About Proctor Harvey, M.D.
"The art of cardiac auscultation, as we know it today, is virtually synonymous with the name W. Proctor Harvey."
– Michael A. Chizner, M.D., Editor, Classic Teachings in Clinical Cardiology
Dr. Harvey was Professor Emeritus of Cardiology at Georgetown University School of Medicine and former Director of the Division of Cardiology. He also served as a Consultant in Cardiology to the U.S. Department of State, Walter Reed Army Medical Center and Andrews Air Force Base Hospital in Washington, D.C., and to the U.S. Naval Hospital and the National Heart, Lung and Blood Institute. Dr. Harvey had served as President of the American Heart Association and as President of the Association of University Cardiologists. He was a Master of the American College of Physicians, a Fellow of the American College of Cardiology and a Fellow of the council of Clinical Cardiology of the American Heart Association.
W. Proctor Harvey dedicated his life to the teaching and refinement of the art of clinical cardiology. Proctor Harvey’s decision to pursue cardiology began as he completed his internship at Harvard’s Peter Bent Brigham Hospital in Boston, where he met the legendary cardiologist Samuel A. Levine. Dr. Harvey began his training as the first fellow in cardiology at Brigham Hospital, becoming, as well, Levine’s first fellow. Dr. Levine went on to teach a generation of distinguished physicians, but his first and perhaps most beloved pupil was recruited to develop another cardiology division and one of the most sought-after fellowship programs in the world. At a time when student and faculty morale at the Georgetown University Medical Center was low and funding scarce, Harvey began the formidable task of building Georgetown’s division of cardiology. He quickly developed Georgetown’s heart station, patient clinic, and, with the help of Charles Hufnagel, its cardiac surgery division. Word of the quality of the cardiovascular care spread quickly among patients, and among physicians and other caregivers at area hospitals where Harvey practiced.
Proctor Harvey spoke frequently of the "Give-Take Ratio,” which refers to his position that one should always try to give more than one receives. Dr. Harvey had the greatest contempt for the doctor who makes financial gain the first object of his work. He also has said that “The practice of medicine, as life, is very much what you make of it—to one a worry, a care, to another a daily joy filled with as much happiness in serving others as one could ever have.” A self-proclaimed type B personality, Harvey gave the appearance of being the most carefree of individuals, with a gracefully boyish charm. He knew intuitively how to capture the moment and appeared never to be bothered by interruptions.
The unprecedented application of technological equipment to the practice of twentieth-century medicine has been credited by Harvey not only for its genuine contributions to patient care but for its establishment of auscultation’s validity, by demonstrating the physiologic basis of heart sounds and murmurs. Dr. Harvey maintains that, amidst these technological advances, one thing has remained constant—patients have continued to experience the same symptoms, thereby presenting with the same findings for the same reasons. He continues to maintain that a properly trained clinician can diagnose ninety percent of patients with cardiovascular problems in his office or at the bedside, often more reliably than with a machine. Harvey goes so far as to say that if the clinical findings show prolapse of the mitral valve, but the echocardiogram fails to show it, “You should state that it is too bad, but the echo missed it.” He emphasizes that “your ears are better than any test and don’t cost the patient a cent.”
Approaching medicine as a naturalist rather than an experimentalist, Harvey has himself contributed greatly to advancements in the clinical recognition and treatment of heart disease, his basic method being to observe and reason rather than to analyze a single variable under controlled conditions. Through his descriptive observations of nature, use of critical thinking, and constant awareness of clinical findings, he has effectively correlated heart sounds and murmurs with known conditions, elevating cardiovascular diagnosis at the bedside to the level of maturity at which it stands today. Long after it was thought that all findings had been characterized, he discovered and described the significance of the split second sound, face-down auscultation in pericardial effusion, the rightward distribution of the murmur of aortic regurgitation, the mitral opening snap, the changing first sound of atrial flutter with 4:1 block, the multiple sounds of ventricular tachycardia, and the contour of the aortic ejection murmur. To be certain that medical professionals do not miss acoustic findings because their stethoscopes are unable to pick them up, he designed the Harvey Double and Triple Head Stethoscopes: The Triple Head includes a third chest piece, the corrugated diaphragm, which provides an amplified overview of the patient’s cardiovascular events.
It was through his intuitive and trained power of observation that he developed “cardiac pearls,” which he defines as facts or findings in the clinical assessment of the patient that either make a diagnosis or provide a clue that leads to diagnosis. He states, “A cardiac pearl has ‘stood the test of time’ and does not change with the passage of time.”
Both the American Heart Association and the American College of Cardiology have honored Dr. Harvey as a recipient of the Gifted Teacher Award. In 1978, the American Heart Association, which Harvey had served as president from 1969 to 1970, honored him as a recipient of its James B. Herrick Award, stating: “As physician, teacher, communicator, and medical innovator, Dr. Harvey has contributed outstandingly to the advancement and practice of clinical cardiology. He has exerted an extraordinary influence on modern cardiological teaching, nurturing generations of medical students and developing and conducting post-graduate training for physicians in practice throughout the United States… His achievements in research into auscultation and physical assessment of the heart patient and improvements in teaching methods are measurable. Not measurable is the magnitude of his contribution in terms of those whom he has inspired to reach just a bit higher.”