Elders provide the fabric for the weaving of a profession. The strength of that fabric determines the character of that profession. That fabric may stretch or bend in one direction or another depending on external or internal influences, but it is the elders who keep it from breaking and add new strands to strengthen it over the years The medical profession in general, and the cardiovascular specialty in particular, have been the beneficiaries of the brightest and most dedicated to preserving our fabric.

The realization that our elders play a real role in our lives and profession takes time to develop. Recognition of this contribution too often comes after our elders have left the scene. And only then are the epitaphs and eulogies written. Although their place in the sun is all too short, the symbolism of our elders is pervasive and long-lasting.

William L. Winters, Jr., The Elders (June 2010, issue 6.2)

We lost one of our most beloved elders in March with the passing of William L. Winters, Jr., MD, MACC, founding editor of the Methodist DeBakey Cardiovascular Journal. Throughout his more than 60-year career, Dr. Winters wove a robust strand in the cardiology tapestry, touching countless lives as a physician, mentor, educator, scholar, and friend. That we were fortunate enough to realize his contributions before he was gone makes his loss all the more profound.

Barbara and William Winters, Jr.

Michael E. DeBakey with William Winters, Jr., at The Methodist Hospital Doctor's Day celebration in 1999.

Dr. Winters was the consummate servicemanto his country, as a Navy medic in the US Naval Reserve; to his family (wife Barbara; sons Christopher, William, and Scott; five grandchildren; and one great-grandchild), who he placed above all others; to his profession, where he established the first echocardiography laboratory in the southwest United States; to his patients, who he treated with an unsurpassed level of compassion and care; to a constant influx of medical residents, who he taught to live by faith and the Hippocratic oath; to Houston Methodist Hospital, where he elevated everything and everyone he touched in his 50 years at the institution; and to this journal, which he lead for 15 years as part of his lifelong passion for academic medicine and medical communication.

Winters was born in 1926 in Highland Park, Illinois. He credited his early interest in cardiology to his father, also a physician, who showed him the wonders of an electrocardiogram when Winters was in high school. After serving as a medic in the US Naval Reserve in the South Pacific during World War II, Winters attended medical school at Northwestern University in Chicago, graduating in 1927. Later that spring, he married his beloved wife Barbara, who would stand by his side for the next 66 years. After an internship at Philadelphia General Hospital and residency and fellowship at Temple University Hospital, Winters joined the medical faculty at Temple, where he would serve for 10 years. In 1958, he helped run the heart-lung machine for the hospital's first open-heart surgery.

In 1968, Winters was recruited to The Methodist Hospital (now Houston Methodist Hospital) and Baylor College of Medicine in Houston, Texas. At the time, Houston was the heart of the cardiovascular revolution, spearheaded by the likes of Drs. Michael DeBakey and Denton Cooley and one of the most exciting places for a young cardiologist to be, Winters later reflected. Over the next 50 years, Winters became a giant in his own right, earning the respect and friendship of the Houston cardiovascular community. He ushered in a new age of cardiovascular imaging in southwestern United States when he established the first echocardiography laboratory in the region, and he was one of the early proponents of coronary angiography at Houston Methodist.

Throughout his career, he earned the respect and admiration of his colleagues and was appointed to leadership roles at the highest echelons of the profession; he served as president of the American College of Cardiology (ACC), chairman of the Board of Governors for the ACC, president of the Texas Affiliate of the American Heart Association, governor for South Texas for the American College of Physicians, first president of the Houston Cardiology Society, president of the Houston Methodist Hospital medical staff, and president of the Houston Doctors Club. He was one of the most decorated physicians at Houston Methodist, where he received the John W. Overstreet Award, the institution's most prestigious honor for honesty, integrity, and leadership, and the George P. Noon, M.D. Award recognizing his long legacy of service and contributions to the advancement of cardiovascular medicine.

A prolific writer, poet, and historian, Winters firmly believed that medicine was just as much an art as a science and committed himself to nurturing that art in the medical community, incorporating poetry, art, and humor into scholarly work. As he climbed to the pinnacle of his career, he was dedicated to preserving the lessons and legacies of the elders who came before him. In 2014, he published Houston Hearts, a meticulously researched chronology about the creation and growth of the world-renowned Texas Medical Center and the key players who made it a global destination for cardiovascular care. He recorded countless interviews with cardiovascular luminaries and wrote tributes to those who passed, creating an invaluable record of the leaders who wove the fabric of modern cardiology and adding his own enduring threads along the way.

Many of those threads are woven into the tapestry of this journal. As the founding editor, Winters routinely graced these pages with editorials that captured not only the wisdom of someone who practiced medicine for more than a half century but also the essence of humanity. While he left an enduring legacy of his professional achievements, the legacy he will be most remembered for is his strength of character, boundless compassion, gentle sense of humor, and love for those around him. He will be dearly missed.

Dr. Winters with the Methodist DeBakey Cardiovascular Journal editorial team in 2017. Left to right: Shelley Barnes, Susan Daniels, William Winters, Jr., Miguel Quiones, and Laura Gerik

We leave you with his own words from an address he made to the graduates of the inaugural Houston Methodist Hospital Cardiology Training Program, which held its first commencement ceremony in June 2014.

The rapid expansion and knowledge of cardiovascular medicine over the past 60 years is really difficult to put into perspective. But it may presage what's to come in the next 50 years. As you enter practice, it is imperative to remember that the science of medicine should be a partner to the art of medicine. The art of medicine is not taught well in training programs today, nor has it ever been. That has nearly always been the province of mentors and role models from whom young physicians learn.

To that extent, I have formulated over the years what I call Rules for the Road and Complements to those rules derived from personal experience and observation of other physicians I have admired.

The first rule is Attitude is everything. Without a positive attitude, you might as well stay home. It is reflected in how you treat patients. A big smile and a strong handshake have prompted many patients to tell me, I always feel better after I have seen you. There is strong evidence that a physician's demeanor affects the outcome of treatments.

Rule number two is Be the best you can be. You may never be the best, but you can always be the best you can be. Listen, communicate, examine your patient. What better way is there to connect with them? Besides, you may turn up unexpected findings: enlarged organs, a tumor, an aneurysm. Be interested in their lives. As Dr. Francis Weld Peabody noted in 1927, The secret of the care of the patient is in caring for the patient.

Rule number three is Become a lifelong learner. Learn something new every day. Particularly learn from your mistakes and failures; it will keep you humble. And remember, there is much to learn from outside the world of medicine. Become a fly fisherman. That became my passion.

The fourth rule is Live your faith every day. Whatever your faith may be, live it. At the very least, believe in yourself. This is where the golden rule comes in: Treat your patients as you would wish to be treated. It applies to your colleagues and friends as well.

Then there are the Complements.

  • Honesty and integrity go hand in hand. You have it or you don't. You don't buy it off the shelf. You earn it by earning the trust of your patients. I'm always amazed at how many people don't know the meaning of integrity: it is your moral compass; knowing right from wrong.
  • Practice humility. Humility is sadly lacking from many physicians. They lose it between medical school and success. You're a better doctor for having it.
  • Be perseverantit comes in handy when dealing with contrary and/or uncooperative patients. Don't be discouraged if a proven treatment is not always successful. At the same time, learn when to hold and when to fold, particularly where end-of-life is concerned.
  • Have a sense of humor. A sense of humor often diffuses tense situations, especially when it includes the ability to poke fun at yourself.
  • Show gratitude. Gratitude is important to portray, but don't expect other people to have it. My father once told me, If you expect to be thanked for the good things you do in life, you'll be sadly disappointed.

William Zoghbi, William Winters, Jr., Barbara Winters, Marc Boom, and Miguel Quiones celebrate Dr. Winters' retirement from Houston Methodist Hospital in 2016.

As your practice and professional responsibilities weigh on your time, do not forget your family. You have two lives to live: your professional life and your private life. You will be hard-pressed not to shirk your private life for your professional life. But let me assure you, after 61 years of marriage, it is very comforting to age with someone you love.

I would like to be a fly on the wall 40 or 50 years into your careers to see if the extraordinary advances in medicine made in the last half-century are replicated. My guess is they will be even more extraordinary.