https://orcid.org/0000-0001-7189-1638
On 16 February 2021, Dr Bernard Lown died at his home in Chestnut Hill, Massachusetts. He was 99 years old, survived by three children, four grandchildren, and one great grandchild, and legions of cardiologists around the world whom he mentored and trained. Dr Lown joined his beloved wife, Louise who died in 2019 after 73 years of marriage.
Dr Lown’s passing was noted in news outlets around the world, as he was feted as one of the most innovative, and influential physicians of his era. These tributes were highly appropriate: seldom has one man impacted the health and the welfare of humankind as did he.
Bernard Lown was born in Lithuania on 7 June 1921. At the age of 14, he and his family immigrated to Maine. The young Bernard attended the University of Maine before receiving his medical degree from Johns Hopkins University. After an internship and residency in New York, Dr Lown moved to the Peter Bent Brigham Hospital, joining Dr Samuel Levine as a cardiovascular fellow and then as an associate. For the next several decades, Dr Lown was a fixture on the Boston scene, attending his patients at the Brigham, founding laboratories at the Harvard School of Public Heath, and establishing the Lown Cardiovascular Group.
It was clear from the outset that Bernard Lown would be no ordinary physician, and certainly not one to accept the status quo. The first clue of his radical predisposition may have come during his experience as a student. Perhaps apocryphal, Dr Lown, a master story teller, related that he had been temporarily suspended from medical school for having been caught, during his duties in the blood bank, mixing up containers of blood that had been designated for white vs. black patients.
But it remained for Levine to ignite the Lown genius, supplying ideas that Dr Lown happily developed, including their seminal description of the Lown–Ganong–Levine syndrome. One that gained widespread attention was the ‘armchair treatment’ of patients who had suffered a heart attack. Whereas conventional thinking was that several weeks of absolute bedrest were always necessary, Lown and Levine advocated for getting patients out of bed early to improve their hemodynamics and their sense of wellbeing.
Lown’s most famous contribution to cardiology was the defibrillator. His painstaking experiments led to the finding that precise amounts of direct current, applied to specific areas of the chest, was highly effective. His breathtaking clinical research results were published in prestigious journals and the technology was rapidly adopted by thousands of doctors. Effective and safe defibrillation revolutionized the care of patients with a wide variety of cardiac disorders and enabled modern surgical techniques.
But that was just the beginning of Lown’s prolific career as a cardiology innovator. Over the next 40 years, he and his group would research and develop a variety of treatments for patients with cardiac arrhythmia. Lidocaine was one of the first, a drug given intravenously to quell rhythm disturbances in heart attack patients. Lown became a strong proponent of the concept of the ‘brain–heart’ connection, showing in basic and clinical experiments that a person’s emotional stability and psychological health was critically important to their cardiac treatment and recovery. Lown also spearheaded the development of one of the first coronary care units in the world, eventually dubbed the Levine Cardiac Unit.
Never content with his medical accomplishments, a young Dr Lown became interested in public health, specifically the threat of nuclear war. In 1962, he published an article in the New England Journal of Medicine describing the terrifying effects of a nuclear attack on the city of Boston and became the founding president of Physicians for Social Responsibility. Taking advantage of his scientific relationships with leading Soviet cardiologists, Dr Lown joined with Yevgeny Chazov, Leonid Brezhnev’s personal physician, and several other American and Soviet doctors to form International Physicians for the Prevention of Nuclear War. The group actively campaigned against nuclear testing, petitioning leaders in the USA and the Soviet Union to end atmospheric explosions, fending off attacks by conservative critics who called the group’s ideas ‘naïve’. For their persistent and successful campaign to ‘create public awareness of the catastrophic consequences of atomic warfare’, the group was awarded the Nobel Peace Prize in 1985.
Dr Lown was far from finished. In 1991, he founded SatelLife USA that launched a communications satellite to provide online training and information to doctors in underdeveloped countries. He also started ProCor, a global web-based network to disseminate medical information to third world countries. Dr Lown published several books; in 1996, ‘The Lost Art of Healing’ captured international attention as he described how doctors had been seduced by technology to the detriment of patient care.
Dr Lown retired from the Harvard School of Public Health in 2000 but he remained a senior physician at the Brigham and Women’s Hospital, seeing patients in his office, mentoring young doctors, and directing research. To the end, Dr Lown continued to rail against the inhumanity of the medical machine, encouraging his last caregivers to publicize his own dehumanizing experiences as a patient.
While it is wholly appropriate at his passing for us to detail Dr Lown’s manifold achievements, only those of us whom he touched can understand what a remarkable human being he truly was. He had a wonderful sense of humour, insisting that every day for the months that I rounded with him, I supply a (clean) joke to be enjoyed by the multitude of trainees who accompanied us. And he loved to tease his minions. To make a point about the uselessness of polypharmacy, one of his favourite piques, Dr Lown would turn to the hapless intern caring for a patient receiving 12 drugs and instruct her to stop every one of them except one. ‘But which one, Dr Lown, would come the inevitable plea’. ‘I don’t care’, Dr Lown would thunder as he moved on to his next patient.
Dr Lown was a master story teller and he relished it, intertwining vignettes into his many presentations to the delight of so many varied audiences. His Friday afternoon clinical conference at the School of Public Health was standing room only.
Dr Lown encouraged us to sit by the bedside to reassure the patient that we were not in a hurry, to touch the patient, to examine her carefully, to listen instead of pontificating, and to treat each patient with respect and with compassion. His skill at the bedside was breathtaking, possessing an almost instinctual sense of the patient’s problem and its ultimate solution, mystifying those of us mortals who failed to discover a root cause let alone the best treatment.
Dr Lown was a therapeutic sceptic, encouraging his trainees to examine each new therapeutic idea in depth. He and his group argued for years that complex interventions like coronary artery surgery were over rated and utilized. They were attacked by the mainstream medical establishment, only to be proven correct years later.
Dr Lown was a taskmaster and a perfectionist. Each piece of data was scrutinized by Dr Lown and his associates with suggestions for more experiments. He returned the first drafts of papers and grants nearly unreadable for the red ink. Information had to be correct and perfectly expressed, or it would not see the light of day.
Like all great people, Dr Lown will be remembered for his accomplishments. It is true that his innovations and ideas have had a powerful impact on the lives of millions around the world. But the essence of Dr Lown was that no patient, no trainee, no colleague, no one was ever the same after he touched them. He always strove to find a way to make them better. Can there be a more meaningful testimonial for a human being?
Conflict of interest: none declared.
