Heart History: The Invention of

the Stethoscope: Rene Laen-

nec and his “Le Cylindre”

N o two symbols have come

to represent the medical

profession more than the ca-

duceus and the stethoscope.

Apollo, the Greek god of medi-

cine and music, gave the ca-

duceus to Mercury in ex-

change for the lyre which Mer-

cury had invented. Laennec,

perhaps as skilled in music as

he was in medicine, gave us

the stethoscope and, in ex-

Volume 3, I ssue 1

TH E D IR ECTO R ’S C U T C H R I S T I N E D O N N E L L Y , M D

Winter 2011 -12

THE HEART BEAT

Children’s Heart Center

Goryeb Children’s Hospital

Morristown Medical Center

100 Madison Ave.

Morristown, NJ 07960

Goryeb Children’s Center

Overlook Medical Center

99 Beauvoir Ave.

Summit, NJ 07901

Newton Medical Center

175 High Street

Newton, NJ 07860

Physicians

Christine Donnelly, MD-Director

Stuart Kaufman, MD

Donna M. Timchak, MD

Suzanne Mone, MD

Lauren Rosenthal, MD, MPH

Leonardo Liberman, MD-EP Consultant

Nurses

Wanda Kaminski, RN

Maria Lawton, RN

Elena Cobleigh, RN

Technologists

Colleen Henderson, RCS, RDCS-Lead tech

Alexis Harrison, RCS, RDCS

Bhavisha Pandya

Alla Greenberg

Ashley DeRosa

Kelli Vranch, RDCS

Medical Assistant

Joanne Spiropoulos

Social Worker

Margaret Micchelli, LCSW

Administrative Staff

Lynn Vanderyajt

Jessica Darcy

Diann Vivar

Sandy Segreto

Crystal Hernandez

Phone: (973) 971-5996

Fax: (973) 290-7979

Visit the Children's Heart Center Web Site

Edited by:

Margaret Micchelli and Stuart Kaufman

change, achieved “immortal”

fame.

B efore Rene Laennec,

medical diagnoses were

made on the basis of informa-

tion obtained from a patient’s

history, observation and lim-

ited examination, including

palpation, percussion of the

body and “immediate” auscul-

tation, or the direct application

of the ear to the patient’s

chest. Laennec, chief of the

l’Hopital Necker in Paris which

specialized in the care of pa-

tients with chest afflictions,

found this last method of diag-

nosis inadequate in certain

situations and “as uncomfort-

able for the doctor as it was

for the patient” and sought a

better means of examination.

And so he did:

“I was consulted, in 1816, for

a young person who presented

with generalized symptoms of

heart disease and in whom

palpation and percussion gave

few results because of plump-

ness. The age and sex of the

patient prevented me from

conducting the type of exami-

nation I have just described

(immediate auscultation); I

recalled a well-known acoustic

phenomenon: if the ear is

placed at one end of a log, the

tap of a pin can be heard very

distinctly at the other end. I

imagined that this property of

bodies could be applied to the

case at hand. I took a paper

notebook, made it into a tight

roll, one end of which I applied

to the region of the heart, and

putting my ear on the other

(Continued on page 3)

H A L L E T O T H E C H I E F !

T here aren’t many 6-1/2 year olds who can say they had a chat with the president of the United

States. But Halle Major and her family were treated to a VIP tour of the White House that included

time with President Barak Obama in the Oval Office.

H alle is one of Dr. Donna Timchak’s long-time pediatric cardiology patients. Many children, when

given the chance for any wish in the world, think of trips to faraway places or some of their favor-

ite past times. But Halle’s fondest wish was to meet the president. So,

she patiently remained on a waiting list until the fateful call came at the

end of March 2011. Can the family be ready in a week to go to Washing-

ton to meet President Obama?

T he Make-A-Wish Foundation © of NJ is part of a national non-profit

organization that grants wishes to children whose health conditions

meet the organization’s criteria. They arranged for a deluxe 4-day stay in

the capital for Halle, her parents, her sister Nya and her grandmother.

They enjoyed the National Zoo, the National Aquarium and the Smith-

sonian National Air and Space Museum, but the highlight was definitely

the White House.

P resident Obama gave his undivided attention to Halle, asking about

her school work and encouraging her to dream big dreams. She also

got to play with the presidential pooch, Bo, and to meet the president’s personal chef. Halle and her

sister had fun bowling in the White House bowling alley and they saw the White House movie theater

where Halle sat in the president’s favorite seat. After it was all over, Halle presented Dr. Timchak with a

framed picture of herself with the president. Now how many first graders can say that?

Save The Date: Valentine’s Day Family Event, February 12, 2012

Why did you want to be a

pediatric cardiologist?

M y father suffered his

first heart attack when I

was in the 2nd grade. He went

on to have a second heart

attack and cardiac bypass

surgery when I was a fresh-

man in high school. The im-

print that these events left on

my life is clear in my choice of

careers. It influenced not only

my decision to pursue a ca-

reer in medicine, but also

initially sparked my interest in

cardiology.

W hile completing my pedi-

atric residency and

fellowship in cardiology at the

Children’s Hospital of New

York Columbia Presbyterian

Hospital, I was trained by

pioneers in the field of pediat-

ric cardiology. I was inspired

by the idea of offering mean-

ingful therapeutic interven-

tions to children with cardiac

disease. The field has

evolved to change the way we

view conditions that were

once, at best, chronic ill-

nesses into treatable prob-

lems. I’m fortunate to be in a

position to guide my patients

through treatments that will

significantly improve their

quality of life.

P ediatric cardiologists have

a unique opportunity to

care for patients in a broad

range of clinical settings and

from a wide range of age

groups. When I establish a

relationship with a family it’s

often one that will span many

years and clinical scenarios. I

consider it a privilege to get to

know a patient and his or her

family on this intimate level.

The opportunity to begin to

form this bond even before

birth is but one of the many

reasons I’m interested in fetal

echocardiography.

A nother one of the reasons

I chose to become a phy-

sician was to have the oppor-

tunity to make a community-

based impact. After college

graduation, I spent several

months in Costa Rica where I

worked in a rural public

health clinic. During my time

there, I developed an under-

standing of the dramatic con-

tribution that a grass-roots

initiative can make to the

welfare of a population. This

experience motivated me to

obtain a Master’s Degree in

Public Health at Columbia

University’s Mailman School

of Public Health and it contin-

ues to shape the way in which

I practice medicine.

W hen my father was

acutely ill I used to hope

that he would live to see me

graduate from high school.

He lived not only to witness

that moment, but he also

shared many of my other im-

portant milestones. He ulti-

mately saw me graduate from

medical school, walked me

down the aisle at my wedding

and got to hold both of his

grandchildren. So, finally, as

a pediatric cardiologist, I hope

to have the chance to help

give families the priceless

time with a loved one that my

father’s physicians gave to my

family and me.

The Heart Beat Vo lume 3, Issue 1

HEA LTH Y HEA RT S U Z A N N E M O N E , M D

STAFF H I GH L I GH T L A U R E N R O S E N T H A L , M D , M P H

Take the stairs whenever

you can instead of the

elevator or escalator.

Choose a restroom that

is the furthest way, if you

have an option.

Grab a friend and go for

a 30 minute brisk walk

on the weekends. You

can catch up on every-

thing and exercise while

doing so.

Go for a walk while talk-

ing on your cell phone,

but be careful of traffic.

If you find yourself in

front of the TV, jump rope

or do calisthenics during

the commercial breaks.

Exercise first thing in the

morning. Get up 20–30

(Continued on page 3)

steps between your car

and the store.

Take a “walk break”

whenever you can find

time during the day.

Taking short 10 minute

walks a few times a day

will do wonders for your

metabolism!

Use your lunch break as

time for exercise. Spend

half the time eating and

half the time walking.

Play with your children!

This is great attention for

them and a great activity

for everyone.

A way to spend time as a

family is to take a walk

together around the

neighborhood after din-

ner.

Importance of Exercise

W e all know exercise is

good for us. Exercise

controls weight, combats

health conditions and dis-

eases, promotes better sleep,

improves mood, boosts en-

ergy and is fun! All of us

should strive for at least 30

minutes of physical activity

each day.

H ere are ways to incorpo-

rate more exercise into

your daily life. It’s good for

you and it sets a great exam-

ple for your children of “heart

healthy” living.

Seek out the parking

spot that’s furthest away

and get in a few extra

N U R S E S ’ N O T E S

Cold and Flu

Season Tips by Elena Cobleigh, RN

The CDC recommends a

yearly flu vaccine as the

most important step in

protecting against flu

viruses.

If there’s a child in the

home with cyanotic heart

disease (blue at birth), all

family members should

get the flu vaccine.

The flu shot cannot

cause you to get the

flu. Any side effects

are mild and last about

24-48 hours.

Children under the age

of 2 years with certain

heart diseases should

also receive monthly

Synagis injections (Oct.

to April) to minimize the

effects of the RSV virus.

See your pediatrician

for more information.

During cold and flu

season, wash your

hands often with soap

and water. Handwash-

ing is the single most

effective way to prevent

the spread of infection.

Please keep your child

home if sick with a cold

or the flu. If you have a

cardiology appoint-

ment, speak with one

of the nurses to see if

you should reschedule

the appointment.

Page 2

The Heart Beat Volume 3 , Issue 1 Page 3

F A M I L Y C O N N E C T I O N

D I R E C T O R ’ S C U T ( C O N T ’ D )

past fall was our 2nd annual family picnic at

Lewis Morris Park. Families enjoyed the petting

zoo, live music, a climbing wall, a martial arts

demonstration, face painting and crafts.

O ur 3rd annual Valentine’s Day family event

in honor of National Congenital Cardiac

Defect Awareness Day is on Sunday, 2/12/12

from 1pm to 3 pm in the hospital auditorium.

The whole family is invited to an afternoon of fun

and sharing. Please mark your calendar be-

cause we hope to see you there!

T hese smil-

ing boys

have something

very special in

common. Their

parents met at

our pediatric

cardiology fam-

ily events and found out they share many similar

experiences. Now these boys are buddies and

the families have become friends.

I n addition to the monthly parent group, we

hold two large family events every year. This

Did you know??

There is a difference between a

serving size and a portion size.

A portion size is what you

choose to eat, while a serving

size is the recommended

amount.

ONE SERVING SIZE EQUALS…

½ cup cooked rice equals a

filled cupcake wrapper

½ cup cooked pasta equals an

ice cream scoop

1 medium piece of fruit is the

size of a tennis ball

¼ cup raisins or nuts is about

the size of a large egg

1 ounce of cheese equals about

2 dice

1 cup of yogurt is the size of a

baseball

3 ounces lean meat, chicken or

fish is about the size of a deck

of cards

1 teaspoon of salad dressing is

the size of a postage stamp

2 tablespoons of peanut butter

equal a golf ball

1 baked potato is about the size

of a computer mouse

1 slice of bread is the size of a

cassette tape

What is the serving size of one

pancake?

end, I was just as surprised as I was satisfied to

hear the beating of the heart in a manner that

was clearer and more distinct than I had heard it

by the direct application of the ear.”

A lthough Laennec preferred to call his inven-

tion “le cylindre” and indeed the first instru-

ments were wooden cylinders, he eventually

gave into peer pressure and named it the

stethoscope from the Greek “stethos”-chest and

“scope”-to see. Incredible as it may seem to-

day, the stethoscope was not universally ac-

cepted and as late as 1834, a commentary in

the London Times stated:

“That it will ever come into general use…is

extremely doubtful because its beneficial

application requires much time and gives a

good bit of trouble…There is something even

ludicrous in the picture of a gray physician

proudly listening through a long tube applied

to the patient’s thorax.”

Answer: The size of a CD.

O ver time, the stethoscope has evolved from

the monaural cylinder Laennec invented to

today’s familiar binaural instrument. Indeed the

variety of stethoscopes developed since Laen-

nec’s time continues to increase with 318 pat-

ents related to stethoscopes between 1976-

2000 alone. But despite the varieties, colors

and accessories of modern day stethoscopes, it

is still clear, as Dr. Tsung Cheng tells us…“It is

not these fancy accessories that make the dif-

ference. It is what lies between the two ear-

pieces that counts”.

minutes earlier and get in your workout first

thing.

Try to choose a physical activity immedi-

ately following work. A walk, gardening or

even housework is better than sitting on the

couch.

If you are torn between reading at home

and jogging in the park, get an audio ver-

sion of the book of your choice from the

library. You can listen to the book while you

walk or jog.

Walk, jog, or stretch while you’re waiting for

dinner to cook, the laundry to finish up, or

for your child to be finished with an activity.

Turn your house chores into exercise.

When vacuuming, try to use your arm, back

and abdominal muscles to push the vac-

uum. When loading the dishwasher, main-

tain good posture as you are bending and

straightening while keeping your abdominal

muscles tight. Washing the car, weeding,

and mowing the lawn are great ways to

burn extra calories.

It is perfectly fine to break up your intense

workouts. If you split your 30 minutes of

aerobic activity each day into three 10 min-

ute sessions, you may find this more man-

ageable...JUST DO IT!

H E A LT H Y H E A R T ( C O N T ’ D )

Family Picnic 9/18/11

Parent Support Group:

Get Acquainted After the Holidays!!

C ongenital heart problems are the most common birth defect

in the country and throughout the world. Do you know any-

one else who shares your experience? This is a monthly group for

mothers and fathers whose children are under age 5. It’s an op-

portunity to share information and support as different develop-

mental issues arise in the course of family life. The group meets

on the first Monday evening of the month at 7 pm on the second

floor of Goryeb. Upcoming meeting dates are: January 9, Febru-

ary 6, March 5, April 2, May 7, June 4, 2012. Please drop in

whenever it’s convenient for you.

For more information please contact (973) 971-8689.

The Heart Beat Vo lume 3, Issue 1 Page 4

Living With Pediatric Chronic Illness: Empowering

Families to Help and Heal

T he dept. of pediatrics presents a panel of Goryeb experts to

address the impact of any chronic illness on families.

Christopher Lynch, PhD Impact of chronic illness on the

family

Tara Gleason, MSN, CPNP Practical tips for parents when

dealing with school issues

Ann Stocknoff, LCSW Caring for the caregiver: strategies

to reduce stress

When: Sunday, March 25, 2012 from 1 pm to 3 pm

Where: Malcolm Forbes Amphitheatre

Registration is requested. Please call (800) 247-9580.

SO C IAL WOR K COR N ER M A R G A R E T M I C C H E L L I , L C S W

P E D I AT R I C EP N OW O N B OA R D

W e are very pleased to announce

that Dr. Leonardo Liberman, a

pediatric electrophysiologist, has

joined our team. First, an answer to

the question: What exactly is an elec-

trophysiologist? Within the specialty

of pediatric cardiology, an electro-

physiologist focuses on problems with

the heart’s rhythm and electrical im-

pulses. In other words, he’s an electri-

cian for the heart!

D r. Liberman graduated from the

medical school at the University

of Buenos Aires and completed fellow-

ships in pediatric cardiology and pedi-

atric electrophysiology at CHONY-

Columbia University where he is an

Associate Clinical Professor of Pediat-

rics. He also publishes and lectures

extensively in the field.

D r. Liberman now sees patients

here at Goryeb every 3rd Monday

of the month, so families no longer

have to travel to NY for an appoint-

ment. They can receive this expert

specialized care much closer to home.

N U R S E A B O U T T OW N

W anda Kaminski, RN, was at Hill-

crest School in Morristown on

May 27, 2011 to speak with the Mor-

ristown and Morris Township school

nurses who cover grades K through

12. Wanda is committed to commu-

nity outreach to educate others about

pediatric congenital and acquired

heart problems. Also, such a meeting

serves to improve communication

among pediatric cardiologists, schools

and families.

T he nurses discussed various con-

genital heart defects and condi-

tions, such as syncope and postural

orthostatic tachycardia. Also, Wanda

was able to respond to specific stu-

dent scenarios that the school nurses

presented. Issues related to exercise

tolerance and sports activity are espe-

cially important in a school setting.

Overall, this was a wonderful opportu-

nity to answer questions and address

concerns about the daily school life of

children with cardiac conditions.

E M P L OY E E O F T H E M O N T H

C ongratulations to Bhavisha

Pandya, cardiovascular technolo-

gist, who was designated employee of

the month (March/April) in the depart-

ment of pediatrics. She has been with

the Children’s Heart Center for seven

years, after coming from Florida where

she obtained her CVT education. In

addition to

her regular

work in pedi-

atric cardiol-

ogy, she

also does

studies in

both the

NICU and

PICU, when

n e e d e d .

Bhavisha’s

calm man-

ner is a real

help in doing echocardiograms on the

youngest of patients. She also was

commended for her awareness of cost

effective measures in her role of or-

dering clinical supplies for the division.

Bhavisha is a team player and we are

very fortunate to have her as part of

our team.