Philip R. Liebson
Chicago, Illinois, United States

In September 1955 President Dwight Eisenhower suffered a myocardial infarction. Dr. Paul Dudley White (1886–1973) was called in to attend to him. For a time, Dr. White was probably the most famous cardiologist in the US because of his attendance to the president. A noted photograph of him at the time showed White riding a bicycle, for he was a strong advocate of physical activity to prevent cardiovascular disease, and his efforts were instrumental in the increase of emphasis in cardiovascular prevention amongst the medical profession. Long before his photographs on a bicycle in the late 1950s, he was a recognized cyclist and at one time was made honorary president of the Bicycle Touring League of America. One of his quotes was “walk more, eat less, sleep more.” There is a 17-mile bike path along the Charles River that is named after him. He had a habit of walking to and from the airport from his meetings, once walking to the Washington National Airport after a meeting with Eisenhower at the White House.

Growing up in Roxbury Massachusetts, he attended Harvard College and the Medical School, graduating in 1911. While an intern in pediatrics and medicine at the Massachusetts General Hospital he coauthored a paper with Dr. Roger Lee on the coagulation of blood from which the Lee-White clotting time was derived. His interest in cardiology may have been whetted by his sister’s early death from rheumatic heart disease and his father’s from coronary artery disease.

Like his contemporary and Harvard colleague, Dr. Samuel Levine, he studied with the British cardiologist Sir Thomas Lewis and during World War I was a medical officer for the British and then the American Expeditionary Force. After residency at the MGH he became a practicing cardiologist and teacher at Harvard, advancing through the ranks to clinical professorship. Like Sam Levine, he published an important cardiology textbook, Heart Disease, initially in 1931. He became one of the founders of the American Heart Association in 1922. He subsequently helped organize the World Congress of Cardiology and International Society of Cardiology in the late 1940s.

His academic output was prodigious and included 12 books and over 750 scientific articles. However, aside from his initial publication on coagulation, his other most noted paper was the description of ventricular pre-excitation in 1935 with his colleagues, Wolff and Parkinson.

His most important impact, however, was in the field of cardiovascular prevention, and long before he appeared on the public scene as Eisenhower’s cardiologist he was instrumental in the development of prevention as a major field of study and intervention. As a consultant to the then-named National Heart Institute, which he was instrumental in founding, he was partially responsible for the development of the Framingham Heart Study.

In 1999, Rene Favaloro published a special report in Circulation reflecting Dr. White’s legacy in 10 messages: 1) clinical history stands above any technological advances; 2) all patients are equal; 3) team effort; 4) respect for referring doctors; 5) modest fees (from $5 to $25 as late as 1963); 6) clinical teaching and clinical research; 7) prevention; 8) humanitarianism; 9) disarmament and peace; 10) optimism.

Two pithy quotes from Dr. White can summarize his attitude:

“A vigorous five mile walk will do more for an unhappy but otherwise healthy adult than all the medicine and psychology in the world,” and “I wish we could do something useful with tobacco—like making fertilizer out of it.”

In recognition of his contribution to the Massachusetts General Hospital, the Paul Dudley White Society of faculty members and cardiology fellows at the MGH was founded.

References

1. Johnson, Allen, ed. “Paul Dudley White.” Dictionary of American Biography. New York: Charles Scribner’s Sons.
2. Smith, K. S. S. 1974. “Obituary: Paul Dudley White.” Br Heart J 36: 608.
3. Favaloro, R. 1999. “A Revival of Paul Dudley White: An Overview of Present Medical Practice and of Our Society.” Circulation 99: 1525–1537.
4. BrainyQuote. “Paul Dudley White Quotes.” BrainyQuote, February 8. http://www.brainyquote.com/quotes/authors/p/paul_dudley_white.html.