Peter E. Linz, a renowned researcher in hypertension, lipid management and atrial fibrillation, has participated in many multicenter clinical trials and multinational studies, including several for the National Institutes of Health. In 2011, Dr. Linz retired from the U.S. Navy after a 30-year career as cardiologist. Since then, he has worked as a physician with Mercy Ships, a global charity that operates hospital ships in developing countries. Dr. Linz is also associate professor of medicine at the Uniformed Services University in Bethesda, Md., where he earned his doctor of medicine degree. He sits on the dean’s advisory council of the P.C. Rossin College of Engineering and Applied Science, and his son Thomas is a member of the college’s Class of 2014.
Q: You are renowned for your research in hypertension, lipid management and atrial fibrillation. What are some of the discoveries you have made in these areas?
A: I took part in major National Institutes of Health studies that examined the best strategies to treat these conditions, given the medicines we have. They included ALLHAT, a study over more than 10 years of the best combination of medications for hypertension; AFFIRM, an atrial fibrillation study on heart rhythm versus rate control; and ACCORD, which looked at the best strategy to control cardiovascular risk in diabetes patients.
Those studies were pivotal in developing guidelines for treating these conditions. For example, ACCORD, one of the largest NIH studies ever funded, looked at glucose control, high blood pressure and cholesterol. All three parts of the study showed that less intensive therapy was better than more intensive treatment. That has important implications for treatment, safety and costs. Doctors follow the guidelines from those studies today. That gives me a sense of satisfaction.
Q: What kind of changes do you foresee in the ways in which these conditions are treated?
A: We’ll continue to refine strategies for treatment and the best combination of medicines. For atrial fibrillation, one newer treatment is ablation, an invasive procedure in which electrophysiologists try to eliminate the condition mechanically. There’s controversy about who should have that procedure and the risks involved. We’re trying to figure out the best strategy.
Q: How did you first get involved in humanitarian healthcare?
A: One of the highlights of my career with the Navy was in the planning and leadership of a humanitarian healthcare mission in Southeast Asia with the U.S. Navy hospital ship, the USNS Mercy. I spent a year with the mission. We went to the Philippines, Vietnam, East Timor, Papua New Guinea and Micronesia. We had contact with more than 90,000 patients in six months.
Q: After retiring from the U.S. Navy in 2011, you joined Mercy Ships, which has been providing healthcare since 1978 to people in the developing world. What was the impetus for this move?
A: My work with the USNS Mercy ignited a passion in me. Mercy Ships was a natural fit. My wife has known about the organization for about 20 years. It was through her that I got involved.
Q: What countries have you had the opportunity to visit with Mercy Ships?
A: I’ve been to Togo, Guinea and Congo. Mercy Ships works primarily in countries that lie within 15 degrees north and 15 degrees south latitude in Africa, from Senegal in the north to Angola in the south. The U.N. has a Human Development Index, or HDI, that measures life expectancy, infant mortality, educational opportunities and resources. Many countries in the bottom 15 or 20 percent of the HDI are located in that part of West Africa. That’s why Mercy Ships works there.
Q: What kinds of work have you done in these countries?
A: The ship ties up at a location for 10 months and provides oral surgery, plastic surgery, burn reconstruction, eye surgery, cataract surgery, pediatric orthopedics and general surgery. We also have an active dental program. The last time we were in Guinea, we extracted 35,000 teeth and also performed more than 2,800 surgical procedures in a 10-month period.
Q: What kind of impact has this work had on you, personally?
A: I spend a couple months each year aboard the ship, and find it incredibly rewarding. It’s a great way of giving back and demonstrating one’s Christian faith. But it’s hard work. When the ship arrives at a country we have a patient selection day. We might see 5,000 people in line for evaluation. The number of people who need care and whom we screen is greater than the number we can care for. That can be emotionally draining, so we try to do the most good for the biggest number of people.
Q: How can engineers help improve healthcare and its delivery?
A: Some of the solutions needed for healthcare in the developing world go right to engineering skills. These include infrastructure, access to clean water, proper sanitation and reliable electricity. Also, we now have solar power batteries for the equipment that refrigerates vaccines. And cell phones are everywhere. The development of hand-held, smart-phone-based diagnostic aids has a huge potential for portable, easy-to-maintain diagnostic applications. One smart-phone application can take a picture of someone’s eye and diagnose a cataract. Another records an EKG and transmits it wirelessly. These sorts of applications have potential for huge impact in terms of portability and affordability, as well as the development of tele-medicine to do long-distance diagnosis in remote areas with a limited number of physicians.
Q: How have you interacted with engineers during your career?
A: I’ve dealt mostly with people in the medical device industry, engineers making things like pacemakers, defibrillators and cardiac catheterization labs. Plus, I’ve worked with people who develop the IT interface between medical devices on the one hand and medical records or medical imaging on the other, for better interpretation and documentation.
At Mercy Ships, we work with a group called Engineering Ministries International. They do an assessment of a local hospital and develop a plan to meet its infrastructure needs, everything from water to waste management to maintenance needs. On the ship, we have maritime engineers to keep the ship running, and we train biomedical repair technicians to maintain medical equipment. We also work with engineers on the automation of laboratory diagnostic equipment.
Q: What kinds of changes do you foresee in engineering education?
A: I see a need for solutions that help integrate the greatly increasing amount of information. I also see a trend toward more multidisciplinary education between engineering and other fields, and toward increased specialization.
Q: What can we do to improve the teaching of STEM subjects and increase the numbers of engineers and scientists in the U.S.?
A: I think it’s a matter of exposure and getting people excited about science. That comes from excellent teachers and mentors who share their excitement.
Q: What has been the most memorable accomplishment in your career?
A: Two things stand out. First, I was involved in medical education for years. At the Naval hospital in San Diego, I ran the cardiology training program for about seven years, and I chaired the internal medicine department and supervised its training program for 2.5 years. I was fortunate enough to educate and mentor a generation of cardiologists.
Second, being involved in humanitarian work has been life-changing. You can be overwhelmed by the sheer numbers of people who need help. But the reward comes with the individual. Watching someone get their vision back after being blinded by cataracts for years, or someone who is cured from a large facial tumor, is deeply rewarding. There are a thousand stories out there. In the end it comes down to individual relationships. If you take the problems one at a time, you can have a victory in each one.
Interview by William Tavani
Photo by Mercy Ships/Ruben Plomp
Posted on Friday, April 25, 2014