It must have been an oversight. Somehow, I was (again) not included in Time Magazine's ranking of the world's 100 most influential people. But I am not jealous that Dr. Steven Nissen made the list. He deserves it.
Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, was just one of the dozens of world-class speakers at the fifth annual Cleveland Clinic Medical Innovation Summit in October held at the InterContinental Hotel.
With U.S. News & World Report ranking the Cleveland Clinic No. 1 in heart care for the 13th consecutive year, it added special importance to this year's summit, "State of the Heart — Cardiovascular Technologies." Clinic CEO Dr. Delos "Toby" Cosgrove reminded attendees it was 50 years ago, almost to the day, that the first angiogram was performed.
Wandering the exhibition area was like a trip to the future. One large device seemed like an elaborate video game as people peered into a screen and worked joysticks. But in actuality, they were simulating surgical procedures with their movements driving the robotic engine to precise operations.
Chris Coburn, director of Cleveland Clinic Innovations, said the robot, named DaVinci, offered greater control, strength and "far greater precision than you could with your own hand. It removes the tremor that is present in any human [hand]."
Coburn also mentioned a "gee-whiz" item from its annual Top Ten Medical Innovations list. It's a brain implant that will allow a person to manipulate a device using their thoughts alone. Just think of the applications for quadriplegics and the disabled! Coburn enthused, "You talk about the future? This is it."
The summit kicked off with a panel of experts moderated by talk-show host Larry King. Wearing his trademark suspenders, King spoke about the Larry King Cardiac Foundation, which he started shortly after his own heart attack and quintuple bypass surgery 20 years ago. Its mission is "to provide funding for life-saving cardiac procedures for individuals, who, due to limited means and no insurance, would be otherwise unable to receive life-saving treatment."
Along with Nissen, the panel included Elizabeth Nabel, a director at the National Institute of Health, and Bruce Lytle, a Cleveland Clinic cardiothoracic surgeon. Representing pharmaceuticals and medical devices were Tony Zook, CEO of AstraZeneca, and Michael Mussallem, CEO of Edwards Lifesciences.
When moderator King asked what was the biggest innovation of the last five years, Lytle answered by stating the continued progress toward smaller or even no incisions in surgical procedures.
Zook emphasized the fight against arteriosclerosis and diabetes were most innovative. "I think we can cure diabetes," he predicted. All bemoaned the childhood obesity epidemic, with Nissen stating, "We've been winning the war against heart disease over the last 25 to 30 years, but now we're starting to reverse that trend."
Lytle jokingly apologized to TV star King before proclaiming, "I think it started with television."
Zook predicted a diabetes drug might be 12 to 18 months away. A sad but probably accurate indictment of our society, the panel believed we would be more likely to have a drug defeat obesity and diabetes than lifestyle changes. This mirrored Nissen's biggest frustration — patients who don't do their part.
"There's nothing better than preventing a disease," said Nissen, predicting doctors will be able to raise HDL (good cholesterol) and not just lower LDL (bad cholesterol)" as we do now.
But technologies take a long time to develop. "When I came to Cleveland Clinic in 1978, the artificial heart was just around the corner, and it still is," Lytle said.
Nabel sees great promise in stem cells and genetics, as genetics can identify those at the highest risk for certain diseases. "If you knew at age 20 that you were predisposed to a problem in your 50s or 70s, would you change your life?" she asked.
Of course, health care is a business — a huge and growing business. So when King asked how the need for new technology can be balanced with the cost, Nissen responded, "Most of the time new therapies tend to be expensive. We're firemen — we put the fire out. Prevention is so much better, and it saves lots of dollars, too."
And when King asked if drugs should be free, Zook stated a "pharmaceutical reality." It takes 5,000 compounds to get one to market. He realizes the bad public image of Big Pharm but said, "We hide our light under a barrel." A family of four making $60,000 or less and individuals making $30,000 or less get their drugs free, he explained, adding all the innovation comes from the United States. "Europe used to be a stronghold, but no more."
Mussallem pointed out that our aging population naturally leads to more cardiovascular disease; two-thirds of us will have it eventually. Lytle agreed, saying the longer you live, the more you spend on food, clothes, vacations — and health care.
Later in the summit, Gov. Ted Strickland praised Ohio for ranking first of all 50 states in U.S. News' hospital rankings, hosting 25 percent of all clinical trials in the United States and being in the top 10 in biotech growth, stating, "The bioscience revolution has found a home in Ohio."
He then announced the creation of the Global Cardiovascular Innovation Center (GCIC), in collaboration with Fairfax Renaissance Development and more than 20 biomedical and academic institutions. The GCIC will be a 65,000-square-foot incubator for cardiovascular technologies that is being seeded with $60 million of Third Frontier grant funds — the largest ever Third Frontier grant.
Not only will the $250 million effort develop new cardiovascular technology for products to benefit patients, Coburn said, but it should be a magnet to attract companies to Cleveland. "Our vision is that the Cleveland Clinic campus will be ringed by companies who will benefit from the exchange with our innovators and clinicians." Entreprenerd Dan Hanson (firstname.lastname@example.org) has never worn suspenders. He is eager to inform snobs from the coasts that Cleveland is "Heart-land" and not just part of the flyover heartland.