Leading By Example or Intimidation?

Two cardiologists, two very different approaches.

One is this:

He’s an early riser, to say the least — up between 4 a.m. and 4:30 a.m. every day.

First thing on his morning agenda is a cup of green tea. Settling into his home office, he quietly checks his e-mails and reads for about 30 minutes. This is his quiet time, when he prepares himself for the day.

From 5 a.m. to 5:30 a.m. he writes grant proposals, clinical research papers and the like. “It’s amazing how much you can accomplish in the early morning,” he said.

At 5:30 a.m., he’s on his way to the medical branch Field House, which is five minutes from his East End condo. There, he swims laps for 30 to 40 minutes (on an empty stomach) and then showers to head back home.

While he used to enjoy a quick jog in the mornings, a knee injury keeps him away from high-impact exercise.

At 6:30 a.m., it’s finally time for a heart-healthy breakfast at home with his wife, Tamami.

The meal is always the same: salad. But it’s not the salad you’re typically served before a meal.

It’s a special salad he spent years perfecting and includes lettuce, seafood, wasabi, eight kinds of vegetables, ginger, olive and sunflower oils, vinegar, whole jalapeños and mozzarella cheese.

“Every morning, I know I’m getting at least one excellent and nutritious meal in for the day,” Fujise said.

“I never know how the rest of the day will go, but I can feel good about my morning knowing I had the perfect breakfast.”

From 7 a.m. to 7:45 a.m., Fujise responds to more e-mails at home and tends to his department’s administrative work. By 8 a.m., he’s in his office on the medical branch campus.

As the head of cardiology, Fujise frequently is called into business lunches and dinners, which can make it difficult for him to maintain his heart-healthy lifestyle.

His compromise is to order appetizers instead of entrees, a house salad with vinaigrette or grilled fish.

If he’s fortunate enough to not have a lunch meeting, Fujise enjoys a lunch he brings from home.

His preference is one piece of dark chocolate (76 percent cocoa), one box of raisins, a handful of mixed nuts, some tofu and green tea.

While not advisable for everyone, Fujise and Tamami engage in “calorie restriction,” whereby they restrict their caloric intake by 20 percent to 30 percent.

Comfortable at 156 pounds and 5 feet 10 inches tall, Fujise aims to eat no more than 2,000 calories each day. He gains weight fast, he said, and must monitor the scale daily to keep himself in check.

“My wife does an outstanding job of handling my meals and pushing me to exercise,” he said. “Like everyone else, some days I’m weary, but she pushes me to the door and encourages me every morning.”

Fujise does not eat sugar because of metabolic syndrome concerns, although he will have Splenda on occasion, nor does he partake in office doughnuts or cakes or any fried foods.

If he hosts a lunch meeting, he makes sure there are healthy food options.

“I don’t want my young medical students getting accustomed to fried foods. My goal is to promote heart health,” he said.

Coffee also is absent from his heart-healthy list, although he understands why many people must have their jolt in the mornings.

He used to be a coffee drinker himself, but he found the caffeine in coffee to be equivalent to that in green tea but without the jitters that often come with coffee. Plus, green tea has been proven to help fight cancer, he said.

... and the other is this:

He was the most respected man in our training program. The oldest cardiologist at our institution, gruff, never afraid to shy away from a four-letter word to make his point, and with the uncanny ability to diagnose critical aortic stenosis (pulsus tardus et parvus) or insufficiency (bisferiens pulse) by placing his hands on his patient’s pulse. No echocardiogram was necessary. His incredible knack for inductive reasoning of associated diagnoses was unparalleled. His breadth of clinical experience and expertise unequalled. I had always held him in my highest esteem – a real model to follow.

So after returning to that institution of higher learning after fellowship training and getting settled in my new routine as a young staff physician, I headed to lunch with an entourage of medical students and residents. It was then that I saw him, my medical idol, in line with a burger and fries, and a tall Coke.

“Hello, Dr. B., how have you been?”

“Hell, just fine, Wes.” It was then I noticed his tray.

Smiling, I quipped, “Dr. B., aren’t those things bad for you?”

“Well, shit, Wes,” he smiled with a twinkle in his eye, “... I look at this way. I have a 50-50 chance of dying of cancer or heart disease... and I’d much rather die of something I understand!”

Here's the question:

Which cardiologist would you chose to be your doctor?

-Wes