Chris’s Corner: A Family Reunion at ACC.14 | CardioSource WorldNews

By Christopher P. Cannon, MD

How many attendees to the ACC or AHA Scientific Sessions also consider the meeting a family reunion? Probably not many, but Barry, Martin, Brad, and David Maron are the exception. For the Marons—father, son, son, and cousin who work at four different institutions in California, Massachusetts, and Minnesota—presenting original scientific work at national meetings is only part of the event. For this edition of Chris's Corner, we sat down and talked with the Marons about cardiology, family, and what happens when a patient has been referred to the wrong Dr. Maron.

Figure Graphic

Left to right: Barry, Martin, Brad, and David Maron
Click Image to Enlarge.

Chris's Corner: Barry, you are best known in cardiovascular medicine for your work on hypertrophic cardiomyopathy (HCM) and sudden death in the young. Your first significant publication was more than 40 years ago in Circulation (1973). How has clinical research in cardiology changed over that time?

Barry: Just about everything has changed, but from my standpoint in particular, HCM has evolved to a relatively common, contemporary, and treatable disease from a rare, exotic, and uniformly grim condition. What hasn't changed, even in the Internet age: I still first write every word of my manuscripts on a yellow legal tablet. I was pleased to learn recently from Eugene Braunwald that he essentially operates the same way.

It is hard to believe that you have two sons in academic cardiology by chance... or was it? Is that something you planned, like the father of the Williams sisters in professional tennis?

Barry: Not at all. At dinner our family talked mostly about sports and miscellaneous things, anything other than cardiology. Encouraging your children to go into medicine outright always seemed like a bad idea. I only tried to lead by example. By the way, in med school I recommended neurology to one son and gastroenterology to the other.

Still, there must be experiences that brought you closer to your children through medicine?

Barry: Certainly, but they weren't planned. For example, I had the opportunity to be a Grand Rounds speaker at each stage of both Marty's and Brad's medical education. That was very special.

And you co-authored a manuscript with your sons. How did that come about?

Barry: One day, Brad was teaching me the benefits of therapeutic hypothermia for patients with cardiac arrest. He had firsthand experience with this therapy on a clinical rotation during his cardiology fellowship. About the same time, Marty and I had separate experiences with hypothermia in the treatment of patients with HCM and cardiac arrest. We put together a series of patients that was published in JACC with all three of us as co-authors. How often does that happen?

Marty, your dad says he did not go out of his way to influence your career. But I can see you have taken a special interest in HCM. Is this sort of a family business now?

Marty: I never looked at it that way, although I have always been inspired by my father and his commitment to the disease. He cares a tremendous amount about his patients. During cardiology fellowship, I thought I could see myself emulating him in that way. It's an open-ended learning curve, but I definitely am glad to have chosen this pathway.

Do you ever get confused with your father?

Marty: Yes, but, strangely, I am mistaken for my sister-in-law much more often. Jill, who is Brad's wife, is a neonatologist at Tufts Medical Center where I work. When the caller says the patient is 600 grams in respiratory distress, I immediately know there has been a big mistake...

So there are actually more Maron doctors?

Marty: There are in fact five physicians including Jill. My wife, Alex, is a physician's assistant in cardiac surgery at Brigham and Women's Hospital, where Brad works. It can be confusing, even for us.

I am picturing Thanksgiving dinner at the Marons as one big Morning Report. Is that accurate?

Marty: No way! We rarely talk about patients or academic cardiology during holidays or vacations. We enjoy taking time to hang out with Brad and Jill's kids.

The next generation of Maron cardiologists?

Marty: As you know, HCM is a genetic disease and follow-up is very long, over decades of life. We're hoping that interest in studying HCM is also genetic. We may need them.

How does David fit into the family picture?

Marty: David's grandfather and my grandfather were brothers, so my father and his father are first cousins. Brad and I didn't know he existed, let alone that he was a cardiologist, until we literally bumped into him at a national cardiology meeting a few years ago.

Physically ran into him?

Marty: Exactly. My dad and I were walking one way and he was walking the other and we collided. We checked out his nametag and were very confused. But, we sat down and talked it out. David is a truly great person, I have learned a lot from him in a short amount of time. There is no doubt he is one of us.

Brad, you're a basic and clinical scientist studying pulmonary hypertension. How did that happen?

Brad: I wanted to study disease mechanisms and benefited from world-class mentorship in the vascular biology laboratory of Drs. Joseph Loscalzo and Jane Leopold after medicine residency. I was hooked on basic science after that. When I was a clinical fellow, I met my first patient with pulmonary arterial hypertension. It is a dramatic disease and I immediately empathized with the patients. For a vascular biologist, pulmonary hypertension is an important disease.

Often, the youngest in the family tries to “live up” to the other family members. Is that something you think about?

Brad: Of course I do, on some level. I have also learned science from truly accomplished investigators, and living up to them is not a chip shot either. In the end, I am most grateful for the examples my brother, father, and cousin have set for me, and for the advice of my mentors in science.

Your brother said he got paged about your wife's patients. Any similar mix-ups?

Brad: Absolutely! During cardiology fellowship, a patient drove from New Jersey to Boston to see me in clinic. When she arrived, I went through the chart to realize she was supposed to be in Marty's clinic, but she was given wrong information in New Jersey. Amazing—correct town, but wrong hospital, wrong clinic, wrong Dr. Maron. I called Marty and we fixed the problem.

David, I understand you are not an HCM or pulmonary hypertension specialist. Another Maron in another area of cardiology?

David: Yes, I am a preventative cardiologist and a clinical trialist in coronary artery disease. I helped design the COURAGE trial and am currently the co-chair and PI for the ISCHEMIA trial.

Four cardiologists at four different academic centers... we have a lot of stories to share and a lot to learn from each other.

You met the other Marons for the first time recently. What was that like?

David: It was amazing. Long before we met and before the advent of online ancestry sites, I had commissioned the creation of a family tree. It was fantastic to meet in person these family members I had traced on paper. I am very proud to be a member of this family.

I have asked all the other Marons, so I'll ask you: do you get confused with Barry or any other of these Maron cardiologists?

David: Yes, mainly Barry. I receive requests intended for him to review manuscripts or write book chapters. I can usually pull together a couple of sentences about HCM before they figure out they got the wrong Maron! Once I pinch hit for Marty for one of his HCM patients who relocated. If someone mistakes me for Brad, though, I'm in trouble. When it comes to vascular biology or pulmonary arterial hypertension, I don't have much game.

Anything else you would like to mention?

Marty: Most important. We absolutely need to credit our...

Brad: Mother.

Barry: Yes, mom is always the key to something like this.

Christopher P. Cannon, MD, is a professor of medicine at Harvard Medical School in Boston, Massachusetts. He is also the Editor-in-Chief of CardioSource Science and Quality.

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