Lessons About the Heart, of the Heart, and From the Heart: Remembering J. Willis Hurst

The heart is synonymous with Dr. J. Willis Hurst, who recently passed away at Emory University Hospital at the age of 90. Although he may be remembered most for the internationally known text, The Heart, first published in 1966, what I will remember most about him is what he taught me (and thousands of others) about cardiology and the heart, through an education of the heart genuinely from his heart.

J. Willis Hurst was the last cardiology fellow to train with Paul Dudley White at Massachusetts General Hospital in 1948. He was the cardiologist and good friend of President Lyndon Johnson. He became the Chairman of Medicine at Emory at the age of 36, leading the department for the next 30 years. He was President of the American Heart Association from 1971 to 1972. During his 55‐year career at Emory, he taught more than 5000 medical students and 2500 house officers. I had the honor and privilege of being among the thousands he profoundly impacted.

In 1990, as a resident I spent a month on the teaching service at Emory. This was Dr. Hurst's last year actively seeing patients. Each morning we met him to make his hospital rounds on his patients before morning report. He was dedicated to the care of his patients, who felt embraced by his wisdom and sincerity. I remember him taking me to examine one of his patients, who had a grade 6 “cooing dove” diastolic murmur related to annuloaortic ectasia, and then escorting me into the next room to see a patient of his with Eisenmenger physiology, pointing out the clubbing and cyanosis of the fingers. His lessons about the heart were captivating and inspiring, motivating so many young learners to pursue a career in cardiovascular medicine. In 1992, when I was chief resident at Emory University Hospital, he became a mentor in the truest sense. He challenged me to recognize the difference between lecturing and the process of active learning. He tutored me in the art of auscultation, imploring that the stethoscope should be used with skill and not be worn as just a medical ornament. We talked about Paul Dudley White's recording of the electrocardiogram of an elephant1 and whale.2 On the occasional days that Dr. Hurst was unavailable, one of my responsibilities was to cover the Hurst conference, an hour‐long session where a resident would present an unknown electrocardiogram (ECG). For 30 minutes Dr. Hurst would dissect the ECG, teaching us to extract every last drop of useful information from the 12‐lead recording including a vector analysis. The chest x‐ray was then reviewed, followed by a presentation of the exam, and finally the patient's history. After integrating all of the clinical information, Dr. Hurst would proceed to the patient's room to instruct us on his masterful bedside exam.

Education and the process of learning were critically important to Dr. Hurst. He recognized the pivotal role of the educator in medicine. He would frequently ask others, “What have you learned today?” Not just to ask, but because he was sincerely interested. He strived to learn something new himself every day even at age 90. During the graduation ceremony for Emory University School of Medicine this past May 2011, my job was to be sure Dr. Hurst successfully navigated past the other faculty and the dean on stage to “hood” his grandson, marking the third Hurst generation connected to Emory School of Medicine. Before the ceremony began, Dr. Hurst shared with me his thoughts on the upcoming event. He told me, “Medical School graduation is like completing kindergarten. Now these students are ready to begin learning.” Even from his hospital bed during his recent terminal illness, he engaged the team on teaching rounds as he wanted to be sure they were thinking. He asked to inspect their stethoscopes to be sure they met his approval, and he posed the following question: “Is the blood pressure normally higher in the arms or legs and why?” The residents and fellow knew he expected a detailed explanation the next day.

At the memorial service for Dr. Hurst, Dr. Doug Morris, Director of The Emory Heart Center, described him as “one of the giants of medicine.” He truly was. He generously shared his lessons about the heart throughout his career. What distinguished him as a real giant was that he genuinely cared. His passion to educate and his concern for patients, colleagues, students, and family were definitely from the heart. His gift to many others, though, was in the education of the heart. James T. Laney, former President of Emory University, described the goal of education as a sharing of values and wisdom as “stewards of the tradition in which…knowledge is applied for the good of society.”3 In 1973, when his mentor Paul Dudley White died, Dr. Hurst delivered a eulogy at the memorial titled “I'm Not Through Yet.” As his lessons remain in our hearts, J. Willis Hurst will always be remembered.