The Bernard Lown Award for Social Responsibility was created in honor of our founder, Dr. Bernard Lown. Dr. Lown was an inspiration by standing up against racial injustice, nuclear war, and the industrialization of healthcare. He demonstrated both the vision to see the healthcare system as it is, as well as the courage to take a stand and the confidence the lead the way. 

“As the guardians of health, we can’t look away.”

Our 2022 winner truly embodied Dr. Lown’s activist spirit, identifying a severe problem in her community and demanding a solution. Dr. Mona Hanna-Attisha is a pediatrician, author, and activist best known for her role in uncovering the Flint Water Crisis. Despite threats to her career, Dr. Hanna-Attisha stood up for her community and, in the process, inspired physicians across the nation.

We’re looking for young clinicians like Dr. Lown and Dr. Hanna-Attisha who lead the way towards a more just and caring healthcare system. To be eligible, candidates must be 1) age 45 or younger 2) work as a clinician in the United States, and 3) stand out for their bold leadership in social justice, environmentalism, global peace, or other notable humanitarian efforts. Nominations are open until March 1, 2023.

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About the series

Dr. Bernard Lown (1921-2021) was a pioneering cardiologist, humanitarian, and founder of the Lown Institute. In honor of Dr. Lown, we are sharing stories from his remarkable life in his own words, through video and written content.

The post Lessons from Lown: Crisis at the Nobel Prize conference appeared first on Lown Institute.

About the series

Dr. Bernard Lown (1921-2021) was a pioneering cardiologist, humanitarian, and founder of the Lown Institute. In honor of Dr. Lown, we are sharing stories from his remarkable life in his own words, through video and written content. Each episode also ties into an upcoming event sponsored by the Lown Institute Hospitals Index, where we will dive deeper into the topics that meant the most to Dr. Lown.

The post Lessons from Lown: The story of “white” and “colored” blood appeared first on Lown Institute.

In Dr. Lown’s words

For more details on this story, we turn once again to Dr. Lown, who gave a thorough accounting of this experiment in a 2011 blog post, “A Chair to the Rescue,” which was initially published in his book, The Lost Art of Healing.

The “unique torture” of bed rest

[In the early 1950s] I began a cardiovascular fellowship under the mentorship of Dr. Samuel A. Levine at the Peter Bent Brigham Hospital (now the Brigham and Women’s Hospital) in Boston. At the time, the major challenge in hospital-based cardiology was dealing with the steady inflow of patients with acute heart attacks. Care was largely palliative: to relieve chest pain, to prevent blood clots, to ease the breathlessness and edema provoked by a failing heart muscle. Patients were confined to strict bed rest for four to six weeks. Sitting in a chair was prohibited. They were not allowed to turn from side to side without assistance. During the first week, they were fed. Moving their bowels and urinating required a bedpan. For the constipated, which included nearly every patient, precariously balancing on a bedpan was agonizing as well as embarrassing.

“Visiting Martians, witnessing this travail, might have judged the scene differently, regarding hospitals as prisons where inmates were subjected to a unique form of torture.”

Dr. Bernard Lown

Because world events might provoke unease, some physicians prohibited their patients from listening to the radio or reading a newspaper. Visits by family members were limited. Since recumbency provoked much restiveness and anxiety, patients required heavy sedation, which contributed to a pervasive sense of hopelessness and depression. Around one in three patients died. Not surprisingly, many died from blood clots migrating to their lungs.

In addition to the pain stemming from the heart attack and the accompanying fear of dying, patients had to cope with the torment of isolation, the indignity of infantilization, and the unbearable distress of excessive bed rest. Physicians convinced themselves and their patients that complete bed rest was the price of survival. Visiting Martians, witnessing this travail, might have judged the scene differently, regarding hospitals as prisons where inmates were subjected to a unique form of torture.

The impact of chair treatment

The study involved getting patients into a comfortable chair for increasing durations on succeeding days. Compared with recumbent patients, ours required fewer narcotics for chest pain, less sedation for anxiety, and fewer sleeping medications. Nurses commented that the patients’ demeanor changed from anxious and depressed to an eagerness to resume normal living. Witnessing even one patient in a chair rapidly won converts from the house staff, who soon became enthusiastic adherents. Patients in chairs promptly began to harangue their doctors to let them walk and pressed for an early discharge.

Despite dire predictions by senior medical attendants that these patients would experience fatal arrhythmias, heart rupture, or congestive heart failure from an overstressed heart muscle, none of those complications were encountered. Comments by patients experiencing their second or third coronary artery occlusion confirmed that we were on the right track. Invariably they indicated that the current episode was the easiest to bear.

Practicing physicians rapidly abandoned the use of strict bed rest. Until our work, patients were kept in the hospital for a month or longer. Within a few years after our publication, the period of hospitalization was reduced by half. The range of activities permitted to patients was extended, and self‑care became the norm. The hateful and dangerous bedpan was abandoned; walking was allowed earlier; hospital mortality was reduced by about a third. Rehabilitation was hastened, and the return to work was accelerated. The time required for full recovery was reduced from three months to one month. Considering the fact that in the United States about one million people suffer heart attacks annually, perhaps as many as one hundred thousand lives were salvaged each year by this simple strategy.

How did doctors respond?

Although I knew that the project would be a chore, I didn’t expect it to be an act of martyrdom. Little did I realize that violating firmly held traditions can raise a tsunami of opposition. The idea of moving critically ill patients into a chair was regarded as off‑the‑wall. Initially the house staff refused to cooperate and strenuously resisted getting patients out of bed. They accused me of planning to commit crimes not unlike those of the heinous Nazi experimentations in concentration camps. Arriving on the medical ward one morning I was greeted by interns and residents lined up with hands stretched out in a Nazi salute and a “Heil Hitler!” shouted in unison.

Challenging medical dogma

Why subject patients afflicted with a life‑threatening condition to a treatment that could only increase their misery and lead to major complications? This was not just a small error; it was a colossal misjudgment. Why were the deleterious consequences of strict bed rest not detected sooner? 

Medical dogmatism is sustained by a multiplicity of factors. Foremost is the fact that doctors traverse an uncertain terrain. Faced with a myriad of variables, a doctor can never be certain which measures will heal.

“Human beings, when compelled to act, learn to justify a chosen course with an assurance unwarranted by the evidence for the course chosen.”

Dr. Bernard Lown

In pondering other reasons for the practice of strict bed rest, I believe they reflected the sad truth that doctors sixty years ago had little to offer heart attack victims. When good answers are unavailable, bad answers may replace them. Bed rest seemed a logical treatment to reduce the burden on the ever-beating heart. Don’t we go to bed when we are tired?…Yet such simplistic reasoning has been responsible for blood letting, stomach freezing, using X-rays for peptic ulcers, impaling catheters in the heart to gauge its function, dispensing hormone therapy to menopausal women, administering lobotomies to the mentally ill. The list seems unending.

When a new paradigm takes hold in medicine, its acceptance is extraordinarily rapid. Few acknowledge that they once adhered to a discarded method. This was succinctly captured by the German philosopher Schopenhauer. He maintained that all truth passes through three stages: first, it is ridiculed; second, it is violently opposed; and finally, it is accepted as having always been self‑evident.

About the series

Dr. Bernard Lown (1921-2021) was a pioneering cardiologist, humanitarian, and founder of the Lown Institute. In honor of Dr. Lown, we are sharing stories from his remarkable life in his own words, through video and written content. Each episode also ties into an upcoming event sponsored by the Lown Institute Hospitals Index, where we will dive deeper into the topics that meant the most to Dr. Lown.

The post Lessons from Lown: How the Levine Chair changed heart attack treatment forever appeared first on Lown Institute.

In a profile in The BMJ, journalist Jeanne Lenzer highlights some of the important times Dr. Lown took a stand and what this stubbornness cost him. Lenzer describes Dr. Lown’s fight to stop unnecessary heart surgeries (ironically, these surgeries were made possible by his own invention of the defibrillator) and his refusal to bow to the pressure of McCarthy-ism. In medical school, Dr. Lown also rebelled against the segregation of blood donations, which got him briefly expelled.

Dr. Vikas Saini, president of the Lown Institute, spoke on Dr. Lown’s steadfast nature:

“It was easy to see him as an old man who can’t change his ways,” said Saini in the BMJ. “But that stubbornness allowed Lown to continue his care of patients using minimal interventions and technologies. Every year there would be a new wave of fellows and residents who came to train with this great cardiologist, expecting to learn the latest technologies, and he would invariably fight that tide and disappoint them with his minimalist approach. That he could maintain an oasis of humanistic care in the midst of what was going on in US healthcare is a huge, underappreciated achievement.”

The post The principles that drove Bernard Lown appeared first on Lown Institute.

See Also: Timeline of Dr. Lown’s Life

Brookline, MA — Dr. Bernard Lown, pioneering cardiologist, humanitarian, and founder of the Lown Institute, died today at the age of 99. He was a remarkable clinician, scientist, and visionary who will be remembered long into the future. 

As a scientist, Dr. Lown did seminal work on sudden cardiac death. He was co-inventor of the modern direct current defibrillator, a device that revolutionized the practice of cardiology and saved countless lives. He created one of the first cardiac intensive care units and transformed the treatment of heart attack patients. As co-founder of two anti-nuclear proliferation groups, his activism united doctors across the globe during the Cold War, opening the eyes of millions to the dangers of nuclear weapons and earning a Nobel Peace Prize. He was one of the first physicians to recognize the importance of overtreatment and the power of money to corrupt his beloved profession.  

Above all, he advocated for social justice and peace, and worked tirelessly to create the health system we all want and need. At the Lown Institute, we continue to be inspired by Dr. Lown’s bravery, heart, and vision, and we are proud to carry on his legacy in our work.

Statement from Dr. Vikas Saini, president of the Lown Institute

“Bernard Lown was one of the greatest physicians of the last, or any century, and I was privileged to call him my teacher, colleague, and friend. Dr. Lown embodied a rare combination of technical skill, scientific acumen, and profound humanism. His commanding yet deeply comforting presence allowed him to connect with his patients in a way that was truly dazzling to generations of young doctors in training at Harvard. He showed us what it meant to be a healer and a citizen of the world. His commitment to social justice and a radically better health care system illuminated his belief that medicine must exist beyond the clinic to be true to its highest calling. If the moral arc of the universe bends towards justice, Bernard Lown helped move it closer to that destination while continuously challenging everyone else to do the same.”

— Dr. Vikas Saini, president of the Lown Institute

Statement from Dr. Patricia Gabow, chair of the Lown Institute Board of Directors

“On behalf of the board of the Lown Institute, I would like to express the great sadness we feel on learning that our founder, Dr. Bernard Lown, has died. We extend our deepest sympathies to his family and his large circle of friends and admirers. Dr. Lown’s dedication, not only to the well-being of his patients, but to all the world’s people, is a testament to what a single person committed to doing good can achieve. We look forward to carrying out the work of the Institute in a manner that honors the skill, wisdom, and courage that he brought to bear throughout his long and influential career.”

 — Dr. Patricia Gabow, chair of the Lown Institute Board of Directors.

About the Lown Institute

Founded in 1973 by Nobel Peace Prize winner Bernard Lown, MD, developer of the defibrillator and cardioverter, the Lown Institute advances civic leadership, accountability, and value in health care. The Institute believes a radically better system of health is possible and generates bold ideas to that aim. The Lown Hospitals Index, a signature project, is the first hospital ranking focused on civic leadership and includes measures like inclusivity by race, avoidance of overuse, and pay equity.

Contact

Aaron Toleos, VP Communications, atoleos@lowninstitute.org, (617) 992-9349

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The post Statement on the death of Dr. Bernard Lown appeared first on Lown Institute.

During a research career spanning more than 50 years, Dr. Lown considerably changed the practice of cardiology, by pioneering development of medical devices such as the direct current defibrillator and the cardioverter. He was a leader in researching the role of psychological factors in heart disease, and showing how listening to patients is integral to healing.

But Dr. Lown also took his work beyond the walls of hospitals and medical schools, leading countless struggles for justice, social equity, and peace, locally and globally. In the early 1960s he was a founder of Physicians for Social Responsibility, and in the eighties he co-founded International Physicians for the Prevention of Nuclear War (IPPNW) with Dr. Yevgeny Chazov from the Soviet Union. This work came out of a desire to protect not just his patients, but everyone– a similar force that drives doctors to protest police violence today.

Although Dr. Lown and Dr. Chazov were eventually awarded the Nobel Peace Prize for their work, they encountered criticism from politicians for working across borders during the Cold War. In an interview on Boston Public Radio in 2008, Dr. Lown told a story that explains he kept fighting against nuclear proliferation despite the criticism:

“In this packed news conference a Russian journalist is raising his hand and next I look around he’s on the floor, he has collapsed. Chazov and I were next to him and I’ve dealt with sudden death all my life. I recognize that it’s a cardiac arrest, it is clear to any doctor, and the place is also full of doctors. So we start pumping on his chest and start ventilating him. And the rescue team is slow in coming, they come late, and there they roll in- the very cardio defibrillator I developed. And to me, I’m living in some other world. This couldn’t happen by chance. And they shock him, and he doesn’t recover. And the body’s led out.

As they rolled him out, one of the American doctors says, ‘lets give him another shock’ and they did, and he came back. And I, almost in tears, say, Look, what you have just seen is what doctoring is all about and what our movement is all about. When somebody’s threatened with cardiac arrest, we don’t ask who they are, or what they do, what their politics are, we try to save a human life. And now we’re trying to save the life of this world.”

Our country is currently grappling with two public health crises: police brutality and the Covid-19 pandemic, both of which disproportionately affect black Americans. In response to the anti-racism protests sweeping the nation, more than 1000 health care professionals asserted in an open letter that “opposition to racism is vital to public health,” and that the pandemic should not be used as an excuse to try and shut down the protests.

“We believe that the way forward is not to suppress protests in the name of public health but to respond to protesters demands in the name of public health,” the authors wrote. “We can show support by facilitating safest protesting practices without detracting from demonstrators’ ability to gather and demand change.” 

“When somebody’s threatened with cardiac arrest, we don’t ask who they are, or what they do, what their politics are, we try to save a human life. And now we’re trying to save the life of this world.”

Dr. Bernard Lown

Health professionals are frustrated and dismayed to see their patients–and in some cases, their colleagues–being harmed by the police because of their race. One in every 1,000 African American men and boys can expect to be killed by police in their lifetime, making death by police violence a leading cause of death for young black men in America. Many health professionals know, as Dr. Lown knows, that being an advocate for patients means going beyond providing medical care, to addressing the factors outside of the hospital or clinic that contribute to peoples’ health. They also know that without a chance to live, no one has the chance to be healthy.

In his acceptance remarks upon receiving the Nobel Peace Prize in 1985, Dr. Lown said that before turning to other health care concerns “first we must be able to bequeath to our children the most fundamental of all rights, which preconditions all others: the right to survival.” Covid-19 and racism pose deadly threats to us all; it is imperative that we tackle them both.

The post What Dr. Lown teaches us about medicine and activism appeared first on Lown Institute.

–Bernard Lown

Our hearts go out to the Lown family, who lost Louise Lown on Friday. She was the beloved wife of Dr. Bernard Lown for 73 years, and a loving mother, grandmother, and sister. Louise was a graduate of Tufts University (BA) and Smith College School of Social Work (MSW), spending 25 years as a social worker and 70 years as a peace activist.

In 2007, the Louise Lown Heart Hero Award was established to honor Louise Lown and her lifelong commitment to the rights and wellbeing of others through her work as a social worker, activist, and writer. The award was presented annually for six years, recognizing innovative approaches to promoting cardiovascular health in developing countries and other low­-resource settings.  

The Lown Institute would not exist as it does today without Louise’s decades of commitment to social justice and support of Dr. Lown’s work. She will be greatly missed. 

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