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  • Mark Casey

Healing Hearts and Changing Lives


“I love to ‘move the ball down the field.’ I love to innovate with excellence. If we are practicing pediatric cardiology the same way when I retire as when I started then I would consider my career a failure."

Scott Baldwin, MD

Pediatric Heart Institute, Children’s Hospital at Vanderbilt

Katrina Overall McDonald Chair in Pediatrics,

Chief Division of Pediatric Cardiology and Co-Director of the Pediatric Heart Institute,

Professor of Pediatrics and Cell and Developmental Biology


FUN FACTS:

· Born in Hawaii

· Grew up in Norfolk, Virginia

· College at University of Virginia

· Med school at University of Virginia

· Pediatric Residency at Strong Memorial Hospital in Rochester, NY

· Pediatric Cardiology Fellowship at University of Iowa

· Children’s Hospital of Philadelphia for 12 years

· Children’s Hospital at Vanderbilt for 18 years

· Practicing medicine for 30 years

· Lived in Nashville for 18 years

How did you get started in Medicine?

When I was a young boy around the age of 9 my sister was diagnosed with leukemia. In order to receive the latest treatment for what was then a universally fatal disease she had to go to the NIH (National Institutes of Health). I had multiple siblings and mother lived in Bethesda to be with my sister so we had to “take turns” visiting on weekends with my dad. I would travel from Norfolk to Bethesda, to the NIH, and was just amazed at what these doctors were doing. My parents really admired these physician scientists and I looked up to them as well. I think that started my journey towards medicine. In college I was a Psychology, Biology, and Religion major and started Medical School thinking I wanted to become a Child Psychiatrist. But as I was studying, I fell in love with the physiology of the heart and I loved that by understaning physiology, I could figure out how different structural defects caused problems in how the heart functioned. The idea of diagnosing and treating heart problems really spoke to me.

How did you decide to focus on Pediatric Heart?

In residency I took an elective because I thought that pediatric cardiology was the direction that I wanted to go. The physician who supervised me not only did pediatric cardiology but he also had a lab and did basic scientific research. So, we would round on patients in the morning and then spend the afternoons in his lab. He did chicken embryology. He used a chicken model because you can watch the heart develop from the very early stages by simply cutting a window into the shell and keeping the egg warm. That really sealed it for me. Watching the heart develop before your eyes is simply miraculous! It was such a fun and challenging time in my training and it really helped to solidify my path in pediatric cardiology.


How do your life experiences make you a better physician?

Every patient is unique and you bring who you are and what you have experienced to the table in every interaction. I saw first-hand how the loss of a child had a dramatic impact on my parents. It was after I had my own children that I was able to really feel deeply and empathize with the parents of my patients. I remember having routine conversations with parents about SIDS (Sudden Infant Death Syndrome) and the loss of their child. I thought I was as compassionate as I could be having this difficult conversation, but after the birth of my first child I remember going down to talk to some parents who had lost their child who was the same age as my daughter and I just broke into tears and cried with the parents. I also had a childhood where I played many sports. Some doctors want to severely limit sports for a child with heart issues. I really want to understand all the specifics with the individual child because it is a big deal to take away a sport from a child that he or she loves to play. I treat my patient and parents as a “team” because we are all working together for the best outcome for this child.

Tell us about your research:

The focus we have is on understanding the basic mechanisms of heart defects. We deal with congenital heart disease. Something happened in utero that caused the baby’s heart not to form correctly. Congenital heart disease occurs 1 in 100 in babies. It is more common that childhood leukemia. The first question that parents ask when they learn their baby has congenital heart disease is, “how did this happen?” As a trainee in cardiology, I was confounded by the fact that I could not answer the very first question that parents always asked me. This has become the focus of my research to answer to this fundamental question. What are the genes involved, what are the processes that went wrong that might have caused this problem? So we have spent a lot of time looking at how valves form and grow. Many congenital heart problems involve defective valves, so we hope to figure out the basic principles that regulate valve growth and then use what we learn to promote normal valve growth and function. Unlike adults, we cannot usually replace a bad valve with an artificial valve because it will not grow with the child. This is one of the problems that we are working on.

How much of your time is clinical and how much is research?

Theoretically my work is 20% clinical, 20% administration and 60% research, but it is NOT a 40 hr / week job! I am Chief of Pediatric Cardiology and the administrative demands of my job have grown as a result of program expansion in faculty and patient volume. I have an additional responsibility to make sure that everything works with our whole team. There are also times when we are coming into a deadline with a big grant proposal and I will spend 80-90% of my time on research as obtaining funding from grants is required to pay for much of the research we do..


What makes your work/practice unique?

What makes the work I do unique and fulfilling is the great variety between patient care and scientific research. Truly, no two days are alike. When I see a patient in clinic I am able to then go to the lab and explore how we, as pediatric cardiologists, might improve our care of patients by understanding their problems at a cellular and genetic level. I also work with an incredible group of colleagues, some doing basic research, some doing clinical research and some focused primarily on clinical care. Importantly, everyone appreciates and supports the unique contributions of others in the group that advance the care of our patients,

What methods do you employ to keep improving your knowledge and experience?

Our group of pediatric cardiologists have a “Week in Review” meeting every Friday where each of the participating faculty can present their new or difficult patient situations and we all give our thoughts and opinions on what is going on with each individual patient. It brings several hundred years of experience to bear on a patient’s condition. Some people don’t realize the true value that they get coming to Vanderbilt, because when they are treated here, they literally get 25 second opinions. Additionally, I spend a lot of time reading about advances in congenital heart disease and progress in basic research. I have certain topics of articles flagged with alerts so that I get those articles immediately upon release. We also have our annual scientific meetings for the American Heart Association and the American College of Cardiology. We share our results at these meetings and then they are critiqued by our colleagues. The post-Covid environment has been one where the world is much more open to sharing new things they are seeing and diagnosing, even if they are preliminary. We jump on calls with other doctors and scientists throughout the world to share knowledge and learn from each other sometimes in advance of publication.

What keeps you engaged when things get hard in your work?

I love what I do! No day is ever the same. I genuinely love doing the work and engaging with the patients. It is the patients who keep me engaged and encouraged by seeing the results and successes of their treatments. On the scientific side it can be discouraging because there is no instant gratification. It is repetitive and frustrating, but once you have a breakthrough, it is so exhilarating that the success of new knowledge takes away the year of discouragement in an instant.

How do you try and maintain a balanced life outside of work?

That is a constant challenge for me. I really have to be very intentional about that because any part of my job could be all consuming. I have caught myself lost in thought constantly wondering… “what if I had just done it this way instead of that way.” I have had to learn to be particularly intentional at home with my family. For so many years my hobbies were my kids. Whatever they were interested in I would just dive in and do it with them. I didn’t want to do things that didn’t involve them during those years. Now that they are grown my wife and I are thinking together… “what can we do together that we have always wanted to do?” We both love to travel and there are a lot of trips “in the works.” Another thing I have always loved is live music. Living in Nashville has been a good and a bad thing for that addiction. Before Covid, we really enjoyed organizing small home concerts where a few friends come over and we have live music at the house. We are very much looking forward to getting back to these gatherings!


What gets you up in the morning?

Doing something new and making what I am doing, better. I love to “move the ball down the field.” I love to innovate with excellence. If we are practicing pediatric cardiology the same way when I retire as when I started then I would consider my career a failure.

Tell us about some of your medical “hero’s”?

Right now Dr. Anthony Fauci is my hero in that he is working so hard and making hard decisions that affect everyone. I met him when I was in medical school, when he and I were much younger, and he was an impressive and inspiring individual even at a young age….one of my prized positions is a new Fauci bobble head doll!

Dr. Helen Taussig Is a doctor I really admire. She was instrumental in developing the Blalock-Taussig shunt which was one of the first effective treatments for congenital heart disease. She also made some seminal observations on cardiac development and evolution of the heart. As a woman, she was a pioneer in medicine in the 40’s-50’s which is an accomplishment in itself, but she was truly an innovator in her time! I was so honored a few years back to have been asked to give the Helen Taussig Memoriallecture at the national American Heart Association annual scientific meetings.

Dr. Francis Collins is also a physician I admire for his leadership in the human genome project. He worked to sequence the human genome when this was thought to be insane and impossible. Short of the discovery of DNA, his project sequencing the genome is perhaps the second biggest advancement in the history of medicine. He is now the Director of the NIH and continues to garner support for biomedical research in the US.


GETTING TO KNOW THE DOC

Tell us about your family-

My wife, Andrea, is a pediatric nurse. We met in med school. She swore she would never marry and doctor, and I swore I wasn’t going to marry a nurse… we got married a year after we met and have been together now 40 years.

Our oldest daughter, Emily, is in St. Louis. She is married to Eric, an English professor, has 3 children, and is back in grad school studying art history .

Our middle child, Nathan is a software developer and lives in East Nashville with his wife Annie, who coordinates the English Language Learner program at a Charter Metro School, and their 2 children.

Our youngest daughter, Hannah, is a licensed counselor and lives in Seattle with her husband Alex, who is writer and carpenter.


What are some of your hobbies/interests outside of work?

I love Live music – I consider that almost a full-time hobby living in Nashville. I love building big things like decks.

Also, we inherited from Andrea’s parents a 6-bedroom cottage on an island in Ontario, Canada, on the Georgian Bay. I know that sounds luxurious, but the island is only 2 acres (if the water is low), there is no electricity, no running water, and we use a composting toilet! So, if you want to take a bath you jump in the Georgian Bay. It is a full-time effort just to keep the place operational as we only are able to visit a few weeks a year. We have been up there almost every summer as a family over the last 40 years. Absolutely amazing family memories!!


What amazing adventures have you been on?

After we were married, I took a 6 month leave of absence from med school before graduation, we sold everything and travelled in Europe for the entire time. It was the journey of a lifetime and I am so glad that we were able to do that before really being consumed by the demands of my medical training and career.


Favorite Restaurants in Nashville?

Henrietta Red is my favorite for food.

Etc. is my favorite for food and ambiance.

5th and Taylor is great for a fun time.

Lockland Table in East Nashville is my favorite all around restaurant.


What is one thing about you that surprises people?

I think when people first meet me, they are bit surprised to know I seriously considered going to seminary and actually spent 6 months as a psychiatric intern before switching to pediatrics. They are also a bit surprised to see me take on construction of a huge deck or creating custom cement countertops at the cottage. After they get to know me a bit, it is not so surprising.


Among your friends, what are you best known for?

Love of music, my laugh and having fun.


What are accomplishments are you most proud of?

I am perhaps most proud of being the father to three pretty spectacular children who have grown into adults I now consider some of my best friends. However, I think the real credit for this goes to my wife Andrea who poured her life into their formative years when I was often in the hospital or writing a grant or many of the other academic responsibilities that kept me from being at home as much as I would have liked to be!

I am also proud to be part of a superb group of Pediatric Cardiologists who are some of the best clinicians in the country at highly specialized diagnosis an procedural interventions in children with congenital heart disease. I could not have asked for a better group of colleagues and I am honored to have been able to help double the size of our group and expand the expertise we are able to provide the children in the Southeastern United States and throughout the country.

Finally, it is gratifying to think that I may have helped serve as a role model and mentor for others in Pediatric Cardiology showing that clinical care and state of the art research are compatible simultaneous goals when you have the support of your institution and colleagues.

Photos by Nikayla Skolits Photography @nskolitsphotography


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