{"id":11468,"date":"2018-04-03T18:10:09","date_gmt":"2018-04-03T18:10:09","guid":{"rendered":"https:\/\/www.tmc.edu\/news\/spotlight-k-lance-gould-m-d\/"},"modified":"2019-08-16T15:04:00","modified_gmt":"2019-08-16T15:04:00","slug":"spotlight-k-lance-gould-m-d","status":"publish","type":"post","link":"https:\/\/www.tmc.edu\/news\/2018\/04\/spotlight-k-lance-gould-m-d\/","title":{"rendered":"Cardiologist-researcher K. Lance Gould, M.D."},"content":{"rendered":"
For decades, K. LANCE GOULD, M.D.<\/strong>, a cardiology physician-researcher at Memorial Hermann-TMC and McGovern Medical School at UTHealth, has been studying PET imaging technology to determine how blood travels through the heart. Gould developed a way to pinpoint abnormal blood flow that works much like the Google Maps feature that shows traffic in real time, allowing cardiologists to predict a patient\u2019s risk of heart attack five years into the future. He spoke with Pulse about creating PET scan software, growing up in rural Alabama and taking cardiology cues from nature.<\/em><\/p>\n Q | How did you come up with the idea to use PET imaging technology to map coronary blood flow?<\/strong> You could normally increase your blood flow four times, so you could run a marathon. In between, you don\u2019t need that much blood flow. This flow capacity was limited by a narrowing of the artery\u2014it didn\u2019t affect resting flow, but it would impair the increase in flow.<\/p>\n Then, I developed the idea that physiologic imaging of the flow capacity was a measure of the effects of stenosis. It\u2019s the idea that the angiogram [an X-ray test that helps doctors evaluate blockages in the arterial system] is the anatomic severity, but the blood flow is the physiologic or functional severity. It was the first time that anybody ever put that down.<\/p>\n Q | You developed this idea while you were completing your cardiology residency and fellowship at the University of Washington School of Medicine in Seattle. How did you end up in Houston?<\/strong> The first really whole heart PET [positron emission tomography] scan was a brain scanner that was quite small. We built the first system and proved that you can find early heart disease. Since then, research has been driven toward better scanners and better protocols.<\/p>\n What it boils down to is that if the condition is severe, you need the procedures, but then it rules out a lot of unnecessary procedures. There is a fair amount of angiograms and procedures that don\u2019t do much good because they don\u2019t have the measurements to treat the patients right.<\/p>\n Q | You currently have an agreement with GE Healthcare System for PET scan software that you and your team developed, but you are working with GE as an unpaid consultant. Why?<\/strong> We talked to the university to have them agree that whatever property they gave GE, they would have a minimum charge that met state law requirements, and that any royalty that came in would not go to us but it would go to research or to medical scholarships, because we didn\u2019t want a dime of that. From my point of view, that\u2019s dirty money. Now, a lot of people do it, they think it\u2019s okay, it\u2019s a way of stimulating development. But not for me, and not for my team.<\/p>\n Q | You grew up in a small, rural town in South Alabama and spent much of your childhood tagging along with your father, who was a family doctor, during patient visits. Did that exposure to medicine steer you towards a career in medicine?<\/strong> I decided on physics in college, not medicine. Physics was fun, but I realized I wasn\u2019t gifted in that position, which you have to be to be a physicist. My senior year, I took my first biology course and fell in love with it. Plus, my lab mate was a very beautiful girl. I loved it so much that I switched over to medicine, and physics was a wonderful background for medicine. Right away, because of physics, the fluid dynamics and the pressure fluid equations, it just kind of fell into place.<\/p>\n Q | In your book, Heal Your Heart: How You Can Prevent or Reverse Heart Disease<\/em>, you write about early childhood experiences with your father that were the source of your interest in cardiology. What were your father\u2019s early years like?<\/strong> Q | What kinds of quirks?<\/strong>
\nA |<\/strong> I\u2019ve always been interested in coronary blood flow and did some experimental studies. The way we used to deal with coronary disease was to take an angiogram and do bypass surgery. There was no measurement of the pressure flow characteristics, so I did a number of experiments and discovered what\u2019s called coronary flow reserve: the capacity in the coronary arteries to increase their flow and to meet tremendous physical demands.<\/p>\n
\nA |<\/strong> I realized that to make this work, I\u2019d have to go somewhere other than Seattle. At the time, I got an offer to be chief of cardiology here [at UTHealth]. That was in \u201978, and I said, \u2018Okay, on condition that you\u2019ll find the support to set up the whole PET system.\u2019<\/p>\n
\nA |<\/strong> Texas law says that intellectual property can\u2019t be given away to a commercial operation. But my team and I were strongly opposed to the conflict of interest that we see in so much of medicine where docs patent stuff, hawk it out and sell it. Half the time it\u2019s garbage. And there\u2019s a lot of patented garbage that docs do. We didn\u2019t want to get into that.<\/p>\n
\nA |<\/strong> I used to go on house calls with him in his old Jeep. He would talk to me and take care of the people, and I\u2019d help boil the instruments for delivering a baby. But it was overwhelming\u2014all that stuff you had to know.<\/p>\n
\nA |<\/strong> He was born in Ludhiana, India. His mother was a missionary doctor and his daddy was a missionary preacher. He grew up in the British school system, very strict, but ran around the jungles with his two brothers and spoke Urdu as well as English for a long time. He has this kind of foreignness about him. He left home very early and then bummed around the world. He was a boxer for a while, cleaned windows in Chicago, was a taxicab driver and so on. But he was smart. His uncle put him up to medical school. He settled down, went to medical school in Louisville and went into practice\u2014as all doctors did then\u2014in general practice in the Kentucky mountains. He had some odd quirks about him.<\/p>\n
\nA |<\/strong> He grew up in India, so he was used to snakes. He made house calls on horseback. He had a couple of rattlesnakes in a big cage by his window in the cabin. One day, he got this call and takes off
\non his horse for a six-hour house call. He comes back home and the window\u2019s been jimmied open and all the jimmy tools were left on the ground. Somebody ran. What happened was that this burglar jimmied open the window, put his foot in, stepped on top of the rattlesnake cage and set them off. The guy said, \u2018I\u2019ve gotta get out of here!\u2019<\/p>\n