Interview with Dr Alan Farnsworth

By Oscar Zou & Bridget Hwang

Alan Farnsworth, fondly known as the godfather of cardiothoracic surgery, is a highly revered cardiothoracic surgeon from St Vincent’s Hospital. We had the chance to sit down with Dr Farnsworth to discover more about his humbling career and learn from his pearls of wisdom.

How did you become interested in cardiac surgery?

I always wanted to be a surgeon, wasn’t interested in anything else. I trained as a general surgeon initially and applied for a few jobs in Australia, but was unsuccessful so went to America instead. Then an opportunity arose at the university hospital I was working at in Cleveland -  an opening for the chief resident of cardiothoracic surgery - which I did for a couple of years. It was an extremely exciting time, given that cardiothoracic surgery was in its infancy.  For example, coronary artery bypass surgery had only just started in the 1960s, the first of which in Australia was done at Prince Alfred Hospital when I was a registrar. Cardiac surgery was and still is very technically demanding, with a great deal of emphasis on precision and efficiency. Since I was looking for an area that was expanding and different, unlike general surgery which was quite defined and relatively unchanging, cardiac surgery was the one.

“To be a good surgeon, it’s about doing the right thing at the right time, knowing how much or how little to do and knowing when to operate and when not to.”

Did you have a mentor in your early years?

Not really, not in Australia at least. I went around the world looking for jobs – from Australia to America and then to England, where I worked for 3 years at St Thomas’ Hospital. I was, however, influenced by a fellow that I worked with in America. He was the president of the Society of Thoracic Surgeons in America and was an extraordinarily efficient and very adept surgeon.  

Many people describe you as being one of Australia’s most skilled cardiac surgeons, can you tell us about how you learnt your skills?

The fine motor manipulation and cognitive aspect of surgery is equally important. To be a skilful surgeon, learn your techniques, have respect for the tissue, know the general principles. But to be a good surgeon, it’s about doing the right thing at the right time, knowing how much or how little to do and knowing when to operate and when not to.

We understand that you worked at St Vincent’s for 30 years and started the heart valve bank there. Can you tell us about your work at St Vincent’s hospital?

Before me at St Vincent’s was well known cardiac surgeon, Dr Harry Windsor, back when cardiothoracic surgery got its own separate wing, separate operating theatre and ICU. He worked with two remarkable people, Mark Shanahan and Victor Chang. Both excellent surgeons with complementary personalities; Chang had charisma and entrepreneurship whilst Shanahan was extraordinarily talented and took care of basic running of the unit. By the time I arrived, it was a well-established functioning unit doing all sorts of adult cardiac surgeries. However, I didn’t do things quite the same way they did, it was an amalgamation of sorts. I worked at St Vincent’s doing adult cardiac surgery and some transplant activities, but wasn’t a main player in that. I also did 10 years of paediatric cardiothoracic surgery at Prince of Wales as it was something I was comfortable with doing, having done it in America. I also worked 6 years as a consultant cardiac surgeon in Perth following my training.

“Most importantly you need passion and interest; make up your mind early and go for it. . . be focused, assist and get involved.”

We’ve also read about your volunteer work with the Adventist Hospital in Fiji, Nepal and Tonga. Can you talk about those volunteering experiences and the importance of that work?

It was an initiative run by the Adventist Hospital through their interest in developing an outreach program to deliver cardiac surgery to Pacific Islanders. Once every 1-2 years, we would take the whole team of people to perform cardiac surgery in their own hospitals, to be cared for in their own community. We would also disperse knowledge and expertise locally so their doctors and nurses would be more comfortable in dealing with cardiac problems. We started off only doing closed surgeries, but moved to open surgery involving heart-lung machines as well. It’s an interesting program that I was involved with early and has since been carried on by others and now has some affiliations with the colleges. Other than that, I also volunteered in China about 20 times over 20-30 years. They’d come here and I’d go there, and we kept that up for over 20 years, despite the program only having funding for the first 18 months.

Cardiac surgery can be a challenging career, especially in terms of work-life balance. What comments or personal experiences can you give to people aspiring to do surgery?

Surgery can be demanding with very long hours, and in cases of emergencies, will require your immediate attention. It’s important to have a supportive family otherwise it can be quite difficult. I wouldn’t have been able to do it without the complete support of my wife.

What advice would you give to students who are interested in pursuing a career in cardiac surgery?

You’ve got to want to do it. And to know that, you’ve got to get some exposure first. You need to have some dexterity, be realistic about it with yourself, because even if you don’t, you can learn it with practice. You also require stamina to do cardiac operations as they can last for hours on end. But most importantly you need passion and interest; make up your mind early and go for it – sometimes you’ve got to be a bit single-minded about it. Be focussed, assist and get involved.

How can students gain exposure?

Attach yourself to a team or someone within a unit who is prepared to have you tag along. Most people respond to requests for access or involvement, it’s just a matter of showing interest.

What are you doing now that you have retired?

I play a bit of sport, and have occasional contact with young people – it’s very stimulating!

We’d like to thank Dr Farnsworth immensely for his time and generosity in answering our questions!