Silverstein: Decorated cardiologist who shaped Kenya's heart care dies

Dr David Morton Silverstein joined The Nairobi Hospital as an admitting consultant cardiologist in 1977. [Courtesy] 

His legacy is rich. Just a mention of his name would attract local and global attention.

He was a decorated specialist. His death has left the medical fraternity devastated. Known as a ‘father of cardiology’ in Kenya, Dr David Morton Silverstein was pronounced dead on Sunday morning. He died at The Nairobi Hospital at the age of 82. The American-born cardiologist was a long-term personal doctor of President Daniel Arap Moi. He graduated with an MD from the University of Chicago Medical School at the age of 22.

The specialist later completed his internal medicine residency and cardiology fellowship at the University of Washington in Seattle, and became a fellow of the American College of Physicians. Silverstein arrived in Kenya in 1974 and established the region’s first cardiac catheterisation laboratory at Kenyatta National Hospital (KNH). At the time, Kenya’s cardiovascular care was still in its infancy.

Many patients with heart conditions remained undiagnosed and died without treatment. Silverstein transformed an empty room at KNH into the country’s first cardiac catheterisation laboratory, shifting care towards advanced diagnostics.

He introduced catheter-based imaging, allowing doctors to examine the heart’s chambers and blood vessels in real time rather than relying on symptoms to assess arterial blockages or valve damage.

Mentoring legacy

The facility laid the foundation for early open-heart surgeries and has since grown into a regional and continental heart surgery and training centre. Silverstein also mentored a generation of Kenyan cardiologists, including Dr Dan Gikonyo, founder of Karen Hospital, Dr Majid Warshow and Dr Charles Kariuki. Warshow was his first mentee in Kenya.

As a senior lecturer at the University of Nairobi Medical School, he trained many of the country’s earliest indigenous cardiologists.

In 1977, Silverstein was appointed chief cardiothoracic physician for the Government of Kenya. From 1983, when Moi was Vice-President, he served as the former president’s personal physician and confidant for more than four decades. He also treated prominent figures, including former South African President Nelson Mandela.

Silverstein joined The Nairobi Hospital as an admitting consultant cardiologist in 1977. He later served on its board of management and medical advisory committee, chaired several committees and championed antimicrobial stewardship.

Tributes poured in following his death, with the hospital and colleagues mourning a physician whose career helped shape Kenya’s modern cardiac care. “The Nairobi Hospital has lost one of its most distinguished Admitting Consultants, who for almost 50 years gave his all to ensure the hospital led in clinical excellence,” said The Nairobi Hospital Chief Executive Officer (CEO), Dr Felix Osano.

President William Ruto has mourned Silverstein death, describing him as a distinguished doctor.

“His pioneering contribution to the advancement of medicine, particularly cardiology, touched countless lives and helped shape the practice of modern medicine in Kenya,” he said.

Trusted physician

At Moi’s funeral in Kabarak, Silverstein delivered a deeply personal eulogy, wearing a Jewish skullcap and reading from a Hebrew Bible.

He recalled how he, Moi and former Attorney General Charles Njonjo occasionally shared a small glass of sacramental wine from Israel, which they called “Dawa ya Wazee” (medicine for the elders).

He also remembered Moi’s concern that the time the doctor spent with him at State House could disadvantage other patients. Moi never underwent any procedure without Silverstein’s knowledge or authorisation.

The former president died on February 4, 2020, at age 95.

In a condolence message, Kanu chairman Gideon Moi described Silverstein as a compassionate doctor whose care and friendship would remain deeply remembered by the Moi family. “It is with deep sorrow that we mourn the passing of Dr David Silverstein, the long serving personal physician to the late retired President H.E. Mzee Daniel arap Moi,” said Gideon.

“To him, Mzee Moi was not merely a client. He was a human being whose health, dignity and well-being mattered deeply to him,” he added.

He said the doctor took time to listen, understand and care for his patients, bringing warmth and humanity to his medical practice. He extended condolences to Silverstein’s family, led by his wife, Channa Commanday.

Dr Joseph Aluoch, a pulmonologist and an icon in Kenyan medical circles, was among the specialists who worked with Dr Silverstein and was devastated by the news.

In an interview with The Standard, Aluoch said he met Dr Silverstein as a junior doctor specialising in pulmonology. The duo worked together at KNH and The Nairobi Hospital, Aluoch in pulmonology and Silverstein in cardiology- the two specialities are closely connected in the medical field.

“I knew him as a doctor in KNH in 1970 while working together. He has done a lot of teaching in cardiology, he established cardiology unit at KNH,” said Aluoch, who is a year older than Silverstein.

 He said Silverstein also helped improve the Intensive Care Unit (ICU) at The Nairobi Hospital. “He was a great clinician. He liked reading,” Aluoch said. “Perhaps it is him and me who are the senior-most doctors who were working. Most of our colleagues are either dead or retired.”

“Dr Silverstein was a giant of Kenyan medicine and is rightly regarded as one of the fathers of modern cardiology in Kenya,” said Dr Reuben Okioma, Director of Medical Services and Research at The Nairobi Hospital.

Okioma is among the privileged doctors the American specialist mentored. “In my early days in critical care, his guidance, encouragement and clinical wisdom were invaluable.

Medical discipline

“He taught not only through his immense knowledge, but through example. An extraordinary commitment to his patients, unwavering availability even at the most inconvenient hours, and the discipline that saw him routinely at his patients’ bedsides by 6:30am in the morning,” he said.

At The Nairobi Hospital, Silverstein was one of the most passionate and consistent advocates for antimicrobial stewardship, reminding doctors that good medicine demands both decisive treatment and responsible use of the therapies entrusted to them.

“I am deeply saddened by the passing of Dr Silverstein, a senior colleague, mentor and friend whom I had the privilege of knowing and working alongside at The Nairobi Hospital,” said Dr Yubrine Moraa Gachemba, a Consultant Cardiologist.

Gachemba said Silverstein belonged to a generation of physicians for whom medicine was not simply a profession, but a calling built on discipline, intellectual rigour and an unwavering commitment to the patient.

“As a younger cardiologist, I looked up to him. What I valued most was that despite the difference in our generations and backgrounds, he related to colleagues across age, race and circumstance with a refreshing directness and collegiality,” said Gachemba.

The cardiologist, she said, remained engaged with the profession and with the institution he had served for so long, a testament to a life that never became indifferent to the things that mattered.

The Kenya Cardiac Society also paid tribute to the doctor. In a statement to The Standard, the association’s president, Dr Mzee Ngunga, a cardiologist, said Silverstein had an exploratory mind and took a leap of faith when offered an opportunity to head the cardiology programme and set up a cardiac catheterisation laboratory at KNH.

“I sat with him for three years and some of the patients he treated with heart attacks in the 1980s are still alive,” said Ngunga.

New therapies

Ngunga sat with Silverstein last year at the inaugural Pulmonary Hypertension Symposium in Nairobi, where he reflected on how he had witnessed the evolution of the disease over five decades.

This ranged from sickle cell disease, tuberculosis and rheumatic heart disease to newer conditions contributing to the disease, in particular chronic thromboembolic pulmonary hypertension.

He said Dr Silverstein was also known for mentoring young doctors through their training at The Nairobi Hospital and for the new therapies he introduced into the country through his long tenure as a cardiologist.

“I remember him for particularly introducing the tafamidis programme that I got involved in the last three years,” he added.

Tafamidis is available in Kenya through an access programme for patients with cardiac amyloidosis, a deadly disease that causes progressive heart failure and previously had no available cure.

“The Kenya Cardiac Society, the body of cardiologists in Kenya, is indebted to his great service to the cardiovascular community in Kenya for the last five decades,” said Dr Ngunga.

Apart from his impact in the medical field, Silverstein published his memoir titled “Heartbeat: An American Cardiologist in Kenya”.

The book detailed his extraordinary five decades practising medicine and witnessing key historic events not only in Kenya, but East Africa. Initially, Dr Silverstein had intended to stay in Kenya for only two years, but it turned into a lifetime adventure spanning more than five decades.

He then joined a US Air Force base in Taiwan before settling in Seattle, where he completed his cardiology fellowship. He moved to Kenya after being inspired by his Kenyan friend to apply for a position in the country.