Abstract
I first met John Bergan in 1978 when he came to the Cleveland Vascular Society to speak, calling the entity of popliteal cystic disease to the attention of the membership. This was typical of John: a focus on evolving information and the many unique discoveries relative to the rapidly evolving field of vascular surgery. The information became handy for not soon after, a case presented at Grand Rounds which proved to be the rare entity that John had described in exquisite detail. Afterward, I took him to see the Tartan 44 Racing Sloop, made in Cleveland, which had won the Southern Ocean Racing Circuit and was being fitted out for the Bermuda Race. I was to learn that he was an avid, skilled yachtsman and highly respected at the Chicago Yacht Club. In fact, the only time I disagreed with him was during a sailing race on Lake Michigan to Mackinac Island, when, on a dark and stormy night, we took a westerly, badly headed starboard tack instead of close tacking along the shore line. At the time we were wearing Gortex foul weather gear which John had agreed to try out. These required glue at the seams but, in spite of this measure, the suits inexorably leaked during the severe weather encountered that night. Within a few years Gortex foul weather gear became the best that could be obtained … John foresaw their comfort and utility over classic sweaty rubber foul weather gear. He was always willing to try something new.
He and his partner James ST Yao had initiated a series of postgraduate vascular conferences at North Western beginning in the early 1970s, starting with a book on Venous Disorders. This series continues to the present. Each conference produced a book, not meant to be a fixed text, but rather a living record of the evolution and development of the discipline of vascular surgery. John, with earlier experience as transplant surgeon, firmly believed that vascular surgery needed focused definition as a distinct specialty. He worked tirelessly to achieve this end. These volumes are a living record of the steps that made the discipline of Vascular Surgery the success that it has become.
He invited me to contribute our work on vasculogenic impotence, describing surgical methods to prevent erectile failure and to restore normal sexual function. 1 He made suggestions, prodding us to develop new approaches for diagnosis and treatment of this problem. He foresaw the usefulness of endovascular approaches for erectile dysfunction; we used these with success for occlusive lesions of the aorta, common and external iliac arteries. John, always gentile, initially referred to the impotence problem as ‘a pelvic circulatory disorder.’ When I first attended the elegant Chicago conferences at the Drake Hotel, I appreciated immediately the value of this series of updated texts on the rapid expansion of the specialty of vascular surgery. I gave him a small mounted prism inscribed with a notation: ‘John Bergan, who sheds light on things.’
And that is the theme of his life. He early recognized and foresaw the critical importance of endovascular repair of aortic aneurysms, seeing to it that Juan Parodi's seminal work was published in the Annals of Vascular Surgery, inasmuch as this ‘crazy’ idea had been rejected by a leading American vascular journal. 2 As early as 1992, Bergan, Wilson, Wolf and Dupree recognized the unexpected late survival benefits of endovascular procedures as opposed to open vascular surgery. 3 Their contribution in the Archives of Surgery was greeted with little enthusiasm and even disapproval which the authors typically handled with grace in the ensuing discussion. 4
I was with John in London in 1986 when he confided to me that venous disease needed further differentiation and specialization. This insight was soon followed by a meeting of a small group of vascular surgeons in St Thomas VI and the founding of the American Venous Forum in 1988. He was the first president of the foundling organization. John believed and continued to believe, as some did not, that the Venous Forum should consist of a broad base including some non-surgeons as well as international members. The Forum struggled initially, eventually flourishing thanks to its later leadership dedicated to a broad-based society. Recognizing that surgeons, speaking only to themselves, would not advance the discipline, Bergan and coauthors, including basic scientist Schmid-Schonbein, published a seminal review of venous disease in the New England Journal of Medicine in 2006. 5 Up to that time and following into 2011, he and his associates offered innumerable clinical and basic scientific contributions mainly to venous disease. John's curriculum vitae contains over 700 peer reviewed publications and 29 books in print; 18 with his colleague JST Yao, multiple invited commentaries and an amazing array of national and international lectureships requiring extensive travels.
I was privileged to accompany him on some of his international journeys. His energy was endless, his contributions clear and concise, and his manners exquisite. Always, he focused on the novel; what was to come. And most of his predictions were correct. His taste, in other ways, was impeccable. During a visit to London he once took me to purchase a proper blue blazer and then on to another establishment, the first to sell folding 35 mm slide holders. And though long supplanted by electronic power point presentations, I still keep mine. On another occasion, we shopped for a mirror for his classic Morgan and then took a car, courtesy of one of my Middle Eastern patients, to Chartwell, Churchill's Home, and then on to the famous Sissinghurst gardens. He continually sought to educate – those journeys with John, in addition to his contributions to the international vascular community, became part of a personal education. There exists a time to start and a time to finish. John, acutely aware of this, accomplished as much as any human being could during the time allotted to him. He succeeded in shedding light on many things for all of us, particularly in an overarching view of venous disease, The Vein Book. 6 This work now updating progress in a second edition will remain an invaluable resource for clinicians faced with treating venous disorders.