Life and Times of Leading Cardiologists. Guest: Magnus Ohman
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Life and Times of Leading Cardiologists With Rob Califf. Guest: Magnus Ohman

Robert M. Califf, MD; E. Magnus Ohman, MD

Disclosures

April 30, 2014

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Duke Colleagues

Robert M. Califf, MD: Hello. I am Rob Califf from Duke University, and I want to welcome you to this new episode of the Life and Times of Cardiologists. We are here with theheart.org on Medscape, and I am with my friend, Magnus Ohman. Magnus is also at Duke and has been there for quite a while, with a few escapades in other places.

Our goal for this series is to provide inspiration about what makes people tick who have accomplished things in their careers as cardiologists, and to understand where they came from and what they plan to do in the future. Welcome, Magnus.

E. Magnus Ohman, MD: Thank you, Rob.

Dr. Califf: Magnus, what was your early life like? What kind of a household did you grow up in?

Dr. Ohman: I am an only child, although I wasn't destined to be. Unfortunately, my mother had 2 stillbirths and I was in the middle, and so I led a somewhat protected life, as you can imagine. My mother was a stay-at-home mom (although later she started working), and my father was in the clothing business. It was a family business for about 60 years, and I was destined to follow if I hadn't gone down the medicine route.

Dr. Califf: I am trying to imagine growing up as an only child in Stockholm. What was that like?

Dr. Ohman: Stockholm is a beautiful city, particularly in the summer. It is a bit heavier in the winter; a bit cold. I had the usual schooling in Sweden, and I had great friends. It is a great environment in which to grow up.

A Rebel, Not a Hippie

Dr. Califf: I have heard that you were a little rebellious, though.

Dr. Ohman: I did a few things. I was interested in music, although I don't play any instruments, but I worked in a record shop for the better part of 3 years in my spare time. I probably could have gotten better grades in school if I hadn't done that, but it was a great experience. I interacted with a man from New York named Richard Berlin, and Richard Records was the place for records in Stockholm in the early 1970s.

Dr. Califf: Was it a hippie hangout?

Dr. Ohman: No, we were past the hippie era. This was the 1970s, so it was rock and fun music, and great people. Many of the artists who came to Sweden came to the record store because of Berlin, and so I ran into people there, which was fascinating. But I stayed clear of all the badness that happens in music. It was a fun time.

Dr. Califf: What was your favorite subject in high school?

Dr. Ohman: History. I loved history. It is a great educator; my best subjects were English and history. I was decent in the sciences.

Dr. Califf: Why were you interested in English?

Dr. Ohman: Coming from a country that had no simple way of connecting with the rest of the world, you had to learn English. I was sent to England during the summers as a young child. I went to New Forest, and I worked at a kennel that bred Pyrenean mountain dogs, so I used to walk these Pyrenean mountain dogs in the New Forest. It was an incredible experience. These are big dogs, and I am not that big -- but it was an interesting time.

I went there without any dictionary or any way of learning. It was basically what is now called "immersion learning," and at the end of 2 summers, I was pretty fluent in English.

Dr. Califf: Did you play sports in high school?

Dr. Ohman: I played 2 sports: golf and curling.

Dr. Califf: You played curling?

Dr. Ohman: I did, and I participated in the Junior Championship games. We were never very good, but we played and it was fun. Sweden has very long winters, so you have to do something.

Dr. Califf: What is the real trick to curling? It looks to me like you push this thing down the ice and then you start screaming at it, and it is how much you scream at it that seems to be important.

Dr. Ohman: It is a very strategic game, because you essentially have to always mark out your route so that you can get the greatest number of stones in the center of the circle. It looks easy, but it is a fairly difficult sport.

In the summers I played golf, which I really enjoyed, and that is the sport that has stuck with me.

Leaving Sweden for Ireland

Dr. Califf: So when the time came to go to university, you didn't stay in Sweden. Why was that?

Dr. Ohman: In my day, you had to do military service and it is obligatory, so I was carted off to do a year of that. I decided not to do the standard service, which is about 9 months; instead, I did officer training, because I wasn't mentally stimulated by the basic military training. I did that for a year and a half.

By that time, my parents had divorced and my mother had married my stepfather. He was a toothpaste manufacturer, and they were moving the factory to Ireland. So I thought, why not go to medical school in Ireland?

After about a year, my stepfather had some health issues and eventually died of a ruptured thoracic aortic aneurysm, but he had had a number of transient ischemic attacks (TIAs) and other events before that, so they got cold feet about moving. In the meantime, I was having a really good time in medical school and I just stayed. I never regretted it a bit.

Dr. Califf: A toothpaste factory is unusual. That was a big business, though, as I understand.

Dr. Ohman: My stepfather's family had manufactured toothpaste for many years and had actually expanded into Russia, which is interesting. They needed to expand rapidly. The business environment in Sweden in the 1970s wasn't very good, so they decided to try to manufacture the toothpaste elsewhere, and that is how it came about.

Dr. Califf: You played golf while you were in medical school and had some great experiences there, but it is also very different from medical training in the United States. How would you compare the two?

Dr. Ohman: They are very different. In Ireland, as in most of Europe, you essentially start medical school right after high school (although I had done something different in between). You do 6 years. The first year is your pre-med year, and then you have 5 years of medical training. It is less focused on research, so I had no research experience in medical school, but great clinical teachers -- physicians who had real knowledge about how to communicate with patients and others. So it is a very different way of doing things.

Dr. Califf: Did you have a mentor in medical school?

Dr. Ohman: Not directly. I worked fairly closely with a vascular surgeon named David Bouchier-Hayes. He was very helpful in saying, "You need to look into this and this." But it was after I finished medical school and started my internship in Ireland that the research started taking off.

Dr. Califf: What stimulated that, without any background in research?

Dr. Ohman: A physician who had done a lot of his training in the United States --John Horgan -- came back to Ireland, and he said, "If you do anything in medicine, you have to research it." I started some smaller projects (nothing to be proud of), and he was encouraging. I had help from people with knowledge in statistics and other things, but much of it I actually learned myself. The first book on statistics that I read was Stuart Pocock's book[1] on clinical trials. I read that and started learning about research.

At that stage, I was more interested in translational work. I wanted to understand "why" in physiology (which was my favorite subject in medical school), and how does it really work? Why does this happen?

I became interested in adrenergic receptors, which was my route to Duke, eventually. I developed projects to explore the effect of adrenergic stimuli on the cardiovascular condition. To do so, I had to collect lymphocytes that had beta-receptors on them, so I could characterize the receptor density and the signaling that went on. I did this for exercise and other conditions to really understand it.

Dr. Califf: At what point did you decide you were going to be a cardiologist?

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