Portal de Periódicos da CAPES

Memorable Cardiology Quotes

2008; Elsevier BV; Volume: 103; Issue: 3 Linguagem: Inglês

10.1016/j.amjcard.2008.09.097

1879-1913

Barry A. Franklin,

Global Public Health Policies and Epidemiology

For >3 decades, my career has focused on preventive health issues and evidence-based medicine, with specific reference to the primary and secondary prevention of coronary artery disease. I've been privileged to work at a major university-based medical center and, more recently, 1 of the finest hospitals in the nation, soon to be affiliated with a new medical school. Accordingly, my clinical and academic responsibilities are typical of many faculty members and include patient evaluation, treatment, and counseling; research; professional volunteer service; and teaching undergraduate and graduate students as well as medical students, residents, and cardiology fellows. I've also regularly reviewed manuscripts for numerous scientific and clinical journals and have given many invited presentations to local, state, national, and international medical and lay audiences.Almost invariably, after a talk, I'm inundated with snail mail, e-mail, and personal requests for slides. No, not data or trial methods, but rather requests for cartoons, joke slides, and, perhaps most of all, the “memorable cardiology quotes” from interviews, presentations, or publications that I've shared from esteemed colleagues and past and present authorities. Listed here are some of the favorites (and their sources) that I've used in my teaching and presentations over the years, with specific reference to preventive cardiology. I've listed them under the following general categories: the individual “at risk”; coronary angiography and angioplasty; diagnostic testing; heart-healthy eating; exercise, physical activity, and obesity; cardiovascular risk reduction; and patient counseling. Although most quotations are as applicable (and accurate) today as they were when they were originally put forth, a few clearly missed the mark and were subsequently discounted.1Brouardel P. Benham F.L. Death and Sudden Death.in: William Wood, New York1902: 145Google ScholarThe Individual “At Risk”“Another point to remember is that angina pectoris is, like gout, a disease of men, and not women. When it does manifest itself in females, as is occasionally the case, it is often so confused with the common and frequent pains in the left side, due to flatulence or other causes, to which that sex is especially prone, that its recognition may be a matter of some difficulty.”—Prof. P. Brouardel and F. Lucas Benham, MD, 19021“Who is the person least likely to have a heart attack? He is an effeminate municipal worker or embalmer, completely lacking in physical and mental alertness. He has no drive, ambition or competitive spirit. He never has attempted to meet a deadline. He has a poor appetite, subsisting on fruits and vegetables. He detests tobacco. He spurns ownership of a television set or motor car. He has a full head of hair and is scrawny, unathletic in appearance, yet is constantly straining his puny muscles by exercise. He is low in income, blood pressure, blood sugar, uric acid and cholesterol. He has been on nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration.”—Irvine H. Page, MD (1901–1991)“The central problem in heart failure is not that patients are short of breath or that they retain fluid: the problem is that they die. Heart failure is a mortal illness, more serious than most malignancies.”—Arnold M. Katz, MDCoronary Angiography and Angioplasty“It's not the hole in the doughnut where the action is. It's the doughnut itself.”—Steven E. Nissen, MD“Angioplasties are a little like potato chips. You can't have just one.”—William Castelli, MD“We know PCI in the setting of an acute coronary syndrome saves lives, but 85% of PCIs in the U.S. are done in stable patients, and of those I'd bet that at least 25% are asymptomatic patients. This study [Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation] clearly shows something we all knew—but many did not want to believe—that angioplasties don't save lives, except in acutely ill patients, and don't prevent heart attacks.”—James H. Stein, MDDiagnostic Testing“Reading a technically poor echocardiogram is like looking at a polar bear in a snow storm.”—Lynn Y. Zoiopoulos, DOHeart-Healthy Eating“The whiter the bread, the sooner you're dead.”—Zonya Foco, RD“How do you make a hot dog? First you slaughter the animals and cut out all the good parts, the steaks and chops. But you've got a lot of animal left and what are you going to do with it? The hot dog industry took off when a clever guy invented a machine that works like a kitchen disposal—you dump everything in, eyeballs and all, and grind it up. Voila, the hot dog.”—William Castelli, MD“We now believe it's the newest lipid deposits—where that greasy cheeseburger you just ate landed—that rupture and precipitate the majority of heart attacks. These deposits don't impinge on blood flow while on artery walls, but they are unstable and easily rupture to block a coronary vessel. The good news is that these young unstable deposits can be shrunk. Even if you have a heart attack, after two years of lowering your cholesterol, you can dramatically reduce your risk of another attack. There have been numerous studies on reversibility, and they all show that if you really get the numbers down, the lesions in your arteries start to shrink.”—William Castelli, MD“If you can't be a vegetarian yourself, the next best thing is to eat a vegetarian from the sea. These are the mollusks—mussels, clams and oysters—the animals that are rock-bottom lowest in saturated fat. Even the crustaceans—shrimp and lobster, for example—are better to eat than the white breast of chicken without the skin because they are so low in saturated fat. The cholesterol in crustaceans has been recently reanalyzed and found to be much lower than we used to think. You can eat two dozen shrimp and still take in only 200 of the 300 milligrams of cholesterol allowed in a day.”—William Castelli, MD“Our excessive intake of meat is killing us. We fatten our cows and pigs, kill them, eat them, and then they kill us!”—William C. Roberts, MDExercise, Physical Activity, and Obesity“We doctors can now state from our experience with people, both sick and well, and from a growing series of scientific researches that ‘keeping fit’ does pay richly in dividends of health and longevity.”—Paul Dudley White, MD“Vigorous physical activity both protects against and provokes acute cardiac events.”—Paul D. Thompson, MD“As a general rule, moderate activity is less harmful to health than inactivity. You could also put it this way: a medical evaluation is more urgent for those who plan to remain inactive than for those who intend to get into good physical shape.”—Per-Olof Åstrand, MD“Exercise training? An agent with lipid-lowering, antihypertensive, positive inotropic, negative chronotropic, vasodilating, diuretic, anorexigenic, weight-reducing, cathartic, hypoglycemic, tranquilizing, hypnotic and antidepressive qualities.”—William C. Roberts, MD“The most likely explanation for the current obesity epidemic is a continued decline in energy expenditure that has not been matched by an equivalent reduction in energy intake.”—James O. Hill, PhD“In the prospective Danish Diet, Cancer and Health Study, overweight (body mass index, 25 to 29.9 kg/m2) and obesity (body mass index ≥ 30 kg/m2) were associated with a higher risk of acute coronary syndrome (ACS) among the physically active and inactive, in nonsmokers and smokers, and among those who adhered more or less to a heart-healthy dietary pattern. After multivariable adjustments, each unit of body mass index was associated with a 5% and 7% higher risk of ACS among women and men, respectively.”—Majken K. Jensen, MSc“Although physical activity or exercise training may not make all people lean, it appears that an active way of life has important health benefits, even for those who remain overweight/obese.”—Steven N. Blair, PED“Exercise-based cardiac rehabilitation programs should incorporate the types of muscular effort that correspond to that required for the person's daily activity, including selected forms of static and dynamic arm exercise. In actuality, few occupational and leisure-time activities require sustained walking or jogging. Examples include: postmen, protective service personnel, police officers, and their fugitives.”—Herman K. Hellerstein, MD (1913–1993)“From a public health perspective, the emphasis on getting sedentary adults to become moderately active is highly appropriate; the evidence shows that on a population-wide basis, this is where the majority of the health benefits are to be obtained.”—Steven N. Blair, PEDCardiovascular Risk Reduction“The way to lead a long life is to get a chronic disease and take care of it.”—Sir William Osler, MD (1849–1919)“The thing that is essential about hypertension is that it be treated.”—Ira M. Grais, MD“A strong case can be made for there being a single absolute atherosclerotic risk factor and that atherosclerosis does not occur when that factor is missing. In my view the only absolute, unequivocal, independent atherosclerotic risk factor is an elevated serum total or LDL cholesterol level, a low HDL cholesterol level, or both.”—William C. Roberts, MD“Statin drugs, in my view, are the best cardiovascular drugs ever created, in that they have the greatest potential to prevent atherosclerotic plaques and their complications, and they also have the greatest potential to arrest plaque formation, and therefore, to prevent additional atherosclerotic events. These drugs are to atherosclerosis what penicillin was to infectious diseases.”—William C. Roberts, MD“Recent data (using IVUS) show that approximately 85% of individuals in the U.S. over age 50 have atherosclerotic coronary disease. So for me, the question isn't whether middle-aged and older adults have heart disease—they probably do. It's how to prevent acute cardiac events.”—Ira M. Grais, MD“Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.”—James F. Fries, MDPatient Counseling“The healing process demands more than science; it requires mobilizing patient's positive expectations and stimulating faith in physician's ministrations. I know of few remedies more powerful than a carefully chosen word. Patients crave caring, which is dispensed largely with words. Talk, which can be therapeutic, is one of the underrated tools in a physician's armamentarium.”—Bernard Lown, MDIn closing, I'm reminded of 2 other quotations that are fundamental to any discussion of enduring teaching and mentorship. Sir Isaac Newton said, “If I have seen further … it is by standing upon the shoulders of giants.” The late Earl Nightingale echoed these sentiments when he stated, “A candle is not diminished by giving another candle light.” Although many of our best teachers in cardiology are no longer with us, their candles continue to light the candles of others through their speaking, writing, and the students they touched. Their works stand as beacons of light, shining as brightly today as they did when they were first promulgated. Unfortunately, many of our past and present cardiology contemporaries, especially in the current era of information access and exchange, probably have no idea of the vast number of candles they've lit over the years. I was one of them. For >3 decades, my career has focused on preventive health issues and evidence-based medicine, with specific reference to the primary and secondary prevention of coronary artery disease. I've been privileged to work at a major university-based medical center and, more recently, 1 of the finest hospitals in the nation, soon to be affiliated with a new medical school. Accordingly, my clinical and academic responsibilities are typical of many faculty members and include patient evaluation, treatment, and counseling; research; professional volunteer service; and teaching undergraduate and graduate students as well as medical students, residents, and cardiology fellows. I've also regularly reviewed manuscripts for numerous scientific and clinical journals and have given many invited presentations to local, state, national, and international medical and lay audiences. Almost invariably, after a talk, I'm inundated with snail mail, e-mail, and personal requests for slides. No, not data or trial methods, but rather requests for cartoons, joke slides, and, perhaps most of all, the “memorable cardiology quotes” from interviews, presentations, or publications that I've shared from esteemed colleagues and past and present authorities. Listed here are some of the favorites (and their sources) that I've used in my teaching and presentations over the years, with specific reference to preventive cardiology. I've listed them under the following general categories: the individual “at risk”; coronary angiography and angioplasty; diagnostic testing; heart-healthy eating; exercise, physical activity, and obesity; cardiovascular risk reduction; and patient counseling. Although most quotations are as applicable (and accurate) today as they were when they were originally put forth, a few clearly missed the mark and were subsequently discounted.1Brouardel P. Benham F.L. Death and Sudden Death.in: William Wood, New York1902: 145Google Scholar The Individual “At Risk”“Another point to remember is that angina pectoris is, like gout, a disease of men, and not women. When it does manifest itself in females, as is occasionally the case, it is often so confused with the common and frequent pains in the left side, due to flatulence or other causes, to which that sex is especially prone, that its recognition may be a matter of some difficulty.”—Prof. P. Brouardel and F. Lucas Benham, MD, 19021“Who is the person least likely to have a heart attack? He is an effeminate municipal worker or embalmer, completely lacking in physical and mental alertness. He has no drive, ambition or competitive spirit. He never has attempted to meet a deadline. He has a poor appetite, subsisting on fruits and vegetables. He detests tobacco. He spurns ownership of a television set or motor car. He has a full head of hair and is scrawny, unathletic in appearance, yet is constantly straining his puny muscles by exercise. He is low in income, blood pressure, blood sugar, uric acid and cholesterol. He has been on nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration.”—Irvine H. Page, MD (1901–1991)“The central problem in heart failure is not that patients are short of breath or that they retain fluid: the problem is that they die. Heart failure is a mortal illness, more serious than most malignancies.”—Arnold M. Katz, MD “Another point to remember is that angina pectoris is, like gout, a disease of men, and not women. When it does manifest itself in females, as is occasionally the case, it is often so confused with the common and frequent pains in the left side, due to flatulence or other causes, to which that sex is especially prone, that its recognition may be a matter of some difficulty.” —Prof. P. Brouardel and F. Lucas Benham, MD, 19021 “Who is the person least likely to have a heart attack? He is an effeminate municipal worker or embalmer, completely lacking in physical and mental alertness. He has no drive, ambition or competitive spirit. He never has attempted to meet a deadline. He has a poor appetite, subsisting on fruits and vegetables. He detests tobacco. He spurns ownership of a television set or motor car. He has a full head of hair and is scrawny, unathletic in appearance, yet is constantly straining his puny muscles by exercise. He is low in income, blood pressure, blood sugar, uric acid and cholesterol. He has been on nicotinic acid, pyridoxine, and long-term anticoagulant therapy ever since his prophylactic castration.” —Irvine H. Page, MD (1901–1991) “The central problem in heart failure is not that patients are short of breath or that they retain fluid: the problem is that they die. Heart failure is a mortal illness, more serious than most malignancies.” —Arnold M. Katz, MD Coronary Angiography and Angioplasty“It's not the hole in the doughnut where the action is. It's the doughnut itself.”—Steven E. Nissen, MD“Angioplasties are a little like potato chips. You can't have just one.”—William Castelli, MD“We know PCI in the setting of an acute coronary syndrome saves lives, but 85% of PCIs in the U.S. are done in stable patients, and of those I'd bet that at least 25% are asymptomatic patients. This study [Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation] clearly shows something we all knew—but many did not want to believe—that angioplasties don't save lives, except in acutely ill patients, and don't prevent heart attacks.”—James H. Stein, MD “It's not the hole in the doughnut where the action is. It's the doughnut itself.” —Steven E. Nissen, MD “Angioplasties are a little like potato chips. You can't have just one.” —William Castelli, MD “We know PCI in the setting of an acute coronary syndrome saves lives, but 85% of PCIs in the U.S. are done in stable patients, and of those I'd bet that at least 25% are asymptomatic patients. This study [Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation] clearly shows something we all knew—but many did not want to believe—that angioplasties don't save lives, except in acutely ill patients, and don't prevent heart attacks.” —James H. Stein, MD Diagnostic Testing“Reading a technically poor echocardiogram is like looking at a polar bear in a snow storm.”—Lynn Y. Zoiopoulos, DO “Reading a technically poor echocardiogram is like looking at a polar bear in a snow storm.” —Lynn Y. Zoiopoulos, DO Heart-Healthy Eating“The whiter the bread, the sooner you're dead.”—Zonya Foco, RD“How do you make a hot dog? First you slaughter the animals and cut out all the good parts, the steaks and chops. But you've got a lot of animal left and what are you going to do with it? The hot dog industry took off when a clever guy invented a machine that works like a kitchen disposal—you dump everything in, eyeballs and all, and grind it up. Voila, the hot dog.”—William Castelli, MD“We now believe it's the newest lipid deposits—where that greasy cheeseburger you just ate landed—that rupture and precipitate the majority of heart attacks. These deposits don't impinge on blood flow while on artery walls, but they are unstable and easily rupture to block a coronary vessel. The good news is that these young unstable deposits can be shrunk. Even if you have a heart attack, after two years of lowering your cholesterol, you can dramatically reduce your risk of another attack. There have been numerous studies on reversibility, and they all show that if you really get the numbers down, the lesions in your arteries start to shrink.”—William Castelli, MD“If you can't be a vegetarian yourself, the next best thing is to eat a vegetarian from the sea. These are the mollusks—mussels, clams and oysters—the animals that are rock-bottom lowest in saturated fat. Even the crustaceans—shrimp and lobster, for example—are better to eat than the white breast of chicken without the skin because they are so low in saturated fat. The cholesterol in crustaceans has been recently reanalyzed and found to be much lower than we used to think. You can eat two dozen shrimp and still take in only 200 of the 300 milligrams of cholesterol allowed in a day.”—William Castelli, MD“Our excessive intake of meat is killing us. We fatten our cows and pigs, kill them, eat them, and then they kill us!”—William C. Roberts, MD “The whiter the bread, the sooner you're dead.” —Zonya Foco, RD “How do you make a hot dog? First you slaughter the animals and cut out all the good parts, the steaks and chops. But you've got a lot of animal left and what are you going to do with it? The hot dog industry took off when a clever guy invented a machine that works like a kitchen disposal—you dump everything in, eyeballs and all, and grind it up. Voila, the hot dog.” —William Castelli, MD “We now believe it's the newest lipid deposits—where that greasy cheeseburger you just ate landed—that rupture and precipitate the majority of heart attacks. These deposits don't impinge on blood flow while on artery walls, but they are unstable and easily rupture to block a coronary vessel. The good news is that these young unstable deposits can be shrunk. Even if you have a heart attack, after two years of lowering your cholesterol, you can dramatically reduce your risk of another attack. There have been numerous studies on reversibility, and they all show that if you really get the numbers down, the lesions in your arteries start to shrink.” —William Castelli, MD “If you can't be a vegetarian yourself, the next best thing is to eat a vegetarian from the sea. These are the mollusks—mussels, clams and oysters—the animals that are rock-bottom lowest in saturated fat. Even the crustaceans—shrimp and lobster, for example—are better to eat than the white breast of chicken without the skin because they are so low in saturated fat. The cholesterol in crustaceans has been recently reanalyzed and found to be much lower than we used to think. You can eat two dozen shrimp and still take in only 200 of the 300 milligrams of cholesterol allowed in a day.” —William Castelli, MD “Our excessive intake of meat is killing us. We fatten our cows and pigs, kill them, eat them, and then they kill us!” —William C. Roberts, MD Exercise, Physical Activity, and Obesity“We doctors can now state from our experience with people, both sick and well, and from a growing series of scientific researches that ‘keeping fit’ does pay richly in dividends of health and longevity.”—Paul Dudley White, MD“Vigorous physical activity both protects against and provokes acute cardiac events.”—Paul D. Thompson, MD“As a general rule, moderate activity is less harmful to health than inactivity. You could also put it this way: a medical evaluation is more urgent for those who plan to remain inactive than for those who intend to get into good physical shape.”—Per-Olof Åstrand, MD“Exercise training? An agent with lipid-lowering, antihypertensive, positive inotropic, negative chronotropic, vasodilating, diuretic, anorexigenic, weight-reducing, cathartic, hypoglycemic, tranquilizing, hypnotic and antidepressive qualities.”—William C. Roberts, MD“The most likely explanation for the current obesity epidemic is a continued decline in energy expenditure that has not been matched by an equivalent reduction in energy intake.”—James O. Hill, PhD“In the prospective Danish Diet, Cancer and Health Study, overweight (body mass index, 25 to 29.9 kg/m2) and obesity (body mass index ≥ 30 kg/m2) were associated with a higher risk of acute coronary syndrome (ACS) among the physically active and inactive, in nonsmokers and smokers, and among those who adhered more or less to a heart-healthy dietary pattern. After multivariable adjustments, each unit of body mass index was associated with a 5% and 7% higher risk of ACS among women and men, respectively.”—Majken K. Jensen, MSc“Although physical activity or exercise training may not make all people lean, it appears that an active way of life has important health benefits, even for those who remain overweight/obese.”—Steven N. Blair, PED“Exercise-based cardiac rehabilitation programs should incorporate the types of muscular effort that correspond to that required for the person's daily activity, including selected forms of static and dynamic arm exercise. In actuality, few occupational and leisure-time activities require sustained walking or jogging. Examples include: postmen, protective service personnel, police officers, and their fugitives.”—Herman K. Hellerstein, MD (1913–1993)“From a public health perspective, the emphasis on getting sedentary adults to become moderately active is highly appropriate; the evidence shows that on a population-wide basis, this is where the majority of the health benefits are to be obtained.”—Steven N. Blair, PED “We doctors can now state from our experience with people, both sick and well, and from a growing series of scientific researches that ‘keeping fit’ does pay richly in dividends of health and longevity.” —Paul Dudley White, MD “Vigorous physical activity both protects against and provokes acute cardiac events.” —Paul D. Thompson, MD “As a general rule, moderate activity is less harmful to health than inactivity. You could also put it this way: a medical evaluation is more urgent for those who plan to remain inactive than for those who intend to get into good physical shape.” —Per-Olof Åstrand, MD “Exercise training? An agent with lipid-lowering, antihypertensive, positive inotropic, negative chronotropic, vasodilating, diuretic, anorexigenic, weight-reducing, cathartic, hypoglycemic, tranquilizing, hypnotic and antidepressive qualities.” —William C. Roberts, MD “The most likely explanation for the current obesity epidemic is a continued decline in energy expenditure that has not been matched by an equivalent reduction in energy intake.” —James O. Hill, PhD “In the prospective Danish Diet, Cancer and Health Study, overweight (body mass index, 25 to 29.9 kg/m2) and obesity (body mass index ≥ 30 kg/m2) were associated with a higher risk of acute coronary syndrome (ACS) among the physically active and inactive, in nonsmokers and smokers, and among those who adhered more or less to a heart-healthy dietary pattern. After multivariable adjustments, each unit of body mass index was associated with a 5% and 7% higher risk of ACS among women and men, respectively.” —Majken K. Jensen, MSc “Although physical activity or exercise training may not make all people lean, it appears that an active way of life has important health benefits, even for those who remain overweight/obese.” —Steven N. Blair, PED “Exercise-based cardiac rehabilitation programs should incorporate the types of muscular effort that correspond to that required for the person's daily activity, including selected forms of static and dynamic arm exercise. In actuality, few occupational and leisure-time activities require sustained walking or jogging. Examples include: postmen, protective service personnel, police officers, and their fugitives.” —Herman K. Hellerstein, MD (1913–1993) “From a public health perspective, the emphasis on getting sedentary adults to become moderately active is highly appropriate; the evidence shows that on a population-wide basis, this is where the majority of the health benefits are to be obtained.” —Steven N. Blair, PED Cardiovascular Risk Reduction“The way to lead a long life is to get a chronic disease and take care of it.”—Sir William Osler, MD (1849–1919)“The thing that is essential about hypertension is that it be treated.”—Ira M. Grais, MD“A strong case can be made for there being a single absolute atherosclerotic risk factor and that atherosclerosis does not occur when that factor is missing. In my view the only absolute, unequivocal, independent atherosclerotic risk factor is an elevated serum total or LDL cholesterol level, a low HDL cholesterol level, or both.”—William C. Roberts, MD“Statin drugs, in my view, are the best cardiovascular drugs ever created, in that they have the greatest potential to prevent atherosclerotic plaques and their complications, and they also have the greatest potential to arrest plaque formation, and therefore, to prevent additional atherosclerotic events. These drugs are to atherosclerosis what penicillin was to infectious diseases.”—William C. Roberts, MD“Recent data (using IVUS) show that approximately 85% of individuals in the U.S. over age 50 have atherosclerotic coronary disease. So for me, the question isn't whether middle-aged and older adults have heart disease—they probably do. It's how to prevent acute cardiac events.”—Ira M. Grais, MD“Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.”—James F. Fries, MD “The way to lead a long life is to get a chronic disease and take care of it.” —Sir William Osler, MD (1849–1919) “The thing that is essential about hypertension is that it be treated.” —Ira M. Grais, MD “A strong case can be made for there being a single absolute atherosclerotic risk factor and that atherosclerosis does not occur when that factor is missing. In my view the only absolute, unequivocal, independent atherosclerotic risk factor is an elevated serum total or LDL cholesterol level, a low HDL cholesterol level, or both.” —William C. Roberts, MD “Statin drugs, in my view, are the best cardiovascular drugs ever created, in that they have the greatest potential to prevent atherosclerotic plaques and their complications, and they also have the greatest potential to arrest plaque formation, and therefore, to prevent additional atherosclerotic events. These drugs are to atherosclerosis what penicillin was to infectious diseases.” —William C. Roberts, MD “Recent data (using IVUS) show that approximately 85% of individuals in the U.S. over age 50 have atherosclerotic coronary disease. So for me, the question isn't whether middle-aged and older adults have heart disease—they probably do. It's how to prevent acute cardiac events.” —Ira M. Grais, MD “Smoking, body-mass index, and exercise patterns in midlife and late adulthood are predictors of subsequent disability. Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.” —James F. Fries, MD Patient Counseling“The healing process demands more than science; it requires mobilizing patient's positive expectations and stimulating faith in physician's ministrations. I know of few remedies more powerful than a carefully chosen word. Patients crave caring, which is dispensed largely with words. Talk, which can be therapeutic, is one of the underrated tools in a physician's armamentarium.”—Bernard Lown, MDIn closing, I'm reminded of 2 other quotations that are fundamental to any discussion of enduring teaching and mentorship. Sir Isaac Newton said, “If I have seen further … it is by standing upon the shoulders of giants.” The late Earl Nightingale echoed these sentiments when he stated, “A candle is not diminished by giving another candle light.” Although many of our best teachers in cardiology are no longer with us, their candles continue to light the candles of others through their speaking, writing, and the students they touched. Their works stand as beacons of light, shining as brightly today as they did when they were first promulgated. Unfortunately, many of our past and present cardiology contemporaries, especially in the current era of information access and exchange, probably have no idea of the vast number of candles they've lit over the years. I was one of them. “The healing process demands more than science; it requires mobilizing patient's positive expectations and stimulating faith in physician's ministrations. I know of few remedies more powerful than a carefully chosen word. Patients crave caring, which is dispensed largely with words. Talk, which can be therapeutic, is one of the underrated tools in a physician's armamentarium.” —Bernard Lown, MD In closing, I'm reminded of 2 other quotations that are fundamental to any discussion of enduring teaching and mentorship. Sir Isaac Newton said, “If I have seen further … it is by standing upon the shoulders of giants.” The late Earl Nightingale echoed these sentiments when he stated, “A candle is not diminished by giving another candle light.” Although many of our best teachers in cardiology are no longer with us, their candles continue to light the candles of others through their speaking, writing, and the students they touched. Their works stand as beacons of light, shining as brightly today as they did when they were first promulgated. Unfortunately, many of our past and present cardiology contemporaries, especially in the current era of information access and exchange, probably have no idea of the vast number of candles they've lit over the years. I was one of them.