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Peering into the lives of the people behind the physician is part of the thrust of a pair of feature interviews in the current edition of the
University of Toronto Medical Journal's cardiovascular health issue.
In the spotlight—Dr. Barry Rubin, vascular surgeon and Medical Director, Peter Munk Cardiac Centre, and Dr. Heather Ross, cardiologist, heart failure and cardiac transplant specialist and Site Lead, Ted Rogers Centre for Heart Research.
From their thoughts on addiction to the future of cardiovascular health, Drs. Rubin and Ross tackle an array of topics in the University of Toronto Medical Journal—Canada's oldest student-run medical journal, established in 1923.
Interview with Dr. Barry Rubin
Can you tell us about yourself, your career trajectory, your interests and what drew you to vascular surgery?
Dr. Rubin: The truth is that I was a general surgery resident and I had done a straight internship before that. I didn't think that somebody could be that tired and still be alive, so I thought that maybe I should go into a research lab and take a break. I tried to get into a transplant lab because I thought transplantation sounded cool although I didn't know anything about it – never did a transplant in my life. The spot had been filled and the next one available was a vascular surgery lab, so I went into the lab. After a year in the lab, my supervisor Paul Walker said, "So you are going to be a vascular surgeon?" and I said "Okay". And that is the sum total. I've learnt that there is a lot of serendipity in life.
Q: When you see patients who have been very much affected by vascular disease, but are still smoking, how do you counsel these patients when you know there may not be a significant change in their behaviour or outcomes?
Dr. Rubin: Try to have some empathy. Smoking can be more addictive than [heroin]. I remember a while ago—I was on staff maybe five years—and I was coming into the hospital in February during a blinding snow storm. There was a patient sitting outside, bilateral above-knee amputations with a 'trache' (tracheostomy tube) and he was smoking through his 'trache'. You have got to be really addicted to be out in the freezing cold and smoking through your 'trache'. So none of that (weather conditions, tracheostomy tube, etc.) really mattered. I think it is important to recognize how difficult it is for patients to quit smoking.
Q: What is your role in the treatment paradigm of a patient with cardiovascular disease?
Dr. Rubin: It's evolved over time. When I started in practice, I had done a PhD in muscle ischemia (reduced blood flow to the muscle) and had done ischemia-reperfusion (restoration of blood flow after a period without) research for many years while I provided clinical care. After about 10 years of that, I began to transition to administration. I was the head of vascular surgery for nine years and have run the heart centre for the last six years. There's nothing like impacting one patient's care in a major way, and the type of specialty that I am in happens to be basically every case is either life or limb: aortic aneurysms (enlargement of the aorta), ischemic legs, impaired circulation to your brain.
Interview with Dr. Heather Ross
Q: Can you tell us a little about yourself?
Dr. Ross: I was born in Montreal, and I am a diehard Habs (Montreal Canadiens) fan, sorry! For reasons that remain unclear, at the age of 11, I said I wanted to be a doctor. I had a traditional middle class upbringing. My dad was in sales and my mom was a music teacher. My parents had university degrees, so school was a big priority in the family.
Q: Why did you pick cardiology out of all the internal medicine subspecialties?
Dr. Ross: The experience that tipped things was when I was an intern, and my grandmother died of a massive infarct (heart attack). I was the only one there, as my parents were out of town. A few pieces of it made it a moving experience. First, you see things from the patient's perspective, and to see her in the span of a few hours, so vibrant, to having a massive infarct, full pulmonary edema (excess fluid in the lungs), and then to watch her die was an overwhelming experience; I'm still quite emotional about that.
Q: You are one of the giants in cardiac health and research. What research are you currently pursuing and what are your research passions overall?
Dr. Ross: We are seeing this incredible growth of tech, which is enabling us to monitor things that people have never really appreciated. I think we are at the point where we can do a much better job through big data, and artificial intelligence, in terms of predictive analytics. So my goal is leveraging tech to monitor patients, while collecting all the data and creating a data ecosystem or data lake, where we can start asking good questions.
full interviews can be found in the University of Toronto Medical Journal's issue on cardiovascular health published in June 2017.