Bill Roberts has performed a great service by publishing >100 oral history interviews of cardiologists and cardiovascular surgeons. His interview of Howard Burchell recorded a dozen years ago provides rich insight into his life and career. We are pleased to have this opportunity to share our personal perspectives on this remarkable centenarian.
To put things in time perspective, Howard was born in 1907:
Five years after Einthoven published the first electrocardiogram
Four years after the Wright brothers’ first flight at Kitty Hawk, North Carolina
Two years after fellow Canadian William Osler left Johns Hopkins for Oxford
One year after the San Francisco earthquake
I first met Howard at a meeting of the American Osler Society 3 decades ago. A few months later, I wrote to him asking for reprints of his articles on the history of cardiology. My letter began, “Dear Dr. Burchell, We share many interests. I have met you, but you have no real reason to remember me.” Howard’s response will not surprise anyone who knew him: “I do indeed remember meeting you . . . . Hope the enclosed [reprints] may be of some interest.” That was the beginning of a friendship that grew closer over the years.
When we met, Howard had recently retired as chief of cardiology at the University of Minnesota and I was finishing my cardiology training at Johns Hopkins. I was unaware of the vital role he had played in introducing modern cardiology into the Mayo Clinic after World War II. My excuse is that I had not yet begun studying the history of cardiology and my age, or lack of it. When Howard coordinated the first catheterization at Mayo in December 1946, I was 2 months old. When he was a key member of the team that launched Mayo’s open-heart surgery program in March 1955, I was in the third grade. When Howard and I spoke or corresponded during the 1980s and 1990s, he never boasted about his contributions. In fact, he never mentioned them. It was only after I joined the Mayo Clinic in 2000 and began researching and writing a history of cardiology at the clinic that I began to appreciate Howard’s enormous contributions.
It is fitting that we met through the American Osler Society because Howard was more like William Osler than almost anyone of his generation. They never met, of course, but they were kindred spirits. As was Osler, Howard was born in a Canadian village. They studied pathology and physiology after receiving their medical degrees. Importantly, they shared an interest in cardiovascular disease and the history of medicine. Although Osler was a first-generation internist, more than 1/3 of his publications in pathology and clinical medicine dealt with the cardiovascular system. They both edited prestigious journals. Howard Burchell edited Circulation. Osler edited the Quarterly Journal of Medicine , which was launched in 1907, the year Howard was born.
Howard Burchell was a quiet, modest man with intellectual curiosity that knew no bounds—his mind was always working. He stimulated 3 generations of medical students, trainees, and colleagues to read, contemplate, speculate, and draw conclusions. Not absolute conclusions, however. There were always other things to know and other ways to look at things. He filled the margins of drafts of chapters of my history of Mayo cardiology with comments and questions. Three years ago, he wrote in a cover letter, “My scribbles on the manuscript are at places we could have discussions.” That was Howard—as inquisitive as ever and 98 years old.
So much could be said about this remarkable man. I was fortunate to know Howard and to learn so much from him.
To go on rounds with Dr. B—for many of us he was always Dr. B and never Howard—was a treat and a lesson far beyond cardiology. He showed us that a cardiologist could be a primary care physician in the broadest and finest holistic sense—not, of course, with the Eastern flavor of herbs and tea and manipulations.
Often on rounds, Dr. B would show us that the Emperor had no clothes. For example, when the chief resident claimed to have heard a murmur and the students and residents testified they, too, had heard it, Dr. B, who knew the case well, might listen carefully to the heart and then ask for clinical details. As often as not, he might then grasp the patient’s hand and, with a wry but never-condescending smile, assure the patient and the multitude that “this heart has no murmur.”
Dr. B loved physiology, loved what could be measured, but he was likely to be critical when things became metaphysical. I vividly recall a discussion about psychoanalysis and our realization that neither of us had referred a patient to “the couch.” We wondered whether we had missed something with them, or whether it was that we did not sufficiently value psychoanalysis.
A visit to Dr. B’s studio at home revealed a monastic enclave of books and artifacts, including an image of his beloved foxglove on prominent display, a photograph of digitalis from the garden of his long-term Dutch friend Frits Meijler. His fascination with cardiac sounds was revealed by a collection of well-worn stethoscopes hung on a coat rack, some antique and brittle with age. Two were constructed by him, one with a bell and 7 tubes to 7 pairs of earpieces. When in use at the bedside, it gave the appearance of an octopus emanating from the patient’s chest. He admitted it did not work all that well for group auscultation, because the sounds were muffled, presumably by a windkessel phenomenon. He always hoped that an electronic wizard might come up with a better instrument for group learning, one without resort to a loudspeaker.