Remembering a Georgetown Medical Giant

 

 

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Editor’s note: W. Proctor Harvey, MD, known as “Proc” by students and colleagues, was one of the nation’s most respected cardiologists and taught a generation of Georgetown students about the importance of the human touch in medicine.

In an obituary featured in the Washington Post after his death in September 2007, Dr. Harvey was described as a “physician of last resort for people with heart disease,” because of his ability to diagnose complex cardiac problems simply by taking a patient’s pulse or by listening through his stethoscope to a beating heart. In the obituary, a colleague told a story about Dr. Harvey in which he entered the room of a patient near death from a mysterious heart ailment that tests had not been able to identify. From the doorway, the colleague said, Dr. Harvey was able to identify that the man’s veins were pulsing in an irregular manner and immediately –and correctly—diagnosed constrictive pericarditis, an inflammation of the protective lining around the heart. Once treated, the patient walked out of the hospital.

Dr. Harvey had what he called a “five-finger” approach to diagnosing a patient: Detailed history, physician examination, electrocardiogram, X-ray and appropriate tests—in that order.

Georgetown alumnus John F. Stapleton (M’45, R’51, H’83) was Dr. Harvey’s first cardiology fellow. Dr. Stapleton went on to become medical director of Georgetown University and has called the year of his fellowship with Dr. Harvey the best of his life. In honor of Dr. Harvey, Dr. Stapleton offered these remembrances, excerpted from an issue of Georgetown Medicine:

“I was a medical resident when Proctor Harvey came to Georgetown from Boston. He started with a yearly salary, as I recall, of $4,000. He was given an office that was actually a janitor’s closet in the solarium off 2 South. The room was only slightly larger than his small desk, and he started from scratch. He was the first full-time cardiologist. And I would say that Georgetown got a bargain. I think recruiting Proctor Harvey to Georgetown was the academic equivalent of buying Alaska for $7 million.

In 1951, Proc started a series that he called Professors Pro Tempore. The first invitee was Sam Levine, his own mentor, who joined us for a week. I was the chief resident at the time, so it became my privilege to escort him around. And I said to him one day, “On behalf of the house staff, I certainly appreciate your taking this valuable time out of your life to come here.” And he said, “Well Proc Harvey invited me, and I couldn’t say no to Proc Harvey. The whole time he was at the Brigham, he never said no to anyone from the maids to the chiefs.”

Dr. Harvey obtained a grant from the National Heart Institute to study the educational impact of tape-recorded heart sounds. And the grant included a stipend for a fellow. I happened to be in the right place at the right time, and he invited me to be [his first cardiology] fellow. This was one of the happiest years of my professional life. Proc became my big brother. And I so admired him that I changed my career goals. I was going to go off and practice internal medicine. But I decided after watching him in action that I was going to devote my whole life to practicing medicine the way he did and go into cardiology. He was that impressive. He was the most important man in my life outside of my own family.

In the 1950s, when Proc started this fellowship, a cardiac workup consisted of history, physical exam, electrocardiogram, and radiology. And Proc did this well enough that we referred any number of patients for cardiac surgery, with mitral stenosis or aortal regurgitation, and I don’t remember ever misleading a surgeon. We had no cath lab [the lab used for diagnostic imaging during cardiac catheterization]. That was the way medicine was practiced back then, and based on that kind of experience I think Proc felt to his dying day that the history and physical still worked, in face of all the new technology.

I watched him work every day. He was famous for teaching by example, and he was extraordinarily close to his patients. I remember once we had a very crusty, disagreeable patient – but with a very interesting condition- so we presented him to Dr. Harvey. This guy couldn’t get along with any of the doctors or nurses, he was always complaining. We thought we were taking a chance presenting him to Dr. Harvey, but wouldn’t you know, after Proctor talked to him and examined him, the man purred like a kitten, and was as friendly to Harvey as he could be. I think it’s because he immediately saw Dr. Harvey as a friend.

And that is the impact that Harvey always had with people and with patients.

I recall when I was a fellow, Dr. Harvey had a sick patient up on the sixth floor who was dying. His family was very concerned and around him all of the time—and finally the man died about 2:00 a.m.

Of course they called Harvey to notify him that the patient had died. Well, he got up and got dressed in the middle of the night and drove over to the hospital. The next day I asked him why he didn’t just wait until morning. And he said, “I knew that the family would be there, and I knew that they would be upset, and that this would be a good time for the doctor to be there to console them.” He did those things instinctively.

To my cynical self, I thought, well this is young idealism. He’s just starting out. He’ll have to tone this down over time. But 10 years later I was visiting Proc from out of town, and I stayed overnight at his house, and a similar situation arose. The phone rang in the middle of the night, and I heard the garage door go up: Off he went to be with the family after the patient’s death. He was the same man in his eighties as he was in his thirties.

The hereafter will be kind to a man who practiced the golden rule his whole life. If Proc is where I think he is, he is checking angels for 3rd heart sounds.

By Frank Reider
Excerpted from Georgetown Medicine, Fall-Winter 2008