This week concludes a three-part interview with Spencer B. King,
III, M.D., who currently heads the Andreas Gruentzig Cardiovascular
Center at Emory, which will be celebrating the 20th anniversary of
PTCA with a live demonstration
course on April 18-20, 1997. Next year Dr. King will serve as
President of the American College of Cardiology.
Q: People started hearing about angioplasty when Gruentzig began
his demonstration courses in Zurich. What was the initial reaction? King: The first reaction was disbelief. I heard about the first
demonstration course from a friend of mine who had been there, who
had been to the course, who came back telling me stories of blowing
up arteries and everyone becoming so emotional. There was hugging
and kissing among all the physicians involved and I said, this has
got to be strange! This is not what I'd think would happen. So that
was the reaction: disbelief. And the way people were convinced was
simply to go see a demonstration, see what happened and see the result.
Q: How did the courses work as an educational tool? King: I can't think of any technology that has been shared with
as much vigor as balloon angioplasty. And through the media of television,
as Andreas did it. Those meetings in Europe were so astounding to
people, to see someone working in a high-risk situation, such as
dilating a patient in front of a live audience of peers who were
sitting there watching you do it. And the astounding thing to me
was to see someone applauded probably more so for his failures than
for his successes. I mean, everybody was in there pulling along
with him to get this done. And he saw the teaching value of that,
not just to teach the technique but to teach the potential hazards
— he really did control how it went through that meeting.
Q: And you continued the courses here at Emory? King:
I mean the idea of having a live demonstration of things, that was
very primitive at the time. So when he came here our commitment
was that we would continue the courses. So a lot of our work was
trying to facilitate that. We had this nice auditorium many people
have been to in the administration building at Emory. One thing
was we had to have closed circuit television. We ended up laying
coaxial cable from the cath lab direct into that auditorium, putting
up two rear project TV screens and setting up the whole system for
doing live demonstrations, so we could begin at the end of 1980.
We worked together
to build a television system that's been emulated a lot of places,
so I think that the teaching of this technique has really revolutionized
medical education at that level. Now you see many programs who have
taken the medium of television to explain things that aren't easily
explained through the printed media. You can read a journal article
about a lot of things and understand it fully, but there are many
areas of medicine that can't be fully communicated that way. I believe
he did more to utilize that than anybody.
Q: I attended some of the early courses and the atmosphere was
quite intense. Of
course, Andreas was the consummate teacher of angioplasty and everyone
came. I mean, you know, you say that we put on such a fantastic
educational experience that everyone wanted to come and see it.
I told Andreas at the time that really people came not to just sit
there and watch paint dry, watch somebody laboriously work in the
lab, but they came for same reason they came to stock car races
in the South. They came not to watch the cars go round and round,
but waiting for the crash.
Of course there
were crashes, in those early days. I mean things were difficult
and the success rate of angioplasty was not as great. And when you
have that situation and you have the maestro Andreas performing,
you know, the excitement level is quite high in that arena. It's
like going to watch Michael Jordan play basketball. So people came
for that reason.
But I guess the overriding reason was, this was the ticket — to
do angioplasty. I reflect back on that, now that we're in an era
of formalized training, formalized Boards, and requirements and
volumes and everything that people are having put on them. In those
days, you know, you got your little chit that you'd been to the
Emory course and you'd been there for four days. You'd seen some
angioplasty, walked in your hospital and your hospital was happy
to have you and said "Okay. Hang up your shingle and get to work."
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