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From the operating room to Parliament

Yale Medicine Magazine, 2010 - Autumn

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After a youth spent dodging the Communist party, an orthopaedic surgeon is now president of Latvia.

As a young man in Latvia, Valdis Zatlers, M.D., FW ’91, had a polite objection to invitations to join the Communist Party. “I always said ‘I’m not smart enough—I have to learn and study,’ ” he said. “It was an excuse they always accepted.”

Today, Latvia is a democracy and Zatlers is its chief of state. An orthopaedic surgeon who was a visiting fellow at Yale in 1990, he became president in 2007 and is only its third leader since the collapse of the Soviet Union.

After a childhood spent reading deeply in history and geography, playing drums in a rock band, and dodging the Communist Party, Zatlers became a physician. He chose orthopaedics for its satisfyingly concrete results. In 1986 he was dispatched to Chernobyl as a medical officer with the Soviet Army two weeks after the nuclear plant catastrophe there. Nobody, he said, had any idea what to do, since planning had been for nuclear bombings rather than power plant accidents. As his medical career progressed, Zatlers became active in the Popular Front of Latvia, a movement dedicated to regaining independence for the country, which was then still part of the Soviet Union.

It was then, in the era of glasnost, that his work came to the attention of Kristaps Keggi, M.D. ’59, HS ’63, a professor of orthopaedics at Yale. A “lifelong anti-Communist,” Keggi emigrated to the United States from Latvia at the age of 15. He was persuaded to return for a visit behind the Iron Curtain when his daughter was invited to row in the first Goodwill Games, which were held in Moscow in 1986. There he began to talk with Soviet orthopaedists, whose resources he recalled as “very, very primitive,” and soon found himself operating on KGB officials who needed joint replacements. In 1988, he started the Keggi Orthopaedic Foundation (KOF) to allow for formal academic exchanges between the United States and the USSR. Since its founding, the foundation has sponsored some 300 surgeons from the former Soviet Union and Vietnam, who train for several weeks at Waterbury and Yale-New Haven hospitals.

Keggi says that he first heard of Zatlers when several Latvian nurses asked him, “When are you going to start taking somebody who is not associated with the Communist elite?” Zatlers became a KOF fellow in 1990 and studied techniques in joint-replacement at Yale, as well as at Massachusetts General Hospital with Latvian-American orthopaedist Bertram Zarins, M.D., and at the University of Iowa. Keggi, who has kept in touch with Zatlers, calls him “very bright” and a highly qualified surgeon. “He was the first of the Latvians we brought over who had that [activist] history,” said Keggi. “All the others had been good little boys, Communist youths.”

Soon after Zatlers’ return in 1991, Latvia regained its independence. The head of Riga’s State Hospital of Trauma-tology and Orthopaedics, a prominent Communist, stepped down shortly thereafter, and Zatlers replaced him. Zatlers continued to build a successful career, taking on medical leadership positions and lecturing internationally. He was nominated for president in 2007 by the ruling government coalition, and members of Parliament voted him in by a comfortable majority.

“When Zatlers was appointed, people were somewhat worried about him, because here’s this orthopaedic surgeon all of a sudden president of Latvia. But he’s done a great job,” said Keggi. “He always has had a good understanding of world politics and history.”

Zatlers has made political stability, the rule of law, and employment his priorities. He has urged young people to participate in politics and warned against the nostalgic yearning for a political “boss” to lead the country, which underwent a severe economic contraction during the recent global downturn.

Why the jump from orthopaedics to politics? After his success in medicine, Zatlers explained, he felt ready for a new challenge. “Not many people are asked to run for president. ... so I took the chance, I took the challenge, I took the risks. And as a surgeon, I have been used to risks all my life.” Comfort with risk taking is just one way Zatlers said his medical background was good preparation for politics; he also credited years of working long hours and keeping confidences. “Most [important] of all is the ethics of a physician,” he said. “It’s the best training available.”

Zatlers said that his visit to Yale deeply influenced the rest of his life. “Every day, every hour I spent at Yale was a total change of my mindset, because in those post-Cold War years, the two worlds were totally different. It not only changed my physician skills; it really changed me as a man.” His favorite spot on campus? Harvey Cushing’s office in the medical library.

Zatlers returned to Yale last fall during the UN Summit on Climate Change and addressed students in Luce Hall about international affairs. Though he said the visit was a “great experience,” both he and Keggi regret that Zatlers did not have time to address the orthopaedics department. “My lecture about structural bone grafting and difficult cases is still available to the students,” said Zatlers. “You have always to leave something for next time.”

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