Heart surgeon John “Chip” Oswalt refuses to lose touch with his patients or family

BYLINE: Kate McVey, Austin Business Journal Staff
PHOTO: Sarah Jorgenson
DATE: April 20 – 26, 2001
PUBLICATION: Austin Business Journal

It’s not unusual for a heart surgeon to be known for his skillful hands. But some of Dr. John “Chip” Oswalt’s best handiwork has been on a fox and squirrel.

The man who literally holds peoples’ lives in his hands almost daily takes some of his greatest joy from “his girls,” the two daughters for whom he took the time to fix and curl their hair before church when they were small.

“His mother had taught him — and he even knew how to French braid,” says daughter Sarah, now 24 and living in California.
One Halloween he brought his cutting and stitching abilities to bear for the common good — of the family.

That year, the man who is one of the crucial cogs in Austin’s cutting edge health industry decided to make their costumes — a fox and a squirrel. He set everything up in the kitchen, created papier mache masks and sewed “fur patches” to their leotard stomachs — and completed each costume with appropriate tails and ears.
But the skills aren’t all used for the family.

Oswalt was one of the surgeons on the team to perform the first heart transplant in Central Texas at Seton Medical Center in 1986. That same year he helped found its heart transplant program. Last year, he established HeartGift, a nonprofit organization that brings children to Austin from underdeveloped countries for heart surgery at no cost to the families. The program has a goal of treating 10 to 12 children a year for surgeries that can cost as much as $30,000 each.

One of the recent benefactors of the program was 2-year-old Sergio Esteven Solis Morales of Culiacan, Mexico. A day late, he received the perfect Valentine’s Day present. Pediatric heart surgeon Stephen Dewan repaired a hole in one of Sergio’s ventricles and a malfunctioning pulmonary valve. Less than a week later, Sergio was up and around chatting with staff, parents and Dr. Oswalt.
“He didn’t want the program limited only to patients who could pay or had insurance,” says colleague Bobby Richards, Seton director of transplant services and cardiac special programs. “He and Dr. [David] Morris and Dr. [James] Calhoon put the heart transplant program together and they wanted it to be community based.”

Oswalt — known to family, friends and colleagues as simply Chip — joined the staff of the practice known as Cardiothoracic and Vascular Surgeons in Austin in 1980.
He is also known internationally for his expertise and success with the Ross Procedure, which replaces the heart’s aortic valve with a patient’s own tissue. That allows a childhood procedure to create a solution that grows with the patient.

The Oath of Hippocrates, the solemn swear by the Fifth Century physician that is still repeated by today’s doctors, includes the phrase, “and that by precept, lecture and every other mode of instruction, I will impart a knowledge of the Art to my own sons.”

It was taken to heart by the Oswalt family before Chip. His father, Charles “Ozzie” Oswalt was a doctor. It was a path all four of his sons also chose. Even a sister, Judy, found a medical connection — she married a hospital administrator.

“Our father was a family practitioner in Fort Stockton, we grew up in medicine,” says Dr. Charles Oswalt, a trauma surgeon at Hillcrest Baptist Medical Center in Waco and Chip’s older brother. “Dad never really pushed us, but I don’t remember wanting to do anything else. We saw Dad did a lot of people a lot of good.”

“We weren’t pressured into it,” agrees younger brother Dr. Barry Oswalt, a general surgeon, also in Waco, “but I guess Dad just had a big influence — his attitude of life, his practice, living with him.”

“I saw what my father did made a difference in peoples’ lives,” Chip Oswalt says. “He didn’t send me to medicine in that sense of the word, but I think his example helped lead me here.”
Daughter Claire almost funneled down the medical path too. Today she’s a university of Southern California student majoring in creative writing, but she started out with some premed courses and worked as an aide at Seton one summer. How could she not?

“Dad took us to autopsies when we were little,” she says.

But it was his live work that made the greatest impression.

“Once I watched him literally hold a woman’s life in his hands while replacing her pacemaker,” Claire says. “She was wide awake, and Dad could see she was scared. He asked her, ‘What do you do?’ and she answered that she wrote poetry. “Could you recite some for me?’ my Dad asked, and she lay there, with her chest open, reciting her poetry for him.
“That’s my Dad,” Claire says. “He’s comforting, brilliant, with a sense of humor and you can learn so much from him.”
More than a job

On a March morning, five patients wait for Dr. Oswalt in separate exam rooms at his practice. Before talking to each, Oswalt performs the usual reviews of charts and medical histories, scans past Xrays and CT scans, comparing each with more recent “films.”

Three of the patients sit calmly, waiting for their “all clear” signals. They confidently expect words saying they are once again hale and hardy after lifesaving heart surgery.
Two wait more tensely to learn when Oswalt will operate.

One of the two traveled from Puerto Rico for Oswalt to perform the Ross Procedure. Flanked by his wife and daughter, each grins delightedly as Oswalt greets them in Spanish, although they speak English fluently. Three intensely focused faces attend carefully as Oswalt explains the details of the surgery using a clear, black and white diagram and equally clear phrases, devoid of medical jargon. Stark lines of tension disappear one by one as Oswalt answers their questions, with the last few easing as they realize Oswalt is familiar with the blood transfusion prohibitions of their Johovah’s Witnesses religious beliefs.

Later, while viewing chest films of one of the patients expecting an all’s well report, Oswalt notes a “”spot” on the outside of a lung.

“Let me see his films from last year,” Oswalt says. “If it was there last year, it’s not likely to be a problem.” It wasn’t in the previous film — a relatively routine check up unexpectedly turns more critical.

The 60-something, white-haired couple welcome Oswalt with smiles, bright eyes and warm, Scottish accents. The brightness dims as Oswalt moves from follow up results to the new concern. Yet, small I smiles return as Oswalt quietly explains each step needed if it is cancer on his lung. Oswalt answers each of the couple’s questions, queries ending with, “You will be the one if I need surgery, won’t you?”

Terry O’Glee, a long-time friend, says, “Chip’s very different from a lot of physicians. He’s very human, with an empathetic intelligence. He’s so warm and fun and engaging in a profession that doesn’t produce that too often.”

Married for 30 years in December, Karen says, “It was definitely love at first sight — those dimples and that grin. In the early years, I was almost jealous; I thought at first he must love medicine more than me. But when he was an intern, working 48 hours and off 24, sometimes I would go to the hospital to have time with him. I would quietly follow as he took care of patients, and I would fall in love all over again.

“He’s not your typical physician. He really loves his patients, loves what he does,” she says. “He listens to you when you talk to him — his patients, our girls, me — you’re the only one in his world when you talk to him.

“And he still sends me flowers for no reason at all,” she says.

Oswalt was the recipient of the American Heart Association’s very first Cardiac Care Giver of the Year Award in 1999. Nominations came from patients, who spoke about his heart, not theirs.
Wendy Podwalny suffered a heart attack in December 1997. It wasn’t her first heart health problem, but things went from bad to worse that day.

“I remember thinking this was it,” she says. “I was so terrified. I could hear the doctors talking among themselves, but no one seemed to come very close to me or talk to me very much.”
She heard one say, “There’s a surgeon in the parking garage, on his way up.” A few minutes later she met Oswalt.

“He introduced himself to me,” Podwalny says. “He explained my situation had turned into a critical emergency — he noticed how scared I was and came a little closer — he gently stroked my face and told me that it was going to be all right, ‘I can take care of this.’ He looked me right in the eyes, and for the first time I had hope.”

With health problems for the past 10 years, Podwalny says, “I’m pretty prepared I’m going to be seeing him again. When that time comes, it’s going to be Dr. Oswalt. I have this feeling when I talk to him, he listens to me. I haven’t had that too often with other doctors.”