His reputation precedes him
Cardiologist David Holmes is respected worldwide for his knowledge, rigor and integrity
David R. Holmes Jr., MD ’71
At the institution he has called home for the last 36 years, David R. Holmes Jr., MD ’71, has been respectfully dubbed the “Preacher from the Prairie” for his evangelical lecture style. As his close friend and colleague at the Mayo Clinic, Robert D. Simari, MD, explains, “he brings a lot of himself to his lectures in a way that is informative but highly entertaining as well. He must be close to the most sought-after speaker in cardiology if not all academic medicine.”
As a faculty member at the Mayo Clinic College of Medicine, a clinical leader and a pioneering scholar in cardiology, Dr. Holmes demonstrably practices what he preaches. He has been chosen Medical School Alumnus of the Year by the Medical College of Wisconsin/Marquette Medical Alumni Association.
Dr. Holmes is Professor of Medicine in the Department of Cardiovascular Diseases at Mayo Clinic and the Edward W. and Betty Knight Scripps Professor in Cardiovascular Medicine. He has served as Director of both Electrophysiology and Pacing and the Cardiac Catheterization Laboratory. After beginning his career interested broadly in cardiac electrophysiology, his focus shifted as he progressed to interventional cardiology, and he has been at the forefront of therapeutic technologies that have helped transform the field. He describes the growth that has taken place in cardiology during the past three decades as revolutionary and leading to improved outcomes for patients.
“We have learned more about optimizing specific patient care and applying technological improvements as well as system improvements to optimize that care,” Dr. Holmes said. “We can now take patients with acute heart attack, who in the past were treated with bed rest, get them into the hospital, and within three days they can be dismissed to a rehabilitation program.”
Deaths by cardiovascular disease have decreased by 30 percent in this time, he said, despite evidence that the population has become more sedentary and overweight. He points to a disease like aortic stenosis to demonstrate how advances in cardiac care have led to improving results for patients.
“The field of structural heart disease continues to blossom, so we now have strategies for patients we never had before,” Dr. Holmes said. “We saw patients with types of diseases that were once inoperable because of severe comorbidities, like aortic valve diseases, and now we can treat them with catheter-based approaches.”
Coordinating the heart team
Dr. David R. Holmes Jr. addresses his peers after being elected President of the American College of Cardiology in 2011.
Despite authoring 178 book chapters and co-authoring 17 books in his field, despite serving as principal or co-investigator on more than 70 National Institutes of Health and industry-sponsored studies, and despite a list of honors that includes the American College of Cardiology Distinguished Scientist Award and an Honorary Fellowship of the Royal College of Physicians of Ireland, Dr. Holmes considers his most significant contribution to medicine to be furthering team-based care. Optimizing care for patients depends on cooperation between different disciplines, such as cardiovascular surgery and interventional cardiology, an understanding he has worked hard to foster.
His emphasis on collaboration is an example of his humility, said Dr. Simari who was trained by Dr. Holmes and is now Vice Chair of Cardiovascular Diseases and Dean of Clinical and Translational Research for all of Mayo. Among the leading experts worldwide in interventional cardiology, Dr. Holmes has also been an early adopter of emerging technologies and procedures, including coronary angioplasty, Dr. Simari said.
“David learned from the founders of the art but became a skilled leader and top educator in the field of interventional cardiology,” he said. “He became a go-to operator in the most difficult cases worldwide. His reputation grew for intracoronary procedures, and people came from all over the world to see him.”
Dr. Holmes brought sanity to the revolution of interventional cardiology, Dr. Simari said, by engaging in thoughtful, critical research that eschewed self-interest while seeking to develop leading-edge therapies. His work expanded to include the development of devices implanted in the heart to prevent stroke in patients with sustained irregular heartbeat.
He was principal investigator on the recent PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) trial. The study found that occlusion of the left atrial appendage (a part of the heart’s anatomy where blood tends to pool and clot in patients with atrial fibrillation) is effective in preventing thromboembolism without long-term anticoagulant therapy.
With atrial fibrillation affecting about six million Americans, the study’s results are meaningful for those patients for whom warfarin treatment is contraindicated due to increased risk of serious bleeding. The study also points to one of the strengths of cardiology that helped ignite Dr. Holmes’ interest in the field.
“I think cardiology has served as the role model for evidence-based care,” he said. “There have been more randomized trials in cardiovascular disease than in the majority of all other specialties because it’s a field that has embraced the concept of large-scale randomized trials and large-scale registries. There is a wealth of information upon which to base guidelines of care.”
David R. Holmes Jr., MD ’71, Mayo Clinic cardiologist and scholar, is the Alumni Association’s 2012 Medical School Alumnus of the Year.
Having helped advance the field of cardiology through scientific pursuit, Dr. Holmes has also contributed to its legacy by mentoring a generation of cardiologists. His trainees can be found in prestigious positions across the globe, and he continues to interact with residents and medical students on a daily basis. His dedication supports his assertion that one of his greatest sources of pride is the opportunity to put science and education at the forefront of his discipline.
This is a theme that resonated with the membership of the American College of Cardiology (ACC), who elected him President of the society last year. Throughout his one-year term, which concluded at the end of March, Dr. Holmes has emphasized educational enhancement as well as building collaborative relationships with surgeons and other heart team members.
Dr. Holmes’ commitment to the ACC has spanned 34 years, nearly his entire career. A Fellow of the ACC, he has served on its Board of Trustees, led numerous committees and is a former Governor of its Minnesota chapter.
Currently, Dr. Holmes is Chairman of the ACC FAME (Foundation to Advance Medical Education) Initiative, Chairman of the Procedure Training Working Group, Co-Director of the Heart House Interventional Cardiology Course, and Co-Director of the annual Cardiology at Big Sky meeting.
Dr. Holmes is also a Fellow of the American Heart Association and a Fellow and Past President of the Society for Cardiac Angiography and Interventions. He served in the U.S. Navy at the National Naval Medical Center in Bethesda, Md., and retired from the Reserve as a captain in 2004 after more than 25 years of service. He and his wife, Ginger, have raised three sons and a daughter.
His life’s journey has been both purposeful and serendipitous, and his path from the Medical College of Wisconsin to the Mayo Clinic is one upon which he can reflect with satisfaction.
“I didn’t envision an academic career path, initially,” he said. “I was uncertain which direction to go. I lighted here and was lit by here.”
In your career, what has been most rewarding...
...as a physician? “Getting to know and understand individual patients, their expectations, their illness and trying to make a difference in each one of their lives.”
...as a researcher? “The chance to push the frontiers.”
...as a teacher? “The chance to educate and impart my knowledge to students, residents and fellows while learning from them and learning with them.”
Reflections on the honor
“First, I think that there are many people far more worthy than I,” said David R. Holmes Jr., MD ’71, the 2012 Medical School Alumnus of the Year. “I think it’s an amazing honor, given fact that the Medical College is where it all started.
“One goes to medical school not knowing exactly how it will work out. Then to be there and entranced by the science that was there: To see a Dr. Zeit draw with both hands simultaneously on the blackboard and have perfect images with either hand. Or hear about the Wisconsin story of anticoagulant therapy, and how it started in sweet clover that had been spoiled. Or to make rounds with incredibly talented cardiologists who were also talented researchers. To have the opportunity to learn about your colleagues in school who have since gone on to great heights in medicine. And to enjoy, then, the collegial comfortableness of a great school and a great town. And even see to some basketball. My experience at the Medical College wound up being an incredible privilege and pleasure.”
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