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Interview with Eugene Braunwald

Wed, 26/09/2012

Eugene Braunwald is one of THE most renowned cardiologists in the world. He is a professor at Harvard Medical School and the editor of the famous textbook called Braunwald's Heart Disease. Furthermore, he is the founding father of the TIMI (Thrombosis  In Myocardial Infarction) study group, which - according to Wikipedia - "developed the concept of thrombosis superimposed on atherosclerosis as the pathophysiologic basis for acute myocardial infarction". 

Dr. Braunwald was born in Vienna - the hometown of 123sonography. But he and his family had to flee the country during or shortly before World War II. A very sad period in our history :-(

We met Dr. Braunwald at the annual congress of the European Society of Cardiology in Munich just a couple of weeks ago and we are very happy that he agreed to share some of his wisdom with the 123sonography community. In this rare interview, Dr. Braunwald will give you some of his most valuable career and life-advice. Enjoy...
ImageEugene Braunwald  
123 Sonography:  Thank you very much Dr. Braunwald for this interview.  As I've told you, we are writing about success for physicians among other things. Many of our readers often ask us how they can be more successful as physicians.  Could you share some of your insights with them?  What was the best advice that YOU ever got from a mentor of yours?
Eugene Braunwald:  Well, shortly after I finished my training, I went to work at the National Heart Institute [Editor's note: now the National Heart, Lung and Blood Institute] in Bethesda, Maryland and although I was already a staff cardiologist, they had a rule, which might seem strange today.  The rule stated that the Director of Research had to approve every paper before it could be submitted for publication.  The Director of Research at that time who was also my mentor was a very distinguished renal physiologist by the name of Robert Berliner.  I wrote a lot of papers and he would make little comments on them and he would always pick up on key issues.  On one paper in particular that I got back from him, his comment was "Why did you bother to do this?" and that really started me thinking.  Obviously, he considered the work to be trivial and so I started to think a great deal about tackling issues of real importance.  There are so many issues around that are useless.  So, I don't know how successful I've been but since receiving that little note, before starting a project, I ask myself "Is this a really important question?" because the most important and limited thing that we have as physicians or even as human beings, is time. And so you don't want to spend your valuable time doing unimportant things.  Keep your eye on the prize.       
123 Sonography:  Do you have a special way or method for framing really interesting questions?
Eugene Braunwald:  I think that most of the questions that I frame come from direct clinical experiences.  To do clinical research you have to be an experienced doctor.  You can't just be an investigator.  So when I think about the importance of an issue I tend to focus on clinical problems that I have actually seen or experienced and didn't know what to do.  The presentation that I just gave 15 minutes ago would be an example of that method in that these patients have too much thrombin even after they have had a documented ACS, after they get dual anticoagulation therapy and after revascularization. [Editor's note: the interview took place right after an ESC session entitled “Rethinking thrombin: strategies to reduce mortality in acute coronary syndrome“ which was chaired by Eugene Braunwald]
123 Sonography:  In your opinion, what were the most important predictors of your success? 
Eugene Braunwald:  Being at the right place at the right time and with the right people.  The medical school I attended, New York University back in 1950 had a program that gave medical students the opportunity to do significant research.  This was the first program of its kind in the world at that time and where I've been for the last 40 years, Harvard, didn't do this at that time.  I had a wonderful mentor as a medical student, Dr. Ludwig Eichna, who ran a catheterization laboratory and at that time catheterization was a very advanced research technique.  Now catheterization is routine but was not yet so at that time. That experience introduced me to questions that were burning questions at that time.  My mentor introduced me to the pathophysiology of heart failure.  The study of heart disease was just starting and I was very lucky to be there. 
Then my post doctoral fellowship was with Professor André Cournand who was the father of cardiac catheterization.  I was there the year before he won the Nobel Prize.  At that time, people were not flying all over the world giving lectures.  He was there every day.  He worked with his Fellows directly.  It was a small laboratory and a small group. 
I was lucky to get in on the ground floor of the NIH.  When the NIH was started it was a research hospital in Bethesda and after just a few years I had tremendous opportunities.  When I was 31 I was made Chief of Cardiology.  So I was at the right place at the right time.  Then some years later as I became more interested in medical education, I became the first Chairman of Medicine at a medical school in California.  That assignment certainly moved me along a path so that when a professorship became available at Harvard, the fact that I had done research at the NIH and the fact that I had successfully started a Department of Medicine at a new medical school put me in a position to get this prestigious chair. Therefore, if you are at the right place at the right time, the odds are that you will get the right mentors because of the competition to get into good institutions. And I have been blessed with having had outstanding mentors, collaborators and trainees.    
123 Sonography:  How did you choose your mentors?  Did you choose the institution first and then found them there or did you pick certain people because you wanted to learn from them?  
Eugene Braunwald: I knew as a medical student that I was interested in cardiovascular research and at that time, there weren't many people doing cardiovascular research so I went to the one faculty member in my school who  was a solid clinical investigator in cardiology  (Dr. Eichna) and he was superb.  What I recommend is that if you're thinking about your future in research, the laboratory to which you go and the research group with which you will work are more important than any other decision that you will make in your career. Let me tell you something. When you are in high school, people tell you that the most important career decision is which college to choose and I think that’s not true. When you’re in college, people tell you that the most important career decision is which medical school you  attend. And that’s not true either. When you’re in medical school, people will tell you that the choice of your residency program is the most important one. And again, I think they’re wrong. In my opinion, the most important decision you’ll make in your career is, which [research] group to work with and which mentors to choose. And a good mentor does not have to be the most renowned person in the field. Maybe that renowned person is just a good politician. A good mentor will guide you, will listen to you and will give you more and more responsibilities as you move along.
123 Sonography: And how can one find such a mentor?
Eugene Braunwald: The most effective way of finding such a mentor is to talk to people who have come out of a particular research group or institution. Ask them what it was like to work with the  potential mentor.
123 Sonography: That’s really valuable advice. And what’s your recipe for your personal happiness.
Eugene Braunwald: For me it’s having my family around me. I am in the fortunate but atypical situation where my children and most of my grandchildren all live in the same city as my wife and I do. They all live in the Boston area. And that makes me very happy.
123 Sonography: Thank you so much for this interview Dr. Braunwald!
Eugene Braunwald: It was my pleasure.

PS: If you want to share some success advice with your peers, please post them in the comments section.