Cardiologists break with routine and go down the road less traveled

Successful and respected in their individual cardiac specialties, Cardiology Today caught up with three prominent cardiologists who have channeled their creative sparks into interesting ways of spending their time outside of the office. Their pursuits ended up taking them down unexpected paths and have garnered the admiration of patients, the public and many of their colleagues.

Communicating malpractice issues through storytelling

The threat of malpractice litigation is a problem that many physicians deal with on a daily basis. Cardiology Today Editorial Board member Peter Kowey, MD, chief of the division of CVD at the Main Line Health System in Philadelphia, chose to express his concerns with the system by turning his thoughts about experiences with the issue of malpractice litigation in a unique way — by writing a novel.

Peter Kowey

“We practice defensive medicine these days,” he said in an interview.” We physicians want to give the best care to our patients, but that desire is mixed with fear. There are a lot of things we do because we’re afraid of being sued.”

Kowey’s first novel, Lethal Rhythms, addresses the shadow of fear that malpractice suits cast over practitioners of modern medicine. “The threat hangs over us all, but we don’t want to talk about it,” Kowey said, noting that since his novel’s publication, “the response has been incredible,” with many doctors telling him that reading it was a “cathartic experience.”

“There are many doctors who say they’ve needed this,” he said. “There’s such a feeling of shame associated with being named in a lawsuit. It shakes doctors to the core, and yet 90% of practicing physicians will be named in a suit at one time or another.”

According to Kowey, who himself has had the experience of being named in a malpractice suit, the reason malpractice suits are so prevalent is complex, but understanding what he refers to as “the system” is key. “The amount of regulation in the profession makes people tired of having their deficiencies pointed out.”

As a lecturer who often relies on storytelling to convey his message, Kowey approached the subject as an allegory because it is a “good and memorable” way to teach so that doctors and the public alike can understand. “If I’d written [the book] in a non-fiction mode, I think it would have fallen flat,” he said.

Proceeds from the sale of his book are being invested in tort reform efforts. “There needs to be some review process so that doctors, lawyers and judges can look at these cases before they get in court and potentially waste time and money” he said.

Putting out fires before they start

Also treading an unusual parallel path with his cardiology career is Richard E. Collins, MD, who combines his career in cardiology — now working as a preventive cardiologist at South Denver Cardiology Associates — with a passion for cooking and a flair for TV showmanship.

Richard E. Collins

Collins said as he recalled how in 1993, when the concept of reversing heart disease was still nascent, a patient in his 60s still suffered CVD despite having had three bypasses “That’s when I decided to hang up my balloons.” Collins, a fellow of the American College of Cardiology, was led to discover how combining yoga with a low-fat vegetarian diet and exercise could improve the quality of life for CVD patients. Shortly afterward, he decided he would no longer consider himself an interventional cardiologist, but a “preventive cardiologist” instead.

“Medical doctors are trained to act like fire fighters — always putting out fires,” he told Cardiology Today. “But I wanted to be more like a forest ranger — looking for the potential dangers and managing them before they start.”

Collins’ way to scan the horizon for CVD dangers was to teach his patients how to prepare healthier foods. “Patients would bring me their favorite family recipes and I would show them how to rework them so they were still tasty but healthy,” he said. “I became known as the Cooking Cardiologist.”

Several years later, a large Denver-based cardiology practice approached Collins, who is originally from Omaha, Neb., and asked him to join its preventive medicine-focused group. The facility includes a yoga studio, gym and a cooking studio, where Collins offers cooking lessons and is often filmed for appearances on local and regional television.

“At our practice, for every dollar we make using the interventional approach, we reinvest it in our preventive approach. It’s a much more humane business model,” he said.

Collins is also the co-author of three cookbooks, including Cooking with Heart, which is now in its second printing. Regarding his latest book, The Kardea Gourmet, Collins said it was tough to convince other physicians of the efficacy of his approach during the years, but in 2010, “The CMS recommended [the preventive approach] for intensive rehabilitation therapy of CVD.”

From scientific writing to fiction

A prolific publisher of scientific literature in the specialty of arrhythmia research, Douglas P. Zipes, MD, Emeritus Director of the division of cardiology at Indiana University and a Cardiology Today Editorial Board member, has recently added a different kind of writing to his oeuvre.

Douglas P. Zipes

“As the author of hundreds of scientific works, where medical publishers come to me and ask me to write for them, writing and publishing fiction was a real comeuppance,” Zipes said regarding his debut novel, The Black Widows, a self-published medical thriller. The book sold enough copies over the Internet to attract his self-publishing company’s distribution arm, which now markets and sells his title to brick-and-mortar booksellers.

Zipes said although he initially had an agent, “She was unable to sell the book after 2 years, so I just did the whole thing myself.” With dozens of positive reviews on amazon.com, The Black Widows has sold more than 1,000 copies online. “I don’t know who is buying it, but people seem to like it,” he said.

Also the editor of the HeartRhythm journal and author of myriad textbooks and journal articles, Zipes, a past president of the ACC and the Heart Rhythm Society, turned to writing fiction more than 20 years ago. “I read a medical thriller and thought I could do a better job than that guy did,” he said.

As it turned out, Zipes’ first go at fiction writing did not pan out as he had hoped. “It’s sitting in a drawer somewhere,” he said. Zipes then decided he needed lessons. He enrolled in courses and learned important basics of fiction writing such as, “show, don’t tell,” and “don’t rely on adverbs.”

“That one was a revelation for me,” he said.

The Black Widows took Zipes about 4 years to write; the process was interrupted by his scientific writings and other cardiology duties. “I can be interrupted for science writing, but not for fiction. It’s harder to stay with a character,” he said. “Writing fiction is vastly different from writing science. In science, you strive for clarity. Everything is regimented and formulaic. In fiction, you write with an eye dropper. You drop a little fact here, you drop a little fact there. When the reader collects all the facts and then has the ‘Aha!’ moment. That is what you strive for. That takes time and continuity.”

Zipes is intrigued by the irony of trusting the unknown and proceeding without a defined plan. “It’s a different process from treating patients,” he said, likening the process of writing to driving in the dark. “You know where you’re going, but you can only see so many feet ahead of you at a time. You just have to get the words down.”

Progress has become success for Zipes, who while collecting royalty checks for his first novel, is now at work on his second. “I love every minute of this. It’s not for the money. It’s for the fun,” he said. – by Whitney McKnight