Foreword: The following is an abbreviated and edited transcript from the latest Medtech Trailblazers, the real stories behind the Innovators, Fogarty Innovation’s series of casual, in-depth conversations aimed at discovering the people who have forged our industry. To view part 1 of the videocast, click here.
There is virtually no aspect of the cardiovascular health ecosystem that hasn’t been impacted by the work of Dr. Martin (Marty) Leon, professor of medicine at Columbia University Irving Medical Center (CUIMC) and a legendary interventional cardiologist whose many roles and accomplishments have had an indelible effect on the practice of cardiology globally — and the medtech industry along with it.
Marty’s influence on the field was born of personal losses that he used as the catalyst to transform the cardiology industry. This dedication is reflected by the many hats he wears, including Director of Columbia Interventional Cardiovascular Care, Director of the Cardiac Catheterization Laboratories and member of the Executive Board of the Columbia Structural Heart & Valve Center. He is a practicing interventional cardiologist at New York-Presbyterian Hospital in New York City and the founder and Chairman Emeritus of the Cardiovascular Research Foundation, where his work has expanded to cover additional clinical challenges like diabetes, obesity, heart failure and stroke—and more recently, the impact of the pandemic on cardiovascular care.
Equally notable, Marty is the driving force behind the Transcatheter Cardiovascular Therapeutics (TCT) conference, now in its 34th year, where he has set the gold standard for live training of interventionalists and other physicians around the world while showcasing the latest developments in medtech. He has co-authored over 1,550 publications and been the principal investigator on more than 75 clinical trials, many of which have changed the practice of medicine.
Andrew Cleeland (AC) had the pleasure of chatting with Marty (ML) to learn more about the factors that shaped his life and career, his legacy and what lies ahead. The following is an edited excerpt of his interview.
AC. Tell us about your early life and influences.
ML. My grandparents immigrated from Poland and Russia, and my parents were born here. My dad was an NYU graduate and worked for the IRS for about 30 years. But my family was very “maternally oriented;” in fact my grandmother was the icon of the family and one of the wisest people I ever knew. My mother certainly fell into that category. She started at Brooklyn College but quit because her twin brother wanted to be a veterinarian, and the family didn’t have the economic resources to support both educations. That kind of humble family relationship was extremely meaningful, and I learned to value both education and excellence because of my parents.
As a middle-class Jewish kid growing up in a very middle-class Brooklyn neighborhood, I attended public schools with an interesting and heterogeneous environment that included racial and geographic diversity. And in the big city you are surrounded by a kinetic energy, which is one of the reasons my wife and I decided to find a way back after I started my career.
As a side note, I’m a huge Yankees fan; there’s tradition and excellence in the team and those themes are very important to me.
AC. When you were just six years old, you experienced a tragedy that led you to pursue a medical career. Tell us about this.
ML. We’re all faced with adversity, and it’s a matter of how you decide that adversity will influence your thinking and shape your life. In the medical profession, you come to work every day, knowing there may be a crisis you’re going to need to handle. I saw that at an early age as my brother, who was three years older, died of a medical illness that was arguably preventable. The tragic effect it had gave me a firsthand glimpse at how a medical event can impact a family, and I realized that it would be a noble goal to have the ability to reverse or prevent that. It led me to consider becoming a physician who could prevent these tragedies, and from the age of six, I never really cared about doing anything else.
AC. Now moving on to your education, let’s hear about the schools you attended and why you chose cardiology.
ML. The public schools in New York were extremely competitive, and with 40 students in a high school class, there was little opportunity for personalized attention, which actually prepared me well for university.
I attended medical school at Yale University and it was a fairly eclectic environment as the only medical school in the U.S. with a pass/fail system rather than grades. But you also were forced to do a Ph.D. equivalent thesis as part of your medical degree, which taught me the importance of doing research, educating yourself and finding a mentor. It was strikingly different in terms of an educational environment and more closely simulates a smart approach to lifelong education.
I knew I wanted to pursue cardiology, again based on a profound life experience when my grandmother suffered a heart attack and passed away in my arms. Yale helped reinforce that would be a good area for me, particularly when I met Dr. Larry Cohen, the Chief of Cardiology and my thesis advisor, who was truly a significant influence on my career and life.
AC. Why did you decide to go to the National Institutes of Health (NIH) after Yale?
ML. Dr. Cohen told me that if I wanted to be a successful academic physician, I had to go to NIH. A lot of the true academics came out of this institution, and it was an opportunity for me to be in an environment with enormous tradition and gave me a chance to think and hone some of my skills.
I had many mentors at NIH, and I became involved in a variety of projects. Nuclear cardiology was just beginning, and I also became involved in cardiovascular pharmacology where I had an interesting exposure to biomedical engineering and worked very closely with biomedical engineers on a variety of interesting projects. As things began to progress to clinical trials, I had the opportunity to design and understand how to do clinical research. Over the course of that period, I became director of the cath labs, and I set up an experimental angioplasty unit. I learned so many fundamental aspects of what it means to develop ideas and take them through the various phases of exploration, creation, pre-clinical experimentation and then into clinical trials.
AC. How did TCT come about….what was your vision and did you expect it to become what it is today?
ML. A lot of people believe in five-year plans and long-term visions, but I’ve never been very successful at that. I tend to be influenced by what’s happening in the moment…what I can foresee in the more near future. When I was at NIH, I began to explore ways to remodel vessels since at the time there weren’t a large variety of clinical devices. I had access and interest in studying new techniques and wanted to introduce them to others, which is how TCT came about: a multidisciplinary workshop to bring engineers, industry sponsors, scientists and clinicians together to look at some of these new techniques and see how we evaluate new therapies. Dr. Kenny Kent and I came up with a program, and while we had a very small faculty, they were heavy hitters like John Simpson and Patrick Surreys. Even though we thought of this as being a boutique meeting that might last a year or two, it mushroomed into a signature meeting that helped to define the sub-specialty and paralleled its growth.
AC. More than 30 years ago, you founded the Cardiovascular Research Foundation (CRF). Again, what was your vision?
ML. That for me was a labor of love and still is. I try to dedicate one day a week to it, and it’s always my most exciting day. The concept was to take the experiences I had at the NIH and translate them into a working model that could be extrapolated to the outside world. We founded a clinical practice and developed a private, not-for-profit research foundation that would allow us to explore new ideas, develop clinical trials, study these new ideas and then educate physicians on how to best use these new therapies.
That therapy development cycle became so important to me that we built the structure of an organization around it and tried to develop the highest quality we could for pre-clinical facilities, a clinical research organization, and then an educational capability that really became the pillars of what CRF was and still is 30+ years later.
AC. Your career is brimming with highlights. To name a few, you’ve performed over 10,000 interventional procedures, authored or co-authored over 1,550 publications, and influenced the evolution of cardiology as a physician, a clinical trialist, a key opinion leader and advisor for companies. What are you most proud of?
ML. It’s the totality of the experience; it’s being in the arena; it’s being a participant. Just as Teddy Roosevelt said in one of his brilliant speeches, it’s about daring greatly to want to be a participant. I’m proud that I’ve been in the arena. I’ve suffered some of the blows. I’ve had failures, and I’ve had successes, but at least I’ve allowed myself to experience the emotion of both, to learn from each and continue to persevere. So, I think that I’m proud I was part of the process and hopefully continue to be in a meaningful way so that I still have an impact.
AC. What is a lesson that you’d like to pass on to young folks just starting their careers?
ML. There are several. To start with, I think there’s no way to shortcut the experience. First, you’ve got to pay your dues, which is to say that you really have to spend the time to gain experience to be excellent at what you do. And, to appreciate that while experience does matter, you’re in a constant learning environment. Second, is to go deep, rather than superficial—a mile wide and an inch deep is not going to get you anywhere these days and that may require extra training or extra time. Third is that I see people settle too easily into a comfort zone, and once you do that, you tend to flatten out your career. You’ve got to continue to challenge yourself, and force yourself to get out of your comfort zone. It’s not easy, but it allows you to continue to grow. A commitment to excellence and desire to have an impact while maintaining the focus on the patient is critical. You always have to consider the patient at the end of this cycle.