Soup

How do you mend a broken heart?

About a year ago at course registration time, fifteen students signed up for an elective in cardiovascular engineering, expecting to be lectured, given assignments and exams, to be taught in the usual way. It's a 400-level course, open to seniors and graduate students, so these are students savvy in the ways of picking good classes. But when the semester began and they arrived for the first day with new notebooks and sharp pencils, they were surprised. Instead of the usual introductory lecture, the professor is urging them to drop the course. Get out while you can, he says. This is not a normal class. You'll teach yourselves. You'll be in charge of how to grade yourselves. This will be different. The six graduate students took the advice and cut bait. But the nine brave undergraduate students stayed. And it was a very good thing

The professor in this story is Dan Ewert, and though you'd never guess from looking at him, he's been teaching for 25 years. He is a man jazzed about being a teacher, which means he's probably pretty good at it. In fact he has gotten high marks from his students over the years, graduates keep in touch with him as the person who changed their lives, colleagues bestow teaching awards, and other signs of success. So it's worth noting when Ewert says this particular class was the most amazing experience he's had as a teacher. He can't break it down or draw you a graph -- one of his favorite ways to explain a thing -- but every Monday, Wednesday and Friday from noon to one he was one happy instructor. He loved to watch the students participate freely, and see that the chemistry among them helped them all learn from one another. He calls it magic.


This class in cardiovascular engineering meets in a generic classroom in the electrical engineering building. A tiny teacher's table sits at the front next to an old metal folding chair, and there's even an old style hand crank pencil sharpener. Someone has drawn eyes, a handlebar moustache and a smile with its tongue sticking out in blue marker on the standard-issue clock. On this day, the two women and seven men arrange the little chair-desks in a semicircle. Two are eating something from Taco Bell, another is working on a cup of coffee. Ewert arrives early, comfortably lolls in the old folding chair, and sips from a big bottle of Coke.

At the top of the hour, they start on the question of the day: How to measure left atrial pressure in an artificial heart. One of the guys has some thoughts. He starts in on his description, his hands awhirl as he talks, and then he is up at the white board, drawing this device he's imagined. He asks if there's a pharmaceutical option to handle the immune system response, and Ewert nods for him to assume there is, and they're off. His classmates ask and answer a few questions and Ewert jokes with them about who gets credit on the patent. That's follow up from the previous class meeting. They move on to the new subject, self-calibrating pressure transducers. For a few seconds, the room is quiet, and then six or seven of them start talking at once, mostly mumbling, but they seem to be making sense to one another.

He had to nudge them at first -- they are engineers, after all, even if drawn to cardiovascular engineering. At first, they'd qualify their ideas with a "this is probably wrong" but Ewert works to squelch that impulse. He likes a batting average analogy. A good baseball player is "right" three out of 10 times at bat, and scientists are lucky to be right once in 100 tries, he says. So get up there, draw us an idea, the important thing is to ask questions and figure out how to test hypotheses. And so they learn from one another and teach themselves and get fired up about their own curiosity and begin to synthesize a whole lot of information, the very things this teacher loves most about teaching. Which is nice, because a student who learns from a curious person who is not afraid to make mistakes is a lucky student. How Ewert came to be the human he is -- the teacher, researcher, engineer, person -- is another story.


The story begins in 1983, in a room of Station 55 at the University of Minnesota Hospital. A 25-year-old Ewert watches for four months as his infant daughter gets sicker, is tested and treated and tested again, with no diagnosis to explain her condition. From her room, Ewert can see the square nurses' station, surrounded by a square of hospital rooms with windows all around so the nurses can see everything from everywhere. Sometimes the bigger kids ride trikes through the halls, pulling their IV stands along beside. The walls, the light, the furniture, he remembers as a hazy yellow. He knows that's probably not so, but that's how he sees it. He remembers a baby boy in the next room, just old enough to pull himself to a standing position in his crib. Ewert and his wife play peek-a-boo through the window with him, because the boy had no visitors, his family brought him to the hospital and did not return. All the while, this young couple hopes each day to figure out what's making their own baby so sick, watch her suffer through tests and treatments. Ewert always carries her from the room when there is a procedure, even though she comes to understand the pattern and learns to fear him

Kristin Ewert died when she was seven months old, still without a definite diagnosis. Doctors assumed she suffered an autoimmune disease, which destroyed her body from the inside. Eleven years later her youngest sister, Sara, suffered the same disease, but lived a longer and better life, and enough advances had been made that this time a specific diagnosis was possible. Sara was four years old when she died, like Kristin, of familial erythrophagacytic lymphohistiocytosis, which means the destruction of red blood cells and is known as FELS. Two girls born between Kristin and Sara -- Heather and Megan -- were not born with the genetic disease.

Ewert was not prepared for these massive losses. As a boy, he learned from Grandma Ewert that where there's a will there's a way, and he believed it. "Kristin was the first experience where will didn't matter," he says. "I couldn't affect the outcome no matter how hard I worked. It was the first time I felt powerless. It completely shakes your foundation." To honor the memories of his girls, he is an optimist. For a guy who has watched two children die, and endured the almost inevitable dissolution of the marriage to their mother, he's a happy man because he's decided to be so. "Your choice is to give something back, or be angry the rest of your life. It's pretty simple." It wasn't simple, though. He'd lived a good life, mostly on the straight and narrow, with the idea that bad things don't happen to good people, so his worldview was shattered.

Eight months after his second child died, he was called to donate a kidney to his sister, who was diabetic. He'd been working on a summer fellowship in San Antonio for only two weeks when the call came, so he got on his motorcycle and started driving north. The closer he got to the hospital in Minnesota, the sicker he felt. It was his physical reaction to going back to the hospital where he watched his daughters die.


When Kristin was sick, he was working on his master's degree in mechanical engineering, and during all those hours and days and weeks in hospitals he saw plenty of examples where engineering could make a difference, could make those sick kids' lives less awful, if not better. He had a lot of time to think, and he thought about what his life should be about, and decided he wanted his life to be about helping other people. He considered medical school, but that profession seemed too limiting for him, so he decided to pursue a doctorate in neurophysiology. He had hoped to steer his career toward the neuro side of things -- working on the body's computer is considered pretty sexy in engineering circles -- but the opportunities that kept coming his way had to do with the plumbing -- and so cardiovascular engineering became his area.

As it's turning out, the plumbing isn't so dull. After graduate school, Ewert had a research fellowship at the Biodynamics Research Unit of the Department of Physiology and Biophysics at Mayo Medical School, Rochester, Minn., and he loved working with all the best at Mayo, but the job did not include teaching, and he missed students. Truth be told, though, when he came to North Dakota State for a job interview in 1990, he wasn't very serious about it. He agreed to come because there was a curling tournament he wanted to be in on the weekend. He liked the place and the people and got a job offer on the spot.

He's the type to downplay his abilities, and claims any success comes from being a hard worker. Either way, he's done some amazing things. Just lately, he conceived, modeled and helped develop a new ventricular assist device. These devices, known as VADs, are familiar to anyone who watches medical dramas on television, and are thought of as a bridge to transplant. But only half as many hearts become available as are needed, so researchers keep looking for better solutions. Ewert's VAD capitalizes on the fact that some patients' hearts actually were healing while the device was in use, so he decided to try to create something intended to give the heart a rest, the way you'd rest any other sore muscle. "I'm a simple guy," he says, "so I thought about it in a simple way."

Last year his colleagues honored him with the university's Faculty Lectureship. With this campus award, the tradition is for the recipient to suggest a snappy title used to promote his or her lecture. Some years this is a struggle, as one's hard-earned academic career often doesn't lend itself to a catchy phrase. Ewert knew his title right away, because he knows his Bee Gees song titles: "How do you mend a broken heart?"


Ewert and some of his engineering buddies lunch at the Memorial Union most days, and this is clearly their mental break in the day, judging by their goofy repartee. But even as they make fun of each other and themselves, the humor is very much engineering minded, so, for example, if they get started on the differences between the genders, one pulls out a pen and another hands over a napkin to graph how male and female moods swing in opposite directions. Perfectly logical to them. This goofball side adds to the impression that Ewert is just a regular guy, just happy to enjoy a little hot lunch, not an intellectual who can dream up new ways to save human hearts. But if you get him away from the guys and talking, he'll start in on the importance of liberal arts in the education of engineers. Galileo. And wanting to be a better writer. Which book on tape he's listening to on his hour-long drive to his lake home. He likes to talk about how the beauty of engineering is the creative part. "If you get to the synthesis level, all things become art."

You could know Ewert for years and never guess he's had hard times. He does not like to tell about his life. He doesn't want pity or allowances. He's developed a "lite" version he can hurry through when pressed to tell his story. But he is a different guy than he would have been. He'd have continued to be a straight and narrow type, more likely to dog after the things guys like him are supposed to want -- power, prestige, position -- and he thinks he probably would not like that guy. These days, he's happiest when he's at a table full of smart people who want to figure things out, and no one is worried about who gets the headline. Or when his students are teaching themselves. Or when he's out on his all terrain vehicle which is kitted out with some new kind of tracks. Or wrestling with his stepson, and that at 49, he can still prevail over a 6-year-old.

Ewert and Darcie, his wife of four years, married just a few months after their first date, and he says she has helped him heal "in ways no one else can." His daughters are not, despite some efforts on his part, pursuing engineering careers. But he clearly is, in the great way of a dad, proud of them, and enjoys their company. Megan is just back from a year of study in Japan, and Heather is about to begin study in linguistics and foreign service in Washington, D.C. The girls remain very close. Ewert has a favorite snapshot of them when they were little girls asleep, holding hands, one wearing a bunny ears headband.

He's teaching the cardiovascular engineering class again this year. Ironically, word got out that it's a great class, so the size made it harder to recreate the chemistry from last year, but as the semester goes, the class is catching the wave, so much so that by mid-March, a guest speaker from industry felt pinned to the front wall by the students' questions and ideas. Ewert is teaching them to do that -- not to just regurgitate what they are told, but to ask bigger questions, come up with ideas. This is how he decided to deal with his losses, what he found when he dug deep and wondered how to recover. He found a deeper commitment to teaching. "Education and freeing people's minds is a worthy endeavor."

And while he's helping to create thoughtful, inventive engineers, he tries to give his students a little life wisdom. Students, he says, expect their lives to unfold in a straight line, just as he did, but it's more like the children's board game Chutes and Ladders, in which you'll suddenly hurtle down a slide or drop down a chute and lose your place in the game. But you pick up the dice and roll again, and once in a while you get to go up the ladder. The negatives and the positives contribute to who you are in the end. It's not about the knowledge, he says, it's the pursuit of knowing.

--L. McDaniel