I
am of 1967 vintage. Ask an AI agent or Google what defined that year and the first successful human heart transplant will be near the top of the list. It was performed in the early hours of 3 December 1967 by Dr Christiaan Barnard, with his younger brother Marius as his right-hand man, just 15 days after my birthday. It is a historic feat that South Africans are proud of.
My father was a surgeon( and I am happy to say a PPS member) and hence Dr Barnard was a hero to him. Dr Barnard’ s biography, One Life, published in 1969, held a proud place in his library. It has been on my to-read list for many years and I finally got to it during the recent year-end holiday. It is quite a story. Of what it takes to become a medical professional( our members in this field can relate), of client-professional relationships( most members can relate), of advancing the frontiers of science and of perspective, the theme of this edition.
I have a faint memory of my dad’ s specialisation studies in the early 1970s. While he was studying, I was not allowed to make any noise, which was an impossible expectation of a three-year-old. When he finally qualified as a surgeon, my first question was whether I could now be noisier! Once, in my excitement to see him returning from the hospital, I slipped and cut my head on a steel windowsill. It needed stitches. That was no problem – dad could handle it – but he did not have any pain-killing injections at home. And because he needed to get back to his studies, there was no time to drive to the hospital. The result was stitches without pain relief. It probably explains my lifelong fear of needles. In later years, he would sometimes take me to the theatre hoping that I might consider medicine as a career, like him and like his dad – my grandfather. But I often fainted when the scalpels started cutting. At least I am in good company. Chris Barnard also passed out the first time in theatre as a young medical student!
At PPS, Dr Marius Barnard is as much of a legend as his brother Chris. He was the inspiration behind a major life insurance product line – critical illness( also known as dread disease in other parts of the world). South Africa is known as a major innovator in insurance. It is something that stirs national pride, just like that first heart transplant. And critical illness cover is right up there, as acknowledged by actuaries worldwide. Marius Barnard pushed for it. His key idea was that as a surgeon he could“ repair a person physically” but only insurance could repair a patient’ s finances after illness. He repeatedly argued that many patients survived illnesses medically but“ died financially”, and insurance was the way to protect against economic hardship. Marius’ s view can be summarised as:“ We celebrate the skill that pulls a patient back from the brink. But the greater act of prevention is the quiet work that keeps people from the brink at all – health-wise and financially.”
“ Perspective not only changes what we see but also what we build.
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Which brings me to perspective, the lens we use to look at things. Perspective not only changes what we see but also what we build. Chris Barnard looked at a failing heart and asked how to extend life. His was the crisis lens. His knowledge, skill and precision pulled patients back from the brink. Marius Barnard looked at the same illnesses through a wider lens and asked how to protect life’ s fabric – work, dignity, solvency – long after the stitches were tied. One lens delivered heroics in hours; the other delivered resilience over years. Both were acts of care but they solved for different crises: Chris’ s for the body’ s survival; Marius’ s for a household’ s survival. Together, they remind us that progress is not only in spectacular interventions; you also find it in quiet systems that make catastrophe less frequent and less fatal. And the most powerful perspective combines the two: building organisations and systems that can act brilliantly at the edge but design ecosystems that keep people away from that edge. Innovation at the edge saves lives; innovation upstream saves futures. Perspective determines where we focus and how we execute our genius as professionals.
Prevention is, at its core, an act of perspective. It asks us to lift our eyes from the urgency of the present moment and to look instead at the horizon far down the line, at the patterns, behaviours, systems and risks that shape tomorrow’ s outcomes long before they materialise. Where reaction confines us to the visible crisis, prevention demands a different lens: one that sees the forces building beneath the surface.
The world of medicine illustrates this shift so powerfully. For centuries, the doctor was defined by the drama of intervention. But the most forward-looking thinkers in healthcare argued that the true work of medicine lies much earlier – where choices are made, environments are shaped and suffering can be avoided altogether. It changes the question from“ How do we fix this?” to“ How did we arrive
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