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The Impact of Influence

The Impact of Influence

Renowned cardiologist Valentin Fuster believes that caring mentors can set a life, and perhaps the world, on the right path.

Valentin Fuster

Director of Mount Sinai Heart and Physician-in-Chief of Mount SinaiMedical Center
MD: University of Barcelona
PhD: University of Edinburgh (presented at Barcelona University)
Scientific Organizer: For the Academy's "Evolving Challenges in Promoting Cardiovascular Health" in Barcelona, Spain in 2011 (see information about the resulting Annals volume and view the eBriefing)
Favorite Books: All works by Teillard de Chardin and Rabindranath Tagore
Hobbies: Reading and bicycling in the Alps and Pyrenees
You wouldn't be surprised to find a world-renown cardiologist at Gustave L. Levy Place in New York City or on First Street in Rochester, Minnesota. Sesame Street, however, might not seem like the logical destination for a cardiologist who has graced the halls of such esteemed research facilities as the Mayo Clinic and Mount Sinai Medical Center (MSMC).

But for someone who has made mentorship a cornerstone of his career, it seems almost fitting that Valentin Fuster, director of Mount Sinai Heart and physician-in-chief of MSMC, has inspired the latest Muppet. Dr. Valentin Ruster, the Muppet character that Fuster inspired, aims to guide children down a healthier path, with the idea that healthier habits learned early can head off later disease (particularly the devastating heart disease Fuster has spent a lifetime studying and treating).

In the first episode of Barrio Sésamo: Monstrous Supersanos (the Spanish equivalent of Sesame Street), Dr. Ruster enlightens Grover on the functions of the heart, while on another, he hosts a game show testing Cookie Monster on the difference between healthy and unhealthy food.

"The other Muppets look up to him as a leader and a role model," says Fuster. Ironically, this fictional role mirrors Fuster's real life and his belief in the power of individuals in setting us on the right path. He attributes his success to the presence of people guiding him toward good choices, perhaps in the same way an educational program might steer children to make wiser nutritional choices or exercise more frequently.

"We all need tutors," he says. "I strongly believe that in my life, in terms of self satisfaction in my career, there's no doubt that it's due in large part to the fantastic mentors I had. [We] all had something in common—chemistry. I had the feeling they would do anything for me."

Guiding Hands

Spanish-born Fuster, the only cardiologist to receive all four major research awards from the world's four major cardiovascular organizations, is quick to recall the bright minds that shaped his thinking from medical school to now. While at the University of Barcelona, Fuster met Pedro Farreras, a professor of medicine who wrote the major Spanish textbook on medicine and was considered the top physician in the country. "He really guided me. The critical issue of [our] chemistry was that he had a heart attack at age 42. He told me to be a cardiologist, so I did," he says.

"A number of advisors gave me advice and I did it without questioning because I had a sense that their experience and care for me was pointing me in the right direction."

Farreras encouraged Fuster to go to England, where he met Harold Sheehan, a pathologist. There, Fuster recalls studying a tissue sample from a patient who suffered a heart attack. The blood clot was riddled with platelets. He asked Sheehan a question that launched his career: What do platelets have to do with the heart attack? Sheenan answered, "We don't know if it's the cause or the result. You should study this for you thesis."

So Fuster did just that, completing his thesis on the role of platelets in myocardial infarction at the University of Edinburgh, Scotland. He worked closely with another mentor, Desmond Julian, on the first coronary care unit in the world, and became the first cardiologist to go into hematology.

And then he headed to the United States, spending 11 years at the esteemed Mayo Clinic, meeting another mentor, Robert Frye, the chairman of cardiology at the Mayo Clinic. "Occupying high positions as they did," Fuster recalls of the leadership in Rochester, Minn, "they were always dealing with us, the nobodies. But as people at the top, they believed in and supported the people on the bottom."

Paying It Forward

As a mentee, Fuster learned the importance of setting the path for people like himself. For example, he started a program in Spain that identifies young people at ages 15 and 16 who have an interest in science. The program provides grants for these youngsters to spend a month with senior investigators in Madrid, where Fuster leads the Fundacion Centro Nacional de Investigaciones Cardiovasculares Carlos III (equivalent to NHLBI, USA). Once they get a taste of high-level research, the majority of these young scholars set out on scientific career paths, further shaping the future of scientific discovery.

Fuster also made a special point to develop a new Forum for Young Investigators while serving as the president of the American Heart Association. He also started a yearly symposium in Washington DC to teach those interested in the field how to become young investigators.

"When people ask me to be a mentor, the first thing they ask is how they can succeed," he states. "I define success as development of full satisfaction, which is quite different than how general society defines success. I tell them the whole thing is to do the right thing with the right talent and to be fulfilled."

This requires soul searching, and staying motivated--by helping others and learning. He teaches his mentees about the four Ts: time, talent, transmit positivity, and tutoring. He stresses taking 15 minutes to reflect on your priorities every day and discovering your unique talent. He underscores the importance of measuring your worth by your own standards, and not measuring yourself against your neighbors. And tutoring provides the motivation to others, much the way Dr. Ruster could impact the lives of future adults.

The Youngest Change Agents

While Fuster acts a mentor to many individuals, from high school students to early-career doctors and researchers, he sees Sesame Workshop as a way to provide critical advice even earlier in life. Working as a medical advisor to Sesame Workshop since 2006 (with Plaza Sesame, the Latin American version of Sesame Street ), he developed a research protocol that focused on developing healthy habits in 2,000 children between the ages of three and six, giving them 40 hours of training on healthy lifestyles and how to control their emotions.

The work isn't purely for entertainment; Fuster applies his standard of academic rigor to his work with Plaza Sesame as well. Analysis of 1,000 children, who were randomized to the study approach or a conventional approach, showed that the interventions had a short-term impact on health habits and weight reduction. In addition, the children were able to influence the habits of family members, including parents. The impact of this training will be published in The American Journal of Medicine, and was so successful that the program is now being rolled out to 20,000 children in Columbia, as well as children in Spain and England.

"Sesame was so impressed with the impact that health training can have on children, that they decided to create a Muppet to teach children the importance of health," Fuster says. Fuster recalls arriving at a meeting at Plaza Sesame and running into his own likeness, albeit in a furry form. "When I got there, a Muppet came up to me and said, 'I am you.'"

"I believe this world will only be changed by young people, and they are the only ones who can take care of this chaos," he says. "Therefore, I really focus a lot of my efforts on motivation and mentorship and even health for young people."

Fuster has made a lifetime of being led and leading. Whether researching, helping patients, or working with young researchers, colleagues, or a Muppet character that promotes vegetables instead of cookies, Fuster's goal is always to make an impact.

Marci A. Landsmann is a medical writer in Philadelphia.