The European Heart Journal Takes Notice

I have good news to report. My grandfather, who was battling a host of maladies, is now on the mend. Once again he is brimming with innovative ideas and is as energetic as ever. Our posts will resume soon!

Last week, the European Heart Journal published a nice tribute to him and mentioned our blog! The article was written by one of my grandfather’s students in the UK, Dr. Amitava Banerjee.* As a layperson, I found a good deal of the article to be ‘medical speak,’ but I was excited about the shout-out.

Here are a few highlights from the article, as well as some additional facts that I learned from numerous conversations with my grandfather over the years:

Bernard Lown: the nonagenarian blogger with a lifelong thirst for combining clinical practice and social responsibility 

• His earliest discovery (1951) related to the common mineral potassium. He found that when the blood concentration of potassium is diminished, the heart is more prone to dangerous irregularities in rhythm. With low potassium concentrations, numerous pharmaceuticals, especially digitalis drugs may provoke serious toxic reactions.

• Working with the great clinician and pioneer cardiologist, Samuel A. Levine, at the then Peter Bent Brigham Hospital, now Brigham and Women’s Hospital in Boston, together, they revolutionized the treatment of acute heart attack patients. Instead of keeping patients on complete bed rest for 4 to 6 weeks, immediately upon hospital admission, they placed patients in a comfortable armchair. The ‘chair treatment’ as it was called, markedly shortened hospitalization and substantially reduced mortality. My grandfather maintains that this change in managing acute heart attack (acute coronary thrombosis or acute myocardial infraction in medical parlance) resulted in more lives saved than all his other medical contributions combined.

• Together, with coworkers, he developed the widely used direct current defibrillator and cardioverter. These instruments restore a heart beat to the arrested heart and correct various rhythm disorders, like atrial fibrillation.

• Additional points from Dr. Banerjee:

“Dr. Lown has long championed holistic treatment of individuals in health and disease.

“He established SatelLife in 1987, to use inter-networking technology to disseminate [medical] knowledge, long before the world took note of the burden of non-communicable diseases in low-income countries.

“He founded ProCor in 1997 to encourage global dialogue regarding cardiovascular research and practice.”

• His greatest accolade was the Nobel Peace Prize (1985). He shared the Prize with the distinguished Soviet cardiologist, Dr. Evegeny Chazov, on behalf of the International Physicians to Prevent Nuclear War (IPPNW), the group that they co-founded.

 

• Banerjee also calls attention to my grandfather’s essay on climate change in his personal blog, a piece that was recently profiled in the Huffington Post.

• I am especially pleased by this reference: “’The Lown Conversation’ is a blog he started with his granddaughter, a communications professional, as an inter-generational dialogue to highlight and tackle problems in American and global healthcare.”

• Banerjee’s final sentence: “There can be no question that the world needs more cardiologists like Bernard Lown… This wise nonagenarian’s effortless navigation between clinical cardiology, social activism, teaching, and public communication of science leaves one breathless.”

*European Heart Journal, Volume 34 Issue 18, May 7, 2013

Copyright © 2012 The Lown Conversation

For Doctors, A Rose By Any Other Name Should ‘Not’ Smell As Sweet

Melanie: It sounds like you had an interesting visit with your doctor recently. The tables were turned and you became a patient experiencing our health care system. What happened, and why do I get the sense that you make a terrible patient?

Grandpa: Melanie, your judgment about the type of patient I am is off the mark. Indeed I visited an internist and former student who is currently among the most distinguished physicians working in a Boston hospital. One minute after I walked into his consulting room, I exclaimed, “You are running a poor practice.” He was taken aback.

Melanie: I imagine he would be! That sounds pretty harsh. What happened in the waiting room that led you to that conclusion?

Grandpa: When I arrived at his office, the young woman behind the desk greeted me and said, “The doctor will see you soon, Bernard.” Disconcerted at being addressed by my first name and not as Dr. Lown (which you may deem as overblown puffery), I was bothered by this unearned intimacy.

That ‘High’ Feeling Patients Get from Positive Doctors

Melanie: In our last post, we talked about your experience with words that literally turned a patient’s health around. I know doctors can make patients feel better by sounding positive, but the encounter you described must be rare. What about cardiac patients who live with severe anxiety?

Grandpa: Our medicalizing culture amplifies such anxiety. Uncertainty about personal health is unrelenting, from the young and healthy to the ailing elderly. I believe I already told you this, but it’s worth repeating. The great American essayist, Norman Cousins, wrote, “Americans believe they will live forever until they get a cold. Then they are convinced they will be dead within the hour.” It’s an exaggeration that exposes an ugly truth.

Melanie: My point is that it seems harder to conjure up magical words that can heal, or even stay positive for patients with chronic heart disease. What can you say to help ease their anxiety?

The Roots of ‘Medical Bullying’

Melanie: I can understand if doctors use medical jargon that patients may misinterpret. But why describe the most terrifying possible scenarios if they’re unlikely to happen? It almost seems like medical bullying.

Grandpa: I wouldn’t describe it as bullying. Like any widespread social practice, the use of words that maim has several explanations. We live in uneasy times. Life is packed with threats, such as an onrushing climate catastrophe, or terrorism everywhere you look. The doctor is part of our culture wherein doom forecasting is within the social marrow. Even the daily weather is often reported with anxiety provoking rhetoric. To be heard, one learns the need to be strident, equally true for weather predictions as for medical prognostications. The end result is that doctors justify their ill doing by their well meaning.

Melanie: But doctors take an oath to heal the sick (in theory). Shouldn’t they exercise professional judgment as opposed to following the herd? Oath or no oath, it seems like a no-brainer to avoid using expressions like, “You’re a walking time bomb.”

Grandpa: I admire your passion. It’s not too late to pursue a medical career.

When Words Can Be Lethal

Melanie: We received some great feedback on our last post about unfortunate expressions doctors use with patients. Mary Beth wrote, “My ‘former’ doctor told me I wasn’t a toaster… he couldn’t order new parts and fix me. I really never thought I was an appliance!”

Grandpa: Mary Beth’s experience speaks volumes. It’s important to choose your words judiciously, particularly during history taking and the physical exam, the most important aspects of doctoring. The time required is a small exertion on the road to curing and healing. In fact a proper history is itself therapeutic. I am persuaded that words are among the most powerful tools a doctor possesses. Words can both maim as well as heal.

Melanie: I’m not sure that doctors are always aware of how they come across to patients. For instance, I remember when my doctor recommended a referral, but instead of a specialist, she said I should see a ‘surgeon.’ I knew she intended to set me up with a consult, but all I heard was ‘my doctor thinks I need surgery!’ and I started to panic.