Lives of the fellows

Mark Edwin Silverman

b.21 June 1939 d.12 November 2008

Mark Silverman was the founding cardiologist at the Fuqua Heart Center at Piedmont Hospital in Atlanta, Georgia, and an outstanding teacher and mentor to many students, nurses and physicians. He was known internationally as a medical historian who wrote numerous articles, chapters and five books.

Born in Springfield, Ohio, he attended Ohio State University, where he was an honour student and played on the freshman tennis team. After three years he entered the University of Chicago’s school of medicine. In 1963, he returned to Ohio State for his medical residency, where he was profoundly impressed by a visiting professor, J Willis Hurst. He subsequently completed a cardiology fellowship under him at Emory University and co-authored a biography on the noted cardiologist.

As a cardiology fellow, he made front-page news around the world for his article ‘The hand and the heart’ (Am J Cardiol, 1968 Nov;22(5):718-28), in which he put forward the idea that certain heart conditions manifested in abnormalities of the hand. The article begins with a quote from James Bond and emphasises a Sherlock Holmesian approach to bedside medicine. In 1970, after two years in the Air Force, he returned to Piedmont to join the Emory University medical faculty in a unique position based at Piedmont Hospital. This dual role, one at Emory and the other at Piedmont, flourished for 38 years and ultimately brought 75 cardiology fellows and many students and residents under his mentorship, and with it a well-deserved reputation for establishing an academic dimension at a community hospital. In addition, he taught hundreds of auscultation workshops for nurses, students and physicians locally and throughout the region.

His teachings always emphasised the historical traditions and bedside art of medicine. For 37 years he taught the Emory freshman anatomy course, speaking and dressed as William Harvey [Munk’s Roll, Vol.I, p.124] (in period costume as if lecturing to the Royal College of Physicians in 1616 about his discovery of the circulation of blood).

Silverman believed that teaching nurses would have the greatest impact on patient care. During his 38 year career, he enthusiastically taught many nurses, for which he acquired the title ‘the advocate of nurses’. In 2008, the nurses at Piedmont Hospital surprised him with a party, thanking him as their teacher, guide and colleague. He started and chaired one of the first patient education libraries in the country (The Nicholas E Davies Community Health Information Center), spoke at many public gatherings, and started a cardiac care unit booklet (Heart attack, what’s ahead? A manual for patient/consumer health education [Atlanta, Georgia, Prichett & Hull Associates, c.1980]) for coronary care patients that sold several million copies, with royalties given to the American Heart Association. As the sole consultant cardiologist at Piedmont Hospital for eight years, he initiated and ran the treadmill stress, echocardiography, and electrophysiology laboratories, a cardiac rehabilitation programme, and a PRO-HEALTH exercise centre for patients and employees. As chief of cardiology at the Fuqua Heart Center, he oversaw the development of one of the largest cardiac programmes in the south east, now numbering over 60 cardiologists.

In 1998, Silverman and his wife, Diana, spent a six-month sabbatical in London, researching British medical history as an academic fellow at the Wellcome Trust Centre for the History of Medicine. Articles on the lives of British cardiologists such as Paul Wood [Munk’s Roll, Vol.V, p.456] and a book British cardiology in the 20th century (London, Springer, c.2000) were inspired from this special opportunity. For his contribution to the history of British cardiology he was honored with fellowships from the College and from the Royal Society of Medicine. He returned to Atlanta sporting a new car, a BMW Z3 convertible, which he reluctantly sold when his health status began to deteriorate.

Organisations played an important role in his life. He was president of the Georgia chapter of the American Heart Association (1979), governor of the Georgia chapter of the American College of Physicians (1995 to 1999), president of the American Osler Society (1999), and a member of the American Board of Internal Medicine subspecialty board on cardiovascular disease (2001 to 2007). Silverman founded the Atlanta Medical History Society, the Atlanta Forum of Cardiology and the Atlanta Regional Society of Echocardiography.

He was especially proud that he was able to encourage the involvement of others and to see that their work was properly recognised. As a side interest, he designed the membership tie of the American College of Physicians and the American Osler Society. His awards included the Georgia Governor’s Award in the Humanities (1986), Friend of Children Award (1986), the J Willis Hurst Outstanding Bedside Teaching Award of the American College of Physicians (1993), a mastership of the American College of Physicians (1999), the Laureate Award of the Georgia chapter of the American College of Physicians (1999), the Golden Apple Award for teaching given by the Emory Residents (1990) and the J Willis Hurst Award for Excellence in Teaching Cardiac Fellows (1993). He was Atlanta Heart Ball honoree (1999) and the R Bruce Logue honoree for ‘Excellence in Medicine’(2005), given by the American Heart Association. He was chosen to be the Emory Medical School graduation speaker by the class of 1974 and the faculty member of Alpha Omega Alpha (the medical school honorary) by the class of 1983. He was also the Alpha Omega Alpha speaker at the University of South Carolina.

Over the last six years of his life he battled valiantly against debilitating symptoms of a rare small fibre neuropathy. He consulted various physicians and healthcare professionals, researched the literature with his usual thoroughness, and tried a multitude of therapies, all to no avail. He described the symptoms as periodically overwhelming, “like being in a vat of boiling oil, plus electric shocks”. He found it ironic that he, “who had such an interest in teaching about rare diseases, would have such a rare disease that no neurologist had ever seen.”

He had to give up tennis in 2004 and cycling in the following year, both activities he enjoyed. He continued to work hard in his cardiology practice, making hospital rounds on a scooter, as walking was so painful. He was sustained by Diana, “my beautiful, magnificent and caring wife” and found that the disease “brought a new dimension of respect and love and strength” to his marriage. Another source of great joy to him was his young granddaughters, Sophie and Mira.

Silverman was interviewed in 2003 as part of the Piedmont Hospital archives project. When asked a final question as to words of wisdom to anyone coming to work in a hospital, Mark’s response was typical of the man: “I think (the important thing) is always to have the patient as your focus, and to practice medicine for the right reasons. You should go into medicine as a physician or nurse because you feel like you want to do things to make people happier and healthier. The more separated you are from that idea, the more you are involved with technology or finances or things like that, the less happy you will be. And I think that is what has sustained my enthusiasm for medicine; it has always been patient and nursing focused. I am surrounded by people that I enjoy working with, and I feel like I am able to help them do a better job in taking care of the people that they see.”

A great friend, husband, father and grandfather, as well as a dedicated teacher, scholar and cardiologist, Silverman died unexpectedly from a cardiorespiratory arrest in November 2008. He is survived by his wife and two sons, Joel and Adam.

John D Cantwell

[The Atlanta Journal-Constitution 14 November 2008]

(Volume XII, page web)

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