DOCTORS' LOUNGE
Fig. 1 The first hospital (1823). The central building is now the
UofL Abel Administration Building.
Fig. 2 Louisville General Hospital. The many added wings on each side of the central
building reflect a century of expanded patient services.
Fig. 3 Counties across Kentucky and Southern Indiana served by the UofL
Health Trauma Center in 2017.
a surgical technique for deep burns called “early tangential exci-
sion and grafting,” which was originated by a Yugoslavian plastic
surgeon, and which I learned from one of the earliest international
adopters. In refining this technique here, it became apparent that
this method substantially lowered infection rates and severity, and
greatly decreased mortality and permanent disabilities. We applied
this technique to the Radcliff children, and all survived.
TRANSPLANTATION
With the introduction of effective immunosuppression, UofL Health
surgeons working principally at UofL Health Jewish Hospital pio-
neered kidney, liver, pancreas, heart and lung transplantation, and
brought these to recipients across Kentucky. Recently, the Center
(now named the Trager Transplantation Center) marked its 5,000 th
patient transplanted, including 3,000 kidneys, 900 livers and 500
hearts. The Center’s immunosuppression skills allowed the partner-
ship of UofL Health Plastic Surgery and Kleinert-Kutz Hand team at
UofL Health Jewish Hospital to perform the world’s first skin-bearing
transplant, a hand, 20 years ago. The landmark procedure opened up
face, abdominal wall and other new reconstructive transplantation
procedures in centers worldwide and brought international acclaim
to UofL’s pioneering efforts.
CARDIAC SURGERY AND CARDIOLOGY
UofL Health Jewish Hospital is also home to leading cardiac surgery
and cardiology, another set of services that have saved thousands of
Kentucky lives. Citizens from every Kentucky county have received
their heart care here. Also, substantial advanced technology has
been pioneered by UofL Health surgeons, including the world’s
first implantable artificial heart and its subsequent evolution into
increasingly effective life-saving technology called ventricular assist
devices. UofL Health cardiologists address the most difficult con-
ditions of arrhythmias and severe heart failure. In addition, UofL
Health cardiologists and surgeons now partner to treat many defects,
such as some valve replacements and vessel aneurysms, by less inva-
Fig. 4 Helicopter flights speed transport to UofL Health
the many patients needing emergency care.
sive vascular passage, rather than open-heart surgery. UofL Health
also sponsors leading cardiovascular research, including the newly
established Christina Lee Brown Envirome Institute. This research
facility focuses on heart/lung disease prevention and environmental
safety, which will benefit all Kentucky citizens and those beyond.
A THREAT TO CONTINUED SERVICE
The ongoing service to Kentucky citizens by UofL Health and the
affiliated hospitals is severely threatened by recent changes in de-
mographics and Health care economics, especially by the large
burden of uninsured and underinsured patients that they serve.
In November 2019, Jewish Hospital came to the point of closure,
as then-owner, KentuckyOne, could not reverse several years of
deficits, and decided to leave the area market. UofL Health hero-
ically stepped in to preserve Jewish Hospital and its vital services
by purchase and full affiliation. This action preserves the services
described above, as well as the Emergency Department that serves
over 3,000 patients each month. These benefit all of Kentucky, as over
one-third of admissions to UofL Health Jewish Hospital come from
outside Jefferson County. Also preserved are UofL Health medical
education programs for our future practicing physicians, and over
1,900 hospital jobs and their contribution to Kentucky’s economy.
Thus, an enormous effort has been organized to rescue this
invaluable resource. Under ideal circumstance, the University and
UofL Health leaderships would be spared the substantial economic
risks involved. However, the loss of care to citizens locally and across
the entire state demand this action. As this article is being written,
a loan request of $35 million from the state is before the state leg-
islature. It is essential that the great value of this institution to all of
Kentucky be recognized, and that support be given to sustain this
noble legacy of service.
Dr. Tobin is a professor at the University of Louisville School of Medicine, Department
of Surgery, Division of Plastic and Reconstructive Surgery. He practices with UofL
Health Physicians - Plastic and Reconstructive Surgery.
MARCH 2020
33