Noted Cardiologist W. Proctor Harvey
Wednesday, October 17, 2007
W. Proctor Harvey, a Georgetown University professor of medicine whose books, teaching and diagnostic skills made him one of the nation's most respected cardiologists, died Sept. 26 from complications of a fall at his home in Richmond. He was 89.
Dr. Harvey had been a professor at Georgetown since 1950 and was considered the nation's most skilled practitioner of auscultation, or the ability to detect cardiac ailments by listening to the sounds of the heart. He invented stethoscope models, his books have been standard texts for more than 50 years, and his patients included at least four presidents as well as diplomats and Congress members.
With his low-key teaching style, which relied on music, common sense and the careful observation of patients, he trained hundreds of cardiologists who are now at top medical centers across the country.
A strong advocate of the human touch in medicine, Dr. Harvey had a gentle bedside manner that extended to shaking hands with every patient and plumping up their hospital-room pillows. He believed modern physicians had become too dependent on technology and other diagnostic tools and had lost the ability to work with patients on a simple, person-to-person level.
"For the past few decades," he told a Georgetown publication in 2000, "the trend has been to order too many tests too early . . . when a complete and careful history and an excellent physical examination can produce the same information. The sounds of the human heart are enduring. They won't ever change."
Generations of medical students and doctors were astonished by Dr. Harvey's ability to diagnose complex cardiac problems simply by taking a patient's pulse or by listening through his stethoscope to a beating heart.
"He had an uncanny skill at cutting extraneous material and coming up with the correct diagnosis," said David C. Canfield, a specialist in recording technology who collaborated with Dr. Harvey on cardiology textbooks and recordings of heart sounds. "For years, he was the physician of last resort for people with heart disease."
Canfield once saw Dr. Harvey enter the room of a patient near death from a mysterious heart ailment that no tests could identify. From the doorway, Dr. Harvey noticed that the veins in the man's neck were pulsing in an irregular way and immediately diagnosed constrictive pericarditis, an inflammation of the protective lining around the heart. The patient was treated and walked out of the hospital.
"Dr. Harvey's incredible gift was being able to make sound clinical diagnoses from basic clinical examinations and the bedside," said Michael A. Chizner, a former student who is a cardiology professor and medical director of a heart institute in Fort Lauderdale, Fla. "He's an icon whose name is synonymous with the art of clinical auscultation. Dr. Harvey has elevated the discipline of cardiovascular diagnosis to an art form."
Part of his diagnostic artistry came from his sensitivity to music and sound of all kinds. He often began his classes by playing the introductory passages of Beethoven's Symphony No. 9. After a few minutes, he would ask the students whether they had heard the trumpet.
He would play the music again, directing them to listen just to the trumpet, the timpani or another instrument. Then he would ask them to listen for only the rhythm, reminding them that the heart beats in rhythm and that the best way to understand its health is to know the sound it makes.
Dr. Harvey was famous for his "five-finger" approach to diagnosis, which consisted of detailed history, physical examination, electrocardiogram, X-ray and appropriate tests, in that order. For years, he held seminars for practicing cardiologists, as well as Georgetown Thursday Night Cardiology Conferences, that doctors traveled hundreds of miles to attend.