Christopher Kristaps Zarins, MD, chief of Stanford’s division of vascular surgery, has claimed numerous honors since finishing his surgery residency three decades ago, but as far has he’s concerned, the latest tops them all.

Last month Zarins took home the Latvian Republic’s "Tris Zvaigznu Ordenis" (Three Star Order), established in 1924 for service to the nation — Latvia’s highest civilian honor.

The normally soft-spoken Zarins reveals a passionate side when the topic turns to Latvia. Though he has lived in the United States for most of his life, he was born in Latvia and has strong ties to the Baltic nation. He is fluent in Latvian and makes frequent trips there to teach, care for patients and visit family and friends. During the years of Soviet rule, he organized shipments of medical supplies and equipment and even did his part to push for Latvian independence.

Stanford's chief of vascular surgery, Christopher Kristaps Zarins, traveled to Latvia last month to receive that nation's highest honor, the "Tris Zvaigznu Ordenis." Here he celebrates at a reception with Latvian dignitaries, friends and family. Zarins stands with Vaira Vike-Freiberga, president of the Republic of Latvia. Photo: Courtesy of Christopher Zarins

Zarins follows in the footsteps of his father, Richard Zarins, who received the Three Star Order in 2001. The elder Zarins led the main church in Latvia’s capital, Riga, until the Soviets arrived. The family fled to Sweden in 1944 on a small fishing boat. "The captain thought it might be good luck to have a minister and his family on board," said Zarins — and two years later Richard Zarins was asked to lead the Latvian Lutheran Church in New York City.

So the family moved to New York, arriving Dec. 2, 1946, Christopher’s third birthday. "I remember seeing the Statue of Liberty and walking off the gangplank," he said. Richard Zarins led the church for more than 50 years, taking care of New York’s Latvian refugees and helping to maintain the Latvian community.

Zarins grew up in the parish house in Brooklyn and learned to love all things Latvian. "I feel very fortunate having been able to grow up in the United States and I feel like I have to give back to my homeland."

His first visit to Latvia was in 1986 when the nation was under Soviet rule. He spoke at the World Conference on Biomechanics that year and caught the attention of the KGB by beginning his address in Latvian.

"I was supposed to speak in English. The official languages for the conference were Russian or English. After that, we had a government escort with us every second, and every single room we were in was bugged."

In 1989 Zarins helped his brother, Bertram Zarins, also a physician, organize the First World Congress of Latvian Physicians. This event marked the first free expression in the Latvian language since Soviet rule. During the congress, the two headed a parade of 10,000 health-care workers through the streets of Riga and laid a wreath at foot of the Freedom Monument in the center of Riga.

The visit marked the beginning of Zarins’ surgical work in Stradinu and Gailezera hospitals in Riga, teaching vascular surgery and caring for patients.

In the years that followed, Zarins helped organize shipments of medical supplies and equipment, notably, in 1992 sending a C-141 military transport plane full of supplies, including an autotransfuser — a device used to collect and reinfuse blood during heart surgery. He also set up a vascular surgery training exchange and continued to help organize the Latvian medical profession, care for patients and train physicians in Latvia.

One training high point came in 1996 when Zarins and three fellow Stanford faculty introduced their Latvian colleagues to interventional cardiology and endovascular surgery. During this visit, Zarins and Stanford faculty Michael Dake, MD, and Thomas Fogarty, MD, performed the first stent graft repairs of aortic aneurysms in Latvia.

On the same trip, Stephen Oesterle, MD, at the time Stanford’s head of interventional cardiology, performed Latvia’s first cardiac catheterization and demonstrated coronary angioplasty and stenting.

All of these procedures took place before a live international audience. The visit marked the beginning of interventional cardiology in Latvia, which today is among the most active programs in Europe, Zarins said.

Zarins is amazed by how Riga has blossomed since Latvia regained independence in 1991. "Riga is a jewel. The transformation since the Soviets left is absolutely incredible. It was a gray, dark depressing place in 1986. If you look at it now, Riga is a wonderful city on the Baltic Sea. It has beautiful architecture and a great downtown. It’s like a little Paris."

Zarins’ past few weeks could be a page out of a modern fairy tale. The announcement from the president of Latvia’s office that he had been granted the medal took him by surprise, landing in his e-mail inbox just 10 days before the award celebrations in mid-November. Next thing he knew, he was in Riga with his family, being honored at elegant receptions and ceremonies.

Perhaps best of all, the guests included many of those Zarins holds dearest. Among them were two of his cousins who grew up in Latvia and spent years during Soviet rule as slave laborers in Siberia; the Latvian poet laureate Imants Ziedonis, whose life Zarins saved by arranging care for him in the United States for critical coronary ischemia, which could not be treated in Latvia; and Dainis Krievins, the head of the endovascular surgery program at Stradinu Hospital, who came to Stanford for his training in 1995 and became Zarins’ good friend.

Can Zarins think of another honor that means as much to him? When asked, he answers simply, "It’s the biggest honor the Latvian Republic gives." And that says it all.