Author + information
- Spencer B. King III, MD, MACC, Editor-in-Chief, JACC: Cardiovascular Interventions⁎ ()
- ↵⁎Address correspondence to:
Spencer B. King, III, MD, MACC, Saint Joseph's Heart and Vascular Institute, 5665 Peachtree Dunwoody Road NE, Atlanta, Georgia 30342
The wine was particularly good with the seared tuna, arugula, seasonal avocado, and mango salad. Yes, an occasional dinner at George's in La Jolla is one of the better perks of this editor's job and this evening was special. We were launching a new journal and the editor-in-chief of JACC: Heart Failure, Chris O'Connor, had joined Tony, me, and the ACC staff for dinner. The journal will have its first issue out in February, and it promises to be an excellent publication. Chris was pumping me for tips and tricks of journal editing. I told him that I would be of limited help because the authors keep sending very good manuscripts, the reviewers keep improving them, and we, the editors, just pick the best ones. Seems too easy, and despite taking a great deal of time, it does remain fun. I think he was looking for more substantive answers, but after all this is election season and perhaps obtuse answers are catching. In an effort to get something other than platitudes out of me, he asked, “How did Andreas come to America, and specifically to Emory?” I have heard this question hundreds of times but coming from such a knowledgeable academic as Chris caused me to launch into a wine-infused recitation. He said, “You should tell those stories in your Editor's Page.” I do not know if I should or not, but realizing that these events took place 32 to 34 years ago, and predated the literacy of many current cardiologists, I will tell an occasional story from the olden days with apologies to my actual contemporaries.
My first encounter with Andreas Gruentzig was at the invitation of Dr. Paul Lichtlen, then Chief of Cardiology at Hannover, Germany. It was the American Heart Association Scientific Session in Miami Beach in 1976. Professor Lichtlen had stopped briefly at my poster, which I was narrating, and instead of praising it he said, “You must see a poster in the next aisle. A fellow from Zurich is proposing to use a balloon to relieve coronary obstruction.” Andreas was standing in front of the poster illustrating the dog coronary experiment in which a ligature was tied around the artery producing a stenosis and a measurable resting gradient. After the balloon inflation, the gradient disappeared. The histology and the other illustrations were, after all, from a healthy dog artery and I said, “This will never work in human atherosclerotic arteries.” How (mostly) wrong I was. (As it has turned out, stents have been helpful, but that is another story.) In less than 1 year, the first patient had undergone percutaneous transluminal coronary angioplasty (PTCA) and the rush to learn the technique in Zurich was on. A little over 1 year after that first case was done, I invited Andreas to speak at a small conference called the South Atlantic Cardiovascular Society. It was a collection of cardiologists and surgeons with no actual membership who were to assemble at Kiawah Island, South Carolina. Andreas presented his first cases, and, as was the tradition of the meeting, the antagonist, Dr. Francis Robicsek, skewered him severely with irony laced with humor. Andreas and his family met my Emory colleagues, including surgeons, and had a very pleasant time.
Things were not going well in Zurich. Andreas felt inhibited as he was offered only 2 days a week in the cath lab. Tensions with his superiors were increasing but he continued to conduct live demonstration courses in Zurich which were attended by most of the earlier adopters from both sides of the Atlantic. At what I recall was about the third or fourth formal course in January of 1980, a party was held at a restaurant in the Emmental Valley. I will never forget the proprietor of the restaurant saying, “I don't know much about this angioplasty, but its most important feature is the same as for Swiss cheese. It is not so much the taste or texture that sets Swiss cheese apart, but those holes. Angioplasty seems to be about creating holes, so I guess we have something in common.” On the train trip back to Zurich, Andreas sat down beside me and said he was going to leave Zurich and would go to Germany or the United States. I asked where in the United States. He mentioned a few places that had expressed interest but said that the Cleveland Clinic was his first choice. I said, “What do you want to do?” He replied that he felt Cleveland was the center of bypass surgery and that this would be a fine place to develop and remain in the forefront of angioplasty. And then he added, “…and I want to be professor.” When I told him that would not be possible since Cleveland Clinic (at that time) did not have a medical school, he seemed stunned. He asked for advice about other places and I suggested that he come and visit us at Emory. Since he was going to Aspen the next week to speak at Jack Vogel's ACC Snowmass conference, I suggested that afterward he visit with me for a few days to have a look at our place and to be introduced to my chief, Willis Hurst. Dr. Hurst was not amused when I told him what I had done since he had heard from the chief in Zurich (who had been a former fellow at Emory) that Andreas was a “prima donna.” I said that Andreas was staying at my house and at least he should meet him. His skepticism turned to enthusiasm after about 10 minutes with Andreas, and Dr. Hurst became indispensible in the recruitment process. Andreas had no visa, had not taken any U.S. qualifying exams, and certainly did not have a license to practice.
We were invited to have lunch in the “Men's Grill” of the Piedmont Driving Club (made infamous in Tom Wolfe's “A Man in Full”) by Dr. Bruce Logue, Chief of Cardiology, and Dr. Charles Hatcher, Chief of Cardiothoracic Surgery. At the next table was Griffin Bell who had recently served as Attorney General of the United States. I knew Judge Bell since I was on the board of trustees of Mercer University and he was Chairman of the board. When I introduced Andreas I said I was trying to recruit him. Judge Bell offered to help if he could. I replied that his visa might be a problem. He said that he could not do much about that but his firm was well suited to pursue those issues. After 6 months and a stack of legal fees, all hurdles were overcome. Willis Hurst declared Andreas a “national treasure” on applications, and somehow in 1980 it worked. There have been rumors that Andreas was offered vast rewards for coming to Emory. The Coca-Cola Company was said to have provided funding. None of that is true. He enjoyed the faculty with employment conditions similar to the rest of us. I am sure that the exception that enabled Andreas to come to the United States would be virtually impossible today, and it is too bad. The world has become flat and interventional cardiology is global. It is in the interest of the specialty and patients worldwide that cross pollination of ideas and leadership not be unduly restricted. Andreas Gruentzig's move to the United States at that time clearly enabled the development of interventional cardiology that may have been delayed without it. Today, effective migratory routes may spur innovation in many different parts of the world. Many stories about those developments should be told by those who continue to move this field forward. This story is one of mine and others may follow, if Chris O'Connor keeps asking questions.
- American College of Cardiology Foundation