Dr. Kristaps Keggi

Hiding all night in a Latvian forest waiting for a boat to safety in Sweden and deliverance from both Communist Russians and Nazi Germans, Kristaps Keggi had no idea if he would live to see the next day. Ultimately, Kristaps Keggi became the Elihu Professor of Orthopaedics and Rehabilitation at Yale University, Director of the Yale New Haven and Waterbury Hospital Joint Replacement Centers, and one of the most respected surgeons in the United States. But the memory of that boy in the woods is still a constant reminder of how fortunate he is to be practicing surgery in America. 

Born in 1930s Latvia, Kristaps Keggi discovered a love of medicine from his surgeon-father. “My father was a surgeon and thought of medicine as one of life’s highest callings. His feelings about medicine were very obvious to me, especially when I was trying to decide on a career. My maternal grandfather was a well known theologian, writer, poet, and educator; his ideals have left a profound impression on me. My mother, who was also a teacher, cared for us four children during many years of hardship.”

Dr. Keggi: “In 1939, the Baltic States were overtaken by the Russians; for the Baltic people this meant a horrible five years of being caught between the Communists and the Germans, followed by fifty years of Russian rule. One of my most powerful memories is sitting in that Latvian forest waiting for a boat to Sweden. German patrols were nearby and my dad, concerned about the trustworthiness of the fishermen who were supposed to help us, decided against the plan and felt we would be safer in Germany until the end of the war.”

“We did get to Germany, but once there we were taken to an SS Camp for Russians. My father hid us on the train that had taken us there, and we were able to escape. In 1949 we made it to the U.S. via the North Atlantic. The seasickness and cramped quarters were a welcome relief from the chaos we were leaving behind.”

Such a tumultuous youth taught Dr. Keggi the value of life. “I consider myself very lucky. If my father hadn’t been the only person qualified to take care of the communist mayor of our town, we would have been shot or deported. I recently treated a Puerto Rican woman with a complex hip problem. Her poverty and difficult life were things I understood and wanted to correct.”

Arriving in New York, the 15-year-old Kristaps soon found himself on the educational fast track. “Our second day in the U.S. my mother took us to the nearest school—for me, it was the Manual Training High School in Brooklyn. My credits in French, Math, German, History, and Latin placed me in the senior class. I was introduced to a former GI who was helping Estonian and Latvian refugees through the American educational system. A month later the headmaster decreed, ‘You’re going to Yale’… and so it was.”

At Yale, Kristaps Keggi found wisdom in the pages of French literature, his major. “I took premed courses, but stuck to my literature track.”

I have come to learn that having read Victor Hugo, Camus, and others…you don’t need psychiatry.

Remaining at Yale for medical school, Kristaps Keggi flirted with orthopedics early on, but didn’t want to commit just yet. “My anatomy professor suggested that I study orthopedics; I had ruled out the other surgical specialties, but I was impressed by several cardiac surgeons and took some time to explore their work. Later, the inimitable Dr. Wayne Southwick arrived at Yale and my future was sealed—his enthusiasm for orthopedics was total and infectious. I wanted to be part of this vibrant, burgeoning field.”

In many ways, the returning veterans from World War II put their stamp on both the practice of surgery in America and on Dr. Keggi. Following medical school, Dr. Keggi spent two years in general surgery at The Roosevelt Hospital in New York City. “I was put in charge of the ER as an intern. Among the senior surgeons on staff were those who had been in World War II and marched with General Patton…they brooked no nonsense. One of my mentors was the Chief of Surgery, Dr. Howard Patterson. He was a war surgeon, and impressed upon me the importance of being able to operate under any conditions.”

Thoughts of Yale orthopedics stayed with Dr. Keggi, and in 1961 he returned there to work with Dr. Southwick. “Dr. Southwick thought us mature surgeons and expected us to do the right thing on our own. You could say that we were in a free country and could think freely about all aspects of surgery.”

In reality as well, Dr. Keggi was committed to keeping his new country free. He volunteered for the Army and was commissioned as a second lieutenant in 1957; after his residency Dr. Keggi started two years of active duty. “Having survived Communism, I felt strongly about contributing to the U.S. military effort. My first year was in El Paso at the Beaumont General Hospital, where I worked with residents. The colonel in charge was only interested in knee injuries in soldiers, so I was in charge of spine, major trauma and almost all other reconstructive surgery.”

But this couldn’t fully prepare him for his future: the sound of helicopters and gunfire, the wounded, the heat, and once more, the chaos of war.

I was sent to a MASH hospital in Vietnam where the zeitgeist was, ‘Forget the fancy stuff you learned…get back to the surgical basics learned in war surgery for thousands of years.’ We were on our own in the Southeast Asian highlands—there was no Dr. Southwick. It was so new to be all alone in this environment and having to make quick decisions about the care of major wounds, amputations….

To this day Dr. Keggi remembers the often terrifying reality of that war. “Mangled limbs from booby traps, AK-47 gunshot wounds…there was trauma everywhere. Nowadays we have improved ways of stopping a hemorrhage, as well as additional technology, but the basics of war surgery are the same and I teach it to all of my residents. Many of them may have to practice it since, as Plato said, ‘Only the dead will not know war.’”

Returning to Yale in 1966, Dr. Keggi became an assistant professor of orthopedics…and among other duties was given the job of organizing a trauma service. “On a lark I drove to the headquarters of the Insurance Institute of Highway Safety in Hartford, arriving there with blood on my coat from having extracted an injured man from his crashed car. I was granted $20, 000 to continue my work in trauma. This led to a larger grant, which later helped fund a Physician Assistant program at Yale. Another program I instituted involved sending medical students to follow the fire department and record emergency care in the field. This revealed a significant number of mistakes that were being made in trauma care and helped further the Emergency Medical Technician Program.”

Although his head had been set on becoming a Chair, Dr. Keggi increasingly realized that his heart was in doing and teaching surgery. “I began to dread administration. In 1969 I went to Wayne Southwick and told him that I was going into private practice. While maintaining teaching appointments at Yale and continuing clinical research, I operated at Waterbury Hospital.”

But time would, in effect, pull out a Chair for him. “I maintained a clinical professorship at Yale all those years; now there is an endowed professorship in my name. “

“While this is quite an honor, I must say that I have perhaps derived the most satisfaction from teaching nearly 200 residents how to operate, how to deal with patients and how to think independently. I have encouraged them to question my work and everything else they may encounter in their training.”

“They have rewarded me with their teaching Prize on six occasions.”

Some never forget where they came from…and some go beyond that. Dr. Keggi: “While attending the Goodwill Games in Moscow in 1986 I met several prominent Latvian orthopedists who then invited me to Riga. The next year I attended the first ever International Soviet Latvian orthopedic conference. During the event I met Dr. Viktor Kalnberz, a Latvian and the highest ranking Soviet academic surgeon, who invited me to perform an anterior approach to the hip. It was a rare surgery at the time, and they were thrilled. Viktor and I then started an exchange program, which evolved into the Keggi Orthopaedic Foundation. The goal is to promote the training of surgeons from the former Soviet Union and the Baltic States. More than 200 surgeons have trained with us and many are now in prominent positions in their home countries. One of our trainees has even served as the President of Latvia.”

During the last 15 years Dr. Keggi has been primarily involved with teaching hip surgery to residents and fellows, his major area of expertise. “Years ago Dr. Terry Light worked with me on the anterior approach to total hip replacement. It is now accepted and considered a tissue sparing and minimally invasive operation. We used the Smith Peterson approach in which you do not cut muscles, but instead go through an internervous interval. This way you also preserve blood supply to the muscles, thus allowing a faster recovery. All roads lead to Rome and many approaches to the hip work well. If the prosthesis is in the correct position, at the end of a year the result is the same. But, if you do a tissue saving internervous approach the initial recovery is faster (and there is less pain).”

On the homefront, Dr. Keggi takes pride in his marriage of 53 years. “My wife, a ‘Smith gal, ’ is an award winning gardener and golfer who has also devoted much time to many civic activities. We have three daughters and five grandchildren, and much to my satisfaction and pride, our first grandson is now a sophomore at Yale.”

Dr. Kristaps Keggi…an orthopedist against all odds.