Old-School Doc

My first impression of Herb Levine was that I had somehow gotten the wrong guy. It was the summer of 2006, and Levine (rhymes with wine), then 78 years old, was an eminent cardiologist who had just stepped down after serving for 45 straight years at Tufts Medical Center. “Eminent” often means distant, cool. But this spry gentleman with the wispy white hair and the utterly relaxed and genial manner looked like nothing so much as a man about to step through the office door, plunk a canoe into the stream that was waiting there and glide away, laughing. His physical ease and his lightness of bearing were uncanny.

Others were struck by the man in a similar way. Dean Harris Berman has known Levine as a friend and colleague—and as an astute specialist when he suffered a heart attack at age 48 and needed a cardiologist. Berman notes that it didn’t matter whether you were junior staff, or a resident, or a patient, or someone passing on the street, you got the same impression of Levine: “This is a wonderful person who cares about you.” By all accounts Levine never deviated from that model, regardless of the circumstance.

In the early 1970s, Deeb Salem fell under his spell. Now chair of the Department of Medicine at Tufts Medical Center, Salem was, back then, scouting out places for a fellowship early in his career. He happened to come to Tufts and encounter the man who served as chief of cardiology here from 1961 to 1987. “At other places, the cardiologists were sort of sourpusses,” Salem remembers. “But within seconds, Herb put on this big smile and started asking me questions.”

Marvin Konstam, chief physician executive of the CardioVascular Center at Tufts Medical Center, had a parallel first impression. As a young physician poised for a job interview back in 1981, and as someone who was relatively seasoned in the hunt, he knew the drill. “I was used to a certain manner of interaction,” he says, “but what I found was a very different approach. You go in, you’re pretty nervous, but he [Levine] made me feel at ease. I came away thinking this is somebody I wanted to work with.”

Salem and Konstam were not the only ones. A long stream of young cardiologists came to Tufts to study with Levine and never left, smitten as they were with his special qualities—his brimming intelligence, his resolute character, his disarming human touch. Levine “was the first cardiologist at Tufts Medical Center, and he really set the tone,” Salem told the Boston Globe after Levine died this past summer.

To more than one person, Levine came across as an old-fashioned charmer. Sandra Yenkin was a young woman from Columbus, Ohio, recently graduated from Wellesley College, when she met Levine on a blind date. “Well, it was a short date,” she says, looking back. “We spent the evening with the couple who had introduced us, and I thought Herb was very nice and wanted to know him better.” Sandy and Herb were wed in 1958 and had 55 years together, raising a son and a daughter in their home in Newton, Massachusetts. In late life Herb would have three grandsons to adore.

Salem recalls Levine as “a Renaissance man who loved to ask questions. Even in areas where he wasn’t an expert, he would often ask the best questions.” Salem tells of being at medical conferences with Levine where a group of cardiologists would be seated around a table, sounding off on this or that. “The other cardiologists would be thinking highly of themselves,” Salem relates. “Herb would be there, listening and smiling, and then, when he finally spoke, he’d offer some of the more interesting insights.”

The low-key, steady-as-you-go approach paid off in many ways. Levine’s patients loved him, of course. His research had an original flavor. And his personal example of the friendly, unassuming way you could carry yourself as a physician left a mark on cardiology at Tufts that has lasted 50 years and is still going strong, by all accounts. Meanwhile, “he was known nationally and internationally,” Salem says. “He was one of the household names in cardiology.”

Navigating that balance between personal modesty and public acclaim would be a tricky business for just about anyone. But Levine embodied and thrived on that balance. Sandy Levine saw her husband as “a highly intuitive person,” and as someone who had ample stores of confidence without a hint of arrogance. “He wasn’t frightened by things,” she reflects. “I thought it was wonderful.”

Fishing a Mountain Stream

Herbert J. Levine started from an advantaged spot. His father, Samuel Levine, was a world-renowned cardiologist based at Peter Bent Brigham Hospital in Boston, one of two giants in the field that the city offered, together with Paul Dudley White at Massachusetts General Hospital. The young Levine had a job working one summer when he was 14 years old as an EKG technician at the Brigham, where he felt the excitement of the big medical questions early on. “Medicine spun my wheels,” he told Tufts Medicine magazine in 2006. “I guess I never looked back after that.”

Levine attended Johns Hopkins Medical School and afterwards landed a fellowship at the Brigham at a time when the visionary Tufts physician Sam Proger was recruiting fresh talent for what was then called New England Medical Center Hospital (now Tufts Medical Center). Proger wanted Levine, whom he had known since he was a child, to be chief of cardiology. “I was very excited. Of course, I didn’t realize until I got here that the division of cardiology was one other guy and myself,” Levine later told a reporter with a laugh. He was then 33 years old.

From the start, his focus was on the patient in the room. He would ask questions and get patients relaxed enough to trust him with whatever they had to say. He listened intently. He performed a thorough physical examination, taking his time. “Unfortunately,” says Konstam, “many physicians seem to project that they’re coming from a high level. But Herb approached his patients as human beings. He demonstrated that he was interested in them as people. Whatever happened to them, they were confident that they were receiving the best possible care, and that he would be there for them.”

There were virtually no limits to his care. Sandy Levine tells the story that she heard recently from one of Herb’s longtime executive assistants. It seems that Herb had a patient in the hospital who refused to eat and was wasting away in her bed. “What would you like to eat? What appeals to you?” Levine asked the woman in all sincerity. “A cheese blintz,” she answered. At that, the good doctor left the hospital, swung around the corner to a neighborhood shop and bought his patient a blintz—which, on his return, she eagerly consumed.

In 1961, his first year at Tufts, Levine would spend an hour with each new patient, and a half hour with each returning patient, absorbing everything. Amazingly, he persisted in this same way until his retirement at age 78. When Levine was quizzed eight years ago about how he managed to retain this old-school, leisurely habit in a time when patient interactions grow shorter by the day, he responded with a kind of shrug. “Well, you can’t teach an old dog new tricks,” he said. “And I would have resisted it if they tried. I would have said, ‘I’m sorry, there’s no way I can do it.’ ”

The doctor knew who he was and what he needed. His research interests bore the same original stamp. William Gaasch, now semi-retired, first met Levine in the late 1960s, when he was a young physician on a fellowship at Tufts; he later worked beside him for many years as a colleague in cardiology, first at New England Medical Center and later at the Lahey Clinic. “What I got from Herb was his enthusiasm, which was infectious,” said Gaasch when reached last summer at his vacation home in northern Michigan. “Instead of talking about hypotheses, Herb would say, ‘Let’s try this and see what happens.’ It was always fun and didn’t seem like work.”

One example of Levine’s original approach had to do with how he went about studying the heart’s basic operation. Most cardiologists in his day focused their research efforts on understanding the heart during its contraction; this was the standard approach. But Levine decided to be the contrarian. “While everyone was studying how the heart squeezed, Herb studied how the heart relaxed,” Salem says. “It turns out that most of the heart’s energy consumption is in the relaxation phase.” 

According to Konstam, Levine conducted research in multiple areas of the heart, including electrophysiology and valvular heart disease, and contributed “pivotal” work on myocardial muscle mechanics. “Herb had the type of mind that wouldn’t just inhale what other people were thinking,” Konstam says. “He would always investigate things his own way.”

Meanwhile, at home, the doctor was a man of steady habits. He helped his kids, Andrew and Rachel, with their homework and attended their ball games when he could. In domestic life, he retained the calm and patient bearing that he wore like a uniform, even to the point of his wife’s occasional frustration. “Sometimes I’d ask him a question, and he wouldn’t answer right away,” Sandy reports. “I’d think he wasn’t listening. But then he’d say, ‘I’m thinking.’ ” 

When a substantial dispute arose, she had a little sign that she would post for his benefit: Save Time, See It My Way. “We had a strong marriage, a good marriage,” Sandy says, reflecting on their many years together.

Levine knew how to enjoy himself in the margins of his life. On vacation, he tended a lobster pot or two in Buzzards Bay. He loved fly fishing, and it’s easy to imagine the doctor flicking his line out over the rippling water of a mountain stream with the same light touch he brought to all his affairs. Humility was central, even essential, to how he lived. “Herb was never drawn to fame and fortune,” says Gaasch. “That was just not him.” 

William Grossman confirms that notion. A noted cardiologist and professor of medicine at the University of California, San Francisco Medical Center, Grossman met Levine in Boston in the mid-1960s and knew him as a fellow Boston cardiologist when Grossman served on staff at the Brigham for many years. At one point, Grossman was a member of the search committee looking for someone to fill the plum job of chief of medicine at Beth Israel Hospital. He called Levine to offer him the job. 

This would have been a professional “step up,” Grossman notes, but Levine considered the offer for about a day before calling to decline. “You know, Bill,” Levine said, “I really love what I’m doing. I’m good at this, and I’m going to stick with it. For me to take on more administrative work, and maybe see patients less, would be a mistake, I think.”

Among many other distinctions, Levine won a Distinguished Faculty Award from Tufts Medical School, plus the Paul Dudley White Award (given by the American Heart Association) in 1997, the Henry Bouchie Humanitarian Award and the Leonard Tow Humanism in Medicine Award. In his honor, Tufts Medical Center created the Dr. Herbert J. Levine Foundation for Cardiovascular Clinical Research in 2001.

The same untrammeled spirit that led Levine to turn excitedly to a colleague and ask, “Well, what do you think?” when conducting an experiment also found its expression in a few of the whimsical sayings the quietly great man lived by. Grossman remembers one of these in particular. “Herb used to say, ‘God has given each of us just so many heartbeats. The slower we play them out, the longer we live.’ ”

Herb Levine’s personal supply ran out on July 11, 2014. He was 85 years old.

This article first appeared in the Winter 2014 issue of Tufts Medicine magazine.

Bruce Morgan, the editor of Tufts Medicine magazine, can be reached at bruce.morgan@tufts.edu.