PH Specialist story
Francisco Soto, MD
My Experience with Pulmonary Hypertension
In 1992 I had the opportunity to take care of my first patient with severe pulmonary hypertension (PH) during my medical school training in Colombia, South America. She was a middle-age woman who presented to our local county hospital complaining of several months of progressive shortness of breath. An echocardiogram confirmed the suspected diagnosis and also revealed a severely dilated and dysfunctional right heart muscle. Not knowing much about this disease myself, I was directed to read the PH chapter in Harrison’s Textbook of Internal Medicine written by Stuart Rich. The patient’s complex case and Dr. Rich’s comprehensive book chapter allowed me to learn a great deal about this disease.
Some years later I joined a residency training program in Internal Medicine at the University of Illinois at Chicago (UIC). Once there, I had the pleasant surprise of learning that the head of Cardiology at that institution was Dr. Stuart Rich. A young cardiologist, Valerie McLaughlin, had recently joined his PH program. Fortunately, I had the chance to care for one of their patients during my Cardiology rotation. She was receiving therapy with a “new and special” medication delivered intravenously 24 hours a day via an outside pump. Given the complexity of this drug and its delivery system, her young and somewhat inexperienced resident physician (that would be me!) wasn’t allowed “to come close to her infusion pump”. This was somewhat frustrating being as eager as I was to learn more about this disease. However, it also made her case even more intriguing and exciting. It would take me a few years to realize that I had watched history in the making. This young lady was part of the initial intravenous Epoprostenol (Flolan®) trial for “primary” pulmonary hypertension, a study that would dramatically change the field of PH and would bring additional hope to these patients.
I ended up pursuing a career in pulmonary and critical care medicine and had the fortune of training under Dr. Adaani Frost at the Baylor College of Medicine in Houston, Texas. Her passion for this disease and the amazing care she provided to these patients was the final inspiration. My interest in the PH field simply grew stronger and at the end of my sub-specialty training I was clearly committed to focus my career in this area.
After I finished my fellowship I accepted an academic position at the Medical College of Wisconsin in Milwaukee. A pulmonary hypertension program had been recently created there under the direction of Dr. James Maloney with all the necessary infrastructure to take care of these patients. This made it easier to hit the ground running by the time I joined.
Looking back, working with these patients during the last 8 years has clearly made my passion and excitement for this disease grow stronger and it makes me look forward to coming to work every day. Despite the long hours and the hard work, the significant difference that we can make in our patients’ lives is very rewarding. It is hard for me to imagine doing something else.
Francisco J. Soto, MD, MS, FCCP
Diplomate American Board of Sleep Medicine
Master of Science in Epidemiology
Director, Pulmonary Hypertension Program
Medical College of Wisconsin