DeBAKEy CARDIOvASCuLAR JOuRNAL - Methodist Hospital

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W.L. Winters Jr., M.D. in MeMoriaM MICHAEL THOMAS McDONOuGH, M.D. 1928 – 2010 William L. Winters Jr., M.D. Methodist DeBakey Heart & Vascular Center Houston, Texas In everyone’s life, there emerge a importance of honesty, integrity, and few who make a lasting impression. compassion — the hallmarks of trust. In my life, one such person was Teaching by word and example, his Michael T. McDonough, M.D., who professional demeanor was impeccable. died in Philadelphia on March 27, After I left Temple university Hospital 2010, at age 82. A native of Brooklyn, in 1968, our communication became New york, Michael was educated at less frequent but his exploits were Fordham university and received never far from mind through updates his medical degree at Georgetown from colleagues, especially Dr. Fred School of Medicine, where he came Bove, former chairman of the cardiol- under the influence of Dr. Proctor ogy section at TuH and the immediate Harvey. He did a one-year intern- past President of the American College ship in Buffalo, New york, and of Cardiology. His contributions to the returned to Washington, DC, for his medical residency, which he com- Michael Thomas McDonough, M.D. 1928 – 2010 clinical lore of THu’s cardiology section were pervasive for over 35 years. pleted in 1958. Michael and his wife, Mary, always Our close connection began in 1960, when he entered wanted a large family. They were successful in rear- the cardiology fellowship program at Temple university ing eight children, with all but one still living in Hospital (TuH) in Philadelphia after serving two years Philadelphia today. His religion kept him very active as a captain in the united States Army. I was a young in his church, and his love for children kept him busy cardiologist on the faculty at that time, having just fin- coaching young sportsmen. By choice, he was a homeished my own cardiology fellowship two years prior. body living for his family and for his profession. His For the next eight years, we worked side by side — his youngest child summed it up best in a note to me: “I first year as a fellow and the next seven as partners and think he practiced medicine as he parented: with com- close friends in the cardiology section at TuH under the passion, love and patience. He was the best man I have leadership of Dr. Louis A. Soloff. ever known.” What warmer eulogy can there be? Many Dr. McDonough’s positive attributes were numer- of our readers won’t recognize his name, except those ous, but I especially enjoyed his warm personality and in the Philadelphia area. But there are many physicians infectious sense of humor. I watched him mature into like Michael McDonough. you just have to look far for a compassionate physician and intuitive teacher. His them. And when you find them, nourish and treasure ability to find the right answers and communicate with them, because they represent what is best in practicing patients was his forte. For a large man, he was among the gentlest, and his focus never varied from providing superb care for his patients and teaching doctors the the art and science of medicine. 66 vII (1) 2011 | MDCvJ
To the Editor: After reading Dr. Berenson’s article in the November 2010 issue of the Methodist BeBakey Cardiovascular Journal, 1 I was reminded of an editorial I wrote in September 1992 in Clinical Cardiology. Gerry Berenson was the stimulus that led me to write that piece. 2 I have included some excerpts from that editorial relating to hyperlipidemia in children. Facts 1. Children born in the united States have higher blood cholesterol levels compared with the same population in other countries. 2. Autopsy studies have shown fatty streaks and atherosclerotic plaques in the blood vessels of young people dying of other causes. 3. Blood levels of LDL cholesterol correlate with the extent of early atherosclerotic lesions in young people 4. Children and teenagers with elevated LDL cholesterol levels often have older family members with coronary heart disease. 5. young persons with high cholesterol levels have persistently higher levels when they become adults more commonly than do children with low cholesterol levels. Who should be treated for hypercholesterolemia? The answer to this question entails much more than simply obtaining blood cholesterol or lipoprotein studies. Obviously, the initiation of treatment in an adolescent is a serious undertaking since one must consider such things as the growth and development of the patient — something that one doesn’t worry about in the adult. It is my understanding that children and adolescents whose total cholesterol and LDL cholesterol (total cholesterol 170-199 mg/dl, LDL cholesterol 110- 129 mg/dl) should be treated first with diet; and, if that does not result in a satisfactory result, drugs should be instituted by the pediatrician/general practitioner or lipidologist caring for the patient. How can an adult cardiologist influence or practice the prevention of coronary heart disease in the child and adolescent? Children and adolescents without symptoms rarely come in contact with adult cardiologists. In fact, adult cardiologists rarely see adult patients who have no symptoms or other evidence of myocardial ischemia such as a positive exercise test. Thus, it is difficult for an adult cardiologist to advocate strategies to prevent the letters to tHe editor development of risk factors even in adults, since we don’t have contact with the appropriate subset of the population. However, the adult cardiologist does have frequent contact with adult patients who have clinical manifestations of coronary heart disease. In these patients, we are treating them to prevent the end product of multiple risk factors, i.e. myocardial infarction, unstable angina, atrial and ventricular arrhythmias, sudden cardiac death, and heart failure. Should we not consider giving advice about prevention for the offspring of these patients, e.g. prevention of obesity, smoking, hyperlipidemia, hypertension, diabetes etc.? By preventing the risk factors for cardiac disease, we have the opportunity to educate our adult patients that family members, especially the young, may be at high risk for coronary heart disease if they develop the usual risk factors. As Berenson has pointed out, we also must educate our school teachers and society in general about the potential implications of these serious risk factors in our children. C. Richard Conti M.D. References 1. Berenson GS, Srinivasan SR, Fernandez C, Chen W, and Xu J. Can adult cardiologists play a role in the prevention of heart disease beginning in childhood? Methodist DeBakey Cardiovasc J. 2010; 6(4):4-9. 2. Conti CR. Prevention of cardiovascular disease begins in the young. Clin Cardiol. 1992 Dec; 150(12):877-878. To the Editor: I very much enjoyed the issue dedicated to cardiac tumor overview. My thanks to you and all contributing authors for an excellent presentation of this subject. Manucher Nazarian, M.D. Fort Worth, Texas. To the Editor: I just received the most recent issue of your new journal. It is full of interesting material, and I especially enjoyed your piece on “The Elders.” There were SO MANy elders that I had the privilege of work with beginning in 1965. My first recollection of Dr. DeBakey was in the late 60s, and I was in Kansas at my mother’s home mowing MDCvJ | vII (1) 2011 67
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Volume 7, Number 1 • Jan. - Mar.
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W.L. Winters Jr., M.D. EDITOR’S N
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Every generation has its heroes. Dr
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OTHER CHEST 8.96% Figure 5. Surgica
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Baxter Edwards Beall Bjork Shiley C
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mitral valve operations. In most ca
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Figure 30. Myxoma filling the left
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Figure 37. Left: Preoperative aorto
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Page 37 and 38: M.E. Bertrand, M.D. Introduction WH
Page 39 and 40: Vascular Access Complications A num
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Page 51 and 52: N. Kleiman, M.D. M.J. Reardon Intro
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Page 55 and 56: H.J. Safi, M.D. IN TRIBuTE: ERNEST
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Page 59 and 60: Introduction CT Coronary Angiograph
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Page 63 and 64: MetHodist de Bakey Heart & VasCular
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DeBAKEy CARDIOvASCuLAR JOuRNAL - Methodist Hospital

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