Interview with Dr. Stanley Katz of North Shore University Hospital
by Jeff Balcourt, Daniel DiCamillo, David Katz, Teddy Levarda, Jarryd Levine and Zachary Levine

"In the United States of America the most common cause of death is not cancer. It's heart disease, having a heart attack, and dying of it." Dr. Stanley Katz

Dr. Katz is a Diplomat on the American Board of Internal Medicine and is board certified by the Subspecialty Board in Cardiovascular Disease and the Subspecialty Board in Interventional Cardiology.  He is a Professor of Medicine at NYU, vice-president of Cardiac Services for the North Shore-LIJ Health System, a vice-president of the International College of Angiology and serves on the New York State Cardiac Advisory Committee.  Dr. Katz is also a member of the American Heart Association and a Fellow of the American College of Cardiology.

MAIN STREET JOURNAL: When and where were you born?

STANLEY KATZ: I was born in December 1946, right after World War II, in Capetown, South Africa. Do you know where that is? Right at the tip of Africa. Do you know which two oceans are on the side of Africa?

MSJ: Indian and Atlantic.

SK: OK They meet at the bottom. That is where Capetown is.

MSJ: What is your favorite part of the job?

SK: It's being able to help sick people.

MSJ: Why did you want to become a doctor?

SK: Well, initially I wanted to become a doctor because I wanted to leave South Africa. It was a good profession that would allow me to go anywhere in the world. And then as I began to study more in medical school I enjoyed the things I was doing to help sick people.

MSJ: What is the stint and how does it work?

SK: Can I draw it on the board? Let's imagine the heart is like the engine of a car with 8 cylinders; and this is the gasoline tank. There are three pipes that bring gasoline from the gas tank to the engine. If the engine doesn't get gasoline it won't work. You know if you are out of gas the car will stop. In some people blockage is built up in the pipe and so not enough gasoline is going through. So, instead of going 80 miles per hour, you can go only 20 miles per hour. If it becomes completely blocked then there is no gasoline going through and the two cylinders will become damaged. That's what a heart attack is! There is not enough oxygen going to the heart.

About 28 years ago a cardiologist working in Switzerland worked out and built a small balloon and put it across a blockage. Then he inflated the balloon and opened the artery up like that. It was called angioplasty.

MSJ: Does the balloon stay in the vessel?

SK: No the balloon is blown up for a minute or two and then the air is let out and the balloon is taken out. This was one way to get rid of the blockage without having to do an operation. The trouble is that for every five people that have the procedure one person would come back after six months with the same problem -- the blockage would come back. And so the doctors tried to think of a way to prevent the blockage from coming back and so, 20 years ago, someone from Long Island, Richard Chats, thought of an idea of having a balloon to flatten the blockage and then putting a stainless steel tube in to hold the artery open and keep the blockage from coming back. First he did some experiments in animals and then in patients for about 10 years and found that this works very well and the blockage hardly ever came back when he used a stint or a stainless steel metal core. The stint looks like a mesh, like chicken wire. It's not a solid tube.

MSJ: Why doesn't the blockage grow up into the mesh?

SK: That's a good question! Sometimes it does, but most of the time it doesn't grow up into the mesh.

MSJ: How long have you been a doctor?

SK: I finished medical school about 35 years ago at the age of 25.

MSJ: How long did it take you to learn what you do now?

SK: In 1965 I finished high school and then I went to medical school for 6 years. Let's add this up. Then I had to do an internship and residency for 3 years, then I had to do cardiology training for 3 more years to become a cardiologist, and then I had to learn how to do this procedure for another 2 years. The total is 14 years. That's a very long time!

MSJ: And we are not even 14 yet!

MSJ: How long does a stint procedure normally take?

SK: If it is a simple procedure, an hour, sometimes up to three hours.

MSJ: Can it happen for the stint to break or something else to go wrong during a procedure?

SK: The stint does not break, but what can happen is as you to try to push it in the artery it can fall into the aorta and go somewhere else in the body.

MSJ: What is the risk in this procedure?

SK: THere is a 1 in 200 chance that a patient can die during the procedure.

MSJ: Is it true that the stint procedure can prevent bypass surgery?

SK: Yes, it is true. It will outnumber the bypasses also. In the US this year there will be twice as many angioplasties performed as bypasses this year.

MSJ: I have a personal question about your favorite sports.

SK: That's easy! I've been playing soccer since I was a kid like you.

MSJ: And what is your favorite team and why?

SK: My favorite team is Manchester United. The reason why I like this team is because in 1955, when Manchester United was the best in the world, the plane carrying the team from England to Germany crashed and most of the players were killed. They were on the way to a soccer game and after the crash the team had to be rebuilt over the next 10 years. Matt Busby was the coach and he was lucky, he survived the accident and the team members were known as "Busby's Babes."

MSJ: What is actually your job here at North Shore University Hospital?

SK: I am the coach of the soccer team. I actually run the team of doctors or cardiologists. I am the chief of cardiology and there are a hundred people working in the department. It is my responsibility to make sure everything is dome to improve the quality of life here on Long Island.

MSJ: Have you ever worked with the famous doctor Christian Barnard from South Africa, who was the first to perform a heart transplant?

SK: No, I was in medical school then and too young to work with him. But let me tell you it's not so easy to do a heart transplant. You must have perfect conditions for that. The healthy heart is usually taken from someone young who died in a car or motorcycle crash, whose brain is severely damaged, and who has the same blood type as the patient who requires the transplant.

MSJ: Do you enjoy your job at the hospital?

SK: I really do enjoy it very much.

MSJ: How many hours do you have to work daily?

SK: About 14 hour days. It seems a long time but I got used to it.

MSJ: Do you have any regrets about working here?

SK: No, the only regret I have is that I am not spending more time at home with my 4 children and not watching my son David playing soccer.

MSJ: How do you train yourself as a cardiologist?

SK: I go to the major conferences in Cardiology twice a year. The last one I went to was in Dallas, Texas and there were 20,000 cardiologists participating. There were lectures from 8:00 AM to 6:00 PM covering all the subjects that could satisfy everyone's interest.

MSJ: Is North Shore University Hospital the only hospital you have ever worked at?

SK: No, I have worked at Long Island Jewish Hospital also.

MSJ: Where is the hospital getting the money and financial support from?

SK: From rich people through donations and fund raising. One part of my job is to go to meetings and conventions and convince people to donate money for the hospital, for helping sick people, for a good cause.

MSJ: Are your patients really happy with you?

SK: Most of them. I don't actually ask them. But if they don't come back to me, maybe they don't need me anymore -- maybe they are cured.

MSJ: Are there many patients who die on the operating table?

SK: Very few, maybe 2 or 3 a year, and I feel terrible about them because I could not save them.

MSJ: Did it ever happen a joke was played on you and you didn't know about it?

SK: Yes, I remember once they called me to the emergency room and I was told to help a sick patient who was having a heart attack just to find a little doll on the stretcher.

MSJ: Have you played jokes on anybody during your medical career?

SK: Yes. You've got to have a sense of humor, you know. Once, after a stint procedure was over and the patent was happy and in a good mood, I told him that if he stays too long in sea water the stint would rust, which not true.

MSJ: Were you ever not able to get to a sick patient and what happened then?

SK: It happens sometimes and it is very upsetting and usually the patent dies if help does not reach him in time.

MSJ: Thank you very much Dr. Katz for your time and for letting us interview you. Thanks for the interesting voyage to the heart of the matter and good luck in helping sick patients.

SK: Thank you for dropping by and I hope you'll write a nice story about it.

MSJ: Don't worry we will!