John Kennedy, M.D., '92: Heart and soul
The patient was sweating profusely and complaining of chest pain. She also had a laundry list of personal woes, from financial problems to difficult relationships with her children. John Kennedy, then a medical student, gathered with the rest of the medical team in the emergency room to hear the attending physician's diagnosis.
"We're sending you home," the doctor announced.
The team's intern nudged Kennedy and whispered to him that the patient's problems were only in her head. How interesting, Kennedy recalls thinking. She looks pretty stressed-out to me.
Two weeks later, the patient returned to the ER. Coincidentally, the same team was on call. This time, she had suffered a heart attack.
The team's reaction was hardly unusual, especially for the time. Cardiovascular disease has long been a major health problem for women, but until recently it has been associated by both doctors and patients mostly with men. The experience left an indelible impression on Kennedy, convincing him that stress and heart disease must be linked. Exploring that link became the focus of his career, leading him to his current position as director of preventive cardiology and wellness at Marina Del Rey Hospital, near Los Angeles.
Kennedy's interest in medicine arose early. Growing up as the third of five siblings in northern California, he entertained youthful notions of playing professional basketball. But then Dr. James Price, a cardiologist and the father of his best friend, gave a lecture to Kennedy's high school science class on the intricacies of the human heart. Kennedy was enthralled. And it wasn't a flash-in-the-pan fascination. He went on to major in biology in college and worked summers as an electrocardiography technician in Price's office.
Poh is a freelance science writer and a former editorial intern at Dartmouth Medicine. She earned a master's degree in pharmacology from Dartmouth Medical School in 2007.
Around this time, Kennedy's maternal grandfather died. A veteran of World War I, he'd suffered severe shrapnel injuries that led to paraplegia, and he had been nursed for years by Kennedy's grandmother. Just six weeks later, she passed away, too. "It was horrible," Kennedy recalls, "but it strengthened my desire to understand the effects of emotional stress on health. Not long after that, I woke up 3,000 miles away at Dartmouth Medical School."
Kennedy was among the students admitted to the Brown-Dartmouth medical program in 1988. From 1981 to 2006, approximately 20 students were selected each year for this joint program; they spent the first two years at DMS before completing their degree at Brown University's medical school.
Kennedy says he loved the contrast of spending some time at a school in a rural setting and some time in a more urban setting. Also, his mother hails from a large Italian family, so he felt very much at home in Providence, with its decidedly Italian atmosphere.
"I spotted JFK Jr. and [his girlfriend] Sally Munro around campus a few times," Kennedy adds with a chuckle. "People thought I was part of the clan; I'd go to restaurants and get treated well on account of my name, which was kind of fun."
Kennedy had always intended to follow in the footsteps of his friend's father by going into cardiology. Dr. James Bell, a cardiologist at Dartmouth, helped cement that decision.
"He made a very complex subject seem simple," Kennedy says of Bell. "Everything fit and just made sense to me." Bell's lectures emphasized mind-body interactions and ways that anxiety can affect the heart. Bell is a practicing Buddhist, and this influence rubbed off on Kennedy, too. "I'm not into [Buddhism] fully, but I do believe strongly in the power of 'mindfulness' and incorporate that into my life whenever possible," he says.
After medical school, Kennedy returned to California for residency and a fellowship in cardiology at Harbor-UCLA Medical Center. He then headed north, running Kaiser Permanente's Cardiac Catheterization Laboratory in San Rafael for eight years. He was also fascinated enough with pacemakers to sign up for a special pacemaker implantation program, spending a whole year becoming an expert in the art. Not surprisingly, Earl Bakken—the device's inventor—is among his heroes.
As a busy invasive cardiologist, Kennedy has seen many examples of the havoc that stress can wreak on the human heart. During a recent ER summons, he found a woman in agony from an apparently massive heart attack. The case was typical enough, except that 10 police officers were surrounding her bed. He learned that she'd been charged with stealing a Rolex watch from a bin at an airport security checkpoint, in full view of the cameras. As she was swarmed by guards, she experienced acute chest pains.
Grew up: Sonoma County, Calif.
Education: University of California, Santa Barbara '88 (B.A. in biology); Brown-Dartmouth Medical Program '92 (M.D.)
Training: Harbor-UCLA Medical Center (residency in internal medicine and fellowship in cardiology)
Current academic title: Associate clinical professor, Harbor-UCLA Medical Center
A talent he'd like to have: "I wish I could play the piano like Billy Joel."
Named after: His paternal grandfather, not the 35th president
"I expected to find 100% blockage of her arteries," he says, "but they were wide open, even though her heart was severely damaged." She had suffered broken-heart syndrome. A sudden rush of stress hormones—adrenaline and cortisol—had triggered immediate, destructive changes in her left ventricle, the heart's main pumping chamber. Women are more prone to this syndrome, particularly those past menopause and without a history of cardiac problems. Fortunately, the damage is usually reversible.
This condition is "one of the most compelling and, I think, incontrovertible pieces of evidence showing that stress and heart disease are connected," Kennedy says. "People think more about the indirect effects of stress—it can result in poor dietary choices, smoking, drinking, and other negatives—but I believe strongly in the direct effects of stress hormones, too."
If stress is harmful to the heart, relaxation must have the opposite effect, Kennedy reasoned. Yoga, hypnosis, and meditation are proven techniques for stress management, but he wanted to develop "simple, self-directed, accessible tools—something you could do anywhere, from the board room to the scrub sink."
When professional athletes perform effectively and consistently under great stress, it's called being "in the zone." So Kennedy consulted sports psychologists about two forms of relaxation commonly taught to athletes: guided imagery and controlled breathing. Combining these, he devised a seven-step technique—called "B-R-E-A-T-H-E"—that he details in a book titled The 15 Minute Heart Cure.
The second step of the technique, "Relax," involves deep breathing, which is nurturing for the heart, Kennedy says. Exhalation, extended by counting to seven, slows the heart rate and reduces high heart-rate variability. The third step, "Envision," uses mental imagery. Kennedy suggests imagining boulders that impede the flow of a river being pushed out of the way by the momentum of a waterfall, or mist settling on a cherry blossom and dripping rhythmically off its tip, as two examples. "The heart's workings can be simplified to the concept of flow," Kennedy explains. "Hence these metaphors, which help tame the river of the heart, so to speak, and improve its efficiency."
The book has received considerable media attention, but Kennedy is not a newcomer to the spotlight. In San Rafael in the late 1990s, he began doing local news segments on cardiology. He then developed a talk for children called "Big Mind, Brave Heart, Bright Future." It emphasizes proper diet, exercise, stress management, and imagination—the last a trait of another of his heroes, Albert Einstein.
Kennedy also received news coverage as an ambassador for Kaiser Permanente.
And the spotlight has only brightened since his move to Los Angeles, where he's a frequent motivational speaker at venues ranging from area schools to large corporations. He's a media favorite whenever heart issues hit the headlines, too; last year, for example, the local NBC affiliate sought Kennedy's commentary after Michael Jackson's death, regarding the actions of the singer's cardiologist.
Since publishing his book, Kennedy has been busier than ever. He's a regular on NBC's ExtraTV, and he appeared on this year's season premiere of The Doctors on CBS. He's been interviewed by ABC's Diane Sawyer and on Oprah Winfrey's new network, OWN.
Kennedy was on the season premiere of The Doctors, and he's been interviewed by ABC's Diane Sawyer.
Kennedy's television appearances have not gone unnoticed at home. He and his wife have two daughters—Emily, 5, and Alexa, 3. "Emily likes to tell people, 'This is my daddy, he's 44, and he's a heart doctor,' " he chuckles, amused but slightly chagrined over having his age so candidly revealed.
Does being such a public figure ever get in the way of family life? "I'm passionate about my work, and I do enjoy speaking and traveling," Kennedy says. "But it's tricky, with small children in the picture. . . . I don't want to miss their childhood." Hanging out with his "gorgeous girls" is one of his favorite pastimes. "We go on play dates, visit the beach, fly kites, paint and sculpt, and do all sorts of fun things," he says. And he reads to them every night—Dr. Seuss's One Fish Two Fish Red Fish Blue Fish is a current popular choice.
It's now the end of a Friday afternoon, Kennedy's interview for this story is winding down, and he isn't on call. That means he can leave work and the glare of publicity behind for a few hours while he picks up his daughters from school. "We'll probably go grab some ice cream," he says.
For the moment at least, this busy cardiologist, writer, speaker, husband, and father sounds stress-free.
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