I am happily married to my wife Judy and have three children. One is in the Navy, one is a heavy equipment operator, and one is a patient care attendant for the mentally challenged. I am a 30-year veteran of healthcare with twenty-seven years in invasive cardiology. I am culturally diverse as a result of working in several different areas of the country. I also have experience in pediatric, interventional and diagnostic invasive procedures, as well as peripheral vascular interventions.

Why did you choose to work in the invasive cardiology field?
My father had a heart cath while I was a radiologic technologist working in special procedures. The field seemed extremely interesting and I thought, Wow, I want to do that!

Can you describe your role in the CV lab?
My role of director includes that of teacher, scrub assistant, and circulator or gofer you know, go for this and go for that?

What is the biggest challenge you see regarding your role in the CV lab?
Keeping physicians satisfied and the schedule moving. If you have done that, then you have conquered the world for that day.

What motivates you to continue working in the CV lab?
Patients™ thank yous and being able to correct some of their vascular disease immediately. Making people feel better is instant gratification.

What is the most bizarre case you have ever been involved with?
Actually two come to mind. The first was an antero-septal myocardial infarction (MI), which created an apical ventricular septal defect (VSD), and the second was a pedunculated mass attached in the left main that would swing back and forth with systole and diastole.

I also remember a particular event that happened in the early 1980's. We were called in to treat a patient for acute MI. At that time, streptokinase was infused directly into the coronary artery to dissolve the blood clot. Our patient was visiting Nashville from Idaho. The physician asked the patient to cough after the coronary injections. All of a sudden, the patient starts hollering Oooooooooweeeeee! Ooooooooooweeeeee! We all thought he must be in terrible pain, and when we asked the patient what was wrong, he said, Nothing! you asked me to call, and I did. The patient was slightly hearing-impaired and thought we asked him to do a hog call. The physician, Dr. James Ward, almost fell over from laughter.

When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high?
Light comedy and music (usually the choice is left up to the patient.) We all need humor in our lives and the music, turned on low in the lab, is kind of a subliminal mood elevator as long as the patient doesn't mind our choices.

Are you involved with the SICP or other cardiovascular societies?
I recently became a member of SICP, and am also a member of the following:
American Society of Radiologic Technologists
American Heart Association
American Academy of Medical Administrators
American College of Cardiovascular Administrators
Alliance of Cardiovascular Professionals
Advisory Committee, School of Cardiovascular Technology Associate Degree Program, Northwest Mississippi Community College, Desoto Campus, Southaven, MS

Are there websites that you would recommend to other CV labs?
Yes, www.cathlab.com, www.sicp. org, and www.theheart.org.

Do you remember participating in your first invasive procedure?
Yes, it was quite intimidating and I thought I would never learn everything. I had never been in a cath lab before. I had been to the OR, many times, in their sterile environment and in the cath lab, here I was sitting in front of a huge black and gray machine with knobs, wires, and buttons everywhere (for all you old-timers, it was an Electronics for Medicine DR8 [E for M]). The first day I burned my arm several times and everything seemed to go at high speed. I left that day asking, What in the world have I gotten myself into now!?

If you could send a message back to yourself at the beginning of your CV lab career, what advice would you give?
It will get better; just give it twenty or so years!

Where do you hope to be in your career when it is time to retire?
I hope to continue to direct and manage a heart program that is committed to maintaining high expectations and the best possible outcomes. Preferably, in a small-to-medium city somewhere on the beach.

Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
Yes, two people in particular come to mind. The first is Wayne Hunter, RN, in Nashville, Tennessee. The other is William S. Wheeler, MD, in Cary, North Carolina. Both had their own unique teaching styles, and because of this I hold great respect for them.

Where do you think the invasive cardiology field is headed in the future?
I think that at some point in the future, invasive cardiology will be so micro that most of the things done today will be done in an outpatient setting, and will require only a few hours stay. Let's face it thirty years ago the treatment for an MI was to put in a Swan-Ganz monitoring catheter and a pacemaker if necessary, and the patient was monitored through or after their MI. They were then cathed to see if they were a candidate for surgery. Things have changed quite dramatically over the years. Although the techniques are basically the same, the equipment continues to evolve to smaller and smaller sizes. When angioplasty first came along, there were C02 tanks, tubing manometers and the like. The first guide catheters were 9 French. Today's professionals would consider that insane. IABP catheters are now down to 6 French. Things will continue to be miniaturized.