COLUMN ONE : Whites Eye the Exit in S. Africa : Violence and the wrenching process of apartheid reform have professionals wrestling with their consciences. Stick it out? Or build a better future elsewhere?

CAPE TOWN, South Africa — On his last day at work, Dr. Christopher Knott-Craig was visited by a 6-year-old Afrikaner boy in shorts and knee socks. The doctor crouched to place a stethoscope on the boy’s back and smiled with satisfaction.

Only a week before, Knott-Craig had operated on the boy’s heart, correcting a congenital deformity that every other surgeon in South Africa had agreed was inoperable and fatal.

And now, as Knott-Craig listened, the tiny towheaded patient reached out a hand holding a small gift wrapped in blue paper.

“What’s this?” Knott-Craig asked, speaking Afrikaans.

“For you,” the boy said, smiling shyly through gapped teeth.

Knott-Craig’s eyes welled with tears.

“I’m booked to leave at 11 tomorrow morning,” he told a visitor after the boy left. “But as I sit here today, I’m not sure I’ll be on that aircraft.”

The next morning, though, South Africa lost its leading pediatric heart surgeon when Knott-Craig, his wife and two children boarded a plane bound for a new life in the United States. With sadness but no regrets, the doctor left the land of his birth to work at the University of Oklahoma Health Sciences Center.

The wrenching process of apartheid reform, escalating violence and an uncertain future has white doctors, engineers, lawyers, nurses, teachers and other professionals wrestling with their consciences in South Africa these days. Should they stay in South Africa? Or should they bail out?

A few already have decided to leave. Many others are exploring the possibility. Exact figures are difficult to obtain. But leaving South Africa is the prime topic of dinner party conversation in the white suburbs of Cape Town and Johannesburg.

The decisions made by those whites, the professional backbone of South Africa, will have broad ramifications, no matter who governs this country. And both the government and the African National Congress, the main black opposition group, know it.

Nelson Mandela, ANC deputy president, has taken pains to reassure whites that their future in South Africa is secure. So has his political rival, Zulu Chief Mangosuthu Gatsha Buthelezi.

But the fighting between their supporters, and the killings of 1,500 blacks in the past year, has undermined their message.

Helen Suzman, the 72-year-old dean of white liberalism in South Africa, is staying. But she sympathizes with her friends who have left and the others who are pondering an exit.

The black factional fighting “is nerve-racking, and it gives you an uneasy feeling that you are living with people who are not capable of rational behavior,” Suzman said. “Political rivalry is going to be very difficult to bring under control.”

Most of those contemplating a getaway are the more liberal, wealthier and better-educated whites, many of the same people who pushed so hard for black equality. They often hold second passports from European countries. Their jobs have brought them into contact with foreigners. Many have relatives who already live overseas.

On the other hand, the more conservative Afrikaners, who account for half the country’s 4.5 million whites and comprise the bulk of the farmers and civil servants, have no option but to stay. Their families, descendants of South Africa’s first white settlers, have been around for almost four centuries. And their opportunities for escape are limited.

The brain drain actually began more than a decade ago, when many whites fled to avoid the military draft for themselves or their children; about one in four white college graduates left the country during the 1980s.

A result of that exodus has been a critical shortage of doctors. Patients often must wait four months or longer for an appointment, and many doctors refuse to take new patients.

The military draft is no longer driving whites away. Last year, the government trimmed the length of required service to a year, and jail terms for objectors have been replaced with community service.

But now whites have found new reasons to leave.

The Australian and Canadian embassies reported that they were flooded with immigration inquiries after Mandela was freed from prison last year. Some South Africans are leaving the country for extended vacations, hoping to find work in Europe or North America.

“I want to live somewhere where there aren’t newspaper billboards on every corner describing more death and chaos,” explained Vaun Cornell, a white 30-year-old who has resigned her Johannesburg office job to go to Europe next month. She has no specific plans to return.

Cornell, a former anti-apartheid activist and ANC sympathizer, said she is fed up with the high crime rate and the political clashes. And she figures the process of political reconciliation will get much worse before it gets better.

“A lot of us want to get out of South Africa for at least a year or two--while the stuff really hits the fan,” she added. “Some of this process is going to be incredibly bloody. And I can’t bear the thought of watching the destruction.”

When President Frederik W. de Klerk legalized the ANC, freed Mandela and unfettered political expression in the country last year, most white liberals were delighted. But many were frightened by the mass demonstrations, right-wing white violence and black factional fighting that followed.

And the prospect of living under black majority rule had them worried.

As the white liberal newspaper Business Day put it: “The prospect that others will soon be in a position to do to you what you’ve been doing to them concentrates the mind wonderfully. . . .”

Those fears were thrust into the public spotlight last month, when Dr. Christiaan Barnard, who performed the world’s first heart transplant in 1967, said he was thinking of leaving South Africa for Switzerland.

“I’d always thought things would change for the better once Nelson Mandela was free,” he said. “But things have changed for the worse. And I don’t see how my young son can grow up in a society as violent as this one.”

In the days that followed, the 68-year-old retired surgeon, who had been a folk hero among his white countrymen, was roundly criticized by whites across the political spectrum. Even his wife, the mother of their 2-year-old son, told a local paper that she preferred to stay.

But it took De Klerk himself to change Barnard’s mind. After a private meeting with the president, Barnard said he was impressed with De Klerk and now had “hope for the future.”

The president, however, can’t personally stop everyone from leaving.

A few weeks after Barnard’s much-publicized flip-flop, Knott-Craig, one of his proteges, quietly resigned as head of congenital heart surgery at Cape Town’s Tygerberg Hospital to take up his new post in Oklahoma City.

The 37-year-old surgeon didn’t leave because of the violence or even, as many others have, to make more money. He left the university teaching hospital because sanctions and a weak economy had forced the government to slash spending on academic medicine.

It had been a difficult personal decision.

“Some people said I should stay here to help maintain the medical standards,” Knott-Craig said. “But the government’s priorities are changing. The priority is not complex heart surgery on infants, unless of course it’s the president’s son himself.

“In the field I’m trained in, there’s not a good future here for me,” he added. “Not in terms of money, but in terms of just functioning and growing as a surgeon. I’d be prepared to work for next to nothing if I could do my job.”

Knott-Craig’s department has been shackled by spending cuts as the government redirected its dwindling resources toward treating Third World medical problems, such as tuberculosis and measles, that afflict the country’s 28 million blacks.

“I accept that we’ve got to treat those problems,” the surgeon said. “But to forget academic medicine is shortsighted. Once you let that go, you cannot recoup what you have lost.”

The result at Tygerberg Hospital had been more stringent selection criteria for new patients. Some of the ailing were being disqualified for surgery because of such things as their financial ability to get to the hospital for checkups.

Knott-Craig saw South Africa’s worldwide reputation for advances in cardiac surgery being tarnished. And, at the same time, his own skills in child heart surgery were beginning to atrophy with the cutback in operations.

“These kids . . . if you could correct their hearts at a young age, you could save society so much,” he said.

Knott-Craig has had experience in the United States, where he spent a year working at the Mayo Clinic and at the children’s hospital at Harvard University as part of a prestigious surgical fellowship. He had several job offers from American hospitals but decided to accept the post in Oklahoma, where he will be allowed to perform heart surgery on children and learn a new valve transplant procedure from the chief of surgery at the Health Sciences Center.

“I’ll reassess the situation in two years and, if things have changed in South Africa and I’m needed here, I’ll come back,” Knott-Craig said.

But he doubted much would change and figures he will be in America for some time.

“I’d like to feel that there could be a future for my family in South Africa,” he said, thinking of his son, 8, and daughter, 7. “I grew up with cricket and rugby, and I would like to believe the next generation of my family will play cricket and rugby, too.

“But the country is going to have a tough time,” he added. “White people are going to have to learn to share, and black people are going to have to learn that they’ll have to work to achieve what they want.”

Knott-Craig spent most of his last day at work receiving calls from well-wishers, and his office quickly filled with gifts. “Every former patient wants to say goodby,” he said with a shrug.

He was especially touched by the gift, a hunting knife, from the young boy whose life he had saved. When the youngster was referred to Knott-Craig, he was a few months from death, and two hospitals already had determined that nothing could be done to save him.

But Knott-Craig had specialized in a procedure to correct his particular heart defect. And though the operation was risky, the boy’s parents decided to give it a try. It was a success.

“I feel really sad about leaving. Sad and depressed,” Knott-Craig said, his tall, thin frame slumped into his office chair. “But it’s my duty to myself and the person I pray to to reach my full potential. And I’m not able to do that in this environment.”

He paused.

“I know the need is greater in South Africa than in the United States,” he added. “But all I want to do is be able to do my job.”