Fogarty Board Chair Tom Krummel: What Tom Fogarty Means to Me

by | May 2, 2024 | Fogarty Innovation

When people share stories, even the biggest events become small and personal. The atmosphere quiets and people draw up their chairs or lean in attentively. While we had superb storytellers at Tom Fogarty’s 90th birthday celebration, one in particular was sorely missed – Fogarty Innovation chairman of the board Tom Krummel, MD. To make up for it, we caught up with Tom K. after the event to ask about his own history with Fogarty. Following is a transcript of that conversation, lightly edited for clarity and length.

Q. How did you meet Tom Fogarty?

A. I first knocked on his door in December of 1998. I had come to California to interview for chair of the Department of Surgery at Stanford, and he actually wasn’t on the list of people I was supposed to meet. To this day, I think they didn’t mention him ahead of time because they thought he would scare the crap out of me and I wouldn’t take the job!

But I knew of him from my early days in circulatory assist and ECMO, and so when I met him, I just said, “I think what you’ve accomplished has been remarkable, and that ought to set the tone and tenor for the Department of Surgery under my watch.”  I added that I hoped we could grow a colleagueship and friendship. 

It wasn’t until I shared my idea for launching the Fogarty Lecture as an annual touchstone for physicians and inventors that I got the first grumble. He thought I was looking for money. I told him that what I wanted was for him to be the first speaker. And then came his next grumble – that he couldn’t imagine that anyone would want to attend. Well, 25 years later we all know how that ended up working out.  

Q. What were your impressions of Tom when you first met him?

A. Tom is blunt and plain-spoken. I think in general, surgeons are that way – clear and unequivocal – because they can’t afford any confusion about what the plan is, what the post-op issues are, and so on. And although I will add that Tom is a bit gruffer than me, we both tend to be pretty direct. There’s a lot of “yep” and “nope” and “let’s discuss.”  

But I knew I could really learn from him. Once I became department chair, I made it a point to go out to Fogarty Engineering and meet with him regularly, just to have a series of ongoing conversations.  It was during that time that the AneuRx Aortic Stent Graft was in development, and I got interested in how he and Chris Zarins were advancing their ideas. Chris is a celebrated expat in Latvia, and that allowed the team to do their clinical trials in that country. It was an interesting window into how startup medtech companies frequently go offshore because it can be hard to do early work in the U.S.

Q. How did you join the board at Fogarty Innovation?

A. There was an open board seat and at the time I was also co-director of Stanford Biodesign. We all felt like there was a great opportunity for a closer partnership among Biodesign, Stanford Surgery, and Fogarty Innovation. Each institution plays a complementary role in the ecosystem, and taken all together, the resources and intellectual capital available are extraordinary. Later, when Tom took a step back, I became chairman of the board.

Q. What do you see as Tom’s most significant contribution to medical device innovation?

A. It’s actually a sweep of contributions. Everyone knows about the balloon catheter, but people forget about aortic stent grafts and a whole host of other devices he invented. For example, TAVR is built on the work Tom and Chris Zarins did that made it possible to blow up a balloon and expand a nitinol stent in the aortic annulus without it dislodging or creating an embolus.  

Similarly, Tom was the driver behind tissue valves. In the early days, cardiac valves were made of steel and required continuous anticoagulation. And because of that, people bled. When Tom was at the NIH working with Glenn Morrow, MD, he developed the notion of glutaraldehyde fixation and the pig valve. And it was a tricky business with the need to get rid of surface antigens, “tan” the valve, have it sewn inside a ring, be able to ship it so that it could be put into patients, and so forth. Each of those hurdles involved hand-to-hand combat and a slog through things that “couldn’t be done.”  

Q. Can you share a favorite Tom Fogarty story or memory?

A. In 2019 I nominated Tom for the American College of Surgeons “Icons in Surgery” award. As part of that, I had to produce a video. In the video, I asked him a simple question: What’s the hardest thing about innovation?

And Tom looked me dead in the eye and said that hardest thing is displacing the old – the installed base of whatever we’ve been using. Because the inertia is to say that it’s good enough, that we know how to use it, and that all of the forces align – there’s a code for it, a supply chain, and so on. To disrupt that you have to be willing to say, “You know what? That’s a dying business.” 

And that whole notion of displacing the old coming from Tom, who was at the time in his mid-eighties, was a little incongruous because it implied that he was not old. And it was funny, but it also showed that he has this perpetually youthful attitude about embracing change. And I’ve tried to embody that mindset ever since. 

Q. How does Fogarty Innovation preserve Tom’s legacy?

A. One of the ways that surgical science has advanced is that the present experts train the future ones. They give them everything that they can, and then turn them loose. And that continues at Fogarty Innovation. The beauty of that is you don’t just train people to do what you did specifically. You train them to develop future inventions, which become geometrically powerful. 

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