Welcome to the the Office of the President

The Inaudible Language of the Heart Cardiovascular Research Institute Board Meeting

April 12, 2000

Thank you for that kind introduction. It is my great pleasure to welcome you to campus. On behalf of the Medical University, I want to express our appreciation to each of you for your willingness to serve on this Board. We know that you have many other important commitments, so your involvement here is even more meaningful.

This Board is being founded as I begin my term as President of the Medical University. For that reason, it has a great deal of personal significance to me. I take pride in the fact that we are undertaking a significant new commitment to cardiovascular disease research, prevention and treatment at this time. For obvious reasons, it is very important to me that we are successful in this effort. I pledge to you, therefore, my complete dedication and support to the Board and to the Institute.

In setting the stage for this meeting, I thought that it might be useful for me to talk about why the Medical University is undertaking this initiative. Given my background in public health, it probably will not surprise you that I would address this question from a broad societal point-of-view. Probably everyone here is aware of the fact that heart disease is the leading killer of Americans. What you may not know is that South Carolina has the fifth highest death rates from heart disease. Each year, over 10,000 South Carolinians die from this disease. That means that every day, about 28 persons in this State die from heart disease. During every hour that we meet this morning, another South Carolinian will succumb to heart disease.

As you probably realize, stroke is another manifestation of degenerative disease of the vascular system. South Carolina has the highest death rate from stroke of any state. The stroke death rate in South Carolina is almost 50 % higher than the national average. The so-called "Stroke Belt" runs from North Carolina to Louisiana, and South Carolina is the buckle on the Stroke Belt.

Why is the situation in South Carolina so dismal? The answer to that question is not quite as simple as it may seem. We can point to many contributing factors, not the least of which are the demographics of this State and our traditionally high rate of poverty. Of course, a concomitant of poverty is poor access to health care. South Carolina ranked 12th nationally in the percentage of the population who lack access to primary care. About one in seven South Carolinians do not have a regular source of primary care. This percentage is almost half-again as great as the national average.

The citizens of our state also do not lead particularly healthy lifestyles. For example, we might consider the prevalence of one of the leading risk factors for heart disease and stroke Æ cigarette smoking. Almost one in three South Carolinian males smokes — a level that is 17% higher than the national average. Other risk factors for cardiovascular disease, such as obesity and consuming a high fat diet, also are prevalent in our state.

Some health conditions that predispose to cardiovascular illness, such as hypertension and diabetes, are unusually common among our citizens. South Carolina's death rate from diabetes, for example, is the 7th highest in the United States and it is almost one-fifth higher than the national average.

These factors then, our demographics, poverty, poor access to primary health care, unhealthy lifestyles, and predisposing morbidity, all contribute to the high death rates of South Carolinians from cardiovascular disease. Perhaps I should pause at this point and ask the question: "So what?" What difference does it make that South Carolinians have these poor health indices? Why should the Medical University, or this Board, or any other group of informed citizens, care about this issue?

To me, the answer to this question must be found in the essence of what we want to be as a society. Do we aspire to live in a state in which people are able to reach their full potentials? Or are we, on the other hand, content to accept with equanimity that some lives are less valued simply because of poor social, economic, and educational circumstance? I would not presume to speak for everyone in this room. Your very presence here, however, suggests that you are committed to reducing the burden of illness among our people.

Without question, the Medical University is so committed. We have declared this intent in our mission statement - the opening line of which defines our core purpose as: "to preserve and optimize human life in South Carolina and beyond." I take these words very seriously — they are not simply a motivational mantra, they are articles of faith. Underlying everything that we do as an institution must be a fundamental belief that we are here to improve the quality and longevity of the lives of our fellow citizens. Learning, discovery, and service — the holy trinity of academic pursuits — are merely means to a greater end. For us, that greater purpose, that raison d'etre is to preserve and optimize human life.

This then brings us full circle to this Institute and my vision of what it can mean to the Medical University and to the people of South Carolina. We stand today on the threshold of a grand experiment - the outcome of which can only be imagined. It is an experiment in which all of us, you and I, will be observers, but we will also be participants. As we launch this effort, let us set our aspirations high.

My dream is that this Institute will become a center of discovery, where insights into the basic mechanisms of cardiovascular disease will be translated into innovations in clinical care. I see our laboratories populated by the brightest scientists working tirelessly to advance knowledge and communicating their cutting edge work to their colleagues throughout the world.

I see clinicians testing new treatments, bringing to the bedside the advances that emanate from our laboratories. I see patients, treated with dignity and compassion, coming to this Institute because of its reputation for state-of-the-art care. In my vision, the most advanced diagnostic and therapeutic devices and equipment will be used to provide the least invasive management of patients that is possible. The most talented young clinicians will be attracted to learn the latest techniques, and many will stay on to develop their careers here.

The Cardiovascular Research Institute should create an environment in which the patients, clinicians, and scientists all feel that their interests are aligned in perfect harmony. The caregivers will work as partners with the patients and their families, developing treatment plans together. The data gathered in providing this treatment will be collected and analyzed in order to improve care on this campus and elsewhere.

The Institute will reach out to communities throughout South Carolina providing basic education in reducing the risk of heart disease. Collaborations will be established with churches, schools, and other organizations in the community to reach a broad range of citizens. Special efforts will be made to detect and treat high blood pressure and diabetes mellitus. Smoking cessation, weight management and exercise programs will be developed and offered through a variety of venues.

Screening programs will be run to detect elevated cholesterol and other factors that predispose persons to cardiovascular disease. Through partnerships with retail drug stores and pharmaceutical companies, lipid-lowering agents and blood pressure medicines will be offered at low or no cost. The Institute will coordinate clinical trials to test the efficacy of new agents for the prevention and treatment of cardiovascular disease.

The intellectual property developed as part of the discovery process at the Institute will be licensed and patented for commercial application. In some instances, the technology developed will form the basis of start-up biotechnology companies that will obtain venture capital, grow in a research incubator, and spin-off into successful corporate enterprises.

In short, the Cardiovascular Research Institute will become a center of excellence in all aspects of research, education, and clinical care. It will achieve this status, however, not for the glory of those who work here, but for those who will derive the ultimate benefits of this work — the people of South Carolina. The demonstration of that benefit will become manifest by a lowering of the prevalence of obesity, hypertension, diabetes, elevated blood cholesterol, and cigarette smoking. The ultimate reward will be realized in reductions in the death rates from heart disease and stroke.

Now I will readily confess that this vision is grand indeed. It is larger than any single individual, even a great leader such as Mike Assey. It will not be achieved without an unprecedented level of commitment from many persons within and outside of this institution. It will require the formation of partnerships with other health care providers. It will not happen quickly and it will not occur without setbacks.

Yet it is possible. If there is a will to make it happen, then it will happen. If the collective talents of those engaged in this effort are put to coordinated action, we can succeed. The real question is are we, those of us gathered here this morning, up to the challenge?

This brings me to the role of the Board. You are here, as I indicated earlier, not as observers only, but as active participants. You were selected for this Board because you are leaders in the community. By bringing you together as a group, in essence we are uniting the community in this effort. We will call upon you for your advice, we will call upon you for your support, we will call upon you for your participation, and we will call upon you for your advocacy.

To be successful, however, this Board must own the process and the outcomes. You must be self-starters and set your own agenda. We are not hoping that you will follow us, but rather that you will take an active role in leadership. We want you to draw encouragement from us, but equally important, we need you to bring energy to us.

In closing, I would like to remind us all that our purpose here is literally and figuratively about the heart. I searched a bit for a quotation that embraced both the literal and figurative expression of that purpose. In that process, I came across a sentiment from the 1964 Nobel Prize address of Reverend Martin Luther King, Jr. In that speech, Reverend King said that: "Occasionally in life there are those moments of unutterable fulfillment which cannot be completely explained by those symbols called words. Their meanings can only be articulated by the inaudible language of the heart." We are in search today of 'unutterable fulfillment', which can be realized through service to our fellow citizens. If we are so fortunate as to be successful in our efforts, then we will find 'their meanings articulated by the inaudible language of the heart.'

I thank each and every one of you for your commitment to join this Board and to participate in this meeting. I pledge to you my absolute commitment to this effort and I pray with all my heart that we find the unutterable fulfillment that we seek. Thank you.