PANORAMICA DEI DIVERSI LIBRI DI SANTINA
GOD IS THE ROCK OF MY HEART
I. THE BOOK
If you want you can read the Book, click here: God is the rock of my heart
II. INTRODUCTION (DOTT. PAOLO FERRAZZI)
On July 18, 2005 I start scrubbing my hands before surgery. This daily ritual, besides preventing infection, allows me to cleanse my mind of all idle thoughts and concentrate my entire attention on one single patient. Today I have to operate on Santina, the mother of Don Luigi Ginami, a woman who confronts her grave illness and suffering with both great serenity and the will to live. Talking with her before surgery, I sense her determination to undergo the operation that will allow her to continue reaping the fruits of existence. “Yes, Paolo, today you must concentrate hard to help Santina; she suffers from a very serious disorder of the aortic valve; what is even more worrying is that her coronary arteries are completely calcified.” I know that I will have to be very vigilant when I enter the operating room; I will have be very careful in finding a point in the coronaries that is free of calcifications so that I can insert the by-pass. I will also have to be quick so as not to protract unduly an operation on a person so elderly and debilitated; and I will have to be especially careful in the rear part of her heart, where even minimal hemorrhaging could be fatal. I will really have to protect her heart, so that it starts again promptly and starts circulating the blood around her already compromised organs; I am especially worried about the proper functioning of her kidneys and lungs. The cardiologists who studied Santina’s condition before the operation were well aware of the possible risk of organ malfunction. They also knew the difficulty in performing any by-pass on such obstructed coronaries. Nonetheless, they themselves convinced me to operate on her, as they were certain that without an operation Santina had little time left to live. As on every other morning, I am reminded of the words of my American teacher, a man who has spent fifty of his seventy years in cardiac surgery. During my training in the United States, he would say to me: “Paolo, don’t let any operation become just routine; every day you enter the operating theatre is the most important day in your patient’s life”. I have agreed for Santina’s son, Don Luigi Ginami, to be present at the operation, and this gives me some peace of mind. Since Don Gigi has already attended other operations, I thought I would allow him to be present as an active observer during his mother’s struggle for life. It only increases my calm and determination to know that at work just a few metres way from me is a team of eight people endowed with great human qualities and technical abilities. First of all there is Luca Lorini, chief anaesthetist, and my frequent partner in complex, sometimes desperate, surgical procedures, often performed in emergency and at night. We have collaborated in hundreds of operations, over many years, without the least disagreement, often in difficult and dramatic situations, both of us always assured that the other was working for the good of the patient. Then there are Samuele Pentiricci and Kostantin Deyneka, who will assist me in the central phase of the procedure. I am thrilled by their youth and technical skill, and I will try to transform them from surgical technicians into fully-fledged surgeons. Then the scrub nurse, her assistant, the assistant anaesthetist, and the extra-corporeal circulation technician: all of them, I am sure, will give their utmost to make the surgery successful. The timer, which I had set to five minutes for scrubbing my hands, rings. With all these thoughts in mind, thoughts that have given me so much serenity, I can now enter the operating room. I hope the best for Santina as much as the other thousands of patients on whom I have operated, and I am sure everything will go well. I step on the button that opens the door from the Scrub Room to the operating theatre, keeping my hands in the air. The atmosphere in the operating room is perfect: everybody is at their station. My eyes meet those of Don Luigi and, and I immediately feel that he understands my state of mind, and I his. While I am drying my hands, and before the scrub nurse helps me put on the sterile gown and surgical gloves, I ask Samuele if there have been any problems during the preparation of the patient for the cardio pulmonary by-pass. I sense that the surgical team is overly tense, so I ask for the background music to be changed from light music to classical music, more suitable for isolating the operating table from all external tensions. I am ready.
Samuele leaves me in charge of the operation on the right hand side of the patient and moves to the opposite side to assist. Whether it is the classical music or my own presence, I feel as if the average age of everybody in the operating theatre has suddenly risen, the atmosphere becomes muted, and we can start. “Proceed with the extra-corporeal circulation,” I tell the perfusionist: as the blood flows little by little into the oxygenator of the heart-lung machine’s, the enlarged heart drains of blood and I can begin my examination. The aorta displays some calcified patches, and as I had expected, the coronaries are like calcified tubes; but there’s no point worrying now: I know I will be able to insert the by-passes. So I turn to the perfusionist: “Reduce the flow of the extra-corporeal machine, clamp up the aorta, and proceed with the infusion of the cardioplegic solution”. The heartbeat slows progressively until it stops altogether, thanks to the cardioplegia that will protect it during the operation. It’s almost as though after seventy-nine years of beating, it has been exhausted by the illness and would just like to stop and rest for a while. I start the first coronary by-passe on the posterior descending vessel of the right coronary, the most calcified. I examine the whole vessel with great care: “Samuele, here are 3-4 mm without calcifications; let’s cut here”. The vessel looks very healthy. “Give me the vein and the 7/0 prolene thread for suturing”, I tell the scrub nurse. The anasthomosis is quickly done, in 5-6 minutes; it’s just as quick for the lateral coronary branch and the anterior descending branch, to which we attach the mammary artery that Samuele had perfectly isolated in advance. After inserting the three by-passes, and while a new dose of cardioplegia is administered to protect the heart, I can raise my eyes and I begin to sense some tension around me. Father Ginami observes the operating table from behind the anaesthetist’s curtain, and although he wears an expression of fascination it still betrays his preoccupation. I have to lower the tension inside the room. I wink at Gigi Ginami; indeed, I feel that during the operation our relationship has transformed from formal to friendly. “The first part of the operation has been very satisfactory,” I tell him. Then I joke with the scrub nurse and with Samuele about the weight of the classical music that I am forcing them to listen to. The cardioplegia is over; now I am ready to open the aorta and substitute the valve. When I can finally see the valve, full of calcifications with only a small passage of only 4-5 mm in the centre, I always ask myself how patients can keep on living in this state. I whip out the valve; I very carefuly clean off all the calcium from the valve ring so that I can then insert the prosthesis. I choose a prosthesis of the right diameter and decide on a pericardial biological valve n. 21, which I think is the best choice for Santina. “Samuele, expose well, I have to be sure that no fragments of calcium are left in the heart”. I start suturing with cut off stitches, using 24 threads arranged like a cobweb. Again my eyes meet with Don Gigi’s: now he seems more fascinated and less worried. I quickly pass the threads on the prosthesis ring and then tie them off. The valve prosthesis fits perfectly into the ring, its position is perfect, and it looks like a normal valve. It’s even pleasing aesthetically. I look at Luca Lorini, who nods to me that both the anesthesia and the extra-corporeal circulation are proceeding well; his air of composure is always of great comfort to me during the most difficult operations. “Come on lads, let’s quickly close the breach we made in the aorta wall to reach the aortic valve; we right at the limit for the cardioplegia and myocardial protection — one hour and 20 minutes have passed from the clamping”. When suturing is over, we begin the reperfusion of the heart with blood to expell the cardioplegic fluid. “Luca, I am ready to de-clamp the aorta”. “Ok, Paolo; the potassium is within limits; you may de-clamp the aorta,” replies Luca. I make the blood flow into the aorta, and now there is no reflow into the ventricle thanks to the new valve. Slowly the heart starts functioning again, first at 20 beats per minute, then 40; finally it attains a normal rhythm of 80 beats; it seems to be contracting well, already better than before the operation.
I thank God in my heart for having allowed me to exercise this profession, which makes me experience daily the synergy between human nature and technology, and derive joy from caring for the sick. “Santina, it’s still early, but I am sure that you will still be able to enjoy life, near your grand-children, in the prayer that has comforted you in suffering and with the love of your children, who have entrusted their mother’s heart to me”. The heart is now beating well. We quickly suture the two veins to the wall of the aorta, a very delicate procedure due to the presence of calcifications. “Luca, are you ready to suspend the extracorporeal circulation”? “Yes, everything is okay, I have reinitiated pulmonary ventilation”. In cardiac surgery the moment of disengaging extracorporeal ventilation is very stressful, but it is also highly fascinating. It always makes me think of a tiny infant who can walk with balance thanks to his mother’s hand, but then suddenly steps away from her and starts walking freely, by themselves, across the room. In the same way, during this phase of the operation, the assistance provided by the heart-lung machine is gradually reduced, the heart restarts beating on its own and autonomously perfuses all the organs. “The extracorporeal is now suspended and the heart is beating on its own,” the perfusionist announces in a definite and satisfied tone, happy at the positive outcome to his highly responsible task. Everything is OK, and everybody’s eyes gleam with satisfaction. “Thanks, Samuele. Take over; be very careful with the haemostasis, it mustn’t bleed”. “Thanks everybody”. I withdraw from the operating table and I remove the lamp from my forehead, the magnifying glasses, the gown, and the gloves. Then I approach Father Ginami, warmly grasp his arm, and he thanks me visibly moved by two hours certainly of great intensity and worry, but also love for his mother, and general curiosity about things so new to him. He is happy and moved by the experience that he has just lived through. It was good idea to allowe him to be present at his mother’s operation. After Samuele and Kostantin have worked for another hour to secure the haemostasis and re-suture the incision, the surgery on Santina is over. Luca supervises all the delicate phases of her transfer from the operating room to the intensive care unit, always with great professionalism. Things continue to improve and after a few hours Santina is revived, extubated, and weaned off the monitoring of her vital organs that is so crucial to this type of complex surgery. After 48 hours, Santina leaves intensive care and is transferred to the ward: her vital parameters are optimal. On July 22, during my evening round of the ward, I visit Santina: I am reassured by her general conditions and the gradual resumption of her organ functions. “Tonight I can sleep in peace,” I tell myself after the ward visit to the many patients operated on in the previous days, and others in intensive care operated on that very day. But at two o’ clock that same night, like a bolt from the blue, I receive a call from the intensive care unit. “Doctor, it’s Annamaria. Dr. Lorini is asking whether you could please come immediately because Signora Santina has had a sudden cardiac arrest as the result of an arrhythmia”. Often I have asked myself where I find the strength to confront and overcome such difficult moments as the one that involved Santina the night of July 22, 2005. Fortunately they are rare events, yet I have never found an answer to my question. Perhaps, over the years, I have succeeded in overcoming distressing events like these and continued my daily profession thanks to my belief in a higher plan, though I struggle to comprehend, from either basic humanity or science, the motivations. Nonetheless, after the cardiac arrest, Santina’s life has become a Calvary without martyrs, a battle conducted by a mortal in the name of life, a success in solidarity, spirituality and medical science. I will now leave to Don Luigi Ginami the task of relating this story of intense love and devotion towards “mamma Santina.” As for myself, I will treasure in my heart all the richness that I have drawn from it at professional, human and spiritual levels.
Bergamo, July 8, 2008
Paolo Ferrazzi, MD
Chief of Cardiovascular Department
Chief of Cardiac Surgery Unit
III. PREFACE (MONS. RAPHAEL MINASSIAN)
Before reading this book, the title inspired me and took me back to my beloved Armenian Nation. Land and people, both, during the centuries, they witnessed for the Lord glory. The land with its mountain Ararat the unbeatable rock, received God‘s chosen people, with the Noah’s arc. The people as the first Christian Nation in the world, who carried the Cross of our Savior Jesus, and continues to carry it till today with love and devotion. For many centuries the Armenians were persecuted for this choice. The last persecution of their Christian faith was in 1915, where one million and half were martyred for the name of Jesus. One million and half were massacred just because of their Christian belief. I so them, like a dream the Armenians, laying on this rock, that Mgr. Luigi Ginami took it as a Title for his book, and witnessing for it. Yes, I so my own people, the Armenian people, through their brilliant history; I so their faith in God, as unconquerable Rock, I so their national character firm as (…) and understood their continued martyrdom as the best expression of their loyalty and love to this rock, God. Wouldn’t be too far fetched, if I said that God in the Old Testament chose the Jewish people to prepare the coming of his sole Son, our Lord Jesus, the Savior of the human beings; but in the New Testament, He chose the Armenians to witness to this only begotten Son Jesus. Why these two people should be always, during the centuries persecuted by all people in the globe? Just, because, Jewish or Armenians, they were chosen to prepare and the others to witness for this coming Messiah? The answer, we will see it in the book of Mgr. Prof. Luigi Ginami when he entered the Heart surgery, operating room to see and meet with the heart of his mother. In this encounter between mother and son, would give us the capability to understand the deep feeling and connection between these two persons and God. In fact, isn’t easy to enter in this operating room and see in one hand your mother a part and her heart in another part. Isn’t easy to watch the heart of your own mother in the hands of doctors cutting sawing and playing with it like a toy. Isn’t easy to stand before this heart and fly with your thoughts to see how that heart beat for the first time in love and brought you in to this life. Not only, but to continue yet and lead you to the Holy Altar of God. With her milk she gave and nourished you, she leaded you in the spiritual life. Do not say; isn’t bosom to silently talk to your mother’s heart Isn’t easy at all to stand without confusion and fear in front this reality. Like Moses on Sinai, couldn’t resist in front of the Holy God, who called him to go up to the mountain and receive the Ten Commandments. Moses failed of fear in front of His Majesty and couldn’t look at Him. The same I would say, when I am before the heart that gave me the free gift of my life. But the case of Mgr. Doctor Ginami, the facts are different. Mgr. Ginami with his book generously brings us to think with him and link our daily life to the real Life linked with God. That is the real picture impressed me the most. Therefore I would say the book “ God is the Rock of my Soul” is one of the most easy book I read rich in spirituality as well as in the presenting the real value of the medical modus operandi without excluding the presence of God who is the Rock upon who we should lay dawn. God is the only person in this life as well as in the coming life we should relay on him as a person, as a people, as a Nation. Any sacrifice would be a joy to experience it as Mgr. Ginami did passing through all the phases from the crisis, to the Doctors, to the operating room and finally with the heart of his mother to God the Creator and owner of all; who gave it to us freely and generously.
Mgr. Raphael Minassian
Exarches of Jerusalem
IV. THE BOOK SIGNING
A Videoclip about THE BOOK SIGNING in USA September 15th -22th 2009
See ALSO the first travel to promote the book in power point: https://www.fondazionesantina.org/uploads/2008/03/promozionestatiuniti.ppt
V. IT IS A VERY SPIRITUAL BOOK AND VERY EASY TO READ
Dear Don Gigi, I just finished reading the beautiful book of your Mother.” God is the Rock of my Heart.” I am so inspired by your Mother. It is a very spiritual book and very easy to read. What a truly remarkable woman of faith. What a role model she was as a Mother and how proud you must feel to be her son. As a mother of seven myself, I think how lucky she is to have such a devoted son as you. You are God’s blessing to each-other . Through out all her suffering she stood steadfast in her beleif in God and offered her pain and suffering to Him. I truly beleive her recovery is a miracle. Just the fact that she was able to go on Pilgramage to Lourdes is quite amazing. God’s hand. I hope she is well rested after the long journey. After reading the book, I am inspired to be more prayerful in my daily life. To lead by example as your Mother so that my children will also be be strong in their Catholic faith. I have enjoyed the webb site. The photo’s of Los Angles, Denver and N,Y. It’s a very well put together site. I will continue to look for up-dates. Will you be coming to the U.S. with Pope Benedict? He will be in Washington which is close to my home but unfortunately my Parish did not have enough tickets for everyone to see the Pope. God willing in Sept. when I go too Rome. I will pass your book on to my friends and my Priest to read.
God Bless you and Mamma Santina