Life and Times of Leading Cardiologists: P.K. Shah
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Life and Times of Leading Cardiologists: P.K. Shah

Interviewer: E. Magnus Ohman, MD; Interviewee: Prediman K. Shah, MD

Disclosures

May 03, 2017

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E. Magnus Ohman, MD: Hello. I am Magnus Ohman, and I am here with Dr P.K. Shah from Cedars-Sinai in Los Angeles. We actually met a long time ago, and it was a memorable meeting for me. We were in a meeting in São Paulo, Brazil. It was in the 1990s, and we were sitting there, and you said, "I am working on creating a vaccine for atherosclerosis." I said, "Wow, that is something to start with." Obviously, most of us think that somebody who takes that on must have had a very unique life. This series is called Life and Times of Leading Cardiologists. It is about your life and what made you tick and why you took on such a challenge as this. Welcome.

 
I had thought of becoming a detective because I used to read Arthur Conan Doyle and Agatha Christie all the time.
 

Prediman K. Shah, MD: Well, thank you very much, Magnus.

Dr Ohman: Where did you actually grow up?

Dr Shah: I was born in Srinagar, Kashmir, in North India, and I was one of eight children and the only one who went to medical school. My motivation for going to medical school was triggered by the very tragic death of one of my sisters, who was 19 at the time. She died of a very rare form of lung cancer; she was a nonsmoker. I was devastated. I was in my teens at that time. Prior to that event, I had thought of becoming a detective because I used to read Arthur Conan Doyle and Agatha Christie all the time. That day changed my motivation to become a physician because I wanted to prevent cancer from happening. That was the start of my interest in medicine.

Dr Ohman: The detective part is kind of interesting because all of us feel like we are detectives in our science quest.

Dr Shah: Of course; there are many similarities.

Dr Ohman: You grew up in Kashmir, India, and went to medical school.

Dr Shah: I went to medical school locally, and the medical school was not affordable. I had to take a loan from the government, which I repaid from the United States many years later. It was the equivalent of maybe $70 for 4.5 years of medical school.

Dr Ohman: My goodness.

Dr Shah: A loan was a little bit more then than the current.

Dr Ohman: At what time period was this when you went to medical school in India?

Dr Shah: Late '60s, early '70s.

Dr Ohman: Kashmir is a beautiful part of the world.

Dr Shah: It is known as the Switzerland of Asia.

Dr Ohman: How does a young man from Kashmir find his way around the world to end up in Los Angeles?

Dr Shah: After finishing medical school and an internship, I went to New Delhi, to All India Institute of Medical Sciences, which was the premier academic institution in India. I spent a year doing the residency in neurosciences and OBGYN, thinking that I would eventually land up in general internal medicine. My interest piqued in moving to the United States. Through an elaborate series of next steps, I landed up in the United States as a guest of a former classmate of mine, who had already emigrated to the United States, stayed with him for 3 months, cleared the exams, got an internship in Milwaukee, and that was the beginning of my career in the United States.

Dr Ohman: Moving to Milwaukee, so this was probably in the mid '70s?

Dr Shah: Right.

 
[I came to this country] as a single man with $8 and a suitcase. The suitcase got stolen on Canal Street.
 

Dr Ohman: How did it feel coming from the beautiful Kashmir to Milwaukee? Nothing against Milwaukee, but it is a very different climate and lifestyle.

Dr Shah: Well, one interesting parallel was that Kashmir in winter time is like Milwaukee. It is very cold. It freezes, and it snows. In that sense, I did not mind it. The rest of the local culture was completely alien or foreign to me. I was young and willing to take on anything at that time, so I did not really mind it at all.

Dr Ohman: Did you come to this country as a single man?

Dr Shah: As a single man with $8 and a suitcase. The suitcase got stolen on Canal Street in New York. I had to borrow money from my friend to buy some clothes and had only $8 in cash.

Dr Ohman: You stayed with your friend. That was a very thoughtful friend. What was the name of your friend?

Dr Shah: Dr Ashok Koul, a pathologist, now retired.

Dr Ohman: He set you on this pathway.

Dr Shah: Absolutely, he and his older brother. They gave me refuge, if you will, so that I could start my career in the United States.

Dr Ohman: In those days, having gone through medical school, you could go straight into residency. Did you repeat anything?

Dr Shah: I repeated another year of residency at Albert Einstein in Montefiore before starting a cardiology fellowship there, which was really a turning point in my career. Prior to starting cardiology, I was thinking about neurosciences, but then I listened to the chief of cardiology at Montefiore give a grand rounds on atrial septal defect. It was brilliant, and I said, "This is what I want to do." That was the second turning point. I decided to apply for cardiology fellowships. Luckily, I landed a fellowship at Montefiore Einstein and spent 2 years there.

Dr Ohman: Who was the professor who gave the wonderful lecture on atrial septal defect?

Dr Shah: Dr James Scheuer, who subsequently became chair of medicine at Einstein. Now, he is retired; he is a gifted clinician and a wonderful basic scientist, a rare mix. He was a real mentor and really a fantastic human being.

Dr Ohman: You moved from Milwaukee to New York.

Dr Shah: That was another major change and culture shock.

Dr Ohman: Is there a large Indian community in New York that you could tap into?

Dr Shah: There is a very large Indian community, but I was really more interested in learning medicine. I spent most of my time at the hospital.

Dr Ohman: Was there any particular mentor along the way here who had any influence? Obviously, the people in—was it in Mumbai, you mentioned, or New Delhi, where you went to the All India Institute of Medical Sciences...

Dr Shah: Most of my mentors, after India, were in the United States with James Scheuer at Montefiore Einstein. After finishing cardiology, at Montefiore Einstein. I applied for a research fellowship at Cedars-Sinai because I was fascinated by the Swan-Ganz catheter that had just been introduced into clinical medicine; and Jeremy Swan, Willy Ganz, Jim Forrester, Eliot Corday, and Kanu Chatterjee were all at Cedars-Sinai. I wanted to be with them doing research, so I applied for a research fellowship. Along the way, Dr Chatterjee moved to the University of California, San Francisco (UCSF), so I met him at UCSF, and he encouraged me to go to Cedars and not to UCSF. He said it was a better program.

So, I landed at Cedars-Sinai in '76, July, to start a research fellowship in clinical research.

Dr Ohman: You got the bug, the cardiology bug, from people who talked physiology. Then you moved with the physiology piece to work with Dr Swan and Ganz and all of the others who were there; they really focused heavily on the physiology part. Was that where your interests were?

Dr Shah: Yes, absolutely. In fact, I spent the first year of my research fellowship in cardiac surgical suites introducing coronary sinus catheters into patients undergoing bypass surgery, so I could measure coronary blood flow before and during various steps of the bypass surgery to see what happens with myocardial blood flow. That was my project during the time I worked with Dr Richard Gray and Dr Willard Harris, who were in charge of that project at that time.

It gave me a strong footing into the physiology. At the conclusion of the fellowship, I was invited back by Dr Scheuer to come and run the coronary care unit (CCU) at Montefiore, but the California bug had gotten into me. I said that I really wanted to stay in California. I went to see Jeremy Swan and asked him if he could give me a position in his division. He was gracious enough to offer me a position. Subsequently...

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