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“Preexcitation”—- The story of my name on a published paper in the medical journal “Chest”…

November 14, 2024 by Blogfinger

Excuse the ragged paper, but 3 doctors had a moment of fame.  To read the text, click once on the paper. This is a Blogfinger re-post.

 

Paul Goldfinger, MD, FACC.  Blogfinger.net.  Ocean Grove, NJ, USA.

You probably never heard of Willem Einthoven. He was a Dutch physician who, in 1895, invented the ECG (electrocardium) machine for which he won a Nobel Prize in 1924. The ECG machine has remained a wonderful diagnostic test; it records the heart’s electrical patterns.  I learned to read ECG’s in medical school at the George Washington University  and found it to be irreplaceable in studying the heart’s rhythms and electrical conduction.

At Mt. Sinai Hospital and Medical School  in New York,  I spent 5 years. (1966-1971) studying internal medicine and cardiology and teaching on the new medical school’s  faculty.    The hospital was strong in cardiology, and being there captured my imagination where 3 major cardiology journals in addition to the American Journal of Medicine were edited and published.

The field of electrophysiology didn’t exist then,  but the cardiologists there were particularly interested in rhythm abnormalities and electrical conduction disturbances.  Leon Pordy, MD, whom I knew,  was developing computer ECG readings  in the 1960’s. Remarkably he became Chairman of the Board of Chock Full of Nuts coffee, but that is another story. Let’s just say that there were many celebrities who were patients at “Sinai. ”

Over at the Staten Island V.A. Hospital, of all places, something remarkable was going on in the early 1970’s.    Dr. Anthony Damato and his team were recording electrical signals from inside human hearts—the first electrophysiologic recordings of that kind.

Recently there was some quarreling about who was the first to make  such recordings,  but in a current issue of a heart journal I found this:

“Under the leadership of Dr Anthony Damato, the His bundle recording procedure became one of the cornerstones of the emerging sub-science of cardiology, Clinical Electrophysiology.”

One of my chief residents at Sinai, Dr. Kenneth Rosen, finished there and  joined Dr. Damato at Staten Island. We all said, “Staten Island?”    But Ken  became the first electrophysiologist  I ever knew.  He went on to head the Dept of Cardiology at the University of Illinois, Abraham Lincoln Medical School  in Chicago.

When I entered practice in Morris County, NJ,  I continued being intrigued by electrophysiology. One day, in the CCU at Dover General Hospital, I spotted an extremely rare ECG phenomenon.  I was excited. You probably never heard of  the Wolff-Parkinson-White (WPW) pattern  (aka “preexcitation.”)   Not only is it rare,  but when combined with my patient’s ECG left bundle branch block, the combination  occurs in .0024% of people.   I should have bought a lottery ticket.

The 3 doctors who first described  this condition  in 1930 were rewarded by the eponymous naming of the disorder.  WPW  is a congenital  abnormality  of the heart’s electrical conduction system.

Although  I couldn’t figure out this rare and complex pattern seen in my patient,  I knew enough to realize that this was a “fascinoma” (a rare medical finding,)  so I called my friend Ken Rosen, MD,  who, working with another early electrophysiologist Pablo Denis, were pioneering the field in Chicago.

Ken was practically jumping through the phone, and in no time, after discussions with me in New Jersey and Dr. Denes, they wrote the paper and it was accepted by the Journal “Chest.”

They were very kind to include me as an author on the paper, and since then, every once in a while, this paper, with my name, is referenced by more recent publications in the medical literature.

Medical science usually advances over time, and since 1930, hundreds of doctors around the world attached their names to papers about WPW which is now curable with new techniques.

I got a kick out of seeing Dover General listed together with a major academic center.

In more recent times I helped encourage another Mt. Sinai electrophysiologist Stephen Winters, MD to start the first electrophysiology  program at Morristown Hospital, currently the best hospital in New Jersey.

I sent them so much business from Dover  that they referred to my patients as “FOG’s—Friends of Goldfinger.”

Someday I will share my roll in the first pig valve replacement of the tricuspid valve in a child, also at Mt. Sinai in NYC.   And also repeat my post on Blogfinger about  delivering a baby in the middle of the night on Madison Avenue in front of the hospital.

Below is a link which shows me in uniform in NYC during my internship year as a “straight medical” intern. And you should know that “straight” is not about sex.  Eileen, I and the two boys lived at the fringes of Spanish Harlem on the upper East Side in MSH housing.

Paul begins work at Mt. Sinai Hospital.

Here is a theme from the movie Little Women by Thomas Newman and the London Philharmonic.  It is an instrumental called  “New York.”

https://blogfinger.net/wp-content/uploads/2024/04/11-New-York-Instrumental.m4a
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Posted in Blogfinger Presents | 2 Comments

2 Responses

  1. on April 6, 2024 at 1:19 pm Blogfinger

    Thank you Twinkle: Here’s a token for you from the editorial staff at Blogfinger.

    Twinkle, twinkle, little star
    How I wonder what you are
    Up above the world so high
    Like a diamond in the sky…


  2. on April 6, 2024 at 11:14 am Twinkle Twinkle

    Enjoyed reading this article as well as the 3 listed at the bottom, but especially fun to see your name and that of DGH.

    If I end up in the field of medicine in my next life, I just might get into electrophysiology. Always fascinated me.



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