Essay
Learning Is a Community Affair
Excerpt
“. . . [Dr. Stead] saw a very obese man on rounds in the mid-1950s, noting in the course of analyzing the problem that the patient slept a lot and that his electrocardiogram showed right axis deviation and other features, suggesting right ventricular hypertrophy. At that time I was in charge of reading electrocardiograms at the Veterans Administration Hospital. He sent the student over with the ECG, asking for a consultation. I had no explanation for the signs of right heart disease either, so I wrote my old mentor Dr. Robert Grant, then at the National Heart Institute, asking him whether or not he had encountered such an ECG. He recalled one other case, adding that the findings had reverted to normal when the patient lost weight. This led to discussions and a lot of laboratory research, culminating in a paper by Herb Sieker, Henry McIntosh, George Kelser, and me, describing the pathological physiology of the reversible cardiopulmonary syndrome now known as Pickwickian syndrome.”
In This Essay
- Adding a new curve to patient rounds: Formal, authoritarian style loosens up under Stead
- Students, interns, and residents prepped for success in a variety of careers
- A modest proposal: Revive Stead’s system to improve patient care
Biography
Harvey Estes followed two of his mentors, Eugene Stead and James Warren, from Emory to Duke, arriving in Durham in 1952. Estes completed his residency (1952-1953) and fellowship (1953-1954) at Duke, and joined the Division of Cardiology faculty in the Department of Medicine in 1954. In 1966, he became the first chair of the Duke Department of Community and Family Medicine, retiring to emeritus status in 1989. Three of his five children attended Duke.
The views expressed within each of these essays are solely those of the author(s) and do not necessarily reflect the views of Duke University School of Medicine or Duke University Health System.
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