Life and Times of Leading Cardiologists: Thomas Lüscher
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Interviewer: E. Magnus Ohman, MD; Interviewee: Thomas F. Lüscher, MD, FRCP

Disclosures

December 07, 2016

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Editor's Note: This interview was recorded on August 27, 2016, at the European Society of Cardiology (ESC) conference in Rome.

E. Magnus Ohman, MD: Hello. I'm Magnus Ohman, and I'm here with Professor Tom Lüscher, a cardiologist from Switzerland. But for most of the audience, you probably know of him as the editor-in-chief of the European Heart Journal—a very prominent journal in the field of cardiovascular medicine. Welcome to the program.

Thomas F. Lüscher, MD, FRCP: Thank you for having me.

Dr Ohman: The journal has taken off in such a dramatic way over the past several years since you took on the editorship. It would be interesting for people to know [about this], because most physicians when going to medical school really do not start thinking about running a medical journal. Somewhere along the way, you must have had some interest in this area.

But before we get into that, it has only been about 8 years [since you became the editor]. Tell us a little bit about your background, where you were born, and a little bit about your family.

Philosophy, Science, and Tragedy

Dr Lüscher: I was born in Zurich and raised in a doctor's family. Initially, I was not so interested in medicine. I was more interested in philosophy—to understand the world—and started to study philosophy. But over time, I felt that it had to be a bit more practical. Science became my substitute for that—to understand the world, to understand the human body and the mechanisms of how it works, and how it becomes dysfunctional.

[My father] died suddenly after seeing his last patient, and then I became very interested [in practicing medicine].

My father was a traditional physician, a surgeon, a gynecologist who did everything, and I helped him in his practice. He died suddenly after seeing his last patient, and then I became very interested [in practicing medicine].

Dr Ohman: Did he actually die while practicing medicine?

Dr Lüscher: Yes.

Dr Ohman: That is quite unusual for medicine.

Dr Lüscher: He worked until age 73, because you can work as long as you want in our country when you have your own practice. Now you can do this everywhere (even the United States), but at the time it was maybe a bit unusual. He saw his last patient and then dropped dead. I tried to understand why this happened, and still today I am interested in myocardial infarction because of that.

Dr Ohman: But that is not where your interest went later on. Was your mother working as well?

Dr Lüscher: She was working with him; she was an x-ray technician. She did all of the x-rays for him. This was the environment I grew up in.

Dr Ohman: Did you have siblings?

Dr Lüscher: No; I was the only son in the family, so maybe there were a lot of expectations.

Dr Ohman: Did you feel pressure from your parents to go into medicine because both of them were in the medical field?

Dr Lüscher: Yes, of course. They expected that I would pass the exams, and so I tried to and was reasonably successful.

Why Philosophy?

Dr Ohman: When you set out to do philosophy, it's not usual that people later go into medicine. It's a very different part of the psyche. Tell me a little bit about what interested you about philosophy when you must have been a high school student.

Dr Lüscher: I wanted to understand the world or how it evolved. Then more and more, I realized that biology with Darwin, and today molecular biology, offer a lot of insight into how we developed, how we work, why we are here, and why we look like this. Medicine is basically studying why things go wrong.

Molecular medicine gets very close to philosophy. There are lots of questions about ethics and how far can we go. Do we ever understand the brain? It is getting closer for those who think more of this philosophy of science, which is very Anglo-Saxon, in fact. It brought me into science—I was really excited to do science for many years, and also bench science to find out how things work.

Dr Ohman: You brought up an interesting thing about the Anglo-Saxon approach, but is the Germanic science a bit different?

Dr Lüscher: Yes, I think so, with philosophy in particular. They want to understand that it's not so down to earth—not so practical, like the Anglo-Saxon philosophy that is interested in understanding how science works, how we get evidence, and how we are sure that it is true. Today, this is actually a very important question. With all of these conflicts of interest, is it more important that I know about the financing of the study, or is it more important that it survives the test of time? I actually wrote an editorial about conflict of interest and the proof of scientific discovery[1] where I make the point that of course, we have to be transparent, but it's only the test of time that really tells us whether a study is true or useful or not.

 
Gruentzig did the first balloon on the kitchen table in the house that was owned by my mother.
 

Dr Ohman: Such as aspirin, which has been around for several hundreds of years.

Dr Lüscher: Right. That is a good example.

Dr Ohman: You eventually swore off philosophy, although you are still a heart a philosopher in how you think about things. Where did you go to medical school?

Medical School

Dr Lüscher: I went to medical school at the University of Zurich, where there was, of course, a huge tradition of cardiology. We had Åke Senning, who implanted the first pacemaker and invented the Senning procedure for transposition of the great arteries (which is no longer performed). He became a real pioneer. We had Andreas Gruentzig, who did the first angioplasty. In fact, Gruentzig did the first balloon on the kitchen table in the house that was owned by my mother, where he was renting the apartment.

Dr Ohman: Is the table saved anywhere?

Dr Lüscher: No, we did not save it at the time, unfortunately. I could have sold it at Sotheby's for quite some money.

Anyway, there was a lot of stimulation to go into cardiovascular [medicine], so I did. I started in hypertension because initially [my chairman] felt I had to go into hypertension and not cardiology. The chairman in our country was quite powerful, and he decided for you.

Dr Ohman: Very few people will recognize that back in the day when we went through medical school, people actually told us what they thought we ought to do. It's so foreign [now]. Hypertension and philosophy are not really aligned, so how did you receive this?

Dr Lüscher: I thought I should make the best of it. My father had had high blood pressure, as did many other people, so I thought it was an interesting problem. Eventually, if I do well, I could expand to cardiology, and I did.

On to the Mayo Clinic

Dr Lüscher: My chairman, Hans-Peter Krayenbühl, used to be one of these hemodynamic people—you know, dP/dt and tao and all of these things that today most fellows do not even remember that we had to do. But [before I went into cardiology], he said I should go to John Laragh in New York to study hypertension. I wanted to see this for myself, so I bought a round-trip ticket.

Dr Ohman: You paid for it yourself?

Dr Lüscher: Yes. I flew to nine institutions, talked to the guys, and then eventually I met Paul Vanhoutte at the Mayo Clinic. I had coffee with him, and I said, "These endothelial cells that cover the blood vessel are actually quite interesting. This may be important for anything in the circulation."

Dr Ohman: Including hypertension.

Dr Lüscher: Yes. I went to the Mayo Clinic, although I could have also gone to Ed Haber at Massachusetts General Hospital. I felt that Mayo was more innovative. Although Boston was, of course, more attractive than Rochester.

Dr Ohman: Were you at the Mayo Clinic for a couple of years?

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