Author + information
- Valentin Fuster, MD, PhD∗ ()
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address correspondence to:
Dr. Valentin Fuster, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York 10029.
“La ventura va guiando nuestras cosas mejor de lo que acertáramos a desear.”
—Miguel de Cervantes Saavedra (1).
Many people ask how I came to commit my professional life to 3 very different areas of cardiovascular medicine: research, patient care, and education. The famous words in the opening quotation—which translate as “destiny guides our fortunes more favorably than we could have expected” and are from the legendary Spanish novel, The Ingenious Gentleman Don Quixote of La Mancha (1)—adeptly express the unpredictable steps along my journey that have led to my present dedications. However, this circuitous path may have begun by chance, starting with my early interest in sport. Through tennis, I encountered 1 of my first mentors, Dr. Pedro Farreras, who suffered a myocardial infarction at 45 years of age. When I unfortunately learned that my tennis career would not be the final step in my professional pathway, Dr. Farreras encouraged me to dedicate my life to medicine and cardiology, as he was acutely aware of heart disease because of his event. When I began to study medicine in Spain, I knew almost instantly that my studies would cause me to leave the country, as its education at the time was too theoretically focused. I wanted to explore academic programs that exposed me to a better understanding of human biology, which led me to study pathology in London and Liverpool over 2 summers. During this time, while studying with Prof. Dr. Harold Sheehan in Liverpool (where the Beatles were starting to become popular), I examined under electron microscopy a particular blood clot specimen with an abnormally high number of platelets from a patient who had died of a myocardial infarction. This prompted Prof. Sheehan to encourage me to investigate the role of platelets in myocardial infarction. That slide was the true beginning of my career in research—my first passion.
Later, while serving at the Mayo Clinic from 1972 to 1984, I was able to bridge this initial spark for research with patient care and education. Among my defining experiences at Mayo, I had the unique opportunity to review the medical records of the first 500 pediatric patients with Tetralogy of Fallot who underwent surgery between 1955 and 1964, data which were subsequently published. Most of these sick children were among the first in the world to undergo open-heart surgery with the heart-lung machine. The purpose of this study was to assess the long-term operative results of this patient population. In reviewing the medical charts of these young patients with Tetralogy of Fallot, despite the initial mortality, I became acutely aware of the tremendous courage and faith of the Mayo multidisciplinary team. Reading in such medical records about the commitment of each of the physicians, the investigators of the first heart-lung machine, and other caregivers was 1 of the most unique luxuries of my life. Furthermore, reading what Dr. John Kirklin, the leading surgeon, wrote in the medical charts of these high-risk patients taught me about the importance of compassion, humility, and empathy when interacting with patients and their families. Dr. Kirklin, who subsequently joined the University of Alabama at Birmingham, also honed my writing and communication skills, forcing me to rewrite and re-edit manuscripts countless times until they were close to perfection. The value that the Mayo Clinic placed on properly educating the next generation of physicians is an indelible mark that the institution has left on all specialties of medicine. Despite the late development of a medical school, innovation through clinical research and education, along with the outstanding patient care they provide, are long-standing, crucial characteristics of the institution.
I sought to take these lessons with me as I left the Mayo Clinic to become head of cardiology at Mt. Sinai School of Medicine in 1981. Professionally, I had a dedication to these 3 passions: research, patient care, and education. Thus, in my new role at Mt. Sinai, I now had the opportunity to create a culture to foster these passions in the other cardiologists, trainees, and fellows. I felt obligated to serve the community, from which I received so much knowledge and passion. For me, true passion blossoms when you are able to serve society and contribute to the creativity of the future. This is a responsibility that I believe should be focused on the youngest among us: the fellows. One of the most important missions for fellowship programs anywhere in the world should be to develop future academic leaders in cardiovascular medicine by promoting clinical excellence and productive careers in scientific investigation in basic, translational, or clinical areas of interest. Educating these young physicians in such endeavors should become an integral part of our lives’ journeys as more well-established cardiovascular specialists, just as my own education and my mentors were so impactful in informing my life’s passions and course.
I have encountered many adversities along my journey, much like my famed literary friend who chased windmills with lances, and yet, these 3 passions have unexpectedly converged to provide me with direction and purpose. I remain humbled and tremendously grateful that, throughout my life, I have been blessed by wonderful mentors and opportunities that have allowed me an unbridled pursuit of these passions. “I have, as you know, wealth of my own, and I covet not that of others; my taste is for freedom, and I have no relish for constraint” (1).
- American College of Cardiology Foundation
- ↵de Cervantes Saavedra M. The Ingenious Gentleman Don Quixote of La Mancha. 1605.