‘An art and a science’

‘An art and a science’

How a boy from Argentina became a world-class cardiac surgeon in Park Ridge

When Alejandro Jorge Zapolanski was about 7 years old, in the late 1950s, he found himself in the emergency room.

It was nothing unusual or life-threatening. “I’d just gotten home from school, and I was running up the stairs to see my mom, and I slipped and fell and I opened my forehead,” he said.

“My mother sees me with blood all over me, and takes me to the hospital, and the doctor says that he was going to put in two stitches, and said that it would hurt a little bit, so he would give me a local anesthetic.

“And I told him no, that he should do it without anesthesia, because I was going to be a doctor.”

Alex was fine. “I was very stoic, but my mother fainted,” he said.

That little boy is now Dr. Alex Zapolanski of Park Ridge — “I dropped the Alejandro Jorge when I came here,” he said — a cardiac surgeon and the head of cardiac surgery at Valley Hospital in Ridgewood.

Then, home was Buenos Aires.

Dr. Alex Zapolanski talks with students at the Ridgewood Academy for Health Professionals.
Dr. Alex Zapolanski talks with students from the Ridgewood Academy for Health Professionals.

His story is in some ways the typical story of a hard-driving, ambitious, gifted man whose clear-sighted pursuit of his goal got him to the pinnacle of his field. But because it’s set in Argentina, at least at first, at the same time it has an almost topsy-turvy quality to it. Argentina is a world where summer is in December, the spring starts in September, it gets hotter when you go north, and the Jews who fled there from Europe, with the same background as the Jews who came here, found themselves in a lush subtropical Spanish-speaking Nazi-shielding off-and-on dictatorship — and still on the whole they flourished there.

“The government of Argentina took advantage of World War II,” Dr. Zapolanski said. “It produced a lot of grain and meat, and it sold a lot of it to Europe during the war, and made a lot of money. It sold to both sides.” Juan Peron — the dictator whose wife was immortalized in the Broadway musical “Evita” — “was a fascist who supported Mussolini. After the war, a lot of Germans escaped there.”

It also was a haven for Jews, and home to a flourishing Jewish community.

“By 1960, there were about half a million Jews in Argentina — about 400,000 in Buenos Aires and 100,000 in the rest of the country,” Dr. Zapolanski said. The community was far older, however. “There was a colony called Moisés Ville” — established in 1889 and named after one of its benefactors, Baron Maurice Moshe Hirsch — “and there were the Jewish gauchos” — basically cowboys and ranch hands.

Dr. Zapolanski’s grandparents left eastern Europe in the early 1920s, in the wake of the economic and emotional devastation of World War I, but unlike the parents, grandparents, or great grandparents of most of our readers, his family went to Argentina. They would have preferred coming to North America, he said, but already there were quotas in place that kept them out. (Immigration became much more difficult in 1917, and harder still in 1924, with the passage of the Immigration Act.)

“My paternal grandparents, Jacobo and Beila, came from Grodno, which sometimes belonged to Russia and sometimes to Poland,” Dr. Zapolanski said. “My dad was born in Poland, and got to Argentina when he was 5 or 6.”

Dr. Zapolanski’s maternal grandparents, Zalmen and Itka Saginor, came from a small town outside Minsk. The name Saginor comes with a story, he said, and it dates to the time that Russian Jews were mandated to take last names. His great- great-grandfather, the first to have that surname, was blind; he was also a man revered for his wisdom and sought after for his advice. The name comes from a talmudic phrase, sagi nahor, which literally means “much light” in Aramaic. It is used euphemistically to say that someone is blind and metaphorically to describe someone who is both wise and blind — someone who can see without light.

Zalmen Saginor became a teacher in Argentina. He “started with a little one-room school, with just one class, and eventually it became a seven-year elementary school,” Dr. Zapolanski said. “He did that for 35 years, retired in 1955, and spent the rest of his life preparing children for bar mitzvah. He prepared more children for their bar mitzvahs than anyone else in Argentina.”

Dr. Zapolanski’s father, Ignacio, earned a doctorate in economics and worked as a CPA. His mother, Clara, also was an accountant, and the two worked together. “My father said that when he was younger, he thought of going to medical school, but circumstances precluded it,” his son said. But higher education in general and medical education in particular were in the family’s DNA.

Young Alex went to public school, but he had

Dancing with his mother, Clara
Dancing with his mother, Clara

an intensive Jewish education. “Public school was in the morning, and then it ended, I came home for lunch, and then the bus took me to Hebrew school,” he said. “I went to Hebrew school four and a half days a week — on Fridays it ended at 4.” He became fluent in Hebrew during that time. He also learned Yiddish, “at first from listening, and then in elementary school I learned it formally.” Hebrew school wasn’t like afternoon religious school here, he added. “We learned Hebrew, Yiddish, geography, history — it was a formal and involved process.”

The community was tight. “My parents had a wedding or a bar mitzvah or something like that at least every other weekend,” Dr. Zapolanski said.

The Argentine Jewish community also was extremely connected to Israel, he continued. “My father and my mother both were volunteers in Jewish organizations. Because of his background, my father became more or less the treasurer for the organization that was the equivalent to the United Jewish Appeal, and my mom used to work for the Women’s International Zionist Organization” — WIZO.

Alex’s understanding that he was going to be a doctor never abated — he used to play surgeon on “my poor sister’s dolls,” he said — and Argentina’s educational system, which is unlike ours in that it rewards very early career decisions from very young people, eased his way, and his determination pushed him even harder. He skipped first grade and so finished elementary school early, went to high school, and took a yearlong program to prepare for the pre-med tests that students there take before college during his senior year of high school. “That was unusual,” he said. “And it was the worst year of my life. I would go to school in the morning, come home and study all afternoon, and then at 6 I’d go to pre-med classes for three hours every night, four days a week.

“When I finished high school in December 1967, I was 16 years old and I had passed all my exams for medical school.” But it is important to note, he said, urgently if most likely entirely inaccurately, “that it was a function of only one thing — sitzfleisch. The ability to sit and study. It wasn’t talent.”

That time also deepened the already strong relationship with his father, who has been dead for 35 years and whom, it is clear, Dr. Zapolanski still misses as if the loss were fresh. “My dad studied everything that I hated with me,” he said. “I didn’t love to study. For me, studying was just a vehicle. I hated microbiology with a passion — I hate it to this day — and my father used to make me synoptic summaries of microbiology.”

All that study paid off. “In March of 1968 I started medical school” — the school year in Argentina, like ours, starts in the fall, but their fall is in March — and in April I turned 17.”

Medical school in Argentina is six years. “I graduated from medical school in 1973, and I came to the United States instantaneously,” he said.

Why? Because he and his family always saw the future as here, not there. How? Because he had learned English from childhood, with that understanding in mind.

“When I was 12 years old, my dad asked me if I wanted to have a big bar mitzvah party or should we go on a trip,” Dr. Zapolanski said. “I said a trip. Of course we still had a bar mitzvah, and the four of us traveled together for 80 days. It was 40 days in Europe, 20 in Israel, and 20 in the United States. We left in December 1963 and came back the next March.

At 12, in Argentina
At 12, in Argentina

“It was good timing for my dad because he had to work like an animal during tax season,” he added.

When he was 16, the family took another trip, this one for 60 days, 40 in Europe and 20 in the United States. “It was so incredible!” he said. “We would go, say, to Paris, and it wasn’t difficult to get hotel rooms then, so every night the four of us planned the next day.”

Dr. Zapolanski realized early on that he was interested in the heart. “I liked cardiac physiology,” he said. “It’s very dynamic. There is nothing like the heart in action.

“The heart is very fluid. Things happen very quickly. It’s not like the kidney or the stomach — stuff goes through and is extracted.”

A world-famous surgeon, René Favaloro, who developed the coronary bypass at the Cleveland Clinic, had returned to his homeland, Argentina, and established his practice close to where the Zapolanskis lived. “I went there on my own, walked into his office, and told his secretary that I wanted to meet him,” Dr. Zapolanski said. “I said that I had read about him in Time magazine.” Dr. Favaloro was not in, but “a young cardiologist who was there said that if you come on Thursday, I will introduce you. So I was there on Thursday, and he introduced me.

“I am pretty aggressive,” Dr. Zapolanski said. “I am a hustler.”

Dr. Favaloro held a meeting for cardiologists every Thursdays, it turned out, and “every Thursday that I could go, I would go.” The cardiac bypass was very controversial then, and “it was incredibly exciting. Here I have the opportunity to sit with the guy who invented it.”

His choice of cardiac surgery as a career was set irrevocably. “I never considered anything else,” he said. “It was a problem. The first five years of my training were in general surgery, and I couldn’t care less about taking out a gall bladder.”

Because he knew that his career would take him to the United States, Dr. Zapolanski took the tests he needed early, and then flew north for interviews. “I did not waste a minute,” he said. He graduated from medical school and began his internship in Baltimore in July 1974. After that, he moved around a bit, using his understanding of politics as well as surgery to make sure that his career advanced appropriately. At 24, he began a residency in general surgery at the Cleveland Clinic; from there, he spent two years doing cardiac surgery in Toronto, and then he went back to the Cleveland Clinic, this time on staff.

Eventually, he moved to California, where he was happy until changes in regulations and insurance forced changes that he thought compromised his work. “I looked around,” Dr. Zapolanski said. “I had met Dr. Bruce Mindich,” the well-respected cardiologist who retired as the head of the cardiac unit at Valley that Dr. Zapolanski now leads. Hospital officials “were looking for someone to take over from him — so in November 2005 I started working here.”

Dr. Zapolanski also recently joined the medical staff of Holy Name Medical Center in Teaneck as a consultant.

In 1976, Dr. Zapolanski married a fellow Argentine, Leah Nohar; the marriage lasted 14 years. “We should write a book on how to get divorced in a civilized manner,” he said. They had two daughters. The older one, Tamar, a dermatologist, and her husband, David, live in Tenafly; Dr. Zapolanski is the enraptured grandfather of two-and-a-half-year-old Maya. “She called me Zayde!” he said, with delight. His younger daughter, Talia, lives in Manhattan and works for a real estate hedge fund. Their father cannot praise either daughter or their life choices highly enough.

Dr. Zapolanski has remarried; he and his second wife, Laurel Mengarelli, have been together for 20 years.

Dr. Alex Zapolansksi and his wife, Laurel Mangarelli, in front of the Kotel in Jerusalem.
Dr. Alex Zapolansksi and his wife, Laurel Mangarelli, in front of the Kotel in Jerusalem.

And then there is his own decision to move to northern New Jersey. He loves it.

Dr. Alex Zapolansksi and his wife, Laurel Mangarelli
Dr. Alex Zapolansksi and his wife, Laurel Mangarelli

“Valley Hospital is fantastic,” Dr. Zapolanski said. “This program has become nationally renowned over the last decade. We have perfected and perfected our results. We have what is called a triple three star rating from the Society of Thoracic Surgeons; only 12 percent of heart centers earn that.”

“What do we do that is different? Delivering good results starts with the appropriate evaluation of patients. We have meticulous evaluations done by physicians and by nurse practitioners, who see the patients even before the physicians do. We have tremendous support in the operating room. We have the best anesthetists, nurses, technicians — everybody.”

And then there’s the personal part. Being nice counts. “My job is to convey the message to patients and their families that they are in the best possible hands,” he said. “That they can trust us and they should feel at ease with the decision they made. And we have to do it in a way that’s not cocky or arrogant.

“I am so cerebral that I came to the conclusion that I can put someone at ease in three minutes,” he added. “I just explain things to people. I show them their films. If they have an obstruction, I show it to them. I explain it. I am soft-spoken. I make eye contact. Sometimes I make physical contact. Something as simple as putting an arm around someone’s back for three seconds has a psychological effect on the patient.”

With his granddaughter, Maya
With his granddaughter, Maya

“When you finish your training, you know nothing,” he mused. “It takes at least 10 years to become a decent heart surgeon. When I first came here” — to Valley Hospital — “I was 54 years old, and I thought that I was already at my peak.

“I am better now.

“What it comes down to is judgment. It is not sewing. Anybody can sew. It is decision-making. It is a very complex process. We want to take it to the level of perfect, and we are pretty close here. People ask me frequently why I’m not retiring. You must have enough money, they say. And I tell them that I’m not good enough yet — and I mean it.

“I have done almost 10,000 hearts since 1979,” he continued. “There are subtleties to every case.”

Cardiac surgery “is both an art and a science. I argue with surgeons all the time that what they do with their hands has nothing to do with their hands. It has to do with their brains.” You have to judge how to select and handle and aim and use your equipment based on what your brain tells you, and what your brain tells you is based both on your native understanding of geometry and cause and effect and even more on your experience, which mediates your understanding of those things.

“I could not see any better when I was 27 than I can now. I was just as good at suturing then as I am today. The difference is the thousands of cases and the judgment and the refining.

“All the tools, your eyes, and your hands are at the service of your brain,” Dr. Zapolanski said. And that brain understands the workings of the heart.

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