Barry Alpert

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Barry L. Alpert M.D.



Barry L. Alpert M.D.

LifeTime Private Autobiography

The experience of sharing your stories in a private autobiography for the family

Copyright © 2022 Barry L. Alpert M.D.

First produced in the U.S.A. in 2022 by Private Autobiography Service, Inc. for the Author’s private circulation.

This book is produced for private circulation and is not for public distribution. The accuracy of the content is the

sole responsibility of the Author and is based on the Author’s perceptions of his/her experiences over time.

All opinions and statements of fact are those expressed by the Author as his/her personal recollections, and

dialogue and thoughts are consistent with those recollections.

All rights reserved.

No part of this book may be reproduced, stored in a retrieval system,

or transmitted in any form or by any means without the prior

written permission of Private Autobiography Service, Inc., nor be otherwise circulated

in any form of binding or cover other than that in which it is produced.

Spelling, punctuation, and grammar contained in this book have been approved by the Author

and may not be in accordance with contemporary accepted styles and usage.

Typeset in Goudy Old Style.

Printed and bound in the U.K.



Private Autobiography Service, Inc., 503 E Summit Street, Crown Point, IN 46307, U.S.A. +1 800 453 0199

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I would like to dedicate this book to my grandfather, Dr. Eli

Friedman. His memoir, Dr. Eli, inspired me to write my own story.


Introduction 9

1. Family: Parents, Siblings, and Grandparents 13

2. New Hampshire 31

3. Harvard 43

4. Medical School 59

5. Residency 71

6. Cardiology Fellowship 73

7. Air Force 79

8. Family: My Wife and Children 85

9. University 107

10. Private Practice 117

11. Retirement 135

12. Me 147

Conclusion 151



After I retired in April 2021, I had the opportunity to reread a selfpublished

memoir, Dr. Eli, by my maternal grandfather, Dr. Eli

Friedman, one of the first pediatricians in Boston in the early 20th

century. Unfortunately, he suffered a stroke and retired in his early

80s. So, to keep his mind active, my grandmother, Edith, had him

dictate his book to her. She transcribed it, had it printed privately, and

distributed it to his kin. Motivated by their act of legacy, I would like to

do the same for my family.

This book is a personal memoir and, characterized by many thoughts

and observations along the way, it goes beyond a simple recitation of

life events relating to a career in medicine. It was written during the

Covid epidemic of 2021 and 2022 and alongside my diagnosis and

treatment for multiple myeloma, and it has been a valuable diversion

from these unfortunate events. More importantly though, it has given

me tremendous insight to my person, and has made me realize just how

fulfilling my life has been.



My grandfather’s published biography



Family: Parents, Siblings,

and Grandparents

When my father, Joseph Alpert, was in medical school, he had

a close friend named Seymour Shalek who arranged a blind

date for him with his sister-in-law, Tobe Friedman. At the time, Tobe,

who would one day be my mother, was an undergraduate at Wellesley

College. She was exceptionally young at 19 when she married my father,

and my understanding was that they decided to elope owing to the war.

When they married, they actually had two weddings: the first was the

elopement and the second, six months later, was a formal ceremony,

which took place shortly before my birth.

I was born in 1945, in Cambridge, Massachusetts. Following my

birth, and after completing medical school at the end of World War II,

my father spent two years overseas as part of the army of occupation

in the Philippines. During that time, my mother and I lived with my

maternal grandparents, Eli and Edith Friedman, at their house in

Roxbury, Massachusetts.

Back in Boston after the war, my father completed his medical

training as a surgeon at Boston City Hospital in 1947. During that

time, we lived in a duplex in Newton, Massachusetts where I attended

an elementary school down the street. I remember enjoying my early

childhood, but my only clear memories of that time are scattered: being

taken skating by my mother in the late afternoons, and playing baseball

at school with the older kids, sliding into home plate, and scraping my


knee badly on the asphalt. I remember that my childhood hero at the

time was the trash collector!

In 1952, we moved to Laconia, New Hampshire where, as a

physician, my father aspired to be a small-town general surgeon. As

a result, I grew up in a town of 14,000 people in the Lakes Region,

central New Hampshire. However, we often still drove to Boston, a

two-hour journey, to visit, and stay overnight with my grandparents,

particularly for all of the Jewish holidays, such as Rosh Hashanah, Yom

Kippur, and Passover.

My mother was a very complex woman, both as a person and as

a mother. I have to admit that when I was growing up, she was very

supportive of me, particularly in contrast to my father, who worked all

the time and was very distant.

I have an early memory of her from when I was in middle school.

At the time, chino pants were all the rage, but the most popular colors

were hues of royal blue, red and orange. Regardless, I was so desperate

to fit in that I invested in two pairs – blinding orange and shrieking

yellow – which, of course, looked absolutely hideous on me and left

me feeling terribly embarrassed. Fortunately, my mother came to my

rescue with some dye that transformed the pants into a more muted

green and brown. She saved me (from social ridicule, anyway).

My mother was the parent I could confide in without feeling

embarrassed. When I entered my teenage years, I experienced my share

of adolescent angst. “Can I take a girl to the dance who’s taller than

I am?”; “Is it alright to take an underclassman to the prom if I’m in

eleventh grade?” As absurd as they sometimes were, I took my social

dilemmas to my mother and she was very helpful in dispensing advice

on such matters and quelling my doubts.

Over the years, we also did activities together. When I was a boy,

my mother taught me how to play ping pong. She also enrolled us in

a mother–son ping pong competition, from which we were eliminated

in the first round. That said, I do not know if these shared pursuits

brought us closer together. I often think she included me in these

activities because she wanted to do them herself. Through the years, she


was involved with many intellectual endeavors, including the League

of Women Voters, World Affairs Council, and Great Books, and often

ended up bringing me along.

My mother was a very intelligent woman. Unfortunately, she never

harnessed that intelligence into something functional. She went to

Wellesley and graduated at a young age with a desire to become a

doctor, but her parents dissuaded her. At the time there were very few

female physicians, and she probably would not have been a very good

doctor because she was never focused. When she met and married my

father, she began giving birth to and raising children instead. So, it was

a life that really never went anywhere professionally.

There were six children in the family, each born approximately

three years apart. I sometimes have the feeling that my father’s master

plan was purposely to keep my mother pregnant, but the irony is that

motherhood was not her suit. There was nothing motherly about her

at all. She was generally not sympathetic or compassionate, and she

really just focused on herself. Instead of attending to us herself, she

had a mother’s helper who came from the state school for the mentally

challenged down the street from our house. Ultimately, my mother was

just not cut out to be a mother. Perhaps she should have been a doctor.

My family had moved to New Jersey when my father changed career

direction and became a vascular surgeon at Newark Beth Israel Medical

Center. After all my siblings had grown, I encouraged my mother to go

back to school. She earned a master’s degree in teaching from Columbia

and began a career as a high school math teacher; however, she could

not control her classes and students took advantage of her. Ultimately,

she resigned and ended up tutoring math privately.

By then, my parents had divorced. Initially, my mother stayed in

the house in New Jersey, but she later remarried and moved to New

York with her husband, Mort Gerson, settling near the World Trade

Center. She was living there on September 11, 2001, when the Islamic

terrorists crashed the planes into both towers. My mother’s apartment

faced the Hudson River, not the World Trade Center itself, so she did

not see the crash and missed the news. She and her husband, Mort,


were mystified by all the white ashes wafting down and they had no

inkling of what they were. Because they did not listen to the radio or

watch TV, they had, in addition, no idea that they were supposed to

evacuate their home. It was only on September 13, when the National

Guard knocked on their door, that they decamped to New Jersey.

My mother’s self-centeredness, unfortunately, extended to the way

she treated my wife, Judy, and our children. When we got married,

Judy went out of her way to be a dutiful daughter-in-law. We would take

her out to dinner and bring her gifts, but no matter what Judy did, my

mother never acknowledged her gestures or thanked her. Essentially,

she abandoned our family, focusing on herself.

My mother died in Sarasota on November 19, 2021, at 95. I have

little sadness. As Camus said, “Today Mother died, or maybe it was

yesterday. I don’t know.”

If my mother was not very directed, my father was the opposite.

He was laser focused to the point of obsessiveness when it came to his

medical career, and while my mother was a late night person, my father

was up at 5:30 in the morning to do rounds. Not surprisingly, my

parents had very little time to actually connect, and in truth, I never

witnessed much interaction between the two of them, which may later

have affected my relationship with my wife, Judy.

When I was young, I remember my father being very active in my

life. He played baseball with me in the back yard, helping me hone my

skills in batting and pitching for Little League baseball. He also taught

me how to play golf when I was seven, but as I grew older, he played

less of a role in my life. Each spring, symbolically, he took me to a

fishing camp in northern Maine for a week, but I never really bonded

with him. He appeared so distant, and there was no warmth. I never

saw him laugh, and he never shared any intimate feelings with me.

As time passed, there was more distance. I never received plaudits for

my academic success. He never consoled me when I was wait-listed at

Harvard. This later extended to my life after leaving home. Although

he did visit me once in St. Louis during my internship, he never praised

me for my successful career. He even failed to ask my advice when


he received a pacemaker—which was my specialty—in his later years.

Our phone calls were sporadic and uncomfortable. I was a person who

needed praise, and he proved very disappointing to me on this point.

His distance, however, probably became a driving force as I later built

my career.

As I have said previously, he was thoroughly involved in his

professional career, and as a youngster, I tried to be a part of it. When

asked if I wanted to go to the hospital with him to do rounds, I agreed,

but all I did was sit in the waiting room, waiting for him to be done. In

contrast, when I was in practice, I took my son Craig with me on my

rounds and introduced him to patients as “my consultant.”

Essentially, I spent my whole life trying to please him and never got a

response. When he was on his deathbed, dying of natural causes, I did

not, unlike my siblings, fly down to Savannah, where he had retired

with his wife, Jane, to say goodbye. I do not miss him. Unfortunately,

I hold him up as a negative example of a father.

In the end, I think my parents were thoroughly incompatible, and

I have often thought that my father used his medicine as an excuse to

be away from home. Looking back, I also believe that my parents had

their own separate lives.

I had five siblings. After me came Marc, who was three and a half

years younger, and when we were children, he was my family playmate.

We challenged each other to long Monopoly games and to tickle

fights, but as we grew older, however, we each went in completely

different directions. We lived only seven miles from a ski area where

I began skiing at the age of seven, often skiing two or three times a

week. I still ski to this day. While I immersed myself in skiing, Marc

became passionate about candlepin bowling. He developed a love of

science fiction and ended up going to MIT, which says a lot about how

differently our personalities and predilections evolved.

Unlike me, he hated sports, and our pathways and personalities

turned out to be so different, even though, ironically, we both became

physicians. I was fortunate in that I loved what I did, but I do not think

Marc ever developed a passion for medicine. He was very good with his


hands and majored in biology and electrical engineering. Because of

his manual dexterity he chose to be a surgeon after medical school at

Penn; however, he never had the same drive to succeed as I did.

As I got older, I felt that I needed or wanted to have more sense of

family. At a certain point Marc and I addressed our relationship and

became closer. We exchange phone calls every several weeks and have

visited each other at our homes, with Judy and I going to his house in

Pennsylvania and his summer place on the Jersey Shore, and the two of

us, in the past, inviting him and his wife, Hillary, to Nantucket.

Jon was six years younger than I and athletic, and we played baseball

together, but I really did not connect with him until he was in college

at Johns Hopkins and I visited him for a weekend when I was in med

school. We both enjoyed skiing and went on an Italian Alps ski trip

together. I maintained a connection with him in Philadelphia when

I was a cardiology fellow, Marc was a med student and Jon was at

Wharton for his MBA. I also visited him when he moved to New

York City for his first graduation job at Drexel Burnham Lambert.

Unfortunately, we later drifted apart. I only speak to Jon concerning

family business and do not interact with his wife, Laura.

Charlie was next in line. He was the golden boy of our family and

linked the older and younger halves of the family—me, Marc and Jon,

and Bess and Jeff, respectively. He was valedictorian of his class and had

a wonderful group of friends, particularly his next-door neighbor, Jeff

Wilson, the son of my parents’ best friends. He went on to Dartmouth

because of his love of the outdoors. However, during his first semester

he was invited on a Dartmouth Flying Club airplane ride to see the

dawn and died in a crash. The last time I saw him was at the Harvard–

Dartmouth football game, where he was playing trombone in the

Dartmouth band. What a loss to the family!

After Charlie, was Bess, the black sheep of the family. She had

many psychological problems and surrounded herself with friends

of questionable character. I believe she was the most affected by my

parents’ ultimate breakup, although she was not close to either. My

father was distant and stern, and my mother was not feminine enough


to develop a strong mother–daughter relationship with her, so she

was, essentially, alone in her troubles. Ultimately, she dropped out of

school, only later getting her GED. My father, because of his guilt,

provided her with a job at his hospital and supplemented her income.

She later married Ed, who was a laborer. He hurt his back and became

disabled. Later, he tried to do computer repair, but this also failed, and

he, essentially, remained at home on the couch. Her marriage has been

barren, both psychologically and physically, as she has polycystic ovary

disease and is sterile. Now, she has a major office job in the transplant

coordination center at my father’s former hospital in Newark. From

a family point of view, she is isolated, for as Marc and I have forged a

special relationship, so have Jon and Jeff, the youngest.

The youngest was Jeff, 17 years younger than I, and we got to know

each other when he grew older. Since I skied with my son Josh, who was

close to his age, we invited him on two ski trips to Utah and Taos, and

Josh has remained friendly through Facebook. Jeff went to University

of Vermont, and then received an MBA from Thunderbird in Phoenix.

Subsequently, he joined a truck leasing company in San Francisco,

where he ascended to president. The business has been acquired by a

large firm and he remains there to help run it. In the beginning of the

2008 recession, he was almost bankrupt, and my father supported him

and his wife, Lisa, financially. Owing to their business background and

MBAs, Jeff has more recently joined forces with Jon in several business


He was also the only one of us to have a close relationship with my

father, and, among all the dysfunctional relationships in our family, he

has taken the mantle of peacekeeper in our family affairs. After our

parents’ deaths he called himself “the Switzerland of the family.” He

has also been named the executor of their estates, reflecting his role as

mediator in the family.

I loved my maternal grandparents, Eli and Edith Friedman, known

to us as Gram and Gramps. They were my major source of support

in my family. Both of them doted on me and were completely nonjudgmental.

In their kind eyes I could do nothing wrong. Even as a


child, I found them to be such a source of comfort. My grandmother

was also the focal point of the family and she kept us all together,

particularly through celebratory Jewish holidays at her house.

I particularly remember Passover. Since my grandfather had studied

to be a rabbi at Yeshiva before medical school, he was very knowledgeable

about Judaism and would lead the Seder meal, reading the Haggadah

in Hebrew and then providing his own translation. Traditionally, there

are two parts of the ritual; one is completed before the meal, and then

there is a second part after the meal itself, involving the singing of

songs and recounting of stories. Because my grandfather knew we were

all so eager to eat, and the meal took so long, he always dispensed with

the second part.

I loved spending time with my grandparents. I remember taking

showers with my grandfather, playing Casino with him, and sometimes

just watching while he talked to patients on the phone during calling

hour. He was actually one of the first pediatricians in Boston, and

I witnessed the degree to which he was respected in his field. I am sure

that the care with which he treated his patients played an important

role in my decision to become a physician myself.

Meanwhile, my grandmother could not do enough for me.

I remember dragging her to a Dartmouth–Boston College football

game, and we would also go candlepin bowling together. She cut

quite a figure fashion-wise, wearing platform shoes accessorized with

sequined stockings instead of bowling shoes long before the 1960s

craze for them. She also had a long cigarette holder in which were

held, in a vertical position, her Camels. This was an integral part of my

grandmother’s morning constitutional, and she smoked her cigarettes

in the bathroom, as testified to by the many burn stains on the rug and

toilet seat.

Both grandparents also took me to the horse racetrack. Usually,

my grandfather placed six or seven bets for one race. After each race

he went up to the window to collect his winnings. All the bystanders

thought he was a horse-racing wizard, a Guys and Dolls Damon Runyan

character. But going to the races was a source of entertainment to my


grandparents—just as they themselves were a source of happiness for

me and for all my siblings, who they adored and indulged equally.

My grandmother also loved to gamble. After my grandfather’s

death, she flew down to Nassau to stay with my Aunt Miriam Krock,

my father’s sister, who became a close friend. The prime motivation

for my grandmother’s trips to Nassau, however, was playing craps. She

would dress up in her uniform, abandon her wheelchair, and head

to the casino where she would, inevitably, win—and attract a crowd.

Wherever she went she was always very popular.

My grandmother’s astuteness with money was not limited to casino

gambling. She also played the stock market with great aplomb, and

made a lot of money by, in particular, investing in AT&T stock. She

loved to buy on margin and called her broker ritually every morning to

catch up with the latest market trends. In addition to checking in with

her broker, she also religiously relied upon the Boston Globe horoscope

to guide her decisions on any given day.

For years, my grandmother prepared extravagant holiday dinners

and she made the world’s most delicious gefilte fish. The fish themselves

were nauseating to look at and they smelled awful, but the final result

was sublime, even though my grandmother insisted upon leaving the

skin and the bones in the dumplings because she loved to suck on the

bones. She also made a very unique stuffed veal brisket for the holidays.

Chopped liver was another of her specialties, made using one of those

old-fashioned grinders that clamped to the end of the kitchen table.

When it came to cooking, she was not one for precision, much to Judy’s

frustration, who once pleaded with her —to no avail—for measurements

so that she could repeat the recipes at home.

When my wife and I were married in 1980, my grandmother insisted

on having a party for us. According to kosher Jewish tradition, one

cannot mix meat and dairy dishes together; instead, kosher households

have separate sets of dishware for each—milchik, for dairy, and fleishik,

for meat. By law, Jews cannot eat lobster, which is treif (unkosher), but

my grandmother loved it and insisted on having it on our wedding

menu. She worked around the rules by serving hors d’oeuvres inside


and then moving everyone outside to dine on the lobster, served on a

third set of treif dishes. We consumed this forbidden feast out in the

backyard to avoid mixing with the other sanctioned food.

Another food-related eccentricity of my grandmother’s was her

habit of serving food on an ingenious hybrid potty wheelchair that my

grandfather had used. After his death, she resurrected the potty chair

as a serving tray and would wheel it into the dining room laden with

heavy-to-carry fare, such as her trademark chicken soup with matzoh

balls. Equally hilarious, and a little creepy, was the time we took our

children to visit her overnight. In the morning, when they demanded

cereal for breakfast, my grandmother poured out the contents of a box

so old that it was writhing with maggots. She was a true character!

They were certainly very different from my paternal grandparents,

Charles (Charlie) and Bessie Alpert, who were not as close. My

grandfather Charlie was a loud, garrulous man in the printing business

and, apparently, a very astute businessman in the vein of first lieutenant

Milo Minderbinder in Catch 22. Aside from his sister, Miriam Krock,

my father—who was the baby in his family—had two older brothers,

Louis and Ferdinand (Ferdy). Together with my grandfather, my uncles

and father were in business together, although my grandfather and

uncles eventually bought out my father.

My grandfather Charlie was a mafioso-like figure. He was the chief

of the family and whatever he said was to be taken as an absolute

commandment. He ruled the roost, and my grandmother, a firstgeneration

American, was a beautiful but very docile Jewish wife. She

played no role whatsoever in my life. Sadly, he died of colon cancer in the

1960s after undergoing botched colon surgery at Massachusetts General.

My grandmother died some years after him from stomach cancer.

On my mother’s side, sadly, I do not know much about my

grandmother’s origins aside from the fact that she was a secondgeneration

American whose family was from Russia. My grandfather,

Eli, was born in Lithuania and came to America with his brother Ben

as a young boy, following an older brother who had immigrated to

Boston, and arrived in Boston, via Montreal.


Because he was a bright student, Eli’s parents wanted him to be

a rabbi, so, initially, he studied at the Yeshiva, but he did not like it.

He then completed his high school education at Boston English, an

academically select public high school. After high school, he went to

Harvard in 1912, but he decided to become a doctor and transferred

to Tufts Medical School. He completed his medical training in Boston,

where he became interested in pediatrics, a new specialty. Ultimately,

he was one of the first pediatricians in the country, and he later became

the chief of pediatrics at the Beth Israel Medical Center in Boston,

which has since become a Harvard affiliate.

In his autobiography, my grandfather included some fascinating

stories about his medical experiences, such as how to care for patients

prior to the existence of penicillin and how to treat illnesses such as

diphtheria and whooping cough. He had a favorite philosophic quote

that he always cited to patients when treating them: “tincture of time

is important.” It underscored the importance of having the patience to

see if a specific treatment would have an effect. I thought the comment

was so wise that I later ended up adopting and modernizing it, telling

my own patients, “Take two aspirins and call me in the morning.” It is

not that I was dismissing them; I was being patient, waiting to see if a

set of symptoms evolved to help diagnosis and treatment.

Another favorite comment of his was: “Is it post-hoc or propter-hoc?”

(Latin for “after the fact or because of the fact”), by which he was

referring to whether a medical event was independent of or caused by a

specific diagnosis. Ultimately, there are many Eli-isms that have seeped,

consciously or not, into my practice of medicine.

My grandfather’s pathway to medicine represents how immigration

can have a positive effect in giving one the opportunity to succeed.

Grandpa Eli was a role model for me, particularly in the way that he

was so involved with his patients. As a child, I remember how he took

me on house calls around Boston, and I was fortunate to witness the

kinder, gentler aspects of what he did as a physician. Along with his

equipment, he always carried a roll of nickels with him, and at regular

intervals he went to a public phone to call his answering service to


check if anybody needed him. I say “he,” but in truth, it was “they,”

because my grandparents were inseparable and my grandmother

always accompanied him. My grandmother was completely enveloped

in my grandfather’s life, and vice versa, giving up a singing career as a

graduate of the New England Conservatory of Music. Their complicity

and union provided a very positive role model for me.

Back then, Eli drove a Cadillac because it represented success and

safety. He had attached a search light to the top of his outside mirror

to read house signs. In the winters, because Boston was so cold, my

grandparents sat beneath a leopard skin blanket. One time, the blanket

got caught up in my grandfather’s feet and instead of braking, he hit the

accelerator, driving right through the plate glass window of a Stop and

Shop grocery store.

While my grandmother often resided in the spotlight, my

grandfather was the éminence grise of the couple. As much as she was

over the top, he was understated, but if he was more reserved than my

grandmother, he had his own idiosyncrasies. I specifically recall him

reading The Jewish Forward, a Yiddish newspaper. He used to say that

his wife’s name was “Edi Come,” because whenever they went out, he

would be anxious to go home, while my grandmother was loathe to

leave a conversation, so he would start pleading with her, “Edi, come!

Edi, come!”

My Aunt Miriam was my father’s older sister, and they were extremely

close. Her husband, Edward Krock, was a very wealthy industrialist and

they lived in an enormous mansion on a sprawling, luxurious estate in

Brookfield, Massachusetts called Rocking Horse Farm.

Miriam and Ed had an adopted son, Richard, who was just a year

younger than I. As youngsters, we were playmates, and I spent a lot of

time at their mansion in Brookfield, Massachusetts. Their home was

lavish, with countless bedrooms, bathrooms, and sitting rooms, as well

as an artificial lake, a swimming pool, and a tennis court where I often

played with Dick. They also had peacock and pheasant coops, and kept

multiple cocker spaniels as pets. The estate resembled a segment from

Lifestyles of the Rich and Famous.


In a sense, it was kind of selfish of me to exploit their style of living,

but Aunt Miriam was always very magnanimous. When Dick and

I were young, she would take us to New York, where we went to FAO

Schwarz. My cousin loved some of the toys that were there, particularly

miniature horses from Hopalong Cassidy and Roy Rogers, and Miriam

was very caring of me. If he got a horse, then so did I. Every year, her

family wintered at Boca Raton, Florida, and one Christmas vacation,

they invited me to spend a week at the Boca Raton Hotel and Club,

where I golfed and played tennis.

I love the Red Sox, while Dick rooted for the Yankees. Once, Miriam

obtained tickets to see the 1960 World Series in New York, where the

Pittsburgh Pirates played the Yankees—an irony, since I ended up being

a Pirates (and Red Sox) fan. Another time, she had one of Dick’s high

school teachers take us to New York to see My Fair Lady on Broadway.

We also went to the Automat and the Empire State Building; it was a

really wonderful time. Miriam was not trying to buy me. She was just a

very doting woman, and she and Ed included me because I was Dick’s

playmate and Joe’s son.

Unfortunately, when she was in her 60s, Miriam developed ovarian

cancer and died prematurely. As we got older, Dick and I were less in

touch because he had gone to private school at the Williston Academy,

followed by study at Tufts, where he did not do well. Emulating his

father, he ended up transferring to the Babson Institute, a financial

school in Boston, and pursued a career in business with his father. At

that point, we no longer had any common interests.

As for my Uncle Ed, he had several business partners and together

they became involved in some questionable business deals. As a result,

he was indicted by the government for income tax evasion. In order

to avoid prosecution, he fled the States and sought refuge in Nassau.

Initially, he lived on a houseboat, before moving into a mansion

formerly owned by Sidney Poitier.

After Miriam died, I completely lost track of Dick. The last time I saw

him he had married, and we met him and his Swedish wife on vacation

in Nassau. As far as I know, he now resides on the island of Guernsey.


My parents’ wedding picture


The New York Times of the day I was born


Me and my mother

My father’s announcement of move to Laconia



Jon, Bess, Father, Mother, Jeff, me, Charlie, and Marc


Aunt Miriam, Grandfather Eli, Grandmother Edith and Mother

Grandparents, Charles and Bessie Alpert



New Hampshire


found growing up in New Hampshire in a town of just 14,000

residents to be a special experience. Because we were surrounded by

lakes and mountains, there were many fun outdoor activities available

to us in the region.

At first, my family lived in a rented house, until my father purchased

a home with a huge yard just outside of town, which we renovated. It

was across the street from a lake where we kept a boat, and we all took

up waterskiing. Our next-door neighbor was a veterinarian who had

a grove of maple trees, so when the sap ran in the spring he hosted a

sugaring off party in which everyone helped to harvest the sap. The sap

was then boiled to transform it into maple syrup. I remember that we

drizzled the thick amber syrup all over fresh snow and ate it—a bona

fide snow cone!

Growing up, I was somewhat of a goody two-shoes who almost never

got into trouble. There were, however, several notable exceptions. In

Grade 5, there was a rebel, Ralph Gable, who talked me into playing

hooky from school one afternoon. Much to my chagrin, only a short

time after we left the school premises we unwittingly ran into somebody

who worked in the principal’s office. When I was subsequently called

in to the principal’s office to account for my crime, I lied and said I had

been going home because I was not feeling well, and that Ralph had

offered to accompany me. Because I had a reputation for being such a


good student who stayed out of trouble, the principal believed me, and

I escaped reprimand.

When I was a freshman in high school, I had two friends I used to

spend time with, Mike Tannenbaum and John Trapp, both of whom

were more adventurous than I. We used to play table hockey together

after school. At the time, the legal minimum driving age in New

Hampshire was 16, but I remember that when we were all 15 John

took his father’s car out and the three of us went driving. I had a lot

of trepidation about this jaunt, but I wanted to be part of the group.

Needless to say, I never told my parents. Fortunately, when I turned 16,

I got my driver’s license, which gave me a certain degree of freedom.

Sports were very important in Laconia, and, although I liked

them, I was, apart from skiing and golf, never very good at them.

In elementary school, I was not sure that I was aware of my sports

failings, but in high school it became more of an issue. At that time,

as a younger person, being good at sports provided one with access to

the “in” group.

As a youngster, I played a lot of pick-up touch and tackle football,

but I always got picked last. When I was younger, I also played Little

League baseball, which I enjoyed; however, my only advantage was being

left-handed, which helped with pitching. Otherwise, I was a mediocre

baseball player, and my hitting was terrible. My big mistake was that

my parents played golf and they taught me how to play right-handed,

since left-handed golf clubs were very difficult to come by. This, in

turn, ruined my left-handed batting, and I had more strike-outs than

the walks I would have received if I had been batting lefty.

Choosing an alternative sport, I joined the high school’s golf team,

but I was disappointed that, after four years on the team as second

seed, I did not make captain as a senior. The reason for this was that my

father insisted we take a father–son fishing trip up to Maine in spring

each year. The week he chose always coincided with the first week of

golf season, and I think the golf coach resented my yearly absences. In

the end, I did receive my letter that I could proudly wear on my Laconia

High School jacket, but nothing more.


Laconia lived and died with its basketball team. I remember trying

to play basketball with the elementary school team, and this time the

problem was that while I am left-handed, I am right-footed. As a result,

whenever I had the chance to try a lay-up, the wrong leg would go up,

which really made it difficult for me. It became obvious to me, and to

everyone else, that I was not going to be NBA material.

In high school, I attempted a foray into football. In a small town like

Laconia, the high school football team was everything, especially on a

Friday night. Before high school, like all kids, I played touch and tackle

football, but once we got to high school, organized football reigned.

For a time, I actually played Junior Varsity ball, largely because they did

not reject anybody at all at that point. Consequently, I went through all

the training, running up and down hills and vomiting, and keeping my

smelly clothes in the gym. Not surprisingly, since I was small, I was not

very good. I wanted to play tight end and linebacker, but I almost never

got the chance to do so. I think there was one time where I finally did

play at the end of the game. My mother actually came to see me for

that one.

At Laconia High, one’s performance on the field was directly related

to one’s social standing. The most popular boys played on the football

team and went to all the dances with the most popular girls.

While I did not shine on the football field, I had better luck on the

debating team. One of the teachers was well known in the National

Forensic League circles and routinely sent winning teams from

Laconia to the nationals in Montana. I was not the best on the team

by any means because I hated extemporaneous speaking, but I enjoyed

debating because it involved accumulating a set of facts regarding a

given subject, and then creating a paradigm to prove one’s case.

I bonded with a girl named Francie Allen, my partner on the

debating team. Francie and I were together because she was Allen and

I was Alpert, and, in consequence, we sat next to each other in class.

She was a very bright student who was also a good skier, and we became

good friends. Debating was really a lot of fun, and we traveled all over

New Hampshire to debate other teams. We won more than we lost.


Regardless, I would come away from each encounter doused in sweat

(I sweat an awful lot) because public speaking makes me very anxious.

To this day, I loathe speaking in front of people, despite having had to

give multiple lectures as an academician.

In pre-PowerPoint days, I used to rely on slides to avoid speaking

extemporaneously. Years later, I am now at the point where if I am asked

to speak, I will decline because of my discomfort at transitioning to

PowerPoint. It is just too much work to create a PowerPoint presentation.

As for Francie, she went to Smith and then married Roger Rosenblatt,

a Jewish boy from my community. He was brighter than I, and his

parents sent him to Exeter on a scholarship. He was accepted into

Harvard a year before me and graduated early because he accumulated

so many APs. Interestingly, he ended up going to Harvard Medical

School and then the University of Washington where he specialized

in internal medicine, before marrying Francie. When I returned

to Laconia for my 25th and 50th high school reunions, I was very

disappointed that Francie did not attend because I would have liked to

reconnect with her. I heard recently that Roger sadly died of cancer, but

otherwise, I do not keep in touch with anybody from my high school

years at all. When I left Laconia, I felt it was just time to move on, and

I guess I have felt that way ever since.

There were several students who were on my level in high school

and that I could talk to or deal with comfortably, and Francie was

one of those people. Others were Sherry Simmons, who later attended

Wellesley, and Jeff Bowen, who went to Williams. They were all in the

outsider group, but unlike me, this seemed never to bother them.

The fact that I was not great in sports was problematic for me

socially. As I grew older, it was not that I was unpopular, but more

that I was kind of an outlier. I had to find my own niche and was

sometimes frustrated by my social issues. My high school was small,

and, in truth, it was an embarrassment socially to be as academically

strong as I was. I actually spent my time in high school downplaying

my academic achievements with classmates so that I could be accepted.

I was always on the outside because of my grades, so I had to work very


hard to make friends. In the end, I did finally find a coterie of people

with whom I felt comfortable. This was not, though, at Laconia High

School, but at St. Paul’s, which I will describe later.

There were approximately 180 students in my high school class,

and only three of us were Jewish. Initially, I was friendly with Mike

Tannenbaum, but at some point, however, he became extremely friendly

with John Trapp, and they ostracized me. Ironically, when I returned to

Laconia for my 50th high school reunion, he and I reconnected. The

third person, Richard Brindis, was annoying and disliked by everyone,

and I felt that, because of him, I needed to distance myself, and not

dwell on being Jewish.

In high school, egged on by my mother, I took music and piano

lessons. Initially, I was quite devoted to the piano, even though I did

not play well. My prowess suffered as I grew older and other activities

came along that interfered with my practicing.

I was actually fascinated by the sound of the organ. So, in addition

to piano, I took a summer course in organ performance as part of a

fine arts program. Despite my enthusiasm for the organ, my playing

once again left much to be desired. But because I knew the organ, I was

pressured into playing it at a recital for DeMolay, a service organization

related to the Masons. I was also pressed into service to play the organ

or the piano for the high-school Christmas show. I remember doing

a hatchet job on “Good King Wenceslas.” Following that debacle,

I retired permanently from public playing.

Despite my performance setbacks, by the time I finished high school,

I had developed an appreciation for classical music which has remained

with me to this day. I was never a good musician—I have a poor ear for

music—but I very much enjoy listening. As an adult, I have amassed

an impressive vinyl collection in addition to cassette tapes and DVDs,

and, of course, now I stream. I have been a symphony subscriber for

40 years, and since I retired, I have taken several music online courses.

Bach is my favorite composer.

In the academic realm, my teachers recognized how bright I was,

and I always received straight As. My only B was in typing. I did not


eceive any special tutoring at my high school and there were no AP

courses, but I applied for and was admitted to an Advanced Studies

Program at St. Paul’s School in Concord, New Hampshire, which

accepted gifted public high school students for summer enrichment

courses. The program allowed students to take advanced-level highschool

courses in a competitive and stimulating atmosphere. The first

year I was admitted, I took advanced biology, and the following year

I took modern European history, my two competing interests: science

and social science.

I ended up as ranking scholar, first in my class in European history,

for which I received an award. It was gratifying to me to have it

confirmed that I was in a very elite group. I was not so much surprised

as just feeling that I had probably been intellectually muzzled in high

school. What the award meant to me was that I could be competitive

academically at the next level. Just as importantly, I socialized with

peers who valued intellect over sports.

The courses at St. Paul’s were challenging, but what really excited

me was being surrounded, for the first time, by students with my

interests. Finally, I could engage in intellectual conversations and

admit that I read The New York Times on Sundays. The program turned

out to be a very positive, formative experience for me, one that I did

not get at Laconia High, where I completely stood out—and apart—from

my classmates. But there was an added positive. Based on geographic

distribution and diversity, coming from a very small public school in

northern New England contributed to my acceptance at Harvard.

Another plus from St. Paul’s was that I had my first serious relationship.

This was with Linda Frail, a girl from Manchester who was studying

Russian and whom I dated through the fall of my senior year. She

provided a new social dimension, but we drifted apart and did not,

unfortunately, reconnect when she went to Wellesley and I to Harvard.

Ironically, despite my strong academic bent, I did not engage in

much reading as an adolescent. When I was younger, I mostly gravitated

to books such as the Hardy Boys mysteries and, later, biographies.

Perhaps as a result, I was never strong in English; my verbal skills were


weaker than my math skills and I never acquired a literary background,

reflecting a significant discrepancy on my college board SAT scores of

650 and 720. (To this day I hate writing, hence my decision to have

help with this book.)

My parents never encouraged me to read, and in fact they did not

strongly encourage me academically at all. When I was younger, I think

they just wanted me to be a child. As a result, I was very self-directed.

I did, however, receive some help from my mother, who showed an

interest in my academic career when I was in high school. As bright

as I was, I struggled with geometry, so she helped me with homework.

She was also my editor and helped me to write and proofread different

papers, even during college.

My mother also encouraged me intellectually. As noted previously,

she invited me to join a Great Books group she belonged to, in which

participants read renowned works of literature, and she also suggested

I join the Council of International Relations to discuss world affairs.

While I believe that, in part, she was trying to stimulate me, I also

believe her goal was to show me off to other people, to flaunt my

intellectual capacities.

Although Laconia was an idyllic place to grow up as a kid, it was,

as a small town, increasingly stultifying for me by the time I finished

high school. When I considered colleges, I wanted to be in an academic

center and go to the best school I possibly could. I also desperately

wanted to get away from a small town and, hopefully, to be in a large

city. With these desires in mind, I applied to Harvard, Yale, Princeton,

Penn, and Tufts.

In truth, I did not want to go to Yale because I did not think New

Haven offered much outside of the Yale campus, but my principal

told me that if I wanted to go there, he could guarantee admission

because of my school’s track record. Even though I was not very much

interested, I did apply. Harvard was my first choice because I was

infatuated with Cambridge and Boston, and I felt it would provide me

with a more expansive college experience. Penn was my back-up school.

I liked Philadelphia, (which would, coincidentally, play a big role in my


family’s future, with both my brother Marc and me attending medical

school there, as did my son Craig, while my brother Jon got an MBA

from Wharton, and my son Josh did his undergraduate degree at Penn.

In addition, and just as an aside, my two daughters-in-law also went

to Penn). I applied to Tufts as a back-up, but what I truly desired was

to go to Harvard. Having grown up visiting Boston, I knew the city

well, and that is where I wanted to go, although Philadelphia was an

acceptable alternative, if necessary. Princeton was an afterthought, just

to complete the Big Three.

I was very competitive and never considered not applying to these

top schools. I figured, why should I not apply to the best? I applied

that sense of ambition to everything that I did back then, and I was

certainly qualified. Although I was aware that I might not get accepted,

I was mortified when I received a letter in April of 1963 announcing

that I had been placed on the wait list to Harvard! I was crushed.

Although my mother was very sympathetic to my disappointment,

I got no reaction from my father. I had no understanding of his

attitude; perhaps he was jealous. But from that point on, I never

received any support from him, despite all my academic success—no

sympathy or empathy.

Not too surprisingly, I did not get accepted to Yale or Princeton,

which I never really liked, but I was accepted at Penn.

Fortunately, aware of my despair, Phillip Hugny, the head of the

summer program at St. Paul’s School Advanced Studies Program,

called Harvard admissions. “How could you do this?” he demanded.

Barry is one of our top students!” He argued very strongly that

I should be admitted, banking on his relationship with Harvard as the

headmaster at St. Paul’s. To my great relief, one month later I received

full acceptance. I quickly suppressed the fact that I had been wait-listed,

convincing myself that, in the end, getting into Harvard, even off the

waiting list, was the most important point.

My grandparents were thrilled to have a grandson who was going

to Harvard, which was a wish come true for every Jewish grandparent.

When I later chose medicine, their pride took on an added dimension.


Of my schoolmates who went on to college from high school,

the majority went to places such as Plymouth Teachers College or

University of New Hampshire, but, in truth, probably more of my

former classmates went off to barbershop school and the military than

went to college. Only around 10 of us ended up attending known

schools. Francie went to Smith, Sherry Simmons went to Wellesley, our

football jock went to Dartmouth, Mike Tannenbaum went to McGill.

My competitor for valedictorian went to MIT, and Jeff Bowen, the son

of the school superintendent who, like me, was very smart and socially

ostracized, went to Williams.

It was interesting that I went from Laconia High to Harvard.

After all, academics just were not stressed strongly at my high school.

I still remember that in Grade 8, I had to take a vocational arts class,

vocational arts being prized in a small New Hampshire town. One

of the electives was woodworking and our first project was to make a

breadboard. We had to use a level to make the edges perfectly flat, and

I ended up with the smallest breadboard in the class! I was even worse

when it came to metalworking and print shop. Ultimately, the only

activity in which I did not completely humiliate myself was mechanical


Once I was admitted to college, I left Laconia, never to return.

Although I enjoyed high school and ended up being class covaledictorian,

I also found it difficult because of the social pressures

I faced. I was always aware of the fact that people saw me as “different,”

and I don’t think this was because I was Jewish. I never encountered any

overt anti-Semitism, and people were unfazed by the fact that I went to

Hebrew School every Tuesday and Thursday. Friends from school even

attended my bar mitzvah. It could have been because I was so bright,

but ultimately, however, I just felt apart from everybody else and that

fueled a sense that I was in the wrong place, that there was something

more out there, waiting for me.

In terms of my family, I was the oldest of six at the time and had

the urge to be independent. Moreover, there is a self-preservation

gene in my family that verges on self-centeredness. Individualism and


taking care of one’s own needs first and foremost were values that were

instilled in all of us by parental example. As such, the moment I left

home for Harvard in 1963, I did not have any regrets. By then, I did not

have a particularly close relationship with my parents or my siblings.

Ironically, my departure coincided with that of my family’s move

from Laconia when my father pursued a change in career. In 1964,

he decided he wanted to reorient his career to a subspecialty, and he

enrolled in a fellowship program in vascular surgery at Montefiore

Hospital in the Bronx, which involved moving to Larchmont, New

York for a year. Subsequently, he was offered a job at Newark Beth

Israel Medical Center in Newark, New Jersey. My parents and younger

siblings moved to temporary housing in Newark and then to Westfield,

New Jersey. After that, I really only saw them when I came home for

vacations and holidays.

Me as a state winner


High school yearbook





seminal moment occurred during my second year at St. Paul’s.

The head of the program, Phillip Hugny—the man who had fought

successfully to get me off the wait list for Harvard—invited me to be one

of two students interviewed on a local radio program. I remember that

the interviewer asked me, “When you arrived at St. Paul’s, did you

discover that you were not as smart as you thought you were?”

My response was: “Absolutely not. Rather, I realized that there were

people smarter than I.”

That realization carried me through college, because at Harvard,

there were students who were extraordinarily bright. I encountered

students who were absolutely brilliant, while I had to work hard for

my grades. I learned to accept the fact that there were people who were

smarter than I was, which was both humbling, and yet comforting to

me. I felt that I belonged there. Looking back, I think my response on

that radio program was both correct and very profound.

Harvard has always been very important to me. I have never been

afraid to let people know that I attended Harvard because it gives

people a favorable initial impression. Given the fact that I never got my

“stroking” from my parents, it made me feel good. I also found that it

might open doors for me in my career.

When I arrived, I felt like a kid in a candy store; there were so

many intellectual activities going on—lectures, clubs, courses—and,


most importantly, the intellectual environment from my classmates.

My only regret was that I could not do it all because, regrettably, there

was not enough time to devour all the options so tantalizingly on offer.

Arriving at Harvard as a freshman, I was placed in a room in Strauss

overlooking Harvard Square with two other classmates, Harris Hartz

and Steve Fulling, all of us, presumably, computer matched. They were

physics and advanced math majors who later graduated summa cum

laude, and I had absolutely nothing in common with either of them.

Our dorm consisted of two rooms with bunk beds and a living room.

As soon as I arrived, I lay down on the bottom of one bunk, placing my

belongings on the top, thus staking claim to the entire room for myself.

As a result, the other two shared the second room. Steve had a strange

habit of going to the bathroom and urinating while reading books. He

became a professor of advanced math at Texas A&M. Harris went on

to law school and subsequently became a federal judge in New Mexico.

Our paths never crossed after freshman year.

In the mid 1960s, there were always riots at Harvard for crazy causes

such as “Save the Sycamores” on Memorial Drive. During my freshman

year, a riot broke out, with students tossing water balloons from my

dormitory. Although I was only looking out the window, the authorities

believed that I had been involved and interrogated me. I was afraid that

I would be punished, but fortunately, they believed in my innocence.

When I entered Harvard, I had absolutely no idea what I wanted to

do in terms of a career, and I certainly had not considered medicine.

Despite having taken advanced biology, my academic background had,

up until that time, focused on the social sciences, so I took a Kuder

preference test. Reflecting my math proficiency, the results suggested

a career as a manager of an accounting firm! I, though, thought that

I should explore the social sciences in more detail, and consider

business and law. But I also wanted a liberal education, so during my

first year I took economics, psychology, and calculus courses. Thinking

I needed a French requirement, I also felt compelled to continue my

high school French. I did not care for economics, pointing me away

from a business career.


During the summer of my freshman year, my grandparents, through

a patient’s family, got me a job in a meatpacking plant in South Boston,

where I, with Italian immigrants, packed Swiss steak for army contracts.

At the time, my family was moving to New Jersey, so I lived with my

grandparents for the summer, and I enjoyed a vibrant social life with

some friends from Tufts who I had met while skiing.

It was a fun summer, even though the job was boring. The irony was

that I was this Harvard student doing a menial job with all of these

Italian immigrants. Yet, despite our different backgrounds, we really

bonded, and my colleagues really liked me. My grandparents then got

me another job in which I sorted magazines for a magazine distributor.

In retrospect, these jobs were very valuable in terms of teaching me

how to deal with people. I remember asking one of the meatpackers to

help me make a false ID so that I could get served alcohol at 19 instead

of the legal age of 21. That summer I also went to the Newport Folk

Festival with two friends, Mark Orenstein from Tufts, whom I had

met on a ski trip, and my cousin Dick. Since there was no place for us

to stay but there were a lot of empty mansions with no occupants, we

entered one and slept on the floor. It was so unlike me, but great.

Ironically, many years later, my family thought that I had been at

Woodstock, which was, I suppose, a compliment—they did not think

I was so straight after all—but I had to confess that I had not been there.

At the end of my freshman year, with a life in business off the list,

I still did not know what I wanted to do for a career. I decided at

that point that I would move on to the idea that I might become a

lawyer. At the same time though, the thought crossed my mind that

since my father and grandfather had careers in medicine, this might

be a possibility for me. Consequently, as I entered my sophomore year

I decided I might benefit by taking my minimum science course prerequisites

in conjunction with a government major.

To fulfill my bachelor’s degree, I had to have a certain number

of credits in natural sciences, social sciences, and humanities. In my

sophomore year, I opted for biology and chemistry along with a course

in government. I also had to take a literature course, so I enrolled in


“Humanities II: Epic and Drama.” The first semester, the professor was

a renowned classicist, and we studied The Iliad, The Odyssey, The Divine

Comedy and Paradise Lost. During the second semester, our professor

was William Alfred, a playwright and an English professor. We started

off with Aeschylus and progressed to Arthur Miller and Waiting for

Godot. I actually enjoyed the course, despite being nervous about the

type of writing assignments involved. I therefore opted for being a

government major, and the As I received in both sciences allowed me

to straddle possible careers.

During sophomore year, we were placed in different houses, the

equivalent of dorms, and we had to choose our own roommates. Each

house had its own dining room and activities, so one got to know

one’s housemates quite well. I was placed in Winthrop House, along

the Charles River. There was a classmate who had lived across the hall

from me in my freshman year with whom I was friendly, but he had

already made a commitment to room with someone else, and I had a

very difficult time finding a roommate for that year. Ultimately, there

was another student, John Rath, also without a roommate, whom I had

known from St. Paul’s. He had taken advanced math there and was a

math major. We connected and ended up being roommates for three


The summer of my sophomore year was unforgettable. I had taken

French during my freshman year, so when I discovered that a classmate,

Barry Goldstein, was going to France for the summer to study, I asked

if I could join him. Since he was 6 foot 4 inches tall, he was “Barry Le

Grand” and I was “Barry Le Petit”. As a result, I spent that summer in

France, auspiciously becoming the first in my family to journey beyond

the United States.

Initially, I spent four weeks in Paris where I had a homestay with

an interesting family who lived near the Eiffel Tower in Paris’s upscale

7th arrondissement. The father, Louis Olivier, ran the Paris office

of Disney productions. Their son, Antoine, was a year younger than

I, and we became close friends. Together we played tennis and went

swimming in the piscine located along the Seine. Antoine and his


family also helped me considerably with my French by refusing to let

me speak English. I learned a great deal from watching French TV

without subtitles too—I remember watching dubbed movies, including

Les Intouchables (The Untouchables). I felt encouraged by the fact that

many people mistook me for having a German accent instead of an

American one. Somehow, being mistaken for a European seemed like

a compliment.

My daily routine began with morning classes at the Sorbonne,

where I studied French as a second language with a mixed group,

including Swedes, Scots, and Spanish, two of whom became good

friends. Sometimes we did cultural excursions, visiting the Louvre and

Versailles with our teacher. I had lunch at the Cité Universitaire or at

home, before enjoying free time, often in the company of Antoine, and

actually spent a lot of time just discovering Paris. In the company of my

friend Barry, I also visited Paris’s boîtes (night clubs), sometimes staying

out until 3 a.m., and walking all around the city, since I did not have a

curfew. Barry was somewhat of a womanizer, and I remember that he

met a girl one night, which upset me because I did not have anyone,

so he arranged for his girlfriend to introduce me to her friend, and

I danced with her and walked her home.

After four weeks in Paris, Barry and I rented a car, and on August

1, we battled hordes of French vacationers fleeing the city to make

our way down to the Côte d’Azur. I had never driven a stick shift car

before then. Because the traffic was so bad there was lots of stopping

and starting, and I kept stalling out all the time. We finally made it

and had a fun week in the hills above Cannes before heading to Pau,

a small town in the Pyrenees near the Spanish border, where we took

a three-week French language course at the Université de Bordeaux

et Toulouse.

In our class, there was a set of twins from San Sebastian—beautiful

Spanish girls. Strict Catholics, they had very limited social experiences

in terms of interacting with boys, but we met them after class and

chatted with them, becoming good (platonic) friends. From Pau, we

enjoyed some weekend excursions, including a trip to Biarritz, where


I surfed for the first time in my life. Another weekend, we crossed the

border into Spain (at the time still ruled by Franco) to explore San


At summer’s end, I returned to the U.S. with a very good

understanding of French and the ability to speak it quite well. To this

day, I continue to love Paris, and spending a month in the city is on

my bucket list. I can read French now, although I still have difficulty

understanding and speaking vernacular French. I remain a die-hard


Back in the U.S., Barry and I lost touch as we were in different

houses with different friends. In truth, I am kind of introverted, and

I have never made a lot of friends, in contrast to my son Craig, who

creates a permanent bond once he meets someone. I will usually strike

up a relationship, enjoy it for a short period often prescribed by context

or circumstances, and then move on from it. As a result, I have never

collected a lot of friends, although a second roommate in my senior

year, Ken Roemer, is an exception to that rule.

During my junior year, I split my focus between courses in history,

government, and pre-med sciences. Harvard prided itself on its junioryear

tutorials—weekly sessions during which a student and a faculty

member were paired up to engage in studies on a one-on-one basis. My

weekly tutorial on government with Nadav Safran, an Egyptian Jewish

Middle East scholar, was definitely one of the academic highlights

of my junior year. Together, we explored a new idea that Safran was

developing at the time relating to sociology and political science. Being

part of that formulative process was interesting but, ultimately, foreign

to me, and I felt that my junior tutorial was not as interesting as I would

have liked. That year, I also took physics, as well as courses that delved

into American foreign policy history, the history of U.S. presidential

power, and Chinese and Japanese history. At the time, considering a

career path as a lawyer, I took a history of the U.S. Supreme Court,

which became my favorite undergraduate course and played a part in

my potential choice of future career. I also became secretary of the Pre-

Law Society.


The summer between junior and senior year offered me a lifechanging

experience. My uncle, Ed Krock, had become a business

associate of Roy Cohn. As a young lawyer, Cohn entered the annals

of history when he acted as chief counsel to the infamous Joseph

McCarthy, the right-wing senator whose interrogations of alleged

communists during the Cold War had a frightening impact on freedom

of speech in 1950s America. Uncle Ed arranged a summer job for me

as a clerk in Cohn’s back office so that I could experience the legal

profession. My duties included delivering papers to law firms, running

errands, picking up legal decisions at court, and serving papers. Setting

aside my personal feelings about Cohn and his controversial past,

I gained significant insight into the law profession, much more than

I had achieved from the intellectual experiences of writing legal briefs,

delving into law review papers, and consulting prior decisions, all of

which had been part of my Supreme Court history course at Harvard.

I spent much of that summer simply shuffling papers and generating pro

forma responses, with surprisingly little person-to-person interaction

or intellectual stimulation, which I craved. By the end of the summer,

it had become clear to me that a law career was not for me.

Coincidentally, during that same summer, while riding the subway

from midtown Manhattan to the courts downtown, I passed the

time in transit reading Intern by Dr. X. Authored by a Johns Hopkins

graduate doing his internship in Phoenix, Arizona, this fascinatingly

detailed account of day-to-day life in a hospital was utterly gripping

to me—so much so that I realized that I wanted to become a doctor.

Thank you, Roy Cohn!

During our senior year, John Rath and I joined together with

Ken Roemer and Geoff Emerson, who were also living in Winthrop

House, to make a quad from our two-bedroom suites. We had a suite

overlooking the Charles River, with each of us having our own room—a


Ken’s freshman roommate had been a fellow named Robert

Samuelson. He worked on The Harvard Crimson and later became an

economics reporter, writing for Newsweek and later for The Washington


Post and The New York Times. Currently, he is a commentator. However,

Sammy was so involved with The Crimson that he basically lived in the

newspaper office. In his sophomore year, Ken found a new roommate

in Geoff, and, like John and me, they were assigned to Winthrop


Ken and I have been very, very close since our university days. After

graduating from Harvard, I went to Penn Medical School and he went

to Penn for a PhD in American civilization, where we continued as

roommates the first year, after which he married Micki, his highschool

sweetheart. After graduating, the job market was very tight for

university professors, so Ken was lucky to be hired by the University

of Texas at Arlington. He hoped to move up and then transfer back

to New England, possibly to teach at one of the small schools such as

Middlebury or Bowdoin, but it just never happened. Instead, Ken got

very involved at UT Arlington, where he is now an emeritus professor.

As an undergraduate, inspired by his mother’s philanthropic work

on behalf of Native Peoples, Ken became very interested in Indigenous

issues. During the summers, he often did volunteer work at pueblos

in New Mexico and subsequently became an expert on Indigenous

literature, teaching courses and authoring books on the topic. He

wrote his PhD thesis on utopian literature, another specialty of his.

Additionally, he taught general American Studies. When he married,

I was his best man. Never having been to a Catholic wedding or

attended a Catholic mass, I was led to believe that I, as best man, would

have to participate in the Ave Maria. This created a significant amount

of anxiety, but it was just their joke to their Jewish best man!

Ken and Micki have been terribly kind to me over the years, always

looking out for my well-being, social and otherwise, particularly when

I was in medical school in Philadelphia. When I was in the air force,

I was stationed in San Antonio, Texas, and we were able to see one

another. But even when I was elsewhere, we always stayed in touch.

During our senior year, the four of us discovered that we were very

compatible… or at least, three of us were: Ken, John and I. In truth,

Geoff was a hockey player who did not like to study, and he actually got


into Harvard based on his hockey skills and legacy. Geoff kept separate

from us—he had his own life and his own girlfriend. He just took up a

bed when we all lived together in our fourth year.

As for John, he was a math major. After graduating, he was

concerned about the draft and had taken ROTC (Reserve Officers’

Training Corp). He went to Vietnam, but he was in Saigon the whole

time and avoided combat. Upon his return to the U.S., he completed

a PhD in applied mathematics at Stanford and then worked for Bell

Laboratories in central New Jersey as a scientist. He is retired now and

lives in New Jersey. Even though John and I were roommates for four

years, I have been much closer to Ken. I invited them both to Nantucket

for a long weekend a few years ago and we had a wonderful time. John’s

wife, Michele, who is an artist, dubbed us “the Three Amigos,” and

memorialized this relationship in a watercolor, which she sent to Judy

and me. It is now hanging in our Nantucket bedroom.

In terms of academics, John was a very strong student, and he

actually excelled a lot more than I did. He was brighter than I was

in math, but that never interfered in our relationship as roommates.

Ken, however, did not appear to be an intellectual, but he had an

imagination that made literature a good choice for him. Surprisingly,

he had a lot of issues with spelling, and I remember being shocked to

find so many mistakes when I proofread his papers. He just could not

spell, which does not, apparently, correlate with intelligence. He was

and is a wonderful person. He was seriously involved in track and field

in high school, where he threw the shotput, but when he tried out for

Harvard’s track and field team, he was not selected to compete. As

I look back now, I am very impressed by how much he has succeeded as

a tenured professor and author, and what he has achieved academically.

Geoff went on to become an ophthalmologist in Hingham,

Massachusetts, joining his father in practice. As for me, I flourished

intellectually, but work was very hard. If one did not get As or Bs, a C

was almost a failing grade, as everything was weighted. It was easy to

get Bs and B pluses but difficult to get As and A minuses. Ultimately,

I ended up making the Dean’s list, with half As and half Bs.


The worst grade I received at Harvard was for a government course

I had to take. I did well in the first part of the course, comparative

government, but the second part was political theory, which I hated

and for which I received a B minus. For my major, I chose international

relations as my focus. In my senior year, I took a course given by Henry

Kissinger, which, not surprisingly, was all given in the first person

singular. I was very proud of the A that I received in the class.

In addition to the government courses—which included one on

Freud—I used my senior year to branch out. I took a modern art

course, popularly referred to as “Spots and Dots,” and a comparative

literature course on bildungsroman, which refers to a story that follows

a character through the course of his or her lifetime. As part of my

undergraduate requirements, I also had to take a political theory course,

which I absolutely hated. Of note, the classmate who sat next to me was

Tom Ridge, the now former governor of Pennsylvania and the first

director of the Department of Homeland Security when it was created

in 2003. I also saved my last science course, organic chemistry, for my

senior year. I fulfilled my requirements without a thesis, and I opted to

graduate cum laude in general studies rather than in government.

In the 1960s, the two priority activities at Harvard seemed to be

studying and trying to find a date for the weekend. It was so different

from when Craig attended in the early 2000s. For his generation,

classes seemed to be secondary to extracurricular activities.

Although he did well academically, graduating with honors, he was

involved in so many other activities. He was on the business board

of the Harvard Lampoon, was in charge of the speakers’ program

at the Kennedy School of Government Institute of Politics for

undergraduates, volunteered to serve food to the needy at a church,

and did immunology research at Boston Children’s Hospital. The

Harvard experience was much more than just courses, and one was

encouraged to focus on far more than mere academia. But for me, it

all boiled down to studying and looking for weekend dates. In terms

of the latter, I did not meet with much success. I had better results

with my academics.


To my pleasant surprise, my non-dating social life at Harvard was

as important as my academic life. The dinner conversations I had with

my classmates were invigorating and compelling. Socially, I absolutely

flourished with my peers in that atmosphere. I could say what I wanted

to say, and my ability to converse and participate expanded enormously.

I actually listened much more than I talked at the dinners we had,

which frequently lasted several hours.

At Harvard, I learned to smoke a pipe, the preppy affectation of a

Harvard college student! I also learned to drink sherry in my freshman

year. I did not particularly like it, but it was fashionable at the time. At

late afternoon meetings with bow-tie-clad tutors, drinking sherry was

de rigueur. I later switched to more traditional beer and mixed drinks.

What was very memorable from that time was a group of us from

Winthrop House who all sat together at the dinner table. One of my

classmates had a ski house at Wildcat Mountain in New Hampshire, and

during one intersession, we all went on vacation there together. Even

though I was friendly with them, I also sometimes felt uncomfortable

in their presence, like the outsider I had been in high school. Since

I was the only Jewish member of the group, I always wondered whether

this played a role.

During our senior year, we had a 10-day interval between our final

exams and graduation. The parents and grandparents of one of our

classmates, Dave Hodges, had a house in Sconset on Nantucket, and

he invited our group to use it. We all met up on the Woods Hole ferry

and spent a week there together. It was a special time, the pleasures of

which were enhanced by my first experience with pot, Sgt. Pepper’s Lonely

Hearts Club Band, “Lucy in the Sky with Diamonds,” and horrible home

cooking. We just had a fantastic bonding experience at the beach.

I had lost track of these friends over the past 50 years, but I knew

that three of them ended up in the Washington area. One became a

lawyer, one worked as a research physician for NIH, and the third was

a professor at George Mason. They would get together every three or

four months to go out to dinner and discuss a book. When the Covid

pandemic hit, they decided to transform their discussions into a virtual


ook club, and in 2021 they invited 12 of us from Winthrop and

Nantucket to join for a virtual book club. Most recently it was Ken’s

turn to choose a book and lead the discussion. He chose an extremely

compelling work by an Indigenous author, and as he led the discussion,

I realized just how excellent he is at what he does. He had really chosen

the perfect career. I was so pleased that, after 50 years, they chose to

include me, and I have enjoyed the experience immensely, both for the

camaraderie and for the fact that each one of us can choose a book and

lead a discussion. As a result, I have read a wide range of books that

I would never have chosen on my own.

It really meant a lot to me to be invited to Nantucket back in my

Harvard days, and then, 50 years later, to the book club. As I’ve noted,

I’ve always been sensitive about being included because that was not

always the case. In fact, I had gone to my Harvard 50th reunion hoping

to reconnect with many of these friends from Winthrop House with

whom I had lost touch, and I ended up feeling excluded because,

unlike me, many of them had been in contact with each other over the

years. Even at the reunion itself, some of them drank, ate, and talked

together without inviting me into the fold. Indeed, the only positive

thing to come out of the 50th reunion was that I reconnected with my

roommate, John, and spent time with Ken and Micki.

I entered my senior year driven by the need to excel at pre-med

science courses. Since I was not a science major, I needed to do extremely

well. Up to that point, I had received straight As in calculus, biology,

chemistry, and physics. However, doing well in organic chemistry—the

most rigorous of pre-med science courses—was key to my admission to

medical school. Fortunately, I not only found the course to be easy and

enjoyable, but I also received a straight A, which made me competitive

for the most prestigious medical schools.

Although I had to take the medical college admission test, there was

not, at that time, the same emphasis on it as now prevails. I remember

simply reviewing my biology notes the night before the exam. There was

no Kaplan course for review. My subsequent scores reflected my overall

competence in the sciences. However, despite my admirable academic


performance, my unorthodox non-scientific academic pathway was a

source of concern that was, it seemed, shared by some of the schools to

which I applied. I was rejected by the more traditional schools such as

Harvard and Columbia College of Physicians and Surgeons. Yet NYU

not only accepted me but also offered me a scholarship. The University

of Pennsylvania also accepted me, as Penn administrators were trying

to make medical school more of a humanistic experience. With that

goal in mind, they were more willing to offer admission to candidates

other than traditional science majors. I had also applied to Tufts as a

back-up school. I was drawn to Penn, and to Philadelphia, because it

was the more competitive school. So began my Penn experience, and it

was wonderful. I truly believe that things happen for a reason.


Harvard diploma

My Harvard transcript


Dean’s List

Me and my parents at my college graduation


Graduation picture, college yearbook

John Rath and Ken Roemer, my college roommates



Medical School

As I have mentioned before, my college roommate, Ken, was

accepted to Penn to do a PhD in American Studies. Consequently,

we decided to rent an apartment together. Together, we also learned to

cook and clean, and attempted to become self-sufficient. At Harvard,

we had been spoiled by dorm life, where perks included housekeeping

and dining halls. At Penn, we suddenly found ourselves left to our own

domestic devices. We would come together at dinner to share daily

experiences, but we had our own separate lunch friends.

Fortunately, I did not have to cook all the time. As a med student,

after anatomy, I would meet up with colleagues for lunch at Houston

Hall, the student hub, where there was a cafeteria. Whether we

wanted to or not, we were forced to sit together owing to the fact that

we all reeked of formaldehyde. No one else wanted to be anywhere

near us.

During that first year, I also bonded with a classmate, named Lew

Yecies, who became my best friend in medical school. He, unfortunately,

died prematurely of pancreatic cancer while in an allergy and

immunology practice in Watertown, New York. It was actually quite a

challenge to make friends at medical school since everybody had very

different schedules after the preclinical years. One rarely saw the same

people for more than one rotation. At the time, there were 120 students

in my program, only four of whom were women, which is markedly


different from today, with female students now outnumbering males

in med school.

As part of the medical school’s mission to become more humanistic,

during our first year of basic science the administrators sought to give

students a sense of medicine’s various specialties. Every week, we

embarked on a different “field trip,” having diverse and sometimes

quite unconventional experiences. For instance, I remember visiting

a psychiatric hospital at a time when many patients were being treated

with psychotropics. It was enlightening, and also unsettling, to

encounter people who were schizophrenic. We also visited a children’s

hospital and subspecialties such as ophthalmology. It was a wonderful

opportunity to see the tremendous number of options available to

us as medical professionals. It also made the school a kinder, gentler

place, since we were focused on patients and their plights, as opposed

to merely having our noses in books as we attempted to master the first

two years of the basic science curriculum. Commendably, the school

worked to integrate the science with the clinical. Aside from learning

scientific theory, we also witnessed basic science in clinical action.

This approach benefited me in that I did not really need the

background of physical chemistry or advanced science courses to

succeed. All I needed were the building blocks to correlate what

I learned in basic science and apply them. Consequently, I never felt

that I was ill-prepared for medical school.

Another interesting aspect of medical school was that we began

engaging in physical diagnoses from early on. Initially, making

diagnoses made me anxious because I had very little idea of what I was

doing. I remember performing an ophthalmologic examination on

a volunteer patient during which I found it very difficult to actually

see the back of the retina. It did not help that I had turned the

ophthalmoscope around so that it was pointing at my own eye. When

the patient pointed this out, I responded that, “This is just a different

way of doing the exam.”

While I never mastered the ophthalmoscope, I was fascinated by the

stethoscope. Listening to the sound of a human heartbeat enthralled


me. At that time, hearing the various sounds and translating them

into physiology comprised a special skill. I remember a renowned

cardiologist, Abe Ravin, who simulated different heart sounds on

records. We would listen to the records and hear mitral stenosis, aortic

stenosis, and other murmurs reproduced. The irony is that nobody uses

a stethoscope anymore—one can obtain more accurate information

from an echocardiogram.

This early fascination with listening to the human heart fanned

the flames of my passion for cardiology. By the end of my first year

in med school, I already knew that I wanted to be a cardiologist. My

grandfather, thrilled at the prospect that I would be following in his

physician footsteps, gave me a subscription to Circulation, the journal

published by the American Heart Association. Obviously, I did not

know much about what I was reading then, but I saved all the issues

for later reference.

With my future career goal clearly in mind and with the help of

my father, I obtained a summer job after my first year at the Beth

Israel Medical Center in Newark, New Jersey, where he practiced.

Along with his partner, Victor Parsonnet, my father was one of the

first physicians to embrace pacemakers in the 1960s. Parsonnet was

a world leader in pacemaker implantations and my father worked

with him (although he did not like performing implants and later

concentrated on vascular surgery). I embraced the opportunity to

do a cardiology externship eagerly and was able to learn much by

shadowing a cardiology fellow. At the same time, I developed a very

superficial research project involving the ways in which routine blood

work changes with pacing.

A highlight of that summer was a visit by an English cardiologist

named Dr. Desmond Julian. A professor at the University of Edinburgh,

Dr. Julian had an avid interest in pacing. I approached him and asked if

there was any possibility that I might be able to do research with him,

and for an externship. He volunteered that if I could provide my own

funding, he would be pleased to have me, something that later became

a reality.


In my second year, I continued with courses that had more relevance to

practicing medicine, such as pathology and physiology, which I enjoyed.

We also started our first clinicals. I chose pediatrics as my first rotation

because it seemed less threatening with regard to doctor–patient

interaction. As a physician with no skills at the time, I possessed a lot

of anxiety about person-to-person interactions. Unfortunately, working

at the Children’s Hospital of Philadelphia proved to be difficult. I was

in constant contact with children suffering from harrowing conditions

such as spina bifida and leukemia. Ultimately, I found it very depressing

to be a hospital-based pediatrician.

To compensate for this distressing experience, I took an elective

course in outpatient pediatrics in my fourth year. I witnessed more

common benign maladies, such as children with upset stomachs,

suffering from diarrhea, rashes, or upper respiratory tract infections.

On the upside, I got to experience first hand what my grandfather did

as a pediatrician on an outpatient basis. It certainly provided me with

a much better sense of pediatrics, although I never was tempted to

follow in his footsteps, having committed to cardiology. Meanwhile,

I also completed other clinical rotations. Although less daunting

than pediatrics, I found psychiatry to be quite boring. With inpatient

psychiatry, all the patients were constantly medicated. Meanwhile,

outpatient psychiatry struck me at the time as an option for the

very well-to-do. In my second year, I also rotated through obstetricsgynecology.

Although I enjoyed delivering babies, I hated the all-night

hours. Ultimately, all of these clinical experiences merely reinforced

that I wanted to be a cardiologist.

Prior to the summer of my third year, I was thrilled when I was able

to receive funding from the medical school, allowing me to spend the

entire summer working with Dr. Julian in Scotland. In Edinburgh,

I boarded at the house of the head cardiology nurse. Her husband,

Tommy, was a clerk whose two main passions in life were Mozart and

cricket, and he became my close friend and drinking buddy. That

summer was marked by the first landing of a man on the moon, but it

was unforgettable to me in other ways. Aside from Tommy, I bonded


with other Scottish medical students and participated in their social


From a professional perspective, the summer was extremely

rewarding. Dr. Julian was an excellent clinician, and the English way

was to rely on the patient’s history and physical examination, and not

a multitude of tests, like American physicians did. He had also been

kind enough to choose a research topic for me: atropine, PR interval,

and atrial pacing. When one paces the top chamber of the right atrium,

the time from the top to the bottom—or AV interval—gets progressively

longer to the point that if one paces fast enough the signal from the top

chamber never gets through to the bottom chamber, a phenomenon

known as second degree AV block. The question I was trying to resolve

was, what was the physiologic effect of the prolongation of the PR

interval? At the same time, by reversing that PR prolongation with

atropine, one could compare the before and after implications of that

second degree AV block. My research ultimately led to my writing of

a paper, for which I was awarded the Mary Ellis Bell research prize by

the medical school.

Dr. Julian and I developed a strong bond, albeit one that remained

strictly professional. Sadly, his wife had been killed in a tragic

automobile accident, and he had to raise two children on his own. He

was a very private person, and I never saw him outside the hospital

setting; however, at work I had very positive interactions with him and

his entire team. I think that this was, in some ways, owing to the fact

that English and Scottish students tended to be more reticent than

Americans, who could be more aggressive and ambitious. In contrast to

my local peers, I was extremely motivated and that obviously resonated

with the senior staff. Dr. Julian proved to be an éminence grise who

took me under his wing and was, ultimately, instrumental in helping

me obtain a cardiology fellowship. There was also a senior registrar,

the equivalent of a cardiology fellow, named Michael Godman, who

became a personal friend of mine. Another significant contact was a

young Spanish doctor, Valentin Fuster, who was doing research on

lipids. He later trained at the Mayo Clinic and is now Chief of Medicine


at Mount Sinai Hospital in New York, as well as the editor of the Journal

of the American College of Cardiology, a distinguished cardiology journal.

My trip home from Great Britain was memorable, albeit not in

an auspicious way. To travel between London and the U.S., I took

advantage of student fare flights, which were inexpensive but often

had haphazard schedules. Since my return flight home from London

was scheduled for 6 a.m., I decided that I would sleep in the airport;

however, since I needed to eat dinner, I traveled into Soho in London

and, for the first time in my life, went to an Indian restaurant. In the

U.S. at that time, eating habits tended toward the bland and pedestrian,

so when, owing to my non-existent exposure to international cuisine,

the waiter asked me if I like my food “hot” I responded, “Of course,”

imagining that he was referring to the temperature. Of course I wanted

my food hot! As a result, I not only unwittingly set my mouth on fire,

but I had a very unpleasant time trying to sleep at the airport before

heading home to New Jersey, where my family was living.

I began my third year of medical school with a rotation in surgery.

Penn tried to teach surgery via books and a syllabus, which was extremely

boring, not to mention unhelpful; after all, the key to being a surgeon

appeared to be having excellent manual dexterity and developing finely

tuned hands. Unfortunately, I was sorely lacking, and during my firstyear

anatomy courses, I was notorious for making horrible messes of

my dissections—I just did not have the required patience. These early

experiences underscored the fact that a career in surgery was definitely

not for me. Interestingly, my brother Marc, who was skilled with his

hands, enjoyed tinkering, and majored in electrical engineering at

MIT, loved performing surgery. As for me, ironically, despite my lack

of prowess, I ended up doing minor surgeries with pacemakers and

defibrillators my whole life, which proves that it can be an acquired

skill. If one does it repetitively, over a long period of time, one can

actually do a fairly good job.

In my third year, I also began a medical externship at the VA hospital

(which meant I was a junior intern). I absolutely loved it. I had a senior

resident, Bill Fox, from Duke, who was so enthusiastic, and he and


I formed a close bond. I spent a lot of time with him, taking care of very

ill patients, people with diabetic ketoacidosis, and many with GI bleeds.

At that time, there was a high rate of alcoholism among veterans; many

were not taking care of themselves and were, consequently, bleeding

from excess drinking. At that point in my education, it was not so

much that I needed to learn a wide variety of diagnoses, but rather that

I needed to learn to be comfortable as a doctor in charge. The senior

resident who worked with me gave me the flexibility to help make

decisions. He made the whole process very enjoyable and reinforced

the decision that internal medicine and cardiology was for me.

One of the things I loved most about internal medicine was its

similarity to detective work. Ultimately, one is carefully collecting

information with which one has to try to solve a puzzle. Intellectually,

I found it to be a very satisfying process.

At the VA hospital, I also had a very positive experience with the

chief of medicine, Edward Stemmler, who ultimately became dean of

the medical school. Dr. Stemmler wrote my letter of recommendation,

which played an important role in where I did my training.

Coincidentally, Dr. Stemmler taught my brother Marc, who was five

years behind me in medical school, and also wrote a letter that allowed

him to obtain his residency.

The rest of that year, I had electives, including outpatient pediatrics.

I also did a surgery externship. At a very junior level, one cannot

perform any surgery, and instead, one takes care of patients pre-op and

post-op. But I did the surgery externship for fun. I also did an ob-gyn

rotation at Philadelphia General Hospital where I delivered the baby of

a 14-year-old girl. Other rotations I did included radiology, renal, and

pulmonary critical care. I did not do any cardiology because I knew

I would be doing that for a living.

Meanwhile, after our initial year of living together, Ken had married

his high school sweetheart, Micki, so during my second year, I lived

with another medical student named Jeff Drobis. After a few months,

however, Jeff met a girl and had her move in to our apartment, which

resulted in a very difficult living situation. Fortunately, the apartment


had two bedrooms, one at each end of the second floor, so we basically

stayed away from each other. But a very unpleasant atmosphere reigned.

For my third and fourth years, I found a studio apartment of my own at

42nd and Baltimore, although I actually spent very little time at home

since I was always doing rotations and sleeping overnight in hospitals.

Later, when I showed my family where I had lived, I found that it was

now condemned!

With all the focus on work and studies, there was not much time

for socializing. I did date sporadically, but I never met anyone special.

Socializing was not a priority at the time because building a career was

the main focus of my life.

At the end of my third year, I was more than happy to return

to Edinburgh to continue my relationship with Dr. Julian, having

obtained the appropriate funding. This time, I roomed with eight

medical students, all of them ardent soccer fans who got me to watch

the World Cup. Previously, soccer had not even been on my radar, but

I found the game compelling, and I continue to follow it. They also

provided social experiences outside the hospital.

I also had a new project in the summer. When people have heart

attacks, they can develop an abnormality called bundle branch

block. Part of the electric system that connects the top chambers to

the bottom chambers of the heart, the atria to the ventricles, can be

damaged by the heart attack. In some cases, people’s hearts stop, and

they die as a result of this particular complication. Dr. Julian began

investigating the possibility of inserting a temporary pacing lead in

these individuals as a means of preventing sudden fatalities from this

conduction abnormality. He and his team carried out a retrospective

study in their coronary care unit, which was one of the first such units

in the United Kingdom. As a result, they had amassed a great deal

of information concerning patients who suffered from bundle branch

block. The research project sought to explore the potential role for

prophylactic pacing in the bundle branch block in acute myocardial

infarction. When I was not doing an externship and doing rounds and

conferences, I was down in the record room tracking down all the cases,


eviewing them, and providing my findings to Mike Godman, who

was writing the research paper. When it was finally published in The

Lancet, the English equivalent of The New England Journal of Medicine,

I was credited as a second author. This was a great addition to my

curriculum vitae, not to mention extremely helpful in my application

for medical internship and cardiology fellowship. There is a Yiddish

expression, “Beshert,” which means “good fortune,” or “preordained.”

A lot of things in my life have happened for a reason, and this was one

of them.

Upon my return from Edinburgh, I needed to address internship

and residency. After Christmas of our senior year, my friend Lew

and I took a road trip to look at programs. We went to the Beth

Israel Hospital in Boston, Yale, Georgetown, University of Virginia,

Duke, University of North Carolina, Barnes Hospital, Washington

University in St. Louis, and Presbyterian St. Luke’s in Chicago. Then,

he and I split up because we had different interests. I continued on

and visited University of Colorado, University of California, San

Diego, University of California, San Francisco, as well as Stanford

and University of Washington.

At the time, admittance to internship/residency programs was based

upon a match. In order of preference, one listed the schools in which one

was most interested, and, in turn, the schools listed their preferences

in terms of applicants. Ultimately, one is matched to the program

highest on one’s list that has an available opening. My first choice was

the Beth Israel in Boston. My second choice was the University of

California, San Francisco. My third choice, surprisingly, was Barnes

Hospital in St. Louis, where the program for internal medicine was

highly reputed and very competitive. The chief of medicine at Barnes,

Carl Moore, was a world-famous hematologist. Unfortunately, if one

lives on the East Coast, people are fixated upon Harvard and Yale, but

in reality, there are many other programs that are equally good. To be

honest, I chose Beth Israel, and UCSF for their prestige, but I was also

extremely impressed with Barnes’s program. I was not disappointed

when I matched there. St. Louis was definitely my next career stop.


Medical school diploma

Note from Dr. Julian


My published article in The Lancet


Medical school yearbook




At Barnes, I had many colleagues from all over the world, including

from South Africa, Jamaica, and Japan. My initial reaction was

a concern that the program was not as competitive as I thought. The

truth was that Dr. Moore lectured internationally and had ties with

medical schools all over the world. He always asked these schools who

their best students were and would then encourage these students to

apply to Barnes. So, there was a mix with very competent international

interns and residents that made for a very interesting experience.

I guess my initial reaction revealed me to be a bit of a social snob.

In addition to excellent training, I had the good fortune to have

a surrogate family there. My mother’s childhood best friend from

Boston, Rae Porter, had just moved there with her family, and they

were a source of non-medical support. Although I had a wonderful

two-year medical experience at Barnes, one of the problems with

the program was that I needed to have the requisite background in

subspecialty training so I could pass my internal medicine boards,

which were very difficult. I wanted to do two years of clinical on

the floor, taking care of patients, but I also wanted to do a year of

subspecialty rotations. The way Barnes operated, however, in that

third year, one only had six months of specialty rotations and not

12 months, a fact that concerned me. As a result, I decided to go

elsewhere for my third year.


I ended up choosing the Harvard service at Boston City Hospital.

Boston City Hospital, which is now called Boston General, had three

services, a Tufts service, a BU service and a Harvard service. Ironically,

the faculty on the Harvard service did not make enough money to

live on for their Harvard appointments. They all had second jobs

in order to supplement their incomes but wanted the prestige of a

Harvard appointment. Before I got to the program, it was consolidated

and ultimately became a BU program, so even though I was accepted

on the Harvard service, it was a BU program that I had for the year.

Nonetheless, I was able to do all my sub-specialties and study for the

boards, which I passed. I was also able to find a Cambridge apartment

and take advantage of the post-college environment: lectures, adult

education courses, restaurants, movies, and the theater. Being on call

every fifth night instead of every second or third, as I had been before,

certainly facilitated this.

While in Boston, I reconnected socially with Judy Feldman, a doctor

whom I had met while we were at medical school in Philadelphia. Little

did I know that I would meet another Judy Feldman, née Ruben, who

would become my wife.



Cardiology Fellowship

While I was in Edinburgh, Dr. Julian asked me in what area

I wanted to specialize. At that particular time, I aspired to be a

general cardiologist and take care of patients with heart conditions, and

I was not planning to do anything specifically involving catheterizations

or research in other areas. When I asked him where he recommended to

further my studies, he told me about a cardiologist named Joseph Perloff

at Georgetown University who had just been hired by the University of

Pennsylvania to be chief. Perloff was known for his skills as a diagnostician

in terms of correlating EKGs, X-rays, and other forms of diagnostic testing

to make a diagnosis, with a special interest in adult congenital heart

disease. Dr. Julian suggested that I apply to his program, and he wrote me

a supportive letter. The program was very clinically oriented at the time,

and I was already comfortable with the University of Pennsylvania.

I had to apply two years in advance for a fellowship. When I was a

second-year resident, an intern named Alan Gradman worked under

me in St. Louis. I knew he was interested in cardiology as well but

wanted to apply a year early, so I asked him if he had completed his

applications for a fellowship. Completely unaware that he needed to

send them out so far in advance, he was thankful for my advice and

proceeded to apply to schools.

I followed Dr. Julian’s advice and applied to Penn; however, as

I was always driven to get the most prestigious program possible, I also


applied to Massachusetts General Hospital and Brigham and Women’s

Hospital (today affiliated with MGH). I also applied to Stanford, which

had the most important cardiology research program on the West

Coast. We had an acceptance day for our cardiology fellowships, and

when I was accepted to Stanford, Brigham and Women’s, and Penn,

I opted to go to Penn. Meanwhile, Alan was interested in Stanford, but

had not been accepted. I called Stanford to thank them and let them

know I was going somewhere else, and five minutes later, Alan received

a call from Stanford with the good news that there was a slot available

for him after all. Beshert again, for him!

As an aside, after Alan finished his training, he went to Yale and

was a professor at the VA Hospital. By that time, I had gone into private

practice at Western Pennsylvania Hospital in Pittsburgh. At one point,

my hospital was searching for a chief of cardiology for their clinical

program and Alan applied. He concluded that if I was on the staff, it

had to be a good hospital. As fate would have it, Alan’s application was

accepted, and he became my chief of cardiology. What goes around

comes around.

Back in Philadelphia for fellowship, I lived at 12th and Pine, which

is known as Antique Row in Center City. I had a wonderful studio

apartment, which felt very luxurious to me. I also had more of an

opportunity to be sociable because I had rare night calls. Professionally,

there were eight fellows who went through all of our training with

echocardiography, stress testing, cardiology consults, clinics, and

cardiac catheterization (nuclear had just started at that point). In my

program, there was a cardiology fellow by the name of Mark Josephson,

who was a year ahead of me. He had come to Penn because there had

been another cardiologist named Bruce Goldreyer who had trained

at Columbia in the new field of electrophysiology (EP), focused on

arrythmias, and with whom Mark wished to work. Prior to coming to

Penn, Mark had fulfilled his military commitment at a public health

service hospital on Staten Island, where a cardiologist named Anthony

Damato had developed a catheter technique to record signals inside

the heart to determine rhythms—where they came from, and how they


correlated with the ECG. When Mark arrived at Penn, he brought his

experience with Dr. Damato with him. Soon after his arrival at Penn,

Bruce Goldreyer went into private practice on the West Coast, which

left Mark, who was still essentially a cardiology fellow, running a subsection

in EP.

Obviously, the knowledge that one had to accumulate back then was

far less than it is now, and fellowship was only two years rather than at

least three now. I was fascinated by what Mark was doing. Catheterizations

reflected my experience in anatomy class—still a big klutz, I could not

locate an artery to place the catheter. I was just not a catheterizer.

Electrophysiology was brand new. At the time, cardiac surgeons

were performing bypass surgery and catheterizations were necessary to

direct the surgery; however, I liked the idea of EP as an alternative. By

placing a catheter inside the heart, a technique easier than traditional

catheterization, and recording signals, I could determine what was

happening on the surface of the heart. In any case, I was fascinated

by EP and knew that I wanted to pursue it. At the same time, I felt

that owing to my background at Harvard, Penn, and Barnes, I owed

something to the academic community. As a result, and based on

the two Edinburgh papers I had written, I decided to be an academic

cardiologist. I felt that EP would be my entrée into academic medicine,

which is why I focused on it so much during my two-year fellowship

program’s elective period.

There are two specific experiences that have stuck in my mind from

those fellowship years. To gather information about the condition of

a patient’s heart, one must place a catheter inside the heart via a vein

in the groin called the femoral vein. At one point, we did a study on

a VA patient who was blind. Although I warned him in advance that

I was going to infiltrate a local anesthetic called Lidocaine, he sat bolt

upright when I injected it. Since he was blind, he did not know that

the X-ray image intensifier was directly above him, and he smashed his

head into it, ending up with a concussion.

A young staff cardiologist named John Kastor was hired from

Massachusetts General’s coronary care unit, and he had a clinical interest


in EP, but he did not have experience with any of the procedures. At

one point, we were doing a study on a patient with left bundle branch

block, but Dr. Josephson was not available, so Dr. Kastor proceeded to

direct me as I placed the catheter.

There are two bundle branches, the left and the right. When one

puts a catheter inside the heart, sometimes one tickles the right bundle

branch. If a patient already has left bundle branch block and one adds

right bundle branch block to it, the impulse from the atrium does not

get to the ventricle. The result is complete heart block, leading to no

heartbeat, which is what occurred with this patient. Since Dr. Kastor

had no clinical experience in EP, he panicked when he realized that the

patient had heart block. Fortunately, I managed to place the catheter

in the appropriate location and paced the patient until he recovered.

Fellowship: I am in the second row, second from the left. My “Art Garfunkel” days


Textbook published by my mentor



Air Force

As I went through my training, the Vietnam War was still raging and

doctors were being drafted. At the time, there existed a program

called the Berry Plan which allowed physicians to defer obligatory

military service until they had completed their training. My concern

was being stationed in Vietnam as a general medicine physician on the

front lines. I opted for the Berry Plan with the idea that I would be

trained as a general cardiologist, and perhaps as an electrophysiologist

as well, which would obligate me to a large regional hospital away from

the combat zone. I received my deferment, but immediately afterwards,

the war ended. Despite this, I now had a two-year military obligation

with the United States Air Force, from 1976 through 1978.

Originally, I was assigned to Sheppard Air Force Base in Wichita

Falls, Texas. Although I had hoped to do EP, this was a small regional

hospital and it was not very sophisticated, to the point that I asked one

of my fellowship colleagues who had a flair for electronics to create

a stimulator, a piece of equipment crucial to any EP procedure, that

I could bring with me to continue my specialty. As a result, I had a

schematic of a stimulator to bring with me to Sheppard Air Force Base.

As a prelude to Wichita Falls, I received a “Welcome to Wichita Falls”

brochure. It listed major restaurants, including McDonald’s, Pizza Hut

and Long John Silver’s, but otherwise, for cultural activity, there was

nothing substantial for a single Jewish person in Wichita Falls to do.


It was a tiny place in north Texas and I was very upset about being

assigned there. Professionally, I thought it was detrimental to my career.

Socially, it was a wasteland. Vietnam almost sounded more exciting.

Fortunately, I have a knack for always landing on my feet. Not long

after I arrived, the air force reassigned a cardiologist from the School

of Aerospace Medicine (SAM) Brooks Air Force Base, San Antonio

to Wilford Hall Medical Center, the major air force hospital in San

Antonio. Happily, I was transferred to that now vacant slot.

Here I was, a physician who had suddenly become a major in the

air force, and one who had not a clue about how the military worked.

As part of the military routine, whenever I was on campus, I had to

initiate a salute to a superior officer. Early on, I forgot this protocol

when passing a lieutenant colonel. Indeed, to make matters worse,

realizing my error I also exclaimed, “Oh, shoot!” For this double faux

pas, I received a dressing down, but I quickly became comfortable with

military ways.

The School of Aerospace Medicine was a research school that

also screened pilots for abnormalities in case they had a sudden

incapacitation owing to a heart attack or an arrhythmia while flying

a plane. The role of the School of Aerospace Medicine was to evaluate

pilots and also perform meaningful research related to the flying

experience. The pilots did stress tests as outpatients, and if the results

showed an abnormality, they came to the school so that we could

further evaluate them.

Upon my arrival at SAM, the fact that I had a unique skill provided

me with the opportunity to do whatever I wanted in the field of EP

over the next two years. During my time in the air force, I collaborated

with an electrophysiologist, Robert Schnitzler, who was based at

the University of Texas, San Antonio, Medical School. Like Mark

Josephson, Dr. Schnitzler had EP training with Dr. Damato, and

I relied on him to provide me with some help in setting up an EP lab,

where I did procedures, and to be my mentor.

I was therefore also able to continue the pursuit of my interest

in arrythmias. I did diagnostic testing for conditions such as Wolff-


Parkinson-White syndrome, which causes rapid heartbeat owing to

an extra electrical connection. Patients with this condition can now

be treated with a procedure called catheter ablation, which was not

available at that time; however, open heart ablation surgery was an

option, and I sent several patients to Duke, where that procedure was


I also evaluated patients who had rhythms called ventricular

tachycardia, irregularities of the bottom of the four chambers. At

the time, it was thought that anybody with ventricular tachycardia

would end up having a life-threatening arrhythmia, but I carried out

a retrospective study at the school to show that patients who had this

with an otherwise healthy heart could enjoy normal longevity. I wrote

a paper based on my research while enabling many pilots to resume

flying their planes.

Altogether, there were five of us working in the cardiology section

at SAM, and during our time together, we bonded and enjoyed each

other’s company. A bonus of the program was that our arrival coincided

with the closing of the school’s dispensary. As a result, there was no

night call—and an enhanced social life! I became close friends with

some of the nurses in my apartment complex, joined a ski club, and

even learned how to scuba dive. Although I had no major relationships,

it was an enjoyable time for me socially, and I even had a dog, a mixed

breed terrier I named Josh. I also became close to Roger Wolthuis, a

scientist at SAM, with whom I carpooled. He, his wife Donna, and

their two daughters became my family away from home.

I found San Antonio to be a wonderful city. It was a unique place in

that, from a socio-cultural perspective, there existed three main groups:

“gringos” (white people), Chicanos, and Afro-Americans. Adhering to

South Texas codes of conduct, I might don my cowboy hat and boots

and head out to a bar to drink Lone Star beers and eat tamales with

friends. Sometimes, my companions and I would go “kicking,” that is,

Western dancing.

Professionally, my time in San Antonio provided me with an

opportunity to develop my subspecialty by myself with limited support.


I set up a lab, gained some meaningful data, and presented an abstract

at the American College of Cardiology meeting in Anaheim, the

only time in my career that I presented at a national group. All in all,

I came away with a very constructive two-year experience, which also,

presumably, helped me to obtain a faculty job.

I was fortunate in that I was thoroughly engaged in EP during those

two years in Texas. When my time was completed, I was more than ready

for academia and prepared to begin looking for work. Unfortunately,

jobs were hard to find since EP was such a new phenomenon and its

clinical application was unclear to academic centers.

I responded to a call for a job opening at Boston City Hospital,

but, unfortunately, there was no funding for EP. Moreover, because

the chief of cardiology preferred exercise testing, the job was given

to another candidate. I also explored job possibilities at New York

Medical School, University of Rochester, and University of Pittsburgh.

As a curiosity, I also interviewed at private practice jobs in Colorado,

San Diego, Las Vegas, and the Chicago area, but they wanted general

cardiologists or catheterizers, and I had become focused on EP. As a

result, these opportunities were of no interest to me, nor I to them.

Ultimately, I decided that I wanted to do academics. I attended a

meeting of the American Heart Association in Miami where I met Jim

Shaver, who was chief of cardiology at the University of Pittsburgh.

One of Shaver’s faculty members had received clinical tenure instead

of regular tenure and was so angry about it that he transferred to

West Virginia University. Shaver had, therefore, an opening, which he

offered to me. I think he really did not care what I did as long as I filled

the slot and was able to do clinical work, develop EP, and do teaching

rounds. He offered me the job, and for the next four years, I was a

University of Pittsburgh faculty member.


Major Barry Alpert


My abstract presented at ACC


Family: My Wife and Children

In July of 1978, I arrived at the University of Pittsburgh School of

Medicine, Division of Cardiology, where I remained until 1982. In

Pittsburgh, I lived in Shadyside, a younger neighborhood close to the

hospital which is just outside downtown. I rented a townhouse, which

I enjoyed very much, and although my hours were very busy in the

hospital at night, I was able to make some social friends. Professional

considerations aside, one of the reasons I chose Pittsburgh was that

I considered myself to be a very cultured person and it was very

important to me to have access to many cultural pursuits. Pittsburgh

had a world-famous symphony, an acclaimed public theater, and

multiple universities, including Pitt, CMU, and Duquesne, with lecture

events. Unlike New York City, it was just the right size. It is a city that

people do not go out of their way to visit, but it is comfortable enough

that people do not want to leave.

Owing to its steel industry, Pittsburgh had a large Eastern European

community, and much more ethnic diversity than San Antonio. After

spending two years in South Texas, I was thrilled to be able to take

advantage of four distinct seasons. In retrospect, I was obviously very

happy that I ended up here. But more importantly, if I had not moved

to Pittsburgh, I never would have met my wife, Judy.

One of my air force colleagues, Peter Engel, was from the University

of Cincinnati. He had a friend name Norman Levinson who was also


on the faculty of the University of Pittsburgh. Feeling that I was at

the stage of my life and career that I needed life insurance, I asked

Norman, who had recently married, for a recommendation.

Norman gave me the name of an insurance broker named Tom

Kaplan. After I met him and purchased an insurance policy from him,

I received a phone call from a woman named Ruth Cohen who was a

friend of Kaplan’s wife, Debbie. It seemed that after selling my policy

to me, Kaplan had returned home to his wife, Debbie, and remarked

that he had met a young single cardiologist. Did she know of anyone

available with whom to fix him up? Debbie mentioned a friend of

hers, Judy Feldman, a recent divorcee with two children. Although she

thought Judy and I might possibly be compatible, she refused to call

me to suggest I ask Judy out. However, a much more outgoing friend

of hers, Ruth, had no such reticence. And so it was that I received

a call from Ruth. After an hour-long conversation—during which we

both spoke French to one another—she gave me Judy’s number and

suggested I call her, which is what I did.

Prior to Judy, I had dated primarily in order to share a woman’s

company rather than to be intimately involved. Yet, I was now ready to

look for something more romantic and profound. At 33, I also wanted

to have a family and I feared that I was getting too old to start one.

Our love was something that grew gradually. In fact, it almost did

not grow at all. On our first date, I took Judy to see Handel’s Messiah.

I was unaware that she disliked vocal music, and unbeknownst to me

she hated the performance. She was also furious that I did not invite

her out for coffee afterwards. In reality, I was a little socially backward.

Our second date was not much better. I took her to see a performance

given by an Eastern European dance group called the Tamburitzans,

sponsored by Duquesne University, but Judy later confessed that she

hated that outing too. Another time I took her square dancing, which

she also disliked. Although I had never square danced before, I did

remember doing the Virginia Reel in junior high school gym back in

Laconia, New Hampshire. Really, I am surprised she continued to go

out with me after those outings.


Some time later, Judy invited me to dinner. Even though there

was a major snowstorm, and Judy lived in a neighborhood on a major

thoroughfare some five miles away, I went. I had joked previously that

she was geographically undesirable, or “GU.” She must have thought

I was desperate for a home-cooked meal to brave the distance and the

weather. Since I had been conditioned not to waste food, I took care to

finish everything on my plate, but Judy’s reading of my thoroughness was

that she had not prepared a sufficient quantity of food. Consequently,

the next time she invited me over, she made a much larger meal—which

I proceeded to finish. The third time, she cooked up a veritable banquet

and I surrendered, obliged to leave leftovers.

Despite this rocky start, we continued dating for a year and a half,

until—please excuse the expression—we had reached the threshold of

“shitting or getting off the pot.” At that point, I realized that Judy was

more than just someone to do something with and that we actually

had a special relationship. I decided that it would be worthwhile to get

married. I proposed to Judy while we were seeing a movie, La Cage Aux

Folles, a comedy about homosexuals in the south of France.

Judy’s mother had died of a cerebral aneurysm at 39, followed by

her maternal grandmother’s death. Her father was remote, not loving

or supportive, and always working in his clothing store. He quickly

remarried a widow without any input from Judy and her sister. She

was sent to multiple schools. He was a horrible father, was verbally

abusive to her, and the new stepmother came out of Cinderella. He sold

their house and its contents without consulting Judy, leaving multiple

important memories behind. Judy found solace in her maternal

grandfather, Harry Silberstein, in Columbus, Ohio, from whom she

later received emotional as well as financial support when she was a

single mother. Throughout her father Sol’s life, there was a hatred and

bitterness that persisted until he died at the age of 102. At the very

least, she received an inheritance, but this did not make up for the rest

of their relationship.

It was her hope that I could provide the support and empathy she

needed to compensate for such a wounded father–daughter interaction


and a difficult childhood. Unfortunately, I did not have the requisite

skills of support, given my own background, although I tried. At the

same time, she helped me. I became more thoughtful and tried to

be less self-centered. She taught me to care and think of others. She

encouraged me to be a better father. Unfortunately, she has said that

I was a better father than a husband, which hurts. This is true, but, like

her, I try. She is so special, and I never want to lose her.

Judy had married young, at 21, to escape her unpleasant family

situation, and she had two children, Lori and Josh, with her first

husband, Frank, who was, unfortunately, a prescription-drug addict.

After some difficult years, she divorced him, deciding to raise the two

children herself. When I met Lori and Josh, they were eight and five.

I had no second thoughts about dating a divorcee with two children

because by that time, I was 35 and felt it was time to move on with my

life. I really liked children and wanted a family, and I felt that Judy and

her children could be that family. She had the children, and I had the

dog, so it was a perfect match. The only thing we needed was a station

wagon, and to change the dog’s name to Max.

I think that both children were as excited to have a father figure in

their lives as I was to have a family. Things were easier between me and

Josh because his father had not been around for such a long time, and

I could go into the backyard and play baseball or enjoy other sports

with him. Lori was having difficult issues with Judy and gravitated

toward me as a calming influence and a neutral go-between between

herself and her mother.

I embraced Josh and Lori as my own children, but I also felt that

I wanted to participate in the years between pregnancy and childhood.

As such, after our family was settled, we decided to have a third child,

despite Judy’s initial reticence because she was older and a pregnancy

might be risky. After she got pregnant, she had an amniocentesis to

make sure there were no genetic risks involved.

When we got married, Lori was 10 and Josh was 7, and our third

child, Craig, was 12 years younger than Josh. We had a difficult time

getting pregnant, but finally succeeded. At 38, I became a biological


father. However, blood relation or not, I was adamant that I would

never differentiate among my three children. As a result, I decided that

I would adopt Lori and Josh and officially make us a family of five, with

everything divided equally among the three children. This was easy to

do because Josh and Lori’s father was in drug rehab and had no contact

with his children. Although, initially, he had made attempts to see

them, after a while, he just vanished. Nonetheless, I waited until the

children were 18 to adopt them out of concern that their father might

contest the adoption. At 18, they were no longer considered minors

and could make their own decisions. As an initial step, as soon as Judy

and I got married, Lori and Josh legally changed their names to Alpert.

We moved from Churchill to the city when education choices

became limited in our neighborhood. Lori went to Ellis, a private girls’

school, where, unfortunately, she got pegged at the academic bottom of

the class, despite her intelligence. To prove a point, I wrote an English

essay for her and received the only C I ever had in my whole life! I also

remember how special our father–daughter dance was as we danced to

“Stairway to Heaven” by Led Zeppelin. It represented a special bond

that we carry to the present day.

She was accepted to Boston University, but it was not a good fit

for her, and she transferred to Mount Ida for two years and then to

Drexel Institute of Technology in Philadelphia for a four-year degree,

majoring in interior design. She returned home to a job in a toy store

and later married Ben Smolar, a young neurologist, and they have

three wonderful children: Aaron, Zach and Emma. Aaron is 23 and a

graduate student in architecture at Columbia. Zach is 20 and a junior

majoring in chemistry at Carnegie Mellon University. Emma, 17, is a

senior in high school and will be matriculating at Cornell next year.

I am so proud of them.

After moving back to Pittsburgh after college, she developed a

close relationship with Judy, which has persisted until today. Lori’s

relationship with me has also grown. She acknowledges me as a

moderating influence in her family relationships, and, despite me not

being her biological father, she treats me as her “real” father.


Since Josh was seven when Judy and I married, he and I were able

to develop a relationship based on sports—baseball in the backyard,

soccer, and skiing. I once took Josh the boy to a softball game with

Josh the dog before Judy and I were married. A spectator asked why

I had a son and a dog by the same name (which we always thought was

funny), which later prompted the renaming of the dog to Max, after

Maxwell Smart from the TV show Get Smart. With Josh, I was initially

concerned about my ability to provide authority. I was particularly

waiting for a time when I might need to discipline him and was afraid

he might say that I was not his father; I worried about that possibility,

but thankfully, it never happened. As Josh grew, he became depressed

from bullying at his private school, Shady Side Academy and transferred

for one year to Falk Experimental School before he found his home at

Taylor Allderdice High School, where he cultivated close friendships.

He was an excellent student and an expert at Trivial Pursuit.

He went to University of Pennsylvania, majoring in philosophy,

adding to the Alpert Penn legacy. After college, he opted to move to

Portland, Oregon with his college girlfriend, and later wife, Katy. It was

this move that led us to discover that he had a major conflict with Judy

and me, possibly resenting her for absenting his natural father, and me

for not being his real father. However, he never shared his real thoughts

with us. In Portland, he went back to law school at Lewis & Clark.

Initially, he worked as a lobbyist and later worked in non-profits—

Americans for Nonsmokers’ Rights, and the Trust for Public Land, as

well as working in a private law practice. He then served as assistant to a

Portland city councilman, Charlie Hales, who later became mayor. Josh

reached his pinnacle as his chief of staff. He now works for a Londonbased

climate non-profit, C40, sponsored by Bloomberg. Along the

way, he divorced Katy immediately after she delivered their daughter,

Lucy, and went on to marry Jill.

Two and a half years ago, he came to Nantucket with Lucy. A terrible

argument about family issues occurred, and he and Lucy left abruptly

the next morning. We have not spoken to him since, waiting for an



Our relationship with Craig is very different. We both participated

in his childbirth. He presented fewer issues growing up. He was

extremely sensitive to other people and was goal-directed. We were

careful to afford him only the same opportunities as the older children

and tried not to single him out as special. He was bright and caring, like

Judy. He rewarded us in each step of his education, with Valedictorian

and special awards. We were so proud. He spent his summers with

a competitive Johns Hopkins astronomy course at Hamilton College,

with Mark Zuckerberg as a classmate in the eighth grade, and then

had exchange experiences in Guadeloupe for French and St. Petersburg

in Russia for Russian language. From high school, he was accepted

at Harvard, although he was embarrassed that his classmates might

consider that he was accepted because of my alumnus status. He had

an amazingly diverse college experience, which included biochemistry

as a major for pre-med, with enough time to do electives in World War

II history, Russian literature, and a music course called “First Nights.”

From an extra-curricular perspective, as noted before, he was on the

business board of The Harvard Lampoon, helped to run the speakers’

program for the Institute of Politics, an undergraduate program for

the Kennedy School of Government, and volunteered for a food bank,

while doing medical research in immunology at Children’s Hospital.

Then, it was on to medical school at University of Pennsylvania,

where he met his future wife, Aviva, followed by an internship and

residency at the Hospital of the University of Pennsylvania, while Aviva

went to Temple School of Medicine. He then went to the University

of Michigan for a three-year cardiology fellowship and stayed for an

additional year to specialise in advanced heart failure, while Aviva

completed a pediatric residency.

It was our good fortune that he accepted a job at Allegheny General

Hospital in Pittsburgh, where he took on additional responsibilities as

the fellowship program director (possibly the youngest in the country),

as a member of the palliative care committee, and director of the

amyloid and hypertrophic cardiomyopathy clinic. Aviva took a job

at a private pediatric practice affiliated with UPMC and Children’s


Hospital. Craig continues to maintain a close family relationship with

Lori and her family, coming together for family dinners and holidays,

although each focuses on their own families, which now include Noah,

almost five, and Andrew, almost two.

We were pleased to have Lori 0.2 of a mile in one direction and

Craig 0.2 of a mile in the other because this allowed us to be doting

grandparents and for me to experience the growing years of Noah and


Craig continues to be sensitive and caring as he raises his family,

including their golden retriever, Maizey. He also has a wonderful wife

and two fantastic children who bring us so much joy.

We are so fortunate for all of this.

Following our marriage, I suddenly had a wife and an immediate

family, and I loved it. During the years I was in practice at the University

of Pittsburgh, I spent a significant amount of time at the hospital.

I began work at 7:30 a.m. and usually did not return home until 7 p.m.

Even so, I tried as best as I could to get to Josh’s baseball games and to

Lori’s activities, making family as much of a priority as possible within

the constraints of my profession. Weekends were completely devoted to

family, unless I was on call. On Wednesday evenings, Judy and I had a

date night for dinner at a restaurant.

I realize that, over the years, owing to my heavy work schedule, Judy

sometimes paid a price. She says that for 43 years she was “a doctor’s

wife.” Of course, the hours were a burden and she rightfully complained

about them. In compensation, there were some advantages as well.

Although I had not gone into medicine for the financial rewards, I did

make a comfortable living. My position afforded us certain niceties,

and I think Judy also took a certain pride in what I did professionally.

That said, I think, to be honest, she complained about it mostly because

of the hours.

In Pittsburgh, we engaged in many enjoyable activities together.

We went to the symphony and public theater, and Judy organized a

robust social life for us, which included dining out with friends. Our

relationship was a close one and she was a special companion, but in


etrospect, I regret that I was not more intimate. I am a very private

person. I have a very difficult time opening up and expressing my inner

thoughts. It came from my father’s coldness and my mother’s lack of

boundaries, which affected my personality powerfully.

Over the years, Judy and I have certainly had our ups and downs.

After almost 42 years of marriage, however, it is clear that our

relationship works.

To compensate for my medicine, we traveled a lot. As soon as Judy

and I were married, conscious of the fact that between the children and

my busy work schedule we would need to carve out time for ourselves,

we made a concerted effort to ensure personal time by going on trips

together, accepting the need to have a babysitter for the children.

I have push pins in a map of the world to show where we have

traveled. Over the years, we have traveled two to three times a year and

have probably been to 40 or 50 foreign cities and countries, all recorded

in photos or photo books. Even though we often visited places for only

a week because of work commitments, we did a great deal within that

week. Judy sometimes says that there was never enough time to really

relax and enjoy a place, but, truthfully, if we go to a resort, neither of

us can sit on a beach for more than an hour. I like to walk on the beach

and she likes to enjoy the sun with the hope that, maybe later, there

will be time to do some other activity, possibly walking and shopping.

Her dream of relaxing is just a fantasy. For us, life is a roller coaster, not

a merry-go-round, as Steve Martin said in one of his movies. Because of

this, I do not think that we had much romantic time traveling together.

Yet, this was our way.

Our first major trip was our honeymoon to Amsterdam and

Scandinavia. From then on, we never stopped. We went away on our

own at least twice a year, traveling throughout the world. The only

restriction was that, owing to my professional obligations, the trips

were always limited to a week. I would have to leave on a Friday night

or on a Saturday and return the following Sunday. Later, in the age of

cell phones, I also always had my cell phone with me and always on. Of

course, there were also work-related trips—seminars and conferences


sponsored by drug and device companies—which Judy enjoyed. She

loved interacting with our peers, and, professionally, we were treated

to wonderful accommodations and dining experiences in places such

as Switzerland, Mexico, France, California and Arizona.

Perhaps the epitome of our special trips was Judy’s 60th birthday trip

to Paris for a curated chocolate tour of the city. This included chocolate

shops, markets, bakeries, luxurious dinners, and a cocktail party on a

houseboat on the Seine, led by an expatriate American chef and author

and an Associated Press journalist who had moved to France. For Judy’s

70th birthday, we did a barge cruise on the Canal du Midi. Other trips

included Dubai, Bali, Singapore, Cuba, Scotland, Colombia, Finland,

a safari in South Africa, Egypt, Vietnam, Thailand, Switzerland, and

Croatia, to name but a few. Aside from our trips as a couple, we also

took vacations with the children, usually during the school vacations,

and over Christmas and Easter we went skiing or enjoyed the beaches

of Mexico. Judy was always arranging family trips.

A very special family experience was a trip to Israel for my 70th

birthday. Originally, Judy suggested it as a nice way to celebrate this

special occasion, but I, with my typical penchant for not wanting to

spend money, despite our comfortable financial situation, demurred.

However, the more I thought about it, the more excited I became, as

Judy continued to push for it. The trip, which took place from June

14 to 24, 2015, was entitled “Barry’s 70th Biblical Bonanza” by Craig.

To celebrate the event, he made special T-shirts, one for each of the 12

family members, with each depicting me and the wearer of the T-shirt.

Later, he had a quilt made of the T-shirts for our family room. Prior to

Israel, we did a pre-trip to Jordan and Petra.

Despite difficulties with canceled flights and lost baggage, we

were all, ultimately, able to rendezvous in Jerusalem. Our guide was

Yahaloma, and we had our own van which, when we boarded it, we

found bore a sign reading “Alpert Bar Mitzvah Tour.” An auspicious

beginning! We did so much on our trip, including spending lots of

time in the Old City, with very meaningful experiences at the Wailing

Wall and Yad Vashem. We also had a scavenger hunt in the Old


City and camel rides at Genesis Land, where the children learned a

considerable amount about biblical history. From Jerusalem, we drove

south to Masada, and on the way back we all floated on the waters of

the Dead Sea before heading back to Jerusalem. We also participated in

an archaeological dig where we each got ancient pottery souvenirs. We

then headed north to the synagogues and art galleries of Safed. From

Safed, we went to the Golan Heights to view the military outposts and

Syria, followed by a visit to Kibbutz Kfar, with its cherry orchards, and

a rafting trip on the Jordan river. We then went back to Tel Aviv for

the beaches, bike rides, and restaurants, as well as to old Jaffa, before

heading back to the U.S.

The trip was so much a reflection of our family; 15 days of family

interaction gave me a perspective of pride in Judy as the glue that knit

us together, with a bit of my help as well. It allowed me to forge a close

family unit, and it was a realization of the family that I had sought

when Judy and I married.

Skiing was another very special family experience. I had learned

in New Hampshire at the age of seven, and skied several times a week

at the local ski area, Belknap, later known as Gunstock. I continued

skiing throughout my single years, using my vacations to ski out west

and in Europe. When Judy and I married, I wanted her to learn, and

she reluctantly tagged along to a cardiology symposium at Snowmass,

Colorado. Our hotel was on the hill, and she had to ski down without

ever having been on skis, something for which she never forgave me.

She ultimately became a regular on Fanny Hill for the week, and later

improved with lessons, but without progressing significantly. I was,

unfortunately, a poor teacher—impatient and unsympathetic—and

I had also made the mistake of initially teaching Judy and the children

by the method I had learned at a local slope, which was to walk up a

hill sidestep and herringbone before going down, which she felt was

barbaric since there was a Poma lift which would allow her to go uphill

without much effort.

Wanting skiing as a family activity, I taught Lori and Josh, first at

Snowshoe, West Virginia, and later out west at Aspen, Vail, and Park


City. Fortunately, they enjoyed it, but because they easily surpassed

Judy, she gave it up and would just tag along, walking, shopping, and coordinating

meals and other activities. Nevertheless, it was an important

Alpert experience. Before college, Josh and I were skiing buddies, and

we did special trips to Colorado together. Later, I taught Craig and

he became my partner. When he left college, I then taught Lori’s two

boys, Aaron and Zach, and they became the focus of my skiing. We

had a large family trip to Breckenridge, and recently skied more locally

at Elk Mountain in Pennsylvania, and Holiday Valley in New York. At

Elk Mountain, Zach fell off the lift, and I dropped down to help him,

unfortunately tearing my left calf muscle, which took a few months to

heal. Most recently, Craig got Aviva and Noah on skis. Skiing remains

an Alpert legacy, although, after 69 years, I have now stopped.

More important than skiing was Nantucket. Judy and I spent our

first summer in Nantucket after we were married. Neither of us can

remember why we chose it, but we are so fortunate that we did. We

had both been there independently in 1967, Judy for her honeymoon

with her first husband, and me for a week with my classmates after

exams and before graduation from Harvard. This time, we rented a

cottage on a wharf and arrived in the rain. From the ferry, we used an

A&P shopping cart to transport our luggage to the cottage, including a

television and an Atari game to occupy Josh. For five of the seven days

we had rain, but we loved Nantucket—the history, the food, the beach,

and biking—despite Lori with splinters from grabbing a telephone

pole while biking and Josh with a load of sand in his bathing suit

while biking home from the beach. Subsequent to this, Judy, a newborn

Craig, and I returned, and we have never missed a summer there

since. Again, the history, the beach, biking, fishing from the dock,

and sailing made us fall in love with the island. Initially, we stayed

one week, then two weeks, then three to four weeks, as I commuted

back and forth. In 1991, there was a real estate bubble and we started

looking at houses, despite Judy’s concerns that it was expensive and

impractical. We found a house in a private cul-de-sac, the Stone Barn,

where we had rented before. With some negotiation, we made a final


decision to buy while leaving on the ferry as Hurricane Bob bore down

on the island.

Buying the house, which we called “The Great Escape,” was the best

decision I ever made (next to marrying Judy), and we have integrated

it into our lives ever since. Every summer, I would drive Judy up at the

beginning of the summer and stay a week, fly back to Pittsburgh, and

then return to Nantucket 10 days later for a long weekend. I did this

until the end of the summer and would then fly up for a week at the

end of the summer and drive us home. As Judy said to her friends, each

summer she was dropped off at summer camp. She had the luxury of

spending three months there since she was a non-working wife and

mother, and I had the flexibility of going back and forth. We would also

go to Nantucket over Thanksgiving, when family schedules allowed. In

the spring, Judy and two girlfriends visited the island for a girls’ trip for

Daffodil Weekend and shopping.

Nantucket provided a marked contrast from Pittsburgh life—a

different set of friends and activities. We had the luxury of getting up

in the morning without an alarm, and of reading the papers in bed

with a cup of coffee. We could walk, go to different beaches, tandem

bike, eat at different restaurants, invite friends and family to visit, and,

most importantly, relax.

Lori never really embraced Nantucket the way we did, but came for a

week with her children. Josh came sporadically because he lived on the

west coast, but Craig has never missed a summer there. After his highschool

summer academic activities, he would come up to work, sorting

the Sunday New York Times in the basement of the Hub newsstand,

working at a kitchen store making sandwiches, and, ultimately, doing

his dream job at Henry’s Sandwiches. He now arranges to bring his

family for a week’s vacation, re-enacting for Noah and Andrew all the

activities he did as a child—biking, fishing, and playing at the beach.

Aviva, who is originally from Lexington, Massachusetts, has become

addicted to the island, and particularly to the Juice Bar’s ice creams,

with at least 10 flavors always in our freezer.

We are so Nantucket!


Our wedding


Lori’s wedding, 1995: Mort Gerson, Mother, Judy, Josh, Lori, Ben, me, Craig, Jane Alpert,

and Father

Craig’s wedding, 2013: Josh, Jill, Lucy, me, Zach, Aviva, Emma, Craig, Judy, Ben,

Lori, and Aaron


Me, Zach, Lori, Emma, Judy, and Aaron in Nantucket



Noah, Craig, Maizey, Aviva, and Andrew

Our travels


Judy and me on the Blue Trail in Cinque Terre, Italy


Some of the picture books I created


The Alperts at Masada in our special T-shirts

In Vail


Nantucket Harbor

The Great Escape




My official appointment at University of Pittsburgh was Assistant

Chief of the ECG department. As a junior person, I read ECGs

and 24-hour monitors. More importantly, the administrators bought

the equipment I needed for EP, giving me carte blanche to do what

I wanted to establish an EP specialty.

Meanwhile, professionally, I was involved in many activities. I was

also teaching physical diagnosis to first-year medical students and

doing rounds with internal medicine interns and residents, and was

also responsible for reading the ECGs and monitor strips daily with Ed

Curtiss, my senior faculty member in the heart station. While doing

this, I also performed EP studies and did clinical research.

Electrophysiology is very complicated, involving placing catheters

inside the heart and recording the heart’s electric signals on a

recorder. From the recording, I would then print out the relevant data

to analyze. I could then diagnose arrhythmic disturbances, often then

also gaining insight to mechanisms and therapy. An EP study could

take many hours to complete as data is obtained and then analyzed.

Because it took so long and no one had an understanding of what

I was doing (my colleagues were much more interested in cardiac

catheterization and the hemodynamics of heart valve problems), I was

given a time slot at the end of the day. As a consequence, my workdays

were very long.


Since EP was a subspecialty in search of an application, I had to

explain to people what I actually did as an electrophysiologist and how

it was relevant to clinical practice. I spent a lot of time traveling around

the tri-state area, giving many lectures at luncheons and dinners, not

to mention consuming many bologna sandwiches and pizzas, in order

to attract referrals.

Once, one of the former fellows from my program at the University

of Pittsburgh, who had gone into practice in Youngstown, Ohio,

invited me to give a grand rounds there, which involved giving a formal

lecture followed by seeing patients at bedside visits with house staff.

He suggested that Judy and I come the night before so that we could

participate in a formal dinner and then stay overnight in a nice hotel.

Judy was excited about the excursion. Unfortunately, as soon as

we arrived in Youngstown, which was about an hour and a half away,

I realized that I had forgotten my slide carousel for the presentation.

We went to dinner and then, at 9 p.m., we turned around and drove

back to Pittsburgh for the forgotten carousel. By the time we returned

to the hotel it was 1 a.m., which ruined a romantic night.

From the beginning, I was always very anxious when confronted

with public speaking. My initial grand rounds would leave me drenched

in sweat. After the first few words, I would settle in with a glass of

water and plow ahead. An important aid I relied on sometimes was

to take a beta blocker, propranolol, a drug which blocks adrenaline.

Interestingly, there was an article in The Lancet that discussed how

professional violinists took beta blockers to combat stage fright, which

produced improvements in their performances. For me, it was a useful

solution until, over time, I gained more comfort with public speaking.

The first time I did grand rounds at the university was memorable

in more ways than one. My first patient was a young woman named

Marie McKinnon, who was pregnant and had an arrhythmia called

supraventricular tachycardia. Owing to her pregnancy, I could not

treat her with medication or with surgical ablation, the standard

treatments, but I controlled her arrythmia with older, less dangerous

medications. I was then asked to discuss her case and treatment in


front of the medical school. So, I used her as an example to explain the

different types of supraventricular arrhythmias, and how the different

mechanisms could be utilized to differentiate them and, subsequently,

treat the patient.

As an aside, following her delivery, Marie went through open heart

ablation surgery. Amazingly, she remained my patient until I retired on

April 1, 2021—43 years later!

The first month I was in practice, I only had two procedures, but

my role with these and many subsequent patients was longstanding as

the arrhythmias might recur or change, warranting a shift in therapy. It

also reflected the fact that since arrhythmias were frequently chronic, it

afforded me the opportunity to take care of patients over a long period

of time.

In general, I initially treated patients in two ways. There are

arrhythmias that one can provoke by putting a catheter inside the heart

and stimulating it. Having had the ability to initiate an arrhythmia,

I would then try different anti-arrhythmic medications to prevent my

ability to stimulate the arrhythmia, suggesting a favorable response.

This method was known as serial drug testing, and it allowed one to

predict the effectiveness of a medication for rhythms for the top, but

also more importantly for the bottom chambers, called ventricular

tachycardia, and which were life threatening. For rhythms that could not

be reproduced, I would need to try different medications empirically.

In addition to standard and investigational anti-arrhythmics, a drug

from France, amiodarone, manufactured by Sanofi, was shown to be

very effective. Unfortunately, the requisite studies had not been done

in the United States and it was not therefore approved for use here.

However, at an NIH symposium on the drug to which I was invited,

I learned that a compassionate use exception could be used. The only

way I could obtain it was to import it personally, and I had to make

arrangements for it to clear customs at the Pittsburgh airport for each

shipment. This became my “French Connection.” As an aside, the

FDA later approved the drug for use in the U.S., and it is now the most

effective and most commonly used medication in rhythm management.


I also later implanted devices, with pacemakers and defibrillators

providing another method of treating arrythmias. In this regard,

I became involved with what was, at the time, the world’s third

defibrillator implantation. It was believed that this device could shock

someone out of a life-threatening arrhythmia. A doctor at Johns

Hopkins, Michel Mirowski, developed the implanted defibrillator. He

went to Medtronic, the world’s largest pacemaker company, and showed

them a video in which he had implanted a defibrillator into a dog.

Mirowski stimulated the defibrillator to cause a cardiac arrest. The video

then revealed the dog passing out, defecating, and shortly afterwards,

regaining consciousness after a shock, jumping up, and behaving with

great vitality. It was quite amazing to behold, but Medtronic was not

interested in the device. A biomedical engineer named Steve Heilman

had a company called Medrad in Pittsburgh where he had developed

a dye injector for cardiac catheterizations. This injector was later sold

to Siemens, earning Heilman a great deal of money. When Mirowski

showed him his device, Heilman was enthusiastic enough to invest

in it. As a result, the implantable defibrillator was developed and

manufactured in Pittsburgh by a company called Intec, in Blawnox.

(As an aside, Intec was later bought by a company called Cardiac

Pacemakers Incorporated, which later became Guidant, and is now

Boston Scientific.)

At that point, much of the medical research performed on animals

was carried out at the University of Pittsburgh School of Medicine

because of its proximity to Intec. The first implant was performed at

Johns Hopkins by Mirowski and his clinical EP counterpart, Phil Reid.

The second was performed by Roger Winkle at Stanford. Mirowski

wanted to continue research in the Pittsburgh area and utilize me as

the Pittsburgh electrophysiologist for implants.

As a result, I was invited to Johns Hopkins to watch an implant

before overseeing my own. Unfortunately, the procedure was delayed

and was only concluded at 10 p.m. in the evening. Since it was too late

for me to return home to Pittsburgh, Phil Reid invited me to sleep

on a couch in his basement. He was used to working late into the


night himself. I remember meeting his daughters at breakfast, and they

laughingly joked that the only way they ever knew that Dad had slept at

home on any given night was if the toilet seat was up in the morning.

Ultimately, I performed the world’s third implant in 1981. The

patient was a young insurance executive named Lou Arturo, who

subsequently lived for many years before dying of congestive heart

failure, or weakened heart. Unfortunately, I never received any academic

credit for my accomplishments. While the first two implants had taken

place at major academic centers, I performed mine at the University of

Pittsburgh as a matter of convenience, because of the proximity to the

manufacturing site.

At that time, I saw my career possibilities in a realistic light. I was

a young faculty member who had not written many papers. The EPs

who received plaudits were internationally famous cardiologists who

published in the major journals such as Circulation and The New

England Journal of Medicine. It was enough for me to rub elbows with

these people and earn their respect, which was satisfying for me. (As

a comment, now that I am retired, I lament that younger EPs were

unaware of the contributions I made to the early days of clinical EP.

In that regard, I have many additional stories I could have shared

with them.)

Regardless, performing this implant was one of the highlights of my

four-year experience at the University of Pittsburgh, one that I would

not have received had I initially opted to enter private practice.

Another special patient of mine at the university was Louis Wolititch.

When he was in his 50s, Lou had a heart attack and also suffered from

recurrent ventricular tachycardia. Between 1978 and 1982, I took care

of him at the university. After serial drug testing, I found a medicine

that initially worked for him.

Like Marie, Lou became a patient who followed me throughout

my professional career. As I continued in EP, the therapy evolved to

include not only the serial drug testing, but also investigational antiarrhythmic

medications. Later, in addition to defibrillators, I learned

how to use pacemakers and to perform ablative surgery for the


ventricular tachycardia, the arrhythmia from which he suffered. As EP

evolved, so did the therapies for Lou. During all the time he was my

patient, a period spanning 30 years, he received each new treatment

modality as necessary. His most noteworthy therapy was a patientactivated

radiofrequency anti-tachycardia pacemaker. When he had

his arrhythmia, he would present to the emergency room where he

would activate his device and terminate his arrhythmia while being

monitored. Ultimately, Lou died of his underlying heart disease.

Following two patients over such a vast period of time afforded me

valuable insights and provided a history of the evolution of EP. It also

reinforced my preference for treating a patient as a person and not as a

disease or a procedure.

When I was a cardiology fellow, the University of Pennsylvania

developed a highly significant surgical technique for arrhythmias.

Much ventricular tachycardia occurs at the border of a heart attack

scar. A heart attack is a blockage of blood supply which causes the

tissue to die. However, on the periphery, there are outpouchings of

the scar with normal tissue, an area known as the border zone. This

is where ventricular tachycardia may develop. At Penn, researchers

developed a technique whereby they would cut out the scar, called an

aneurysm. They would then scrape the area on the outer portion of the

aneurysm in order to destroy the healthy outpouching of tissue among

the dead tissue. This groundbreaking technique became known as the

“Pennsylvania Peel,” as it was described by Newsweek. I pushed surgeons

to perform a Pennsylvania Peel procedure at Pitt that saved a patient’s

life. Judy remembers that moment well because I had I invited her to the

grand rounds at which I explained the procedure, and she developed a

horrible migraine from the anxiety of watching me give the lecture to

the medical audience.

Although my position at the University of Pittsburgh was very

enjoyable, I became disenchanted with academics. Teaching the same

courses year after year gradually grew tedious, and even the research

projects I was engaged in were not stimulating. Ultimately, in 1982,

I decided that I really no longer cared for university life and that I would


e more fulfilled in a clinical practice. My ultimate satisfaction came

from caring for patients, rather than achieving academic success. As a

result, I made the decision to leave the university for private practice.

After I married, my salary was only $38,500, and I was also secondarily

concerned about my ability to support my new family.

Memorobilia of an electrophysiologist


Published article


Board certification in electrophysiology


My first defibrillator implant


Private Practice

In 1982, my decision to move into private practice was actually a

pioneering move in the subspeciality of EP. At the time, there were

only 50 EPs in the United States, all of whom were academics and

part of a national group known as the North American Society of

Pacing and Electrophysiology, which I had joined. Although many

young EPs like myself were toying with the idea of going into private

practice, there was serious concern about how an esoteric subspecialty

could be successful in the private realm, and I was only the second

electrophysiologist to make such a move. In the aftermath, I received

calls from several of the stellar academic people in the field, wanting

to know what it was like to go into private practice. My response was

that nothing really changed in my EP activities, aside from the fact that

I had fewer constraints and could focus completely on EP, while also

earning a living.

At the time, what bound our small, select group together was that

our livelihoods all depended upon clinical research, particularly for

new medications, new devices, and new techniques. Manufacturers

of these devices viewed us as specialists, regardless of our academic

status. My academic peers and industry did not discriminate against

the private practitioners. We remained “in the club.” Among the

private practice forerunners were John Gallagher from Duke, who

invented a surgery for Wolff-Parkinson-White Syndrome, a special


arrhythmia problem; Eric Prystowsky from the University of Indiana,

an exceptional teacher; and Roger Winkle from Stanford, who had

implanted the second defibrillator. All three of these men initially

called me to get a sense of the pros and cons of private practice before

launching their own practices. Even though few young physicians today

are aware of my legacy, the forging of my own non-academic path in

1982 was groundbreaking.

As a result of the four years I spent developing my specialty at

the University of Pittsburgh, I had, by 1982, become known as the

electrophysiologist in Pittsburgh. My reputation extended beyond the

city itself, and I had patients from the tri-state area of West Virginia,

Ohio, and western Pennsylvania being referred to me.

In 1982, I joined West Penn Cardiology Associates at West Penn

Hospital. In order to be sure of my decision, I had also explored jobs

in Florida, California, and Colorado, but none of them provided me

with assurances of practicing EP. Because of competition with the

University of Pittsburgh Medical Center, local hospital systems were

looking for an advantage. West Penn Hospital was willing to set up an

EP lab for me, and Dr. Richard Heppner, a private cardiologist on staff,

was willing to incorporate me in his practice.

Dr. Heppner had a partner, Dr. Fred Porkolab, and I became the

third partner. I was so busy that I thought it would be to my advantage

to teach Dr. Porkolab EP to help me. My thinking was that he could

operate as my backup while also building up his own practice. In reality,

there was a lot of friction between us during the 19 years we worked

together. I think he resented my success. At the same time, I did not

always give him a lot of my cases because I wanted him to generate his

own. The practice was structured so that each person was renumerated

on the basis of collections. Because there was no equal splitting of

fees, a competitive atmosphere reigned, which only increased as more

physicians joined, ultimately, up to nine.

My practice continued to grow and was successful both academically

and financially; nevertheless, I never lost my overriding interest in

fostering doctor–patient relationships.


In 1984, a patient named George Derrick was referred to me from

Jefferson Hospital. He suffered from ventricular tachycardia with the

bottom chamber of his heart racing too fast, like Mr. Wolititch, but

more incessantly. It was necessary to shock him out of that rhythm

multiple times during attempts to find a medication to suppress it.

As EPs developed pacing techniques for dealing with ventricular

tachycardia, we discovered that we could pace the heart at a rate

faster than the ventricular tachycardia to terminate the rhythm, a

technique called burst pacing, which was similar to what was done

with Mr. Wolititch’s radiofrequency pacemaker. If the heart rate was at

150 in the dangerous rhythm and we paced temporarily at 160 or 170

per minute, we could stop the tachycardia. What I opted to do was to

put a temporary catheter in Mr. Derrick’s shoulder vein to pace him so

as to avoid giving him shocks while searching for a solution.

After two days, the rhythm could not be controlled, so Dr. Heppner

did a catheterization on the patient to find out what his anatomy

was. He had what was called single vessel disease—one of the three

coronary blood vessels had blocked off and he had a large aneurysm or

outpouching of dead tissue. Urgently, we performed the Pennsylvania

Peel procedure on him that Monday night, which cured his arrhythmia

and led to his recovery. Over the weekend, Mr. Derrick had received

over 400 episodes that were burst. Most of them were stopped by

pacing, although he did occasionally receive shocks.

We found the experience so interesting that we released it to the

local newspaper, which then had it picked up by the Associated Press,

which in turn passed the story on to news outlets throughout the world.

Amazingly, I was receiving newspaper clips from people as far away as

Japan. There was even a headline in the tabloid, Star Magazine, which

is similar to the National Enquirer: “Man dies 400 times and lives to tell

about it.” As a result of all this media coverage, I became an international

celebrity. My sudden Andy Warhol fame led to an invitation to appear

on The Jack Bogut Show, the local Pittsburgh equivalent of The Today

Show. I roused my family early in the morning so that they could fill a

row of audience seats during my televised interview.


Like the other two patients I have mentioned, George Derrick

became a longstanding patient of mine. After we cut out his aneurysm,

his heart was weakened, and although he lived for another 20 years, he

eventually succumbed to heart failure as well. Later, I inherited his son

as a patient. He had a different heart condition causing his ventricular

tachycardia, known as cardiomyopathy, or a weak heart muscle, and he

received a defibrillator and medication to correct his rhythm, as well

as heart-strengthening medication. I took care of him until I retired on

April 1, 2021.

West Penn put out a booklet for marketing purposes in which it was

recorded that we had performed 1,300 procedures on over 1,000 patients

in a single year. I do not think these were all EP procedures, but it is,

nonetheless, an impressive number. This explains why I got home so late!

I also had a number of patients from West Virginia. Among them

was a 14-year-old girl named Denise Sadowski who had hypertrophic

cardiomyopathy, a congenital thickening of the heart. Such patients

are prone to cardiac arrest and sudden death. Denise suffered a cardiac

arrest and was resuscitated before being referred to me. At 14, she was

the youngest person into whom I placed a defibrillator, and I replaced

it four times as she grew older. Consequently, I became very close to

Denise and her family. She later married, had children, and moved to

Ohio where she was referred to another cardiologist. Unfortunately,

her hypertrophic cardiomyopathy worsened and she developed heart

failure, as well as an infected defibrillator. The Cleveland Clinic had

to replace the device, and later performed a cardiac transplant because

her heart condition had worsened considerably. Happily, today, she is

alive and well in Ohio.

Even in private practice, drug and device companies sought me

out to do research and help advance the field. Because of my interest

in anti-arrhythmic medication, I became involved in a rhythm pill

developed in Russia called ethmozine. It was co-owned by DuPont

Pharmaceutical at the time.

There were two ways of using anti-arrhythmic drugs at that time.

One was to do formal research, in which one would have randomized


controlled trials to make a decision about whether a drug was effective,

but DuPont also wanted to know about the drug’s side effects and

efficacy. There was an approach called compassionate clearance to be

able to use the drug before FDA approval. I applied for compassionate

clearance and then used the drug significantly over a period of time,

as I did with many other drugs. That was how I acquired access to

research drugs to take care of dangerous arrhythmias in a private

practice setting.

At a certain point, DuPont decided it would be helpful to have

a symposium to review knowledge about the drug. However, there

was a problem in that the drug was developed by Russian scientists.

Because of Cold War concerns, a neutral site had to be found where

investigators could gather. Consequently, the symposium was arranged

in Montreux, Switzerland. I was allowed to take Judy with me. Not only

did I have a wonderful academic experience, but we flew business class

with Swiss Air, and enjoyed stellar accommodation on Lake Geneva,

and this was just the starting point for a subsequent Swiss vacation,

which included visits to Lucerne, Bern, Lugano and Zurich.

At that time, there was not yet much concern that drug companies

were influencing doctors. As a result, I was invited to countless

symposia all over the world. Judy and I traveled frequently to France,

Switzerland, Mexico, and the southwest U.S., often housed in luxurious

hotels and resorts and able to add on a few days for leisure travel. Judy

still remembers—not too fondly—our stay in a high-end resort in San

Diego where she choked on a hot dog and I performed a Heimlich

procedure, saving her life.

A group of rising young EPs such as myself attended these meetings,

and over time we became quite friendly. Seeing each other in these

different locales was always a pleasant experience.

I had been involved with pacemakers ever since I was a first-year

medical student and had joined the project being undertaken at my

father’s hospital. I had subsequently written the paper about pacing

when I was in Edinburgh as a medical student. By the time I got to

West Penn Hospital, I had developed a major interest in pacemakers.


Up until that time, surgeons were implanting pacemakers but without

truly understanding how to manage them after surgery. Over time,

there had been an evolution from single chamber pacemakers with a

lead in one chamber to dual chamber pacemakers. The latter possessed

a lead electrode in the top chamber synchronized to a lead in the

bottom chamber to allow the heart to beat in a normal fashion (top to

bottom). These were known as physiologic pacemakers. It was a feat of

engineering to create those devices. Surgeons who wanted to implant

the devices had no concept of how they worked, how to follow them, or

what to do with complications. Conscious of this shortcoming, I chose

to become actively involved in pacing.

In 1984, one or two of my colleagues in the U.S. who were EPs

decided that they were going to implant pacemakers, instead of

surgeons doing them. Since this was a minor surgery procedure, they

were having political battles with surgeons over who would implant

the devices. These battles further reinforced my desire to be involved

in pacing, and I resolved to pursue this goal aggressively. I realized

that no cardiothoracic surgeon was going to teach me how to implant.

With this in mind, I sought out a friend, Harvey Slater, who was a

general surgeon and who did pockets in the chest for chemotherapy,

making a simple incision just under the skin on top of the muscle and

underneath the clavicle—the same surgery involved with pacemakers.

Moreover, he shared my antipathy for cardiothoracic surgeons. United,

we decided to join forces to perform a procedure together—without

permission. Working together in the outpatient operating room, my

friend created the pocket while I put the leads into a patient. Although

I had never before implanted a permanent pacing lead into a patient’s

heart, I had successfully placed other leads under the collarbone in the

subclavian vein and was comfortable with the procedure.

Together, he and I performed the first non-cardiothoracic surgery

pacemaker in the city of Pittsburgh. Our triumph was short-lived,

for our subversive feat caused an immediate uproar. The chief of

cardiothoracic surgery claimed that we did not have credentials to do

what we had done and banned us from the operating room. Moreover,


we created tremendous animosity between us and the heart surgeons,

who complained that we were stealing procedures from them.

Ultimately, the hospital determined that I had the interest and the

potential skill level to be able to implant pacemakers. However, the

problem that then emerged was that I could not learn how to do them

if I could not gain access to the operating room.

Fortunately, a young cardiologist on staff at West Penn, Mark Geller,

had trained to do pacemakers at Tufts University as a fellow. He was

really obnoxious and universally disliked, but I saw that I could use

him to help me. He was willing to teach me how to do pacemakers if

I would let him do pacemakers in the EP lab where I worked. It was a

win-win situation for both of us. As a result, I did 10 pacemakers with

him and became quite proficient at the procedure, receiving credentials

from the hospital to implant.

This was in 1986. With my newly acquired skill, I made the rounds of

all the pacemaker companies to let them know that I would be happy to

carry out clinical research for them. Such research entailed implanting

a certain number of new pacemakers in patients and then presenting

the results to the FDA for approval. Although the manufacturers were

fairly indifferent to where the pacemakers were implanted, I was at

a disadvantage compared to major institutions such as the Cleveland

Clinic that routinely installed large numbers of pacemakers. Owing to

the large volumes they dealt with, the pacemaker companies routinely

sought out these major institutions to carry out their research, rather

than those with smaller volumes.

Although I was facing an uphill battle, my determination finally

paid off. Medtronic, the largest pacemaker company in the world,

had a deadline to approve a pacemaker called the Medtronic Symbios

bipolar dual chamber pacemaker. Fortuitously, I was able to perform

six implants within the space of two weeks, which helped Medtronic

achieve success with its FDA filing. Because I provided a large

volume with this device, Medtronic took me on as an investigator,

which expanded my reputation and gave me access to additional

investigational devices.


From that point onward, I spent a lot of time with the Institutional

Review Board, getting permission for doing research on these new

pacemakers, as well as anti-arrhythmic medications. Before long,

I had a major pacemaker practice, with state-of-the-art pacemakers

and, eventually, state-of-the-art defibrillators as well. In addition to

being known as an electrophysiologist, I quickly gained renown as a

pacemaker/defibrillator device specialist.

In 1982, a paper was published in The New England Journal of Medicine

describing destruction of underlying cardiac conduction tissue with an

electrical impulse. Wanting to learn this new technique, I contacted

a friend, John Fisher at Montefiore Hospital in the Bronx, to obtain

additional information. He described the procedure and encouraged

me to observe the effect in vitro by placing a bipolar catheter in a

container of saline, emphasizing plastic and not glass for reasons not

apparent to me. I attached the catheter to a defibrillator, turned off the

lights, and delivered a 200-joule shock. There was a bright flash, the

catheter shredded apart, and the container went flying. He had failed

to tell me to attach only one of the electrodes to the defibrillator and

the other to ground.

At this point, ablation therapy became an integral part of therapies

that I could offer patients. As the procedure evolved, I made pilgrimages

to friends at University of Oklahoma and Bordeaux to acquire these

new skills in order to provide the most advanced treatments. At the

same time, I prevailed on West Penn to obtain the requisite 3-D

mapping equipment and energy sources to facilitate the procedure.

Over time, the technology has evolved considerably. Today’s devices

are very complicated and have their own special needs for follow up

management. Similarly, EP has taken a different path. The mapping

procedures—by which a specialist detects the origin of an arrhythmia

in conjunction with new energies for ablation—have transformed

ablation into the key aspect of EP. Ironically, the area has come full

circle to the way it was at the outset. When an EP fellow finishes his

training now, he either becomes a specialist in pacing or in invasive

ablation. The North American Society of Pacing and Electrophysiology


enamed itself the Heart Rhythm Society to reflect the evolution of

the field.

What ultimately happened to me at the end of my career was that,

as I grew older, I did not keep up with the ablation technology, which

was increasingly sophisticated and technically demanding. Moreover,

all the young physicians emerging out of fellowships were trained to

perform ablations every day. Not surprisingly, all they wanted to do

was procedures. As such, a young electrophysiologist with three years

of training would have already completed a multitude of ablations

that were, technically, far more complex than the ones I carried out.

Indeed, I did not do my first complex ablation until 1991. From then

on, I only did an average of four to five a month. When an ablation

technique, for atrial fibrillation, a different arrhythmia, was developed,

I was the first physician in the city to perform it; however, afterwards

I only performed one or two a month since they were so complicated.

Now, younger colleagues easily do two or three a day. Obviously, the

more one does, the better one gets. In that regard, I fell by the wayside.

Instead, more recently, I focused on what I was comfortable with:

pacemakers and defibrillators. By the time I retired, I had implanted

more devices than anyone else in Pittsburgh. I could do a pacemaker

in my sleep.

I never followed anyone’s path; I created my own. I always wanted to

be on the leading edge of technology, and for a long time that’s where

I was. What I always wanted was for people in the local EP community

to ask the question, “What is Alpert doing?” And even up until three

or four years ago, that was the way it was. When I first started out,

I was one of 50 electrophysiologists in the world. Today, there are 50

electrophysiologists in Pittsburgh alone.

I absolutely loved being in private practice. I loved taking care of

patients and enjoyed continuing to do so over 44 years. I was very

busy in my practice. Being in private practice was also very financially

rewarding; however, that was not a motivating factor for me. To me,

medicine was always a profession and not a business, but I was very

fortunate in terms of my specialty. Currently, there is a popular belief


that radiology, ophthalmology, anesthesia, and dermatology are the

“road” to success, but all of these specialties are relatively easy compared

to what I did in terms of hours spent, and they are extremely lucrative.

Money, though, was not my driving force.

At one point, Dr. Heppner suffered a heart attack and had to have

stents and later, bypass surgery. By then, he had been heading the

practice for 15 years and he confessed that he could no longer deal

with the stress of trying to mediate among the competing interests of

nine physicians. His solution was to retire, and in the aftermath the

practice slowly disintegrated. I made life even more difficult for the

other partners by leaving the practice in 2001, after 19 years.

At that time, I had a falling out with my partners based on how

to split overhead and my ongoing chafing with Dr. Porkolab. It was

a very difficult moment for me. My partners actually had a choice

between modifying finances and firing Dr. Porkolab or letting me go.

To my initial great disappointment, they chose to let me go. I was very

anxious as to where I would acquire new patients, but we agreed that

I would take my own patients with me. However, the deal was that

my (former) partners would split revenues with me for every patient

from the practice that I treated. The agreement was probably illegal,

but I signed a contract whereby they did the billing and I received the

payments. Not surprisingly, they made my leave-taking very unpleasant.

In order to treat my pre-existing patients, I needed access to my charts.

My now former partners insisted I return to the office with two of my

employees to copy necessary records at 5 cents a page. It was very petty.

The irony was that Dick Heppner had retired owing to coronary

artery disease, his specialty. The person who took his place, Larry

Hurwitz, was a general cardiologist without a place to practice and

I had been the one who had recommended he join our practice. This

obviously had no effect on the decision to let me go. Once I left,

I severed my relationship with him and everyone else in the group.

I suppose a practice is similar to a marriage in some respects. My

father was part of a practice where all the partners split profits evenly,

based on the belief that each physician brought something different


to the practice and that he should be rewarded equally. In retrospect,

I wonder if this solution would have made the relationships in my

practice healthier and happier. On the other hand, some of the partners

were very financially oriented and had a particular skill and work ethic,

making individual salaries appropriate.

I remember that when I signed my first contract with West Penn

Cardiology, I had the option of accepting a guaranteed salary with a

limited bonus, or taking a smaller salary with a larger incentive bonus

based on my patient volume. I ended up opting for the more secure

choice, which was a financial error on my part, considering how

successful I became. Moreover, when we were splitting up the practice,

there was a division plan that strongly favored Dr. Heppner in terms of

the percentage of the practice he would receive.

In the end, I was not a very good businessman. Throughout my

career, my prime motivation was to practice medicine and help my

patients, and as Judy will remind me, I made poor business decisions.

I really did not want to be involved in any type of management. I had

office managers to take care of such details. Because I did not oversee

them as well as I should have, they presumably made decisions that

might have been financially detrimental.

Fortunately, after the split, West Penn Hospital was not going to

get rid of me; I was far too successful. At that point, I had the biggest

reputation in my hospital, and my name was important for advertising.

Consequently, even though Dr. Heppner’s practice was the most well

known at the hospital, the administration was very supportive of me,

and they set me up as a single practitioner.

I had to organize a private practice and had the good fortune to

have Tammy Rock as office manager. Judy worked the front desk, and

Merri Lee was our billing specialist. Connie Glagola was my trusted

nurse practitioner and colleague. Throughout my private practice years,

I never wanted to embrace the management of the office, leaving it to

a long list of incompetent office managers and billing specialists after

Tammy retired to raise a family in 2004, until I hired Mary Grover in

2014. With her, and with Kristi Siters as my medical assistant, we formed


a cohesive group. I signed paperwork and helped with decisions, and

they took care of daily office responsibilities. I was free to be a doctor.

However, after I went solo I became so busy that I urgently needed

a partner. I also wanted a younger person who was comfortable with

the newer procedures, particularly the new ablation technique of atrial

fibrillation, a complicated rhythm in the upper chambers, which I had

not been trained to do. This would allow me to focus more on my love

for implantable devices. For four years, I searched for a partner, but to

no avail. The candidates were of poor quality and the salaries they were

commanding were exorbitant.

I made an unfortunate error in terms of the person I ultimately chose.

Dr. Leonard Ganz was chief of EP at the University of Pittsburgh, having

been Harvard-trained, and had been the prior chief of EP at Allegheny

General Hospital, UPMC’s competitor. For professional and financial

reasons, he approached me to see if he might join me in practice. I made

the assumption that we would have a regional monopoly by merging

our two practices. I thought that, like my personal experience, he

would carry his patient population with him, making it a true merger.

As a result, I offered him a very lucrative employment contract, since

he was, presumably, self-sufficient. Unfortunately, he never generated

his own cases and I had to support him. We began together in 2005.

My resentment grew as he continued to feed off me, and I found that

his EP skill set was no different than mine. In short, my assumptions

about him were not correct. He did not add a new dimension to the

practice. Nevertheless, our practice, now named Arrythmia Associates

P.C., flourished.

After some time, Len suggested adding a third and younger person

who did have newer skills and who would provide us with the ability to

expand our hospital affiliation to outlying hospitals, including Forbes

to the east and Jefferson to the south. Although I was fearful of having

to support another person, I reluctantly agreed, and Jonas Cooper

joined us.

He had an academic background from Washington University in

St. Louis and could provide a more contemporary approach to EP.


Very naive about money, he just wanted to do what was good for the

patients. He had acquired more recent skills and knowledge that I did

not have. Over time, we forged a very close professional relationship

that I enjoyed very much. He ultimately left in 2013, not because of

me, but because he had issues with Len stealing his cases. His wife,

who was from St. Louis, also disliked Pittsburgh and missed St. Louis.

In 2008, West Penn Hospital, which had rescued a bankrupt

Allegheny General Hospital and formed Allegheny Health Network,

became involved in a board coup and lost its primacy, suffering

financial setbacks that left it almost bankrupt. As a result, it could not

afford physicians, and its reputation plunged. Our group was offered

a financial incentive to move our practice to Shadyside hospital, a

UPMC affiliate. We were successful there for five years, competing

with the full-time university EPs. In 2013, I alone was offered an

opportunity to return to a resurrected West Penn hospital, thereby

breaking up Arrhythmia Associates, with Jonas moving to Butler, and

then St. Louis, and Len to Heritage Valley Health System in Beaver,

Pennsylvania. In the final stage of negotiating a lucrative contract,

West Penn pulled my deal. I was then left with a practice, but without a

location. Fortunately, my lawyer negotiated a settlement that provided

me with office space at West Penn and money for moving expenses.

At this point, I had to give up Connie, my trusted nurse practitioner,

and a medical assistant because of overhead issues as a solo practitioner.

I serviced West Penn, Shadyside, Forbes, UPMC East, and Jefferson

until 2019, as a solo physician. When it became apparent that my focus

was Forbes and UPMC East in Monroeville and I was being squeezed

as a private practitioner for office space at West Penn, I moved my

office to Monroeville, thanks to Dr. Athan Georgiades, who provided

me with leased office space.

My final two years of practice were complicated by health issues

and hospital politics. In the past, I had had a radical prostatectomy

for prostate cancer and then later chemotherapy for in situ bladder

cancer, neither of which impacted my practice. In January of 2020,

I developed a loculated pleural empyema from a post-viral pneumonia,


which required a thoracic surgical decortication procedure in January

of 2020 and incapacitated me for two months. This was followed by a

two-month practice closure at the onset of Covid between March and

May of 2020, when I was able to start telehealth before returning to the

office in July. More importantly, I came under strong political pressure

from Allegheny Health Network to retire and turn my practice over to

a new full time AHN EP, Mati Friehling. My volume and complication

rates were unfairly scrutinized, and my ablation privileges were severely

limited by Dr. Srinivas Murali, the chief of cardiology at AHN. I had

had coverage from another private EP, Dr. Vijaykumar, but his privileges

were later rescinded because of a high complication rate. At this point,

the full-time AHN EPs refused to cover me. As a result, without any

backup coverage, I lost my EP privileges. In my last months of practice,

I was relegated to UPMC East and Shadyside hospitals, implanting

devices until I retired on April 1, 2021. At the same time, my private

practice was winding down. My patients were dying or moving to the

two dominant health care systems. I was also no longer receiving new

consults or office patients as 90 percent of the physicians in Allegheny

County were owned by the two systems. I was left with no choice but

to consider retirement.


Private practice brochure


My “15 minutes of fame”

My patient


Newspaper article on ablation

Solo practice




In addition to the political pressures upon me, there were other

factors that contributed to my decision to retire. For some time, the

diminished scope of my activities—which had largely been reduced to

pacemaker/defibrillator follow-ups and limited procedures—had made

practicing medicine much less satisfying to me on both a professional

and personal level. There was also the fact that my decreasing number

of patients made it increasingly difficult to cover expenses as a solo

physician. However, the final straw was the arrival of the Covid

pandemic in early 2020, which created enormous disruption and

complications. As such, in February 2021, after careful deliberation,

I informed my staff that we would be closing the practice for good on

April 1. By giving this advance notice, I wanted them to have sufficient

time to inform patients of the news and transfer records. Fortuitously,

I was able to sell my patient records to UPMC; I used the payments

I received to help defray the substantial costs of closing a practice

(unfortunately, there was no one to inherit it).

One afternoon, shortly before we shuttered our doors, Judy, Craig,

Lori and my staff threw a retirement party for me. I was very moved

that they were able to track down so many of the people I had worked

with during the entire length of my career. Among those who attended

were my former nurse practitioner, Connie, as well as vendors, doctors,

nurses, and some special patients. Craig and Judy also compiled a


scrapbook filled with newspaper clippings, magazine articles, and

“thank you” notes from grateful patients that Craig had solicited. As a

way of summing up and capping off my 43 years of practicing medicine,

the party was quite momentous. Although it provided me with closure,

in truth, as I left my office for the last time, the sensations that washed

over me were bittersweet.

Prior to retiring, I had spent a year contemplating making such a

drastic change, trying to gauge the possible ramifications on my life.

What concerned me most was what I would do to occupy all that

sudden free time after decades of 12-hour workdays. Seeking insight,

I consulted with various people who had already taken the plunge. A

close friend, Joel Harris, a former neighbor of Judy’s, warned me that

it would likely take a year for me to define what my retirement would

look like.

Joel’s warning turned out to be stunningly wrong. My life as a

retiree came into crystal clear focus on April 2, the day I officially

turned my back on medicine. Purging myself of my past, I canceled

my electrophysiology journals and quit my medical societies. The only

remnants of my former life I allowed myself were my subscription to

The New England Journal of Medicine and Journal of the American College of

Cardiology, as well as continued membership in the American College,

which was free upon my retirement.

With great enthusiasm, I embraced activities that I had forsaken

during my career. I also took enormous pleasure in making up for lost

time with Judy and my family. Seeking intellectual stimulation, I went

hunting for online courses. These had the advantage of being free, with

no papers or exams, and I could enroll at any time I desired. One of the

first courses I selected was “First Nights,” a music course archived from

Harvard and taught by Thomas Kelly, which, coincidentally, Craig had

taken 15 years earlier at college. I also took a course in the history

of finance. Eager for knowledge, I downloaded courses about jazz,

meteorology, particle physics, the Internet, European history, Russian

history, world literature, Bach, and photography—all of which I still

look forward to taking.


I also began reading, another pursuit for which I had never found

time, except for during long airplane flights. I developed a proclivity

for non-fiction, particularly biographies, as well as popular fiction,

and classical mysteries such as David Silva’s Gabriel Allon series,

John Grisham, Sherlock Holmes, Agatha Christie and Dorothy

Sayers. Also, becoming involved in a book club with 12 of my college

roommates led me to discover books I might not have found on my

own or chosen myself.

Apart from tending to my intellectual side, I also dove into physical

pursuits. My friend Joel invited me to take part in a senior doubles

tennis group. I also joined a country club, where I spent hours trying to

improve my golf game, which had lain dormant since college.

Most important, however, was taking up my role as a grandfather.

All the hours that I had devoted to work left me unable to experience

the growing years of my children and grandchildren. When I married

Judy, Lori and Josh were 10 and 7. Later, since I was available only at

nights and on weekends, Craig’s early childhood was mostly overseen

by Judy. When Craig was older, I spent more time with him, engaging

in sporting activities such as baseball, hockey and soccer. However,

I then missed out on spending time with Lori’s three children because

her primary focus was her children, and our services were not needed.

As they grew up, there was little room for me in their lives, except for

the rare game of hallway hockey on the Wednesday nights when Lori

and Ben went to dinner, leaving me and Judy to babysit.

With retirement, I was free to participate in the lives of Craig’s

young children, Noah and Andrew, who at the time of this writing are

five and two, respectively. Embracing the concept of grandfather has

been very important to me. It has felt so good to be “Grampy” to Judy’s

“Grammy,” to play Legos and Hidden Pictures, to toss a ball with Noah

while chasing Andrew around to keep him out of mischief. Sleepovers

with Noah, giving him a bath and reading him bedtime stories were so

special—until Covid intervened.

During the summer of 2021, Judy and I escaped to Nantucket

for three months, which was the longest time I had ever spent there.


Armed with the luxury of time, I fully embraced this beautiful place

and its many attributes. I spent precious hours with Judy, walking

and beaching, tandem biking and dining out. We also entertained,

hosting our families, as well as two couples who are close friends of

ours. I joined a twice-weekly cardio-tennis clinic, where I was the oldest

member. With 45 miles of bike trails available, I rode my bike daily,

usually for 10 or 15 miles, while listening to audio tapes of my favorite

detective stories and classical music. I would also bike to the golf course

to practice, even though a shank crept into my game, causing significant

frustration and preventing me from wanting to play on the course.

All in all, it was a very special summer for us. At the end of September,

we attended Rosh Hashanah services at Temple Shirat Hayam, which

we had embraced over Pittsburgh’s Tree of Life synagogue after the

shootings in October of 2018. We felt the synagogue had ignored the

needs of the congregation. Then, at the beginning of autumn, Judy and

I returned home and settled back into our Pittsburgh routine.

On October 6, I went for my yearly appointment with my internist,

Alan Steckel. When he read me the results of my blood test, I felt as if

I had fallen off a cliff. My blood work was markedly abnormal. It was

consistent with a transformation of previous monoclonal gammopathy

of undetermined significance (MGUS)—which I had known about for

11 years—into full-blown multiple myeloma, a plasma cell blood cancer.

Ironically, this transformation occurs about one percent per year, or

11 percent over the period. How unlucky I was! Perhaps my illness was

influenced by the fact that, in his 80s, my father had apparently suffered

from smoldering myeloma (a type of myeloma without symptoms,

which requires no treatment).

Having received this shocking diagnosis, I was referred to Dr. James

Rossetti, a hematologist oncologist at UPMC Hillman Cancer

Center whom I had known when he was at West Penn Hospital as a

fellow and staff member specializing in bone marrow transplants for

blood cancers. In the meantime, in early October, I also developed

excruciating back pain and a shortness of breath from anemia. Lab

exams revealed that between March and October there had been a


jump in my M-spike measurement, a reflection of myeloma activity,

from 2.1 to 4.5, necessitating that I receive immediate treatment. In

addition, a bone marrow biopsy revealed a cytogenetic pattern that

carried a high-risk prognosis.

I immediately began a four-drug regimen consisting of Velcade

(Bortezomib), a proteasome inhibitor; Revlimid (lenalidomide), an

immunomodulatory drug; Dexamethasone, a high dose steroid; and

Daratumumab, an anti-cancer monoclonal antibody. The possibility

was left open for an autologous bone marrow transplant in the future, if

and when the M-spike decreased enough to allow harvesting of my stem

cells. Fortunately, my lab tests have improved, and I am contemplating

a stem cell harvesting for a transplant, hopefully after I return from

Nantucket in the fall.

Given my present condition, I take comfort from the fact that, on

most days, I am able to embrace my philosophy of living life to the

fullest. I will continue to do so as long as I am physically capable. As

I reflect back, I am confident that I gave my utmost to my family and

my work. As I have said before, my life has definitely been more of a

roller coaster than a merry-go-round.

As I write this, I am seven months into therapy. Up until my

diagnosis, I had felt that I was younger than my chronological age.

I thought that the fact that my two parents passed away in their 90s

would have allowed me to reach at least my mid 80s. Now, I will feel

fortunate if I reach 80. It is difficult to accept a potentially decreased

lifespan, and I frequently contemplate my limited future with sadness.

Nevertheless, I also embrace cautious optimism. My mantra going

forward has been “fingers crossed.” And as Craig says, “Enjoy the good

days and weather the bad.”

I have a tendency to be optimistic about outcomes, but I can also

accept when they do not come to fruition. I am able to rationalize failure

and move on. I would hope that my sense of optimism, even if tempered

with realism, is a perspective that Judy and my family can adopt.

I cannot fully express how much Judy has meant to me—now and

always. Although she and I are opposites in so many ways, we are also


strikingly complementary. While I veer toward the positive, she can be

negative. I tend to be very reserved, private and sometimes stiff, while

she is warm, open and social. While I am self-focused, she thinks of

others first. My bent is intellectual, while hers is practical. On paper,

our polarities may seem irreconcilable. In practice, our very differences

bind us together.

I am certain that Judy has made me a better person. At the same

time, I hope that I have been a positive force in her life. She has taught

me how to open up, to become more giving—and romantic. She is my

life, my love and my closest companion.


From my retirement scrapbook


From my retirement scrapbook


From my retirement scrapbook


From my retirement scrapbook

Grandparenting is special


From when I first got sick


My special person




On our trip to Israel, we did a scavenger hunt around Jerusalem.

Craig added bonus points for objects specifically related to

me. Over the years, my family has playfully brought up various

characteristics, habits, and idiosyncrasies that define me. Since this

book is about me, I thought it appropriate to share some of these.

I never throw things out and am a terrible hoarder—of which clothes

and food are the most blatant example. I am an adventurous eater,

seeking out exotic cuisines and street food. Every night, I have a glass

of red wine—for “medicinal purposes.” I love spicy foods, particularly

Szechuan, and choose 7 out of 10 with Thai food. I always have loved

cookies and prefer chocolate chip cookies without the chips. I am

known as the “cookie monster.” I like potato knishes and pierogis. In

Nantucket, I love to eat clam chowder, fried clams, and bluefish, and

am lukewarm about lobster. I never leave anything on my plate and will

contrive to taste or finish whatever is on Judy’s.

Despite being conservative, I have always driven a sporty car with

a stick shift, starting with a red Volvo P1800 coupe when I came to

Pittsburgh, and most recently, a BMW 430 Xi coupe. I have always enjoyed

the challenge of shifting gears, adjusting the radio while answering my

cell phone, and drinking a cup of coffee all at once on the way to work.

From a sartorial standpoint, my uniform is a button-down shirt

from Brooks Brothers, khaki trousers, loafers, and one of the more


than 200 ties I have collected, many with motifs from stethoscopes to

wine bottles and Bugs Bunny. I love crew-neck sweaters. When I was a

medical student in Edinburgh, I bought my first university scarf with

vertical stripes. Subsequently, whenever I traveled to England or went

to J. Press clothiers in Cambridge or New York, I would buy one and

now have over 40. As I do with aftershave lotion, I rotate them on a

regular basis to wear with my toggle coat.

One of my loves is the Boston Red Sox, who I have followed since

I was growing up in New Hampshire. I cherish my 60th birthday

present of a Red Sox–Yankees game on the Green Monster with Craig.

I read the sports page every day. Other loves include biking, classical

music, particularly Bach, classic rock, Bob Marley and U2 (influenced

by my kids), and The New York Times.

I refuse to be limited by physical ailments and rarely complain of

pain or discomfort. I was hit by a car crossing the street in a crosswalk

and was thrown 15 feet. Since I could get up and had no pain, I then

proceeded to the hospital to do a procedure after a stat X-ray showed

no fractures. After my prostatectomy, with a Foley catheter in place,

I saw office patients dressed in baggy pants with a urine bag strapped

around my leg. I let little interfere with work.

I was always available to patients and doctors 24–7, and I never

turned my phone off, which led to calls at inopportune times. I was

interrupted during Noah’s bris, have received calls on the chairlift and

airplane, and have gotten calls from doctors at 12 midnight in Vietnam

and 4 a.m. on safari in South Africa.

At work, in the afternoon, I would become sleepy interviewing a

patient. I would then disappear into my office to close my eyes at my

desk for a few minutes, awakening refreshed and ready for the next

patient—my power nap.

I am well known for my pratfalls. On our first trip to Israel, Craig

tipped a glass of coke over and I fell over backwards trying to move out

of the way, my back chair legs caught on a ceramic tile floor. I have also

missed steps in the plaza of Milan’s cathedral and Mont-Saint-Michel,

and I have been “gummed” by a toothless chimpanzee belonging to a


street vendor in Acapulco while trying to retrieve a wallet that he had

pilfered from Craig’s hand.

I always read instructions first and try to complete tasks. I am

terribly stubborn and need to provide my own answer without hearing

the answer already given to me. I try to multitask but have seen this

deteriorate as I have aged. I hear but I don’t listen. I become so involved

in doing something that I am oblivious to anything around me,

particularly to what Judy is saying. Verbally, I have no shut-off valve,

and “hoof in mouth disease,” invariably saying the wrong thing at the

wrong time and creating trouble.

Finally, I have several stock quotes or “Barryisms,” as Judy calls

them. “If you are not standing on the edge, you are taking up too much

space.” “The glass is always half full,” (and half empty for Judy). When

Judy gets nervous, “Relax Max,” and “Whatever.” When asked to weigh

in on a decision when I don’t know or don’t care, “It’s a 50-50 chance.”

Our toast with each evening’s wine is “Health and happiness.”

In short, I am me.


Israel trip scavenger hunt list of objects related to me



Looking back over my life, I am conscious that my medical career

has always taken a front seat. Medicine offered me a profession

in which I could feel confident about myself. It allowed me to strive

in order to excel and succeed using my intellectual gifts. At the same

time, the relationships I was able to forge with patients allowed me

to overcome the shortcomings I usually experienced with people in

wider social settings. Armed with knowledge, I was buoyed, capable of

sharing my expertise and compassion with my fellow human beings.

In my role as a physician, I connected with many wonderful patients,

some of whom became long-lasting friends. I was also gratified that

I provided a legacy for Craig, impacting on his decision to become a


Unfortunately, the political battles into which I was thrust, primarily

with AHN, and the discrimination I suffered as an independent

physician, soured me on the current state of medicine in the United

States. The focus of insurance companies on bureaucratic paperwork,

numerous government regulations, and the institution of electronic

health records also contributed to my disenchantment with the current

state of the profession. Medicine has become a business and is no longer

the altruistic, community-based practice that my grandfather exercised

and passed along to me. I regret that my career interfered with my

family life to the extent that it did, with long hours and incessant

phone calls causing Judy, and to a lesser extent my children, to be

denied the fruits of personal and family life. I so appreciate Judy being


the consummate doctor’s wife and my children never complaining. It

was always a challenge for me to balance my work life and my home

life, but I tried. Now that I am in retirement, I hope to make amends.

As I write these words, my body is responding to treatment and my

condition is improving. But none of us know what the future portends.

At the moment, I am getting better. The question is, what will I be like

when this is all over and done with? I would love for my back pain to

vanish and to regain my physical strength and stamina.

I hope that I can get back to biking and at least swing a golf club.

Maybe I will even be able to play old fogey tennis in some fashion.

I dream of returning with Judy to Nantucket, to walk along the beach,

hand in hand, and to be able to travel again, but without the constraints

my practice imposed. I would love to be able to do all these things. But

if I cannot, I cannot. I am thankful for where I am now.

As a final word to my children and grandchildren and greatgrandchildren,

I would tell you to make your family your first and most

important priority. I would encourage you to do what you like and

like what you do. Be open and loving. Live your life to the fullest and

be happy.


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