How American Heart Association President Dr Mitchell Elkind Is Reminding People That For Medical Emergencies Like Heart Attack And Stroke, The Hospital Is The Safest Place To Be Even During The Pandemic
I think that our movement to end racial injustice and dismantle structural racism in the US is one of the most important things that we can do right now. The COVID crisis is our most immediate crisis in many ways and one that with science we will hopefully be able to overcome. But the crisis of social justice and racism is going to be more challenging and COVID has brought that out in ways. Long-term that’s what we need to do. There are a lot of crises facing us, but structural racism lies at the heart of a lot of these. Those that are disadvantaged are going to have bigger problems when future crises come along and that’s where we need to see change occur.
Mitchell Elkind, M.D., M.S. is a tenured Professor of Neurology and Epidemiology at Columbia University Irving Medical Center, and Chief of the Division of Neurology Clinical Outcomes Research and Population Sciences (Neuro CORPS) in the Neurology Department.
Dr. Elkind received his medical degree from Harvard Medical School and trained in Internal Medicine at Brigham and Women’s Hospital and in Neurology at Massachusetts General Hospital, both in Boston, M.A. He completed a fellowship in Vascular Neurology and Neuroepidemiology at Columbia University Medical Center. Dr. Elkind holds a Master’s degree in Epidemiology from Columbia’s Mailman School of Public Health.
Dr. Elkind’s research focuses on stroke prevention, inflammatory and infectious biomarkers in stroke risk prediction, atrial cardiopathy, immune therapy for acute stroke, and vascular causes of cognitive aging. Dr. Elkind is the Principal Investigator of several independent investigator awards from NIH/NINDS.
Dr. Elkind also has a longstanding commitment to medical education and research training. In addition to leading the Columbia Neurology residency and fellowship programs, he serves as editor of the American Heart Association/American Stroke Association Stroke journal’s new International Stroke Early Career and Training Section. He runs two NIH-funded research training programs for residents and fellows. Dr. Elkind has served on several American Heart Association/American Stroke Association committees, including three terms on the National Board of Directors (2014–2020), two terms as Chair of the ASA Advisory Committee (2016–2020), and co-chair or member of several writing committees for guidelines and scientific statements. He co-chaired the writing committee for the 2012 scientific statement on the inclusion of stroke as an outcome and risk equivalent in vascular disease risk scores and currently serves as Chair of the stroke section of the annual statistical update. Dr. Elkind is the current President of the American Heart Association.
His research focuses on different inflammatory markers and infections, such as C. pneumoniae and periodontal disease, as potential causes of atherosclerosis and ischemic stroke; heart disease and stroke risk; and clinical trials for acute stroke and stroke prevention.
Thank you so much for doing this with us Dr. Elkind! Can you tell us a story about what brought you to this specific career path?
My dad was a physician, but I wanted to do something different, maybe in journalism or writing. But I always enjoyed the science classes I took in college and got more and more involved in research projects, so I ultimately decided to go to medical school. Neurology and figuring out how the brain works were so interesting to me. I loved thinking about the quirky ways that neurological diseases present, revealing so much about our personalities, perceptions of the world, and behavior. During my neurology training was when we first began to see treatments for things like stroke, multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease. Before, neurology had been kind of like a “black box” and there was not a lot you could do for patients. I was there at a time when things were changing, and it was super exciting. But I was also very torn between neurology and cardiology. You could tell that the people who were doing cardiology were really happy and having fun. When you put the brain and the heart together you get stroke, and that’s one reason why I ended up in stroke and why I initially got involved with the American Heart Association. One of my major research projects right now is a clinical trial targeting a form of heart disease as a way to prevent stroke. I think I never wanted to fully give up the heart side of things.
Can you share the most interesting story that happened to you since you began leading your company or organization?
About 20 years ago I got one of my first grants from the American Heart Association as a junior faculty member from a gentleman named Bert Scott. His wife had died from a hemorrhagic stroke years before and he donated the money for the research grant. Fast forward to now and he’s the chairman of the board of the American Heart Association and I’m the president. That really put the icing on the cake of this position, to be able to work with the person who helped fund me and start my career and get me involved with the American Heart Association to begin with.
The most challenging and interesting thing that has happened since becoming president has been navigating through the COVID-19 pandemic. I think part of the reason I was initially selected to serve as president was because of the American Heart Association’s interest in brain health and moving beyond just stroke into other diseases of the brain like cognitive aging and dementia. We recognize that a lot of these degenerative processes of the brain have vascular contributions. I was really looking forward to bringing more neurologists and neuroscientists into the community of the Association. Then COVID hit. That really changed things and put those plans on pause a bit. Much of our thinking and effort has been put toward how to address this crisis — funding research to understand the virus, ensuring people seek care, advocating for equitable access to care, and more — and that’s really the most important thing right now.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
During medical school back in the 90s, there were fewer limits on students’ hours — and I didn’t want to miss a thing. After a long all-nighter and a very full day in the OR, I was about to shuffle home and get some sleep when an attending surgeon asked if I wanted to scrub in on an aortic procedure. How could I say no to that? Soon I was holding retractors over the patient, and realized I was starting to fall asleep. I jolted awake. It happened again. I had to fight every instinct in my body to stay awake and alert, blasts of adrenaline kicking in at the last second every time I almost dipped forward! Luckily my work wasn’t particularly vital, and the patient’s life was never in danger from my exhaustion, but still — I was not at my very best.
From this, I learned two things: one is that young doctors and trainees tend to be eager to learn, help, and participate. They never want to say no. But it’s important for those of us who are mentors and leaders in medical education and public health to make sure we are aware and protective of the health of all those around us. Not just the patients but also our colleagues, staff, and trainees. A second, bonus thing I learned from the experience is: I do love a good nap, but the couch is a better place for it than the OR.
Can you describe how you or your organization is making a significant social impact?
In the early days of the pandemic, the American Heart Association noticed an alarming trend: 9–1–1 calls and ER visits were down, but we knew that medical emergencies like heart attacks and strokes hadn’t stopped. We suspected this was likely fueled by fear of contracting COVID-19 at the hospital, and a recent consumer insights poll conducted by the Harris Poll on behalf of the Association suggests we were right. The poll found more than 1 in 4 adults (28%) experiencing a heart attack or stroke would rather stay at home than risk getting infected with COVID-19 at the hospital, and these concerns are higher in Black (33%) and Hispanic (41%) populations. The American Heart Association moved quickly to launch a public awareness campaign called, Don’t Die of Doubt™, reminding people that for medical emergencies like heart attack and stroke, the hospital is the safest place to be.
Can you tell us a story about a particular individual who was impacted or helped by your cause?
In December 2019, a woman named Charley Bednarsh had been diagnosed with pneumonia. For the next few months, she developed pain across her upper back and shortness of breath, and her discomfort continued to worsen. She Googled her symptoms and decided her pneumonia had been COVID and self-diagnosed her increasing discomfort as COVID-related lung damage and didn’t seek treatment based upon her concerns about going to the hospital during the pandemic.
On April 30th, she experienced excruciating upper back pain, falling to the floor. Her service dog, a Labradoodle named Atticus, frantically licked her face and barked incessantly. On several occasions prior to that day, Atticus had howled and pawed at her chest, as if he sensed something was wrong. Later that same day, she spoke with her physician who immediately expressed concerns. Finally, she decided to go to a nearby urgent care center and ultimately went to an ER. It turns out she was having a heart attack with a 100% blocked coronary artery. She had a stent placed and was recovering within a few short hours.
Charley says her hospitalization felt safe and strict infection control protocol was observed. The hospital staff was compassionate, caring, and took great effort to meet her needs. She is now an American Heart Association volunteer aiding the Association’s new Don’t Die of Doubt campaign and hoping that her story can help others.
Are there three things the community/society/politicians can do to help you address the root of the problem you are trying to solve?
Continue to follow the recommendations of healthcare professionals and organizations like the American Heart Association and the Centers for Disease Control and Prevention. Wash your hands, wear a mask, and social distance. And learn the signs of a heart attack and stroke so that if you or a loved one are having a medical emergency, you know what to do — call 9–1–1 and get to the ER as soon as possible.
Heart attack:
Chest discomfort that can feel like pressure, squeezing, fullness or pain
Pain or discomfort in one or both arms, the back, neck, jaw or stomach
Shortness of breath
Other signs may include a cold sweat, nausea or lightheadedness.
Stroke:
Follow the acronym F.A.S.T.
Face drooping on one side or numb
Arm weakness
Speech that’s slurred, difficulty speaking
T stands for time to call 911.
How do you define “Leadership”? Can you explain what you mean or give an example?
For me, leadership has been about listening and learning and trying to understand where people are coming from. As a physician leader who’s involved with trying to communicate health information to the public, it’s trying to balance the language of the professional with the language of the community. There is often a gap between what we as physicians expect or think and others understand. As doctors, we sometimes live in a bubble and are used to talking to other professionals, and the language we use can be unfamiliar to others. That’s what I’m really trying to do in this leadership role, is understand where people are coming from, what they know, and how to communicate effectively. This is a really important time to be doing that because there is so much misinformation out there. The American Heart Association has a big role there as a trusted scientific organization since we can use our abilities as communicators and marketers, in this case marketing good science and good healthcare to the general public who needs this critical information.
What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.
Don’t be afraid to meet with your teachers or professors. They want to get to know you.
Find a mentor or mentors. Find people that you really respect, whose values you share, and get their advice and learn from them.
Seek out those who are different from you as well. It’s important to have different perspectives.
Learn things and read things outside of your comfort zone. Travel when possible to do so, seek out new cultures, and have an open mind.
Take time off to recharge. Getting away from work is really important to the work as well.
You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
I think that our movement to end racial injustice and dismantle structural racism in the US is one of the most important things that we can do right now. The COVID crisis is our most immediate crisis in many ways and one that with science we will hopefully be able to overcome. But the crisis of social justice and racism is going to be more challenging and COVID has brought that out in ways. Long-term that’s what we need to do. There are a lot of crises facing us, but structural racism lies at the heart of a lot of these. Those that are disadvantaged are going to have bigger problems when future crises come along and that’s where we need to see change occur.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I would say: “Listen to your patients.” Perhaps it sounds obvious, but too often doctors think they know what is going on, and don’t stop to listen to what the patient is saying. We have access to so much technology now, like MRI scans and other tests, that we forget to listen to what people are telling us when they are sitting right in front of us. I was repeatedly reminded that only by listening to the patient do you really begin to understand their experience, and in medicine that often means the difference between the right and wrong diagnosis or treatment. And what works for doctors should work in every other field as well: I think we need to listen to each other more, take a step back, and rethink our assumptions. It’s amazing what you learn!
Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂
Honestly right now the person I’d most like to see is my older son Zachary. We’ve been socially distancing and not getting to see enough of each other since March. After Zachary, I would say LeBron James. I was in Akron to give a talk a few years ago, and I learned about how much he has given back to the community. His educational initiatives especially are so impressive. He had his own elementary education interrupted because his family had to move so often when he was a kid, and he has now made a STEM-based elementary school a focus of his giving. And he is committed to giving the graduates of the program the funding to go to university as well. It’s clear that he is as proud of these kids, their accomplishments, and their future as he is about his own phenomenal basketball career. It is no wonder that he is considered King James in Cleveland! Plus, maybe we’d get to shoot some hoops after lunch!
How can our readers follow you on social media?
@MitchElkind on Twitter
This was very meaningful, thank you so much. We wish you only continued success on your great work!
