Methodist Journal

IN THIS ISSUE

Lipids and Lipoproteins

Vol 15, Issue 1 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

Lipids and Cardiovascular Disease: Putting it All Together

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RECOGNITIONS

Guest Editors Henry Pownall and Antonio Gotto Offer Insight and Expertise on the topic of Lipids and Cardiovascular Disease

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REVIEW ARTICLES See More

Cholesterol: Can’t Live With It, Can’t Live Without It

How Much Do Lipid Guidelines Help the Clinician? Reading Between the (Guide)lines

Statins: Then and Now

Poststatin Lipid Therapeutics: A Review

HDL and Reverse Cholesterol Transport Biomarkers

Revisiting Reverse Cholesterol Transport in the Context of High-Density Lipoprotein Free Cholesterol Bioavailability

High-Density Lipoprotein Subspecies in Health and Human Disease: Focus on Type 2 Diabetes

Gene Delivery in Lipid Research and Therapies

CASE REPORTS See More

Device-Related Thrombus: A Reason for Concern?

Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies

Loperamide Mimicking Brugada Pattern

Reversed Pulsus Paradoxus in Right Ventricular Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Transcatheter Embolization of a Persistent Vertical Vein: A Rare Cause of Left-to-Right Shunt and Right-Sided Heart Failure

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease

POINTS TO REMEMBER

The Kidney as an Endocrine Organ

EXCERPTA

The Other Side of the Prescription

EDITORIALS

Letter to the Editor in response to “Role of Subcutaneous Leadless Implantable Cardioverter Defibrillator in Young Patients

Vol 15, Issue 1 (2019)

Article Full Text

POET'S PEN

The Wait

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Article Citation:

Young JB. The Wait. Methodist DeBakey Cardiovasc J. 2019;15(1):90-1.



Fifty years ago, 1968 was termed “The year of heart transplants.” It was a fascinating, thrilling, inspirational yet, in many senses, tragic year. On the occasion of the 50th anniversary of that year, I reread Thomas Thomson’s best seller Hearts: Of Surgeons and Transplants, Miracles and Disasters Along the Cardiac Frontier. It was published in 1971, the year I began medical school at Baylor College of Medicine in Houston.1 Despite being swamped with the torturing deluge of Dr. Michael E. DeBakey’s new 3-year curriculum, I found time to read that gonzo journalistic effort. It had a profound impact on me because we were still living the dream and fallout of that 1968 heart transplant and mechanical circulatory assist device (MCAD) epoch in 1971—indeed, the first such epoch. Several years later, after completing a residency and fellowship and joining Baylor as faculty, Dr. DeBakey asked me to be on the team that would restart those programs. Heart transplants were again being performed at St. Luke’s/Texas Heart Institute, cyclosporine would soon be available, and the drama of Barney Clark’s 112 days with a total artificial heart was playing out. As a young pup on the faculty, it was an extraordinary honor, and I have been enmeshed in that world ever since. What I experienced was profound: medicine at its best (and sometimes worst); learning the meaning of true love and gifting as I dealt with brain death, organ donation, and retrieval; and the suffering of families of the near-dead and dying patients with advanced heart failure. They all became my heroes, and they still are.

A prized possession of mine is a framed collage that we made to celebrate the “second epoch of cardiac transplantation.” It was February 21, 1994, the tenth anniversary of restarting The Methodist Hospital’s heart transplant program. In the center of the collage is a dramatic picture taken in the operating room as our surgeons lifted a recently arrested and amputated donor heart from the chest cavity. Three hands are in the picture, two of the retrieval surgeon and one of the assistant. They were captured in the photo lifting the heart up high, and it is a beautiful site—a perfect heart that soon would rest in the thorax of a fortunate death-defying recipient. The picture always reminds me of a priest lifting high the Eucharist at a Catholic Mass, because for me, heart transplantation has always been a sacred event. To the right of this image are columns of initials of 310 heart transplant patients who had rested within that second epoch. To the left is a poem I penned in 1985 out of frustration with the wait for an organ donation. The subject was a favored patient of mine. A profound dilemma of heart transplantation is the wait we still face (although MCADs are now making great strides to reach Dr. DeBakey’s vison of cardiac replacement machines). The autographs of Michael E. DeBakey, George P. Noon, Antonio M. Gotto, Jr., Hartwell H. Whisennhand, H. David Short III, and me are in the margins, though so many more teammates and teams-of-teams made heart transplantation possible and successful enough to continue to this day. Every time this procedure is performed we witness a miracle, and it reminds us of the extraordinary profession to which we are privileged to belong.

James B. Young, M.D.

Chief Academic Officer, Cleveland Clinic
Professor of Medicine and Vice-Dean for Cleveland Clinic Academic Affairs
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Section Editor, Poet’s Pen, Methodist DeBakey Cardiovascular Journal

  1. Thompson T. HEARTS: of surgeons and transplants, miracles and disasters along the cardiac frontier. New York: McCall Publishing; 1971. 304 p.
     

 

The Wait

I saw him
Alabama man
spying closed eyed into the late afternoon
early spring Texas sun

while quickly fleeing
some where
reigned short and
awake for an instant
from my defensive drowze

I saw him
sitting face gently up
with white chipmunk cheeks
sucking 02 and
afternoon rays warmth

Thinking of recent deaths
makes wonderment of
life and then

I saw him
grass green tube
nose stretched
giving sort of a
tethered life

While we wait for
someone else’s tragedy
so that his
would not be

I saw him
wait
wait
wait
wait
and wait
waiting

Sometimes dying
more often alive

When will life’s
drama
giving life
come
to stop

That awful
wait that
I saw him have
while lifting head closed eyed into a late
afternoon early spring Texas sun
while he was in
WAIT.

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