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 INTERVIEW WITH
DR. ISADORE ROSENFELD
Rossi Distinguished Professor of Clinical Medicine/Cardiology, Weill Medical College, Cornell University
CBS CARES: Is that a reason why women are often misdiagnosed when they're having a heart attack?
DR. ROSENFELD: Yes, because the index of suspicion is not high. The false belief is that, because women are free of heart disease before menopause, they're safe from it after menopause as well.
CBS CARES: Are any steps being taken in medical schools and in communications with physicians to change these attitudes?
DR. ROSENFELD: Steps are being taken to teach medical students differently. We say to our students: "Listen, it's important to treat a woman for heart disease even though she's a woman." More and more doctors are becoming aware of the risks and of the need to talk to their female patients even before menopause, so they can start protecting themselves.
CBS CARES: It seems that women undergo fewer invasive heart procedures such as angioplasty and bypass. In your experience, do you find that they are more resistant to these types of procedures?
DR. ROSENFELD: Not when they are properly told of the risks of not having the procedure. At least, I haven't found them to be so. It depends on the doctor/patient relationship. When I tell a woman patient that she needs to have a procedure, she has never turned me down.
CBS CARES: Who in your opinion should own a home defibrillator?
DR. ROSENFELD: Anyone over the age of 45, who has had symptoms of coronary artery disease or has had a heart attack should invest the $2,000 and have the spouse and children learn how to use it. The defibrillators can be purchased at pharmacies now. They send an electric shock to a heart in cardiac arrest. The devices instruct users where to apply the two paddles to shock the heart back into a normal pattern, if it is necessary.
CBS CARES: We noticed that signed photo from Dr. Albert Einstein on your bookshelf with a warm note of appreciation to you. Could you say a few words about how it was to have Einstein as a patient?
DR. ROSENFELD: Well, actually, that's Walter Matthau, whom I knew well, playing Einstein in a movie. He signed the note to me as Einstein.
CBS CARES: Well, that gives new meaning to the expression "He's no Einstein"! Okay, could you tell us why you decided to study medicine and become a cardiologist?
DR. ROSENFELD: An experience I'd had when I was five-years-old when I was sick with a respiratory infection and high fever and so on. And we were a family of modest means in Canada. And my mother called the doctor. And he came to the house. He sat down on my bed. He held my hand. I thought he was a magician. He said, "You're gonna feel better." And when he left, I did feel better. His presence made me feel like he was a magician. And I got it into my head and I became obsessed with doctors.
I never wanted to become a great scientist or a great researcher or a great surgeon. I just wanted to be a magician like he was. And why I became a cardiologist is that my father, whom I loved very much, had heart disease at the age of 48. I wanted to be able to help him. Young men and women still want to become doctors very, very much. But I don't think they have the role model that I had.
CBS CARES: What would you say to other doctors about what they should be doing differently right now for women's heart disease?
DR. ROSENFELD: Their role, regardless of what they do, should be that of a healer, not a fixer. A healer is something special. A doctor empathizes, sympathizes, gets involved with the patient. Today the tendency is to let the machines do it and avoid any kind of emotional involvement, because it is perceived that it is not good for the doctor to be emotionally involved. But I like to be emotionally involved with my patients.
CBS CARES: What, in a capsule, are the most important things for us to communicate to our viewers and readers of the CBS Cares website?
DR. ROSENFELD: The main message is that women are as vulnerable as men to heart disease after the menopause. Their vulnerability is established before the menopause by the risk factors. You can't smoke from 20 to the age of 48 without causing harm. Having smoked all that time has made you more vulnerable. You can't have ignored high blood pressure all that time because you say, "Well, now I'm pre-menopausal, I'll start behaving." All these things accelerate the impact of the hormonal changes that occur with the menopause. So you've got to start early in life. And then focus on symptoms later in life.
Special thanks to Rosalind Whitehead, leading healthcare advocate and philanthropist, for facilitating the interview with Dr. Rosenfeld.
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