The little white house. And the medical visionary who made a difference.
It sat on 18th Avenue in Squire Park, across from the backside of Providence Hospital. It was a little, white turn-of-the-century house — it could have been a Midwestern farmhouse — set back from the street. It looked like the kind of house my aunt Florence lived in in Ripon, Wisconsin.
You didn’t get the idea that this place was different until you got inside the front door and the smells hit you. Medical chemicals and animal scents — like a messy vet’s office that reeked of dog pee and antiseptics. The rooms were not filled with comfy old furniture but rather office equipment, desks, blackboards and lab equipment. Dogs could be heard yapping in the basement. Up a flight of stairs was a main room that seemed to be the center of activity.
A section of the upstairs linoleum floor could be lifted to reveal a window into a room down below. How strange, a window in the floor. Below was an operating theater, and frequently if you peaked in you would see a cluster of men in surgical scrubs operating on an animal. You’d have a birds-eye view of an open chest cavity, sometimes a beating heart. It was fascinating and a bit repellent, incongruous with what you expected, but utterly transfixing.
For many years, this was the workplace for Dr. Lester Sauvage, one of Seattle’s foremost heart surgeons, researchers and evangelists of the link between the medical and the spiritual. I first saw the house in the early 1960s when my parents went to work for Sauvage at what was the called the Reconstructive Cardiovascular Research Laboratory. My mother was the lab’s administrator; my father, a former surgeon, became the chief research pathologist. In the early 1980s, after the little white house had been expanded, remodeled and rebranded, I worked there for a couple of years in the fundraising office when it was called the Bob Hope International Heart Institute.
The work at the lab shaped my family, my life, and impacted the lives of many thousands of people around the world for the better. And its humble beginnings and great ambitions came back to me when I heard of Sauvage’s death on June 5.
There was a time when Lester Sauvage was a big name in Seattle. He was a homegrown native son from Wapato who, like Doogie Houser, was a boy wonder in medicine getting his MD at age 21. He rose to be an internationally recognized surgeon who hobnobbed with contemporary heart pioneers like Michael DeBakey, Denton Cooley and Christian Barnard. He won the Jefferson Award and received the endorsement of the beloved Bob Hope. A devout Catholic, he quoted St. Francis and corresponded with Mother Teresa. The Seattle Weekly dubbed him “St. Sauvage” for his blend of work, faith and intensity.
Sauvage stood out as a brilliant heart surgeon and a passionate man. He lived in his scrubs and worked all hours. He washed his patient’s hair and encouraged them to use their health problems as motivation to reflect on how to live more meaningful lives. He shaved his head and looked like a holy man, and many folks were either inspired by him or put off as a medical meddler in realms better left to chaplains, priests or therapists. But he was a man on a mission.
In the early days, it was to find better ways of fixing broken hearts in adults and children. He experimented with making patches for congenital defects, designing and installing better heart valves, and re-plumbing the arteries and veins via techniques like coronary bypass surgery to bring blood where it was needed to keep hearts pumping. His patients and their families were devoted to him, and often inspired by a question he would ask them on the eve of surgery: “If you get more life, what are you going to do with it?” At the moment where people feel keenly their mortality, Sauvage believed, there was a chance to reach people to transform their lives into something more meaningful.
In the days of the little white house, the work seemed both advanced, yet very primitive. While Sauvage was a successful practicing surgeon, he sought to improve surgical techniques and materials. My mother remembers being asked to go find fabrics they could experiment with for repairing hearts and being sent to the Bon Marche to obtain ladies lingerie nylon tricot cloth to see if it would be suitable to experiment with to patch a heart with a hole in it.
The lab focused on animal experimentation, in my memory dogs and pigs mostly. Sauvage argued the animals were partners in research, though many were sacrificed in the cause. Could surgical techniques be perfected on them? Could their parts be treated and implanted into humans? Which artificial materials work best? How do you suture them to avoid clotting or other complications? How do they heal?
Such work with animals made some people uncomfortable with the lab’s work, and it’s even more controversial today. Sauvage was proud of it. He defended it to one of his patients — a PAWS activist who required heart surgery — by saying to her, “You’ve done so much for the animals, isn’t it time they did something for you?”
The lab survived on grant funding, including major support from the National Institutes of Health. Sauvage drew on surgical fellows from around the world. I met doctors from China, Armenia, Norway and Eastern Europe who came to work at the lab. He consulted engineers at Seattle University who worked on the flow dynamics of blood and how they contributed to the surgical challenges. He pioneered techniques in coronary bypass surgeries that became almost routine. He developed Dacron grafts that became widely used, and helped fund research. Scientific papers flowed from the laboratory and spread findings around the world. The lab was not alone in its work, but almost unique in its approach emphasizing surgical experimentation.
But Sauvage was convinced that surgery, ultimately, wasn’t the answer. It was expensive, intrusive, high-risk. With the same passion he took to operating on patients, he took up the cause of prevention. That proved controversial too. Academics at the University of Washington and elsewhere said a research lab like Sauvage’s shouldn’t engage in public education. Sauvage ignored them and published The Hope newsletter that distributed prevention and lifestyle information nationwide. He envisioned an expanded center that would combine research with public outreach. He planned to expand the little white house into a larger, $30 million facility, named for Bob Hope. That did not happen, in part because in early 1980s, pre-Microsoft Seattle, $30 million was too steep a fundraising hill to climb. Sauvage took to writing his own books on the subject, blending his prevention and spiritual messages.
Lester was a larger than life figure. I first met him in my family’s living room in Mount Baker — a young surgeon with a friendly intensity and piercing eyes. Later when I worked for him I got the treatment that all of those who worked for him got: You were available 24/7, received calls, sometimes from surgery, at 4 a.m. to hear his latest idea, scrambled to adapt to his unscripted moments with the media or potential donors — he was known to abruptly ask people of means for $1 million, whether they could afford it or not. He slept little, often in short catnaps, and worked on everything up to the last second. I remember my mother staying up for days with almost no sleep while Sauvage rewrote grant proposals in the hours before final deadlines.
It felt like it was all to a pioneering purpose. As a child I was often bored when my parents grew diagrams on napkins to explain how the heart worked, or what they were doing in their research. Still, I remember my parents bringing home the latest grafts and the newest experimental heart valves, and getting to see specimens under the microscope in my father’s home lab.
It all seems very personal now. As an aging adult with friends and contemporaries requiring heart surgery, I am more aware than ever of the value of the work Sauvage championed and shaped with his own hands, and by guiding the hands of others. When a friend gets a bypass or a new aorta, I am reminded of Dr. Sauvage’s dedication as a healer and of the work done long ago in that little white house.