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Harold T. Dodge, M.D.
1924 - 1999
Harold Trace Dodge, Jr, MD, great physician, investigator, teacher, and friend of many in the cardiology community, died in Seattle on February 26, 1999. Dr Dodge grew up in Seattle and attended the University of Washington for 2 years and Harvard University for 1 year before entering Harvard Medical School. He graduated in 1948. He did his internship at the Peter Bent Brigham Hospital in Boston and then returned to Seattle, where he completed a year of residency in medicine and a year of fellowship in hematology with Dr Clement Finch. By this time, he had decided to specialize in cardiology, so he returned to the East Coast for a year of training at the National Institutes of Health (NIH) and a year at Emory; this was followed by 3 more years at the NIH as a clinical investigator working with Dr Robert Grant. Dr Dodge then joined the faculty at Duke for a year before being recruited by Drs Robert H. Williams and Robert A. Bruce to return to Seattle to become the first Chief of Cardiology at the new Seattle Veterans Administration Hospital. Dr Dodge remained in Seattle for most of his career, with the exception of a 3-year interval as Professor of Medicine and Head of the Division of Cardiology at the University of Alabama in the late 1960s.
Dr Dodge began his investigative career as a junior associate of Dr Robert P. Grant at the National Institutes of Health. His first article, which was published in 1953 with Dr Grant, described the changes of induced hyperkalemia on the ECG. While at the NIH, Dr Dodge developed his interest in measuring the volume of the chambers of the heart using angiographic techniques. His first work in this area was done in collaboration with Dr H.L. Tanenbaum and was published as an abstract in Circulation in 1956. When Dr Dodge returned to Seattle the following year, he established a biplane angiographic laboratory at the Seattle Veterans Administration hospital. The Schonander roll film changer that he acquired with an NIH grant was capable of recording high-quality biplane images of the heart at up to 12 frames per second. These rapid imaging sequences were necessary to determine left ventricular volume throughout the cardiac cycle. Working with his principal collaborator, Harold Sandler, MD, and with the aid of numerous research fellows and dedicated technicians, the Dodge team developed and verified methods to determine left atrial and left ventricular volumes. They constructed left ventricular pressure-volume curves and used these curves to measure left ventricular stoke-volume and stroke-work and to make quantitative assessments of aortic and mitral valve regurgitation.
During this period of time, Drs Dodge and Sandler developed a working relationship with engineers at the Boeing Airplane Company and, with the use of their more advanced computers, were able to develop methods for the determination of left ventricular wall tension and wall stress in patients with various forms of heart disease. These studies led to the development of a method to determine left ventricular myocardial mass by Charles E. Rackley, MD, a fellow in the laboratory at that time.
This early work was performed during an era when cineangiography was still under development and single and biplane cineangiographic images were of poor quality in all but a few laboratories. It was not until the mid-1970s that the Dodge team applied cineangiographic methods to the coronary arteries; this work was lead by B. Greg Brown, MD. Ultimately, these techniques allowed for the accurate determination of coronary artery percent stenosis, luminal diameter, the hemodynamic resistance of a specific lesion, and an estimation of the mass of the intraluminal atherosclerotic material comprising the lesion. These methods were later used in important studies by Dr Brown and others to determine the course of progression and/or regression of coronary artery lesions over time and in response to various treatment programs.
As the Dodge laboratory began to focus on ischemic heart disease and the abnormalities resulting from acute myocardial infarction, it was necessary to develop methods for the quantitation of regional contraction abnormalities of the left ventricle. This important area of investigation was spearheaded by Florence H. Sheehan, MD, who with others developed the "center-line" method for the quantitation of segmental wall motion abnormalities and myocardial infarction size.
During his long and productive career, Dr Dodge made many other contributions to our understanding of cardiovascular medicine that cannot be reviewed here. He was a superb clinician and cared for many devoted patients. He was one of the best beside teachers that I was privileged to have during my training and early professional life (the other was Paul N. Yu, MD). He made important programmatic contributions in his leadership positions at both the University of Washington and at the University of Alabama School of Medicine.
Dr Dodge published a large number of articles and book chapters, he served on many important committees both locally and nationally, and he received a number of honors and awards. Among those that I believe he was particularly pleased to receive were the American Heart Association Research Award (1985) and the American Heart Association James B. Herrick Award (1987).
It is interesting to reflect on how much of the practice of cardiology today has been influenced by the work of Harold Dodge. The way we evaluate left ventricular function and how that information influences our clinical management and perceptions of the patient’s prognosis relate directly to his work. The evaluation of interventional procedures and the of the efficacy of reperfusion therapies often uses methods based on the work of Brown, Sheehan, and Dodge. Dr Dodge was one of a small number of men and women who, in the era immediately after World Was II, established the basis for the scientific revolution of cardiovascular medicine that continues today.
In addition to his many contributions to the science of cardiovascular medicine, to those who knew him as a teacher, physician, and friend, Harold (Hal) Dodge was a warm and spirited man who was full of fun and affection. In the early years, he regularly played volleyball during his lunch break at the hospital, and experienced residents quickly learned to be out of range when he spiked the ball. Dr Dodge was a man of the Northwest, with strong Swedish roots and a love of the sea and of salmon and crab. He spent much of his leisure time with his family and friends at his home on Hood Canal on Puget Sound, fishing and telling fish and other stories. He had an enormous influence on the lives on all who were privileged to work with him. All who care for patients with heart disease appreciate the many contributions of this special man and will honor his memory for years to come.