July/August 2007

Mind and Heart

A background in materials science helps cardiologist Debra Judelson '73 probe the mysteries of heart disease in women.

By Anne Murphy

Debra Judelson, '73 Credit: Daniel Chavkin

When a new patient visits Dr. Debra Judelson's office at the Women's Heart Institute in Beverly Hills, CA, the first thing she faces, besides the wait to get an appointment, is not a stress test, or a cholesterol test, or even an electrocardiogram--although she'll eventually undergo all three, if she hasn't already. Instead, it's an hourlong investigative interview with the doctor, whose self-described "obsessive-compulsive" attention to detail in patient care is one source of her distinction in a field that she helped create: women's cardiology.

"So tell me about your 87-year-old mother and the onset of her diabetes," she'll say to a patient across her wide, journal-strewn desk, with its collection of glass and polished-metal hearts. "Describe that pain more exactly," she'll urge another. "Was it pressing? Burning? Tightening? Squeezing?"

"You've got to ask people the right questions and be pushy about getting the answers," says Judelson, who graduated from MIT in 1973 and founded the heart institute in 1996. "It's the patients who teach you. Listening to them, digesting what they tell you, and keeping track of it will teach you more than any journal or medical meeting."

As the patients discuss the answers they've supplied on the doctor's six-page questionnaire, they can end up delivering medical histories that span three generations. "Women tend to want to tell you stories about themselves anyway," Judelson says. "But they don't always recognize what they're experiencing as symptoms of heart disease."

Dead relatives, dietary habits, stress, and sexual practices are all on the table. Judelson believes they must be, because understanding of risk factors and symptoms in women is still evolving. So are the diagnosis and treatment protocols.

"In the 1970s, cardiologists laughed at the suggestion that women got coronary disease at all," Judelson recalls. Untold numbers of women died undiagnosed and untreated. "Today," she says, "we know it's the number one killer of women." Cardiovascular disease kills more women than it does men--and more than all cancers, AIDS, and violence combined.

The way women are diagnosed and treated has improved substantially since 1980, when Judelson began studying heart disease. That's due in no small part to the doggedness and leadership of a woman who started her academic career in materials science but proved her mettle in medicine.

"She's a superb clinical cardiologist who puts extraordinary time and effort into understanding and solving patient problems," says Harold Karpman, a clinical professor at UCLA Medical School and cofounder of the practice in which Judelson is a senior partner. "She's involved in [several] clinical research projects at all times, and she has medical students with her constantly. In the field of women and heart disease, she's godlike."

In fact, she's considered one of the most influential cardiologists and medical educators in the country. Judelson has discussed overlooked women's health issues on Oprah and written books and articles for popular as well as professional audiences. She's been quoted in major newspapers and has won more than a dozen awards for her work in medicine and public health. As she sees it, her authority derives from her penchant for "drilling down into the data" and "solving problems," practices familiar to any scientist or engineer. But she coupled her discipline and her talent for clinical research with a broad commitment to education and communication.