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Switzerland

From Opera To Operating Table: Swiss Doctor Breaks New Ground On Fetal Surgery

Martin Meuli, a pioneer in the field of fetal surgery, is looking to operate on victims of spina bifida, a condition that can lead to severe life-long disability -- and often prompts couples to choose abortion.

Meuli after surgery (SFTV)
Meuli after surgery (SFTV)

ZURICH -- Martin Meuli has a penchant for the unconventional. Before becoming a world-renown surgeon, he almost wound up as a professional opera singer.

Although he entered medicine by chance, Meuli was soon convinced that his destiny was to pursue surgery, which he describes as "a very active, vibrant field with a certain kind of aggressiveness."

Having risen to become chief of surgery at the Children's Hospital of Zurich, Dr. Meuli is one of only a handful of specialists to perform surgery on unborn fetuses.

On this particular day, Meuli will be leading a team in kidney surgery on a six-year-old girl. Even before the top surgeon has the chance to get warm, his assistant stands in the doorway, noting the challenge: "Open kidney biopsy, it would be important," the assistant says.

Meuli arrives soon after, donning a protective mask and surgical green from head to toe. With monitors flashing and machines beeping, the young patient lies on the operating table, under anesthesia with her kidneys laid bare. Around her, a dozen doctors and assistants discuss the nature of the kidney cysts that have appeared.

The atmosphere is concentrated, but relaxed, with intermittent laughter. After half-an-hour, the lab reports the biopsy results: everyone is relieved, and the surgery can continue without Meuli.

The 56-year old surgeon is a pioneer in his field. This summer he successfully operated on two unborn fetuses in the womb – the first operation of its kind in Europe, garnering wide attention in the medical community. The fetuses both had spina bifida, a failure of the spinal tubes to close properly during intrauterine development, which can lead to severe life-long disability. Often, couples choose to abort a fetus with the condition.

Meuli's surgery was a success, an objective he'd been steadfastly working towards for the past 15 years. In 2007, he performed the first successful operation separating Siamese twins in Switzerland in 24 years. Originally specialized in children with severe burns, Meuli would go on to pave the way for the Zurich Children's Hospital to be a leading center for pediatric surgery.

Outlandish, from time to time

On the way back from the operating room, Meuli is quietly humming a tune. Normally he would be much louder. Music, in particular classical, is his secret passion. "For a long time I hesitated as to whether I should stay in medicine," he confesses.

He studied singing for many years and was accepted to the international opera studio of the Zurich Opera at the age of 31. But while preparing for this full commitment to a professional opera career, he was offered the position as head of staff at the children's hospital. With a bit of a heavy heart, he opted for medicine. "I told myself: Basta, now this is the way it is!," he recalled, theatrically banging his hands on the desk.

The decision turned out to be the right one. When he applied for a professorship in pediatric surgery, medical schools in Bern and Zurich were fighting to have him.

Ernst Reichmann, head of the research lab of surgery, says Meuli "combines creativity and charm in a unique way, enabling him to pull others along with his enthusiasm. He also ensures that his projects get done."

Sometimes his outlandish side still comes out. During the last world congress on burn surgery, Meuli directed a choir from inside the swimming pool, with a rubber tube around the waist, in front of researchers and doctors from all over the world.

His interest in fetal surgery goes back to his days at the burn center, where he encountered some horrific burns. Meuli was fascinated by the fact that fetal wounds healed without the slightest trace of a scar. Along with his wife Claudia, who is also a professor and chief surgeon for plastic and reconstructive hand surgery, he spent time in the 1990s at the University of California, San Francisco, the world's only center for fetal surgery at the time.

Fetal surgery is the youngest surgical discipline, and Meuli is driven both by ambition and for the passion of doing something few have ever done. In Europe, the only other place doing these operations is in Germany. There it is performed through a so-called keyhole operation, which is not without complications, Meuli warns, because the tiny holes in the uterus often fail to adequately close.

Since he came back in Switzerland in 1995, Meuli decided he also wanted to operate on the unborn. Five years later the team was ready, and Meuli alerted the media, though at first there were no cases. In Switzerland there are only about 10 cases of spina bifida a year, and the few cases where fetal surgery was an option, the parents all decided against it.

From 2003 until the end of last year, a large medical study in the United States on spina bifida operations prevented him from performing a surgery. The U.S. specialists that he wanted on board were only permitted to operate on American patients, and Meuli did not want to pursue the surgery without more experienced colleagues by his side.

Now that he has effectively performed a fetal operation, Meuli wants to make Zurich the European center for fetal surgery, where patients from everywhere will be sent. "Other countries will have a hard time catching up," he says.

Read the original article in German

Photo by SFTV

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Geopolitics

Utter Pessimism, What Israelis And Palestinians Share In Common

Right now, according to a joint survey of Israelis and Palestinians, hopes for a peaceful solution of coexistence simply don't exist. The recent spate of violence is confirmation of the deepest kind of pessimism on both sides for any solution other than domination of the other.

An old Palestinian protester waves Palestinian flag while he confronts the Israeli soldiers during the demonstration against Israeli settlements in the village of Beit Dajan near the West Bank city of Nablus.

A Palestinian protester confronts Israeli soldiers during the demonstration against Israeli settlements in the West Bank village of Beit Dajan on Jan. 6.

Pierre Haski

-Analysis-

PARIS — Just before the latest outbreak of violence between Israelis and Palestinians, a survey of public opinion among the two peoples provided a key to understanding the current situation unfolding before our eyes.

It was a joint study, entitled "Palestinian-Israeli Pulse", carried out by two research centers, one Israeli, the other Palestinian, which for years have been regularly asking the same questions to both sides.

The result is disastrous: not only is the support for the two-state solution — Israel and Palestine side by side — at its lowest point in two decades, but there is now a significant share of opinion on both sides that favors a "non-democratic" solution, i.e., a single state controlled by either the Israelis or Palestinians.

This captures the absolute sense of pessimism commonly felt regarding the chances of the two-state option ever being realized, which currently appears to be our grim reality today. But the results are also an expression of the growing acceptance on both sides that it is inconceivable for either state to live without dominating the other — and therefore impossible to live in peace.

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