Through a Cardiac Lens: How a Grandfather’s Lessons Led to a Career in Orthopaedic Surgery

Editor's note: The Final Cut is a recurring editorial series written by a member of the AAOS Now Editorial Board.

My grandfather, Ralph Kaufer, was one of the oldest (if not the oldest) living quadruple-bypass patient in the world prior to his passing in October 2024—46 years after his first operation. He survived his first myocardial infarction at the age of 26 and ultimately endured four more before the final one that ultimately took his life. As an orthopaedic surgery resident, my knowledge of cardiology and cardiothoracic surgery is limited, but the lessons I learned from my grandfather’s health journey—specifically how it reshaped his outlook on life and health—left a profound and lasting impact. My parents, siblings, and many others played tremendous roles in my journey, but I want to focus on the unique influence my grandfather had in shaping the path I have taken.

In his book, I’m on My Way to Heaven … Just Not Yet, my grandfather, a businessman, wrote, “These are the factors that are working for me, 46 years later, and maybe would work for you, too: luck, laughter, attitude, common sense, love, and exercise.” Luck, laughter, and exercise certainly played a role in his improbable longevity. But his two values that ultimately shaped my path in medicine were love and attitude.

He reserved a special place in his heart for his grandchildren. Though he was not one to express love through words or overt affection, he showed it through action—instilling in us the principles of resilience, perseverance, and an unwavering determination to pursue our goals. One of his favorite sayings was, “When the going gets tough, the tough get going.” His refusal to let heart disease define him was born out of his deep love for us and his fierce desire to be present for every milestone in our lives. His quiet investment in my development became one of the most powerful influences in my life.

As a child, my first dream was to play professional baseball. I would have done anything to be the starting shortstop for the Los Angeles Dodgers. My grandfather was my biggest fan. He was at every game, analyzing, coaching, and advocating for his grandson. Although professional baseball was always the dream, a more realistic one emerged after I broke my tibia at the age of 12: I wanted to become an orthopaedic surgeon. Still, my grandfather recognized my baseball dreams, and once I reached high school, he essentially became my personal college scout.

As I pursued baseball and pre-med studies in college, my grandfather evolved from scout to pre-med advisor. He knew exactly what I needed to do to get into medical school. I was not the most sought-after high school athlete, and I certainly was not the top applicant to medical school—I only got into one. But I knew nothing would stop me from reaching my goal—my grandfather had instilled this in me. With this attitude and my grandfather’s belief in me, along with his constant presence as my unofficial mentor, I worked toward becoming an orthopaedic surgeon.

Throughout medical school, I had one goal: to put myself in a position to go to one of the best orthopaedic surgery residency programs in the country. At this point, he took on yet another role—my personal residency program director, helping me navigate every step of the process. I will never forget how proud he was on Match Day, when I matched into my top-choice program: NYU Langone Orthopedics. Cleaning out his mailbox after he passed, I found an unopened package: a shirt he had recently ordered. It read “NYU Langone Medical Center.” He could not have been prouder of my success, and I could not have been prouder to have made him proud.

What I learned from my grandfather’s journey through heart disease was the power of grit, perseverance, and unwavering determination in the face of adversity. For him, it meant defying the odds of heart disease to be present for the childhood of his grandchildren. For me, it meant pursuing my goal of becoming an orthopaedic surgeon with the same relentless spirit.

With a little luck, laughter, attitude, common sense, love, and exercise, I hope to carry forward his legacy—not just in my career as an academic orthopaedic surgeon, but in the way I support my family and others, just as he supported me.

In loving memory of my grandfather, Ralph Kaufer (1941 to 2024). “Go Blue, Pop.” Miss you.

Bradley Lezak, MD, MPH, is an orthopaedic surgery resident at NYU Langone Orthopedics and a member of the AAOS Now Editorial Board.