Richard Gorlin, MD
The Passing of a Legend and a Mentor
Dr Richard Gorlin, one of the preeminent cardiologists of the latter half of the 20th century, died on October 16, 1997, at age 71 years, of pancreatic cancer. Until the last days of his illness, Dr Gorlin continued to work as a physician, to serve as Medical Director of the Mount Sinai Health System, and to inspire those around him.
Dr Gorlin’s contributions to cardiovascular medicine are legendary and have immensely influenced the clinical care of patients with valvular heart disease, coronary artery disease, and congestive heart failure. He earned an international reputation when, in collaboration with his father, a mechanical engineer who designed hydraulic systems for gasoline engines at the beginning of the century, he developed a formula to calculate the area of stenotic cardiac valves and congenital heart chamber defects. The “Gorlin formula,” still considered the “gold standard” for diagnosis of critical heart valve obstruction, was crucial to the evolution of cardiac surgery because it allowed proper case selection and contributed greatly to the design of artificial valves.
Dr Gorlin conducted pioneering studies of coronary blood flow and myocardial metabolism in ischemic and hypertrophic heart disease and demonstrated that some areas of the myocardium that appear mechanically quiescent can, when stimulated, exhibit contractile activity. This observation foreshadowed by a decade the concept of “hibernating myocardium.” Dr Gorlin was among the first to describe what is now widely recognized as “microvascular angina” in a group of patients without coronary obstruction. He also described “myocardial asynergy” related to coronary artery disease, defined as localized areas of reduced myocardial contraction. Carrying this observation a step further, he showed that myocardial contraction and ejection fraction are related and importantly determine the prognosis of patients with advanced heart disease. He was also the first to define the idiopathic high-cardiac-output state known as “hyperkinetic heart syndrome,” and more recently, he played a dominant role in the largest trial to evaluate digitalis in patients with chronic congestive heart failure (the DIG Study).
As a teacher, Dr Gorlin inspired and guided a legion of prominent cardiologists. He was highly respected by medical students and residents for bringing sensibility and sensitivity to clinical teaching. His principles and personal attributes have been carried forth into fellowship training programs throughout the world, where they have had powerful influence on the careers of a generation of cardiologists. Specifically, when Dr Gorlin was at Harvard Medical School and Peter Bent Brigham Hospital between 1956 and 1974, his laboratory trained more than 90 fellows. The majority went on to become heads of cardiology divisions across the nation and abroad; several became heads of departments of medicine, and still others became leaders in cardiology in their communities.
On the surface, Dr Gorlin displayed a tough personality, generating respect by his very presence. Indeed, one of his pupils, now head of cardiology of a major university, remarked, “Whenever I see Dr Gorlin, I shake.” Those who worked more closely with him, however, realized that beneath this strong exterior was a shy and sensitive man who was always ready to advise or help. This was, no doubt, the key to his success as an educator and as a physician caring for patients. Perhaps the most fitting summary of Richard Gorlin’s character came from his own mother, who described him as “a clear thinker with a creative mind, anxious to help and to be part of what is going on. … A marvelous son.”
For myself, I will forever be grateful to Dr Gorlin for his wisdom and guidance over many years. He recruited me to the position of Chief of Cardiology at The Mount Sinai Medical Center, where he served 18 years as Chairman of the Department of Medicine and contributed enormously to the strengthening of our faculty and medical school. He was the mentor who gave me the best opportunity of my life and the support to develop an academic career. Just 2 weeks before his death, I had the enormous privilege and gratification of receiving a most distinguished honor: installation in the professorial chair in cardiology that bears his name. I will try, to the best of my abilities, to hold high the torch of excellence as a mentor that symbolizes Dr Richard Gorlin.
- Copyright © 1998 by American Heart Association