operative Procedure]
The operation went well. I used atrio-femoral bypass. The patient responded well immediately after operation and by 12:30
p. m. was propped up in bed and able to smile and say "Merci beaucoup." The patient continued to progress satisfactorily
and in a follow-up note after I returned home I was informed that she was discharged fully recovered.
Lunch at the hospital with Professor Govaerts and his staff, including Dr. Van Wien and his wide.
In the afternoon, I gave a lecture on occlusive disease of the peripheral and visceral arteries and presented a movie on abdominal
angina. The audience included the Gastroenterological Society. My presentation seemed to incite great interest and was well
In the evening to dinner at the home of Professor Paul Govaerts whose wife is the daughter of Professor Bordet who won the
Nobel prize. Their son and daughter-in-law were also present. The son is a physician who spent a year with Francis Moore at
the Brigham. He is not a surgeon, however.
Thursday, December 1, 1960: Spent the morning with Professor Lequime at the University Hospital and discussed with him plans
for the Institute of Cardiology which is being built. It will undoubtedly be an excellent institute for further development
of cardiovascular research in Belgium. It is being built through funds obtained from private and-governmental sources, primarily
through the efforts of Princess Liliane. After reviewing the blueprints with Professor Lequime, I was shown the actual layout
of the Institute in its present stage of construction. The doors, walls, and ceiling have been completed and it is planned
to be available for occupancy within the next few months. Both clinical and research laboratory facilities are being provided
to permit expansion of their current program. I was much impressed with their concept of the objectives of this Institute
and the manner in which they plan to implement the program. Emphasis is being placed upon a clinical research program of a
multidisciplinary type utilizing physiologists and
biochemists somewhat similar to our concept of a clinical cardiovascular research center. With the great tradition of Belgian
physiology one can have high hopes for this Institute. In this connection Professor Riolan, whose laboratory I visited and
who has done such fine fundamental work in the field of electrocardiology, will have close association with the Institute.
I came away from this visit much impressed with the dedication and sincerity of purpose of Professor Lequime and his associates,
as well as with the soundness of their concept and approach to this development. There can be no doubt of the fact that they
have the potential scientific talent, and now with the impetus given by Princess Liliane's efforts and drive, they will
have the proper facilities and organization to undertake a program of cardiovascular research of high quality. To achieve
this objective, however, they will need some financial help, particularly in support of some full-time personnel in the form
of research assistants and technicians and some special equipment. In this connection I was amazed to find how much they
can do with relatively small amounts of money, I am convinced that there are few places where our international research
funds could do more good and be used more effectively and economically than in this Institute. Their strong efforts to help
themselves deserve our support.
Returned to the Palace to lunch with Princess Liliane. We were alone for lunch and this was a most enjoyable and pleasant
visit. She told me of her trials and tribulations in getting her Foundation underway and of the many difficulties and disappointments
she had had, especially with some of the Americans who agreed to help her but who never gave any material help. She recalled
the efforts made by President Hoover who asked some of his friends to join a board of trustees in order to make it an America-Belgium
joint effort, but little or nothing has come of this. She has also had difficulty in getting the Belgians together. There
are so many factions - religious, political, and, of course, always the Flemish and French groups. Despite all of the difficulties,
she has preserved and has maintained the purpose of the Foundation which is to provide the means to send patients requiring
heart surgery to the United States and to improve the facilities for this work in Belgium. She is a truly remarkable person
who deserves an honored place among her people.
In the late afternoon, I went to the Faculty of Medicine to give my lecture on Cerebrovascular Insufficiency. It was a crowded
auditorium and apparently the lecture was well received. The Dean kindly expressed their gratitude and extended to me an honorary
In the evening to a delightful dinner at the charming home of Professor Lequime.
Professor Le Negre arrived from Paris and was present.
Friday, December 2, 1960: This morning I gave my lecture in the auditorium of the Palace, which is very similar to the Little
Theater at Versailles, to a very select audience, representing the deans and faculties of the four universities. Professor
Le Negre preceded me with a short historical account of cardiovascular surgery and paid me a very nice tribute.
King Leopold and Princess Liliane then invited us all to a delicious lunch in the Palace after which the Colloquium was held,
also in the Palace. This consisted of a round-table conference conducted in French and directed by Professor Lequime, who
raised certain questions about a number of different aspects of cardiovascular surgery including particularly congenital and
acquired valvular disease as well as various aspects of diseases of the aorta and its major branches, and the indications
and limitations of surgical treatment. These were discussed by Professor Lequime, Professor Le Negre, and myself as well as
some of the others present. It was an interesting and stimulating session.
Mr. de Sellier's father-in-law came to the Palace to see me just before dinner to talk about his son-in-law, upon whom
I had operated several months previously. He seemed pleased with his progress.
Dinner at 8 p.m. with King Baudouin, Princess Liliane and ex-King Leopold. A most enjoyable evening. They are certainly a
charming family - so simple yet so dignified, so human and deeply interested in the welfare of their people. How fortunate
the Belgians are to have this Royal Family,
Princess Liliane and King Leopold gave me an autographed photograph and Princess Liliane said she would see me off in the
Saturday, December 3, 1960: Up early, finished packing, and then had breakfast in my room. Princess Liliane met me at 8:45
a.m. with her youngest daughter, who is 4 years old. In a most gracious manner she expressed her grateful appreciation for
my visit, stating that she was highly pleased with the enthusiastic response to the "Colloquium" and the stimulus
it had provided. It was difficult to find words to express adequately my deep sense of humility and gratefulness for these
generous sentiments by this truly wonderful lady. They saw me off and wished me "bon voyage." What a kind and gentle
To the airport in the Palace car and checked in at Pan American. We took off on Flight #101 (707 Jet) on schedule at 10 a.m.
and arrived in London 45 minutes later. There we changed to another plane (same flight number and a 707 Jet) and took off
at 11:30 a.m. In accordance with the Captain's announcement that our flight to New York would take seven hours and 45
minutes, we arrived at Idlewild on schedule. After going through customs I went to Eastern Airlines where I found that Jet
Flight #597 would be delayed for an hour. We arrived in Houston at 9:10 p.m. While we gained seven hours by traveling westward,
the fact remains that I left Brussels at 10 o'clock in the morning and arrived in Houston about 9 o'clock the same
evening. One can only wish that we could have made as much progress in our human relationships as has been made in transportation