In Memoriam

Carlos C. Martin was born in Parkersburg, West Virginia, on 16 November 1929. He earned a Bachelor of Science degree in Electrical Engineering from Ohio State University in 1945. In 1964, he joined the Baylor College of Medicine as a research engineer, and in January 1970 he became associated with the Texas Heart Institute as a biomedical engineer.

In 1973, Mr. Martin accepted our invitation to develop a “Heart Sounds Laboratory.” Its purpose was to record, for teaching purposes, the heart murmurs and abnormal heart sounds that characterized the great variety of illnesses of the numerous patients who came to the Institute for diagnosis and treatment. These patients contributed to the training of young cardiology specialists and students, but their rapid turnover seriously limited their long-term availability for teaching. Using Mr. Martin's skills in electrical engineering, we set out to produce high-fidelity recordings of patients' illustrative physical findings for use in both education and research.

Carlos was asked to develop a system that would record, to the most accurate extent possible, what the clinician heard at the bedside examination. This he accomplished with great skill. A generous grant from a wonderful and grateful patient, the late Mrs. Mamie McFadden Ward, helped greatly in the development of our Heart Sounds Laboratory. Under Mr. Martin's direction, the 1st heart sounds were recorded on 10 July 1973.

The 1st recordings consisted of only the audible heart sounds and murmurs, along with a graphic tracing of the sound signal (a phonocardiogram) and a single-lead tracing of the electrocardiogram for timing purposes. The student could view this information on an oscilloscope and listen to the sounds with a stethoscope. All of the necessary equipment was developed and assembled by Mr. Martin. He subsequently added pulse and movement signals, so that simultaneous arterial and venous pulsations, and apical and precordial movements, could be recorded and observed. A library of interesting tapes developed rapidly and became the core of our “teaching from patients” efforts at the Texas Heart Institute. This library also became the source of material from which our highly successful Annual Spring Auscultation Symposia developed. In April 2002, the 20th such symposium was held in the Institute's new Denton A. Cooley Building.

In the late 1970s, Carlos added television video imaging of the patient to the recording process, and this greatly enhanced the realism of the presentation: the student could now experience the entirety of the cardiology physical examination, viewing directly the venous and arterial pulsations, the precordial movements, and the location of the stethoscope on the chest, while simultaneously listening to the heart sounds and murmurs. Carlos had put together an outstanding teaching tool that achieved wide acclaim.

The natural next step—video imaging in the operating suite and the catheterization laboratory—added immeasurably to the collection of illustrative teaching material. Support of the Institute's various symposia became an increasing responsibility of the laboratory, as did “real time” conferencing by means of “on-line” video from surgery or the catheterization laboratory. These efforts expanded the teaching role of Mr. Martin's group, which by then had become the Biocommunications Department, under his direction.

As teaching from recorded data became more frequent, the trainee's stethoscope evolved from a hard-wired device to the Sennheiser wireless stethoscope that received infrared signals, and finally to the current, low-cost Walkman-like device that receives radio-frequency FM signals. Mr. Martin developed this last technique with Drs. Julius Bedynek and Proctor Harvey at Georgetown University. ¹

When digital technology evolved in the 1990s, Carlos supervised the conversion of large amounts of the teaching material from analog to digital format. Now the hard drive and the laptop replaced the videotape cassette player, and even more imaginative manipulation of the teaching material became possible. Digital manipulation facilitated broader dissemination of the teaching material, not only at intramural conferences, but also at extramural conferences and on personal computers, this last by means of compact discs. The technique of teaching bedside cardiology blossomed as a result of Mr. Martin's innovative assembly of equipment: if the item that he needed was not commercially available, he designed and fabricated it.

The Heart Sounds Laboratory became a wonderful vehicle for Carlos's talents and skills, and he performed with great distinction, a constant challenge to those who worked under his direction. In 1990, Carlos was recognized by the Institute for his 20-year commitment and for his unwavering support of the high level of education possible at the Texas Heart Institute. This past year, in spite of a chronic, relentless illness that progressively eroded his strength, he continued to work almost until his death on 9 June 2002. Carlos will be greatly missed by his family and by all of his colleagues and associates at the Institute.

A Heart Sounds Laboratory, Education, and Research Fund has been established in Carlos's honor and memory. This fund will receive donations in his name and will continue to serve the cause that meant so much to him.

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