Obituary: A doctor's dilemma Professor (1933-2007) On 1 November, Egypt lost one of its most accomplished surgeons and medical professors. was a professor at the Qasr Al-Aini School of Medicine, the first faculty of medicine in the Middle East. Born in May 1933, the youngest of four brothers and a sister, he grew up in Shebin Al-Kom, the capital of Menoufiya governorate, where he obtained his high school certificate in 1950. He graduated from Cairo University's Medical School in 1957 and began his academic career as a house officer in the school's Qasr Al-Aini Teaching Hospital. He was head of the school's surgery departments between 1990 and 1993. In 1977, he was awarded the Egyptian State Prize for Science and Arts, First Class. During the course of his career Professor Shafik developed an international reputation. The Mediterranean Society of Coloproctology elected him as its president in 1998, a post he held for two years. In 2001 he became president of the Mediterranean Society of Pelvic Floor Disorders, a position he held until his death. In 2004 he was elected president of the International Society of University Colon and Rectal Surgeons. A memorial service commemorating Professor Shafik will be held when the Society convenes for its 2008 Congress. Professor Shafik was not only a renowned surgeon but a daring researcher. According to the Foundation webpage, "since he was a student [Shafik's] attitude of questioning what is commonly accepted or taken for granted, and his unorthodox earned him as much recognition as criticism." In 1963, Professor Shafik developed a new technique for urinary diversion known as Shafik I. In 1964, he worked on fashioning an artificial bladder; Shafik II. Both projects were published in international medical journals and were sufficiently unorthodox to see him suspended from work for varying periods. Twenty years later he faced similar problems linked to his research on a possible medication for rheumatoid arthritis, RACA85. He was again suspended from work after announcing his findings before consulting the concerned department or the school administration. In return he took the Medical School to court where he won his case. "Regardless of any difference in opinion that might be raised, one major criterion that differentiated Shafik from the majority of us [medical professors] is that he never ceased to think of ways to better understand the human body and improve the technical aspects of care," says Abdel-Aziz Taalab, professor of surgery at Menoufiya University. And Professor Shafik continues to court controversy. Almost immediately after his death Dr Mohamed Abdel-Aal, of the Medical Scientific Society, filed a complaint with the prosecutor- general alleging negligence on the part of the Qasr Al-Aini hospital that contributed to Professor Shafik's death. Shafik's son Ali, an associate professor of Surgery at Cairo University, says that while the family is fully aware of the good intentions of Abdel-Aal, who "loved my father and was one of his closest students and friends" he may not "be aware of the details". Shafik was spending the Lesser Bairam holiday with his family on the North Coast when he suffered a severe heart attack. With no centre with the necessary equipment along that stretch of coast, the family transferred him to the Qasr Al-Aini Intensive Care Unit, upon his own request. "It is the best in Egypt and he received the finest care available. They all did their best and spared no efforts to save his life," says Ali. Taalab agrees that, "if there is any intensive care unit in this country that can be trusted it is the Qasr Al-Aini unit run by Professor Sherif Mukhtar. They have no financial or personal interest other than serving their patients to the best of their ability." Days later, Professor Shafik was moved to France where he underwent a cardiac bypass operation at the George Pompidou Hospital. Ali Shafik stresses that the move had nothing to do with the quality of care his father received at Qasr Al-Aini. "It is just that some advanced equipment is not available as yet in Egypt. We wanted to give him the best chances within our power." Professor Fabiani, head of the cardiac surgery department at the George Pompidou Hospital, who operated on Professor Shafik, told the family that the chances of success were less than five per cent. They went ahead with the operation believing it was his only hope. While the operation was successful, the heart muscle failed to contract and the patient was placed on a left ventricular assist device -- "one that is not available in Egypt," says Ali Shafik. "Unfortunately 10 days later he suffered multi-organ failures which eventually led to his death." "The circumstances of Professor Shafik's death raise two questions," says Taalab. "First, the kind of media coverage of medical care given to celebrities and other popular figures. It has reached such a degree of hysteria that medical professionals may well decide it is not in their interests to treat these people in the first place, so frightened are they of ill- informed stories tarnishing their reputation as the press seek sensational headlines over balanced reporting." More importantly, Taalab says, the case exposes the absence of competent and efficient medical care along a vast stretch of the North Coast. "It is a totally unacceptable situation and needs to be urgently addressed by the relevant authorities." By Hala Sakr
