The Ten-Minute Interview with...David W. Sanford, Jr., CCVT

Why did you choose to work in the invasive cardiology field? I chose the cardiology field because of the personal contribution you can make to each patient. Examples of gratifying experiences include opening a totally occluded coronary artery in the middle of the night that prevented a large heart attack, sitting on an intra-aortic balloon pump in open heart surgery, performing CPR to save a patient’s life and placing a temporary pacemaker or defibrillating a patient. Can you describe your role in the CV lab? My role in the cath lab is to scrub in with the cardiologists on all types of heart catheterizations and percutaneous coronary interventions (i.e., stents, rotoblator, cutting balloons, brachytherapy, pacemakers, etc.). I am also responsible for hemodynamic monitoring. What is the biggest challenge you see regarding your role in the CV lab? Working at Sacred Heart for 20 years has given me an immeasurable amount of experience and knowledge. But new cardiovascular students look at us as elderly techs, and many don’t realize we were pioneers racing to the hospital in the middle of the night to get a patient studied and prepared for open heart surgery in order to save myocardium. What motivates you to continue working in the CV lab? The direct contribution I make by doing a good job and the gratification I feel in being part of a team that helps save the heart muscle of another human being. We all go through certain stages in life and experience some of the same feelings of resolve, sadness, despair, etc., so it is important to maintain the essence of compassion: "Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, tolerant with the weak. Knowing that I have helped someone survive and thrive motivates me. What is the most bizarre case you have ever been involved with? When it comes to bizarre cases, it is difficult to determine which ones to mention. In one case, I was scrubbed in and the patient was placed on bypass percutaneously through the right femoral artery and right femoral vein. The surgeon opened the patient in the cath lab and I performed open-heart massage. You cannot imagine the human heart in your hand! Another case happened about sixteen years ago. We were placing a Swan-Ganz catheter into a patient who had severe aortic stenosis. The ob-gyn physician had requested it because of the potential elevation of right heart pressure during birth. That’s right…birth! And guess who was the lucky cardiovascular technologist who got to deliver an 8 lb. 7 oz. baby girl? Actually, all I did was catch the baby and cut the umbilical cord. What an experience! When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? I wait. Then a miracle comes along, like a patient you think is at the end of life, but because of the efforts of physicians, nurses, technologists, and everyone involved, is given another chance. The essence of a new day: This is a beginning of a new day you have been given. This day is to use as you will. You can waste it or use it for good. What you do today is important because you are exchanging a day of your life for it. When tomorrow comes, this day will be gone forever. Are you involved with the SICP or other cardiovascular societies? Unfortunately, I am not involved with the SICP. I have been a part-time instructor at Spokane Community College (SCC), and was also on the Advisory Board there. I do enjoy monitoring the cardiovascular students as they come through Sacred Heart Medical Center in Spokane. I try to give them special information or tips they can take for personal growth. Are there websites or texts that you would recommend to other CV labs? The Cardiac Catheterization Handbook by Morton Kern, and www.tctmd.com. Do you remember participating in your first invasive procedure? Can you describe what it was like and how you felt? Prior to working as a cardiovascular technologist, I worked on the railroad as a carman, so I was very scared about working with patients. I remember how much I was shaking in my first case as I held the catheters, and was always afraid I was in the wrong place at the wrong time. If you could send a message back to yourself at the beginning of our CV lab career, what advice would you give? You are going to embark on a great educational experience since you are going to be a patient and have heart disease yourself. This will give you a unique opportunity to help others. Where do you hope to be in your career when it is time to retire? At a place where I recognize that my life has been a success. Successful is the person who has lived well, laughed often, and loved much. Who has gained the respect of children. Who leaves the world better than they found it. Who has never lacked appreciation for the earth's beauty. Who never fails to look for the best in others or give the best of themselves. Has anyone in particular been helpful to you in your growth as a cardiovascular professional? Yes. All of the following people: Marcus Dewood, MD; Phil Soucy (cardiovascular technologist); Wes Todd (cardiovascular professor); Lowell Mouser, MD; Michael Ring, MD; Carroll Simpson, MD; Eric Orme, MD; Angelo Ferraro, MD; Henry Reisig, MD; Jack Leonard, MD; Ralph Berg, MD; Samuel Selinger, MD; Don Canaday, MD; Gerald Hensley, MD; Paul Shields, MD; Wesley Allen, MD; Hrair Garabedian, MD; Pierre Leimgruber, MD; Ralph Kunkel, MD; Rod Raabe, MD; and all of the cardiovascular technologists at Sacred Heart Medical Center. Where do you think the invasive cardiology field is headed in the future? In the state of Washington, the Department of Health has just gone through a series of discussions on whether to perform non-emergent percutaneous coronary intervention (PCI) in hospitals without open heart surgery available in the hospital. In their wisdom, the Department of Health decided not to change the law. Washington state will continue to have non-emergent PCIs performed in a facility with open heart surgery capability. I feel this is very important. The risk of doing these procedures in hospitals without open heart surgery available cannot be overstated. All physicians know the dangers (dissections that cannot be stented, perforations that cannot be repaired with covered stents, etc.). One physician (Dr. William Stifter) stated it best when he described it as the Theory of Unintended Consequences. I know non-emergent PCI is going on in other states without open heart surgery available in the hospital, but I believe this is putting patients in grave danger. I also think dissolvable stents will be available in the near future, as well as medicine to reduce atherosclerosis.

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