Joan Coggin: Dialogue with an international health-care ambassador

by Richard Weismeyer

Joan Coggin is a cardiologist, medical educator, and health-care ambassador. For nearly fifty years, Dr. Coggin has served patients, families, and nations around the world. Currently, she is also the vice-president for global outreach at Loma Linda University Adventist Health Sciences Center and professor of medicine at Loma Linda University. Born in Washington, D.C., Coggin graduated from Columbia Union College and joined Loma Linda University School of Medicine in 1948. Armed with a medical degree in 1952, she continued with her postgraduate training in Los Angeles, London, and Toronto, and later launched a career that has earned her a place of distinction in American medical history. At a time when women comprised barely five percent of medical school graduates nationwide, Dr. Coggin built a successful cardiology practice, and made a record for herself as a physician with a keen sensitivity to the personal needs and lives of patients. In the early 1960s, Dr. Coggin extended the boundaries of her service across international borders in co-founding the world-famed Loma Linda University Overseas Heart Surgery Team. In its nearly 40 years, the heart team under her direction has either initiated or upgraded open-heart surgery programs in many countries including Pakistan, India, Thailand, Taiwan, Greece, Vietnam, Saudi Arabia, Hong Kong, Kenya, Zimbabwe, the People’s Republic of China, Chile, Nepal, Malaysia, and North Korea. Dr. Coggin has also been a consultant to the television and motion pictures industries for medically oriented programs. In the course of her international endeavors, Dr. Coggin has personally met with heads of state of Pakistan, Greece, Saudi Arabia, Zimbabwe, Kenya, Vietnam, and Nepal. At home, she has also met Presidents Lyndon Johnson and Richard Nixon. She also has been awarded numerous distinctions for her outstanding service in the health sciences.

Dr. Coggin, you are perhaps best known for co-founding the Loma Linda University Overseas Heart Surgery Team. How was this idea conceived and implemented?

The heart team was conceived in the pioneering days of open-heart surgery. Dr. Ellsworth E. Wareham and I were working at the White Memorial Medical Center in Los Angeles. Since many hospitals were not doing heart surgery at that time, we operated one day a week at Los Angeles County General Hospital. Each week we would pack the heart-lung machine and all the ancillary equipment we would need for a surgery in the trunk of Dr. Wareham’s large car. It is then the idea occurred: “If we can pack all of this in a vehicle and transport it to another hospital, why couldn’t we take a team overseas?”

At about the same time, U.S. Vice President Lyndon Johnson, while on a tour in Pakistan, met a camel driver and invited him to his Texas ranch. At about the same time, a Pakistani factory foreman’s daughter needed heart surgery, which was unavailable in Pakistan. After reading an article about heart surgery at Loma Linda University, the Pakistani foreman reasoned that if a camel driver could be flown to the United States courtesy of the United States Government, then surely his daughter, who was much more needy, could be afforded the same courtesy.

Four-year-old Afshan Zafar was successfully operated on at White Memorial. Almost immediately after Afshan’s return home, the U.S. embassy in Pakistan was flooded with similar requests. It was then that Vice President Johnson called us and asked if we could export heart surgery overseas.

Then what happened?

Johnson’s call seemed almost providential. We had talked about such an opportunity for many months. Within a couple of months we were on our way to Pakistan [in 1963], and the heart team was born. I believe in dreaming dreams and not being afraid of failure.

What has been the impact of the heart team?

One of the most important impacts is on the individual lives of patients. Another impact is on international medicine. When this idea was first conceived, no international medical team existed. Everyone that we talked to said that it was impossible for a surgical team to travel overseas to perform open-heart procedures. They gave us a variety of reasons. We examined each reason and found that we could work around the difficulty. When we travel overseas, one of our goals—in addition to helping as many people as we can—is to teach the team concept. In many countries, the team concept, as it is practiced in the United States, does not exist.

What are some of your most memorable experiences?

I am awed by the hundreds of “extra” patients that our team has helped. If we had stayed home, they would not be alive today. After visiting Greece in 1967 and 1969, I paid a return visit to that country. Somehow, word of my visit reached one of our former patients. She came to the hospital with her beautiful three-year-old daughter and expressed her gratitude to the team for saving her life.

Over the years you have received many awards. Which one do you treasure the most?

The award I treasure the most is a red woolen blanket given to me by the father of a young girl whom we operated on in Greece. She was brought by her employer to Athens from Crete to be operated on. The surgery went well, but complications arose during recovery. After her parents received word, her father traveled to Athens. Through an interpreter, I explained the gravity of his daughter’s situation. He finally understood, and the tears came streaming down his cheeks. We were certain that his daughter was not going to make it. But he was sure that she was going to live. He said, “You pray for your patients.” Miraculously, she survived. Four years later, we traveled to the island of Crete and visited her parents in their small village. That common bond that we established four year earlier, despite the language barrier, still existed. Tears were running down both our cheeks as we hugged each other. As we were leaving, the father brought me a red woolen blanket that his wife had made on their family loom. That is my greatest award.

As director of the heart team, you had the opportunity to meet many heads of state. Who impressed you the most?

Two of them. One was Lyndon Johnson. He had great personal warmth. When you met him, you felt that you were his friend. He had a very cordial, down-to-earth attitude that to me was amazing. The other head of state that stands out in my memory is King Constantine of Greece. I first met him in 1967 through his mother, Queen Fredrika. He was very pleasant, with a keen sense of humor. His government was overthrown in late 1967 and he and his wife, Queen Ann-Marie, moved to England in exile. Over the years, I sent his mother some vegetarian foods and he was very impressed with that. His wife, Queen Ann-Marie, enjoyed the vegetarian recipe books that we sent along.

How did you become interested in medicine?

I really didn’t know any other life than that of a physician. I had my second birthday in Loma Linda when my father entered the School of Medicine. I grew up always wanting to become a physician.

Did you always want to be a cardiologist?

No. I started out wanting to become a pediatrician. One of the reasons I changed my mind was that often times a child could be so sick one day, and the next day the child would be perfectly all right. What I like about cardiology is that you can figure out what the problem is. You have clues. You have the patient’s history. If the heart makes a certain type of sound, you know immediately what the problem is.

How did you become interested in pediatric cardiology?

When I first started practicing medicine, most pediatric cardiology was done by adult cardiologists. I found that I enjoyed the challenges associated with congenital heart disease—the types of heart diseases that you see mostly in pediatric patients. I then took an advanced fellowship at the Hospital for Sick Children in Toronto, and additional study at Hammersmith Hospital in London.

Looking back at your career in medicine, what are your most gratifying moments?

To see people who were incapacitated—whether young or old—and then seeing them well again. This is what makes medicine very rewarding.

What is disappointing about medicine?

Being unable to help your patients. You feel so totally helpless and your patient dies. But this is far less today than when I started medicine. Recently I discarded a teaching slide titled “Cardiac Conditions for Which There Is No Treatment.” Listed on the slide were 12 conditions. Today all 12 of these conditions can be successfully treated. It just boggles the mind to think of the advances that medicine will make in the next 50 years, if time should last!

What influence has your Christian faith had on your professional career?

It has had a very direct and meaningful influence. Being a Christian should make one relate to people with compasion and understanding. This is a positive in any profession, but in the health sciences it has great significance. At times of illness and emergency, people are most vulnerable. Being able to dispense caring compassion and hope for the future are daily goals which I and all other Christian physicians strive to reach.

Interview by Richard Weismeyer. Richard Weismeyer is director of the Office of University Relations for Loma Linda University. Dr. Coggin may be contacted at the Office of International Affairs; Loma Linda University; Loma Linda, California 92350; U.S.A. Fax: 909-558-4116. E-mail: jcoggin@univ.llu.edu