5 Questions with Jeffrey S. Berger, MD
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For this issue, Cardiology Today spoke with Editorial Board Member Jeffrey S. Berger, MD, associate professor of medicine and surgery with appointments in cardiology, hematology and vascular surgery at NYU Grossman School of Medicine and director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health.
Berger received his medical degree from Tel Aviv University in 2001. He completed his residency, in which he was chief resident, at Beth Israel Medical Center, New York City, in 2005, his cardiology fellowship at Duke University and Duke Clinical Research Institute in 2008 and his vascular medicine fellowship at the University of Pennsylvania in 2009.
He has won numerous awards and is one of the cardiology field’s foremost experts on the role of platelets and risk factors beyond cholesterol and BP in CVD. He oversees an NIH-funded lab investigating the role of platelet activity and thrombotic biomarkers. He has published more than 180 peer-reviewed journal articles on topics such as novel mechanisms of CHD, peripheral artery disease and stroke; the etiology of thromboembolism; the use of antithrombotic agents in patients with CVD; and sex differences in the pathophysiology of and response to treatments in CVD. Berger is currently investigating the mechanisms and prevention of thrombosis and its sequelae in patients with COVID-19.
Cardiology Today: Who has been the biggest influence on your career?
Berger: The biggest influence on my life is my parents, who are both immigrants who came to this country fleeing from persecution. They brought me up believing that if you try hard and work hard, you can do anything you want. If you hear it enough, you start to believe it. I grew up with a constant reminder that I should be grateful for where and who you are, for your family and your country. I was reminded constantly to be grateful for what you have and think about helping others. That was how I was brought up.
Medicine was a natural progression for that. I will tell you, there were many bumps along the road. There was a time I thought I wanted to trade heating oil; I worked in the twin towers on the floor of the New York Mercantile Exchange in the mid 1990s. So, my life has changed a few times over. I went into medicine because I thought it was interesting and would be a fulfilling career. I chose cardiology because it was dynamic and exciting.
Within cardiology or medicine, I have been fortunate to have incredible mentors, perhaps because I am attracted to people who do not just tell me I’m doing a great job. I have had incredible mentors who have had high levels of expectation, that has allowed and encouraged me to grow. I feel like I would not be anywhere near where I am today without them. My first mentor, at Beth Israel, was an interventional cardiologist, David L. Brown, MD, now at Washington University in St. Louis. He got me interested and excited about scientific exploration. My next mentor, at Duke, Richard C. Becker, MD, was outstanding and influenced my career interest of platelets and thrombosis. I was privileged to be mentored by Pamela S. Douglas, MD, MACC, when I was a fellow at Duke. She also had a strong influence on my career. I remember working with her on a manuscript late at night. She would not leave until my work was done. I was amazed by her dedication. At Penn, I was privileged to be mentored by Emile Mohler, MD, who was also extremely dedicated to clinical work and research.
The person who had the most impact and influence on my career and has become not just a research mentor, but a life mentor, is Judith S. Hochman, MD, here at NYU, who has always been there for me and has always supported me and shown me firsthand what one can do with significant devotion and effort.
Cardiology Today: What area of research in cardiology inspires you most right now?
Berger: I am very interested in the overlap between cariology and hematology, specifically understanding platelets and clotting and the role clotting plays, who is at risk, and preventing it. In the setting of COVID-19, the interplay of cardiology and hematology are quintessential. Persons infected with SARS-CoV-2 are at higher risk for thrombosis and CV events. What is most interesting is that thrombosis is more than just a hematological abnormality. It is a major player in heightened inflammation and altered immunity. I have become interested in thromboinflammation, the overlap of clotting and inflammation.
Cardiology Today: What advice would you offer to a student in medical school?
Berger: I would tell them that if you like medicine, it is amazing to be a part of. I would quote my father: To be successful at what you do, you have to work hard. Make sure you choose the right area. You will wake up every day and go to work, and if you like it, you enjoy every day. That is a real blessing. Medicine can be incredibly rewarding and filled with rich experiences. If somebody is more interested in the clinical aspect of medicine, the scientific research, that is all wonderful. I remind people that when you are studying in medical school, residency and fellowship, you are reading and learning what people have done in the past. When you practice medicine and are active in research, you are recording what people are going to read about in the future. That is humbling and amazing to think about.
A piece of advice I got as a fellow that I think about often and try to tell my mentees is that every time you say yes to a request, you say no to something else. By reflex, you can’t do two things at the same time. That is one of the most challenging aspects of what we do.
Cardiology Today: Have you ever been fortunate enough to witness or be a part of medical history in the making?
Berger: I have been fortunate to work with great clinicians, scientists and clinical trialists. I spent the last 10 years working on the ISCHEMIA trial, which should change the landscape of cardiology.
The experience over the past year with the pandemic has superseded everything. Practicing medicine in New York City, we learned very quickly there was a lot of micro- and macrothrombosis in COVID-19, and we promptly set up studies trying to understand why clotting was occurring and wondering if we could prevent complications. We have been fortunate to shed important mechanistic insight into the pathogenesis of clotting. We have also been working with a large multinational team leading the ACTIV-4a clinical trial investigating the use of antithrombotic therapy to prevent morbidity and mortality from COVID-19. It has been amazing to set up and help lead a trial with global ramifications. Targeting immunothrombosis has the potential to transform our understanding and treatment of the COVID-19 pandemic.
Cardiology Today: What are your hobbies outside of medicine?
Berger: While I enjoy tennis and golf, what I love most is spending time with my family, including two little girls. Nights and weekends are family time. With my wife, I tried very hard to create a boundary so that my kids will always know that despite how much I enjoy work, they are (and will always be) my No. 1 priority.
My daughters have been asking for a dog for 3 years, and we finally got one a few weeks ago, a Goldendoodle named Maisy. So, I am sure Maisy will become a hobby. Despite my daughters’ promise they would do a lot of the work for our dog, I think I will have my hands full.
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