Congratulations!

Congratulations to Long-Term Cath Lab Technologist and CLD Editorial Board Member Gerry Lagasse, RCIS, Borgess Medical Center, Kalamazoo, Michigan, on his well-deserved retirement!

Send your good wishes to geraldlagasse@att.net. Readers are encouraged to search “Lagasse” on cathlabdigest.com to read and enjoy some of Gerry’s many Cath Lab Digest articles.

Cath Lab Digest asked Gerry to share some of his extensive career and experience with readers.

It’s been a fun run, but alas, the years are catching up. On March 3rd, I’m hanging up my scrubs after forty and a half years of working in the cath lab. Never thought I’d be working this long or at the same hospital for this amount of time. I blame it all on Dr. Enrique Leguizamon.  

I arrived in Kalamazoo in June of 1976 after graduating from a Cardiology/Pulmonary program in El Cajon, California. Before that was seven years, three months and one day in the military with a tour in Vietnam. When I started in the cath lab, its primary function was as a diagnostic tool for coronary, valvular, and pediatric evaluation. There were three cardiologists in the department, along with a pediatric cardiologist. One of these cardiologists was Dr. Enrique Leguizamon. In January of 1979, Dr. Leguizamon came back from Germany after visiting a friend. Some guy by the name of Andreas. He told me, “Next week, we are going to do a PTCA. The equipment will be arriving from Europe sometime next week. The rep will be here and you can get the room ready for the procedure. Oh, and you’ll need to get an E cylinder.” He walked out of the lab and I was left with several questions.  First and foremost was, “What’s PTCA?”, and then, “What’s an E cylinder?” And, “What equipment?” In the next week, the equipment showed up. The rep arrived with a fax copy showing the equipment sent and with no clue how to put it together, because he’d just been hired the week before. He also had no clue as to what an E cylinder was. The day of the procedure was a bit hectic trying to figure out how to get all the equipment hooked up correctly. I also had an opportunity to talk to Dr. Leguizamon and got some idea as to what PTCA stood for, what we would be doing, what the balloon did to the coronary, and also learned where to get an E cylinder. Before the beginning of the procedure, I saw the surgeon in the back of the lab pleading with Dr. Leguizamon to not do this. He said we were going to kill the patient. We started the procedure with the surgeon in the back room and a surgical staff in the hallway. We were successful and I was later told we were the fifth hospital in the United States to do a PTCA. Later that year, Dr. Andreas Gruentzig came to visit his friend. I was introduced to him, shook his hand, and had a conversation with a person that I would have been proud to call a friend.   

In 1982, I went to a weeklong class on the SMEC, which was the first IABP percutaneous balloon available. It was taught by Peter Schiff, who had developed the first percutaneous IABP. I arrived from Tennessee on Friday evening and was told that Dr. Leguizamon had put one in that day. Nobody in the hospital knew how to manage or operate the SMEC. I spent that night in the CSU not sleeping a wink and almost jumping out of my skin whenever an alarm went off. Also in 1982, Dr. Leguizamon showed up one day fresh from a symposium he’d attended. He told me that on Monday morning, I would be starting to perform arterial and venous access using both femoral and brachial pathways, and that he would teach me. I spent a sleepless weekend worrying about the possible complications. He was a man ahead of his time, constantly pushing for the advancement of cardiology. Among his many accomplishments, Dr. Leguizamon brought nuclear cardiology, cardiac rehab, stress testing, and a CVL recovery unit into the hospital. In the cath lab, he initiated peripheral and renal angioplasty in the 1980s. If it could be intervened on, he was willing to give it a try. I assisted on subclavian arteries and once on an esophageal stenosis, and on his first carotid angioplasty, performed in 1992.   

From 1980 to 2000 was a great time of learning and also stress from a constant slew of new devices, new procedures, and the problems of incorporating these into the work schedule. From performing new procedures and having “aha!” moments when the physicians and staff learned that what they thought they knew, they didn’t, or learning that the new product just fresh out of the rep’s trunk didn’t work as advertised — or did. It was a time of developing a whole new field — interventional cardiology. I am glad and proud to have been there and seen it from its first baby steps to what we have today.

Some memories for me will last well into my retirement. Like the day I was shopping in a supercenter (Meijer) and a man walked up to me and with a great big smile said, “BALLOON.” I responded with, “I think they’re in toys.” He said, “No, no. BALLOON.” I said, “Maybe cards and flowers.” He pointed to his chest and said, “BALLOON.” Then I knew. He gave me a hug. Can’t put money on that. 

I worked with Dr. Leguizamon for almost thirty years and still think of him, and thanked him (before he passed) for having given me the opportunity to have a personally satisfying working career. Hope you have one, too. Now I’m off to woodworking, stained glass, my little mini coupe, and grandkids. 

Online addition:

As an old saying goes, “Memories are made of this”. There are remembrances that are jolting, like remembering a lady delivering a baby on the cath table while having a heart attack. Melancholy, like remembering a priest arriving at the emergency department slumped over in the passenger seat. CPR was started in the car. Being placed on the table, CPR in full swing, anesthesiologist putting in an ET tube, cardiologist acquiring arterial access in the right groin, while I’m acquiring arterial access on the left for an IABP. We discovered a closed left main. I remember going to his room several days later to see him and the priest looking up at me, smiling, and saying “Didn’t think I’d make it, did you?” He lived for years after this event, only to die while leaving a casino (he loved to gamble) and driving into a ditch filled with water. Finally, there are remembrances that lead to sadness. My worst and most memorable: I was scrubbed in on a case on a Thursday afternoon right after lunch. The patient had one left renal artery that was severely stenosed. The plan was to dilate the right renal artery. It started as assisting on a femoral cut-down for arterial exposure. The surgeon then de-scrubbed and Dr. Leguizamon scrubbed in. No success. The surgeon came back in around 4:30 pm and we closed the femoral access site. I got called back in at 5pm for the same patient, for another surgical cut-down and back up to the left renal artery. The procedure ended unsuccessfully at 8am the next morning. I went home to sleep, completely exhausted. Dr. Leguizamon went to the patient’s room and remained with him till late morning, when the patient expired. Worst was the memory of being totally exhausted. Twenty hours of focus on a procedure that was being made up as we were performing it. 

My most memorable experience, however, was seeing and working with a person who is/was a pioneer into what is now interventional cardiology. Working with a man who was like a mad scientist. A physician who was definitely more exhausted than myself after this procedure still spent time with the patient to the end.