It might not have been the pivotal moment in the life of future cardiologist James Robinson Harper, but it was a memorable one for his classmates, when he brought a human cadaver’s heart to school one day for a junior high school science project.
“They thought it was gross, but they were also fascinated,” Harper said. “Me, I was just plain fascinated; it was interesting to me to see how the heart worked.”
His dad was a noted cardiologist and professor at UNC School of Medicine, but Harper conveyed that he was never pushed to pursue cardiology, though he was intrigued.
“My interest in medicine and eventually cardiology was really spurred by my older brother, who had Duchenne muscular dystrophy (DMD),” Harper said. “He died when he was 27. His debilitating disease and what he went through spurred my broader interest in medicine.”
Though he could not have foreseen it, with subsequent advances in cardiac and respiratory care, life expectancy for people with DMD has increased to roughly the early 30s.
Harper (who goes by Rob, rather than James) went on to UNC School of Medicine, doing his residency and fellowship at UNC Medical Center in the mid-to-late ’80s.
Best practices and treatments were still being introduced and evolving in 1990 when Harper got started at his first cardiology practice in Wilmington. The way the profession took care of heart attacks was “typically with clot buster medications, and a balloon catheter was usually what we used,” Harper recalled.
In 1995, stents dramatically came on the treatment scene, but the next clinically significant step up was drug-coated stents that prevented harmful scar tissue from forming. These advances were compelling, but beyond these innovations, Harper was convinced that the key was building a practice focusing on stronger collaboration with and commitment to truly taking care of patients.
“We wanted to build a culture of yes,” he said. “I can describe it by looking back at year one of our new practice in 2002. It was 4:30 on Christmas Eve – staff was ready to go home – when a primary care physician called and asked that we see a patient of his. We immediately said yes. The staff completely understood, and it helped us to always say yes on behalf of our patients and be accessible for our referring physicians.”
Harper has been able to build on this foundation of humility, humanity, accessibility and clinical expertise, and thus has been selected for this year’s Health Care Heroes Lifetime Achievement Award.
“The best way to understand him is through the eyes of his patients,” Ellis Tinsley, a surgeon and 40-year professional colleague and friend of Harper’s, wrote in his nomination. “First, every one of his patients knows his name. Secondly, they quote him as a trusted advisor, and they frequently defer to ‘what Dr. Harper says.’
“Third, they count him as family, and they worry about him. Fourth, they will tell you he is gentle and kind and faces you when he speaks. Encounters with Dr. Harper are quiet, calming, and thoughtful.”
John Hodgson, a retired internal medicine specialist who practiced in rural Columbus County for 35 years, has known Harper for decades.
“As a rural practitioner, it often was difficult to get expert help when you needed it,” he said. “Often we felt alone and largely ‘on our own’ in taking care of critically ill patients. When Dr. Harper came to Wilmington, that all changed. Just one example: When (patient) transfers were needed, he always expedited them and that often meant that would miss dinner with his family and sleep at night.”
For Dora Daughhetee, senior director of Novant Health Heart & Vascular Institute, it’s the quiet, often unacknowledged mentor support he has provided that is so impressive.
“He has served as mentor to countless medical professionals,” she said, “offering guidance and education to not only future cardiologists but health care administrators. He also has been a champion of evidence-based medicine and helped develop many new treatments and services.”
For Harper, life changed irrevocably in August 2020, when his practice partner cardiologist Henry Patel went to an oral surgeon’s office in nearby Leland for a dental implant and experienced a deep-sedation-based emergency. He died four days later.
Patel’s wife, Shital, said he died “because the oral surgeon did not know how to manage his (compromised) airway. Since that fateful day, Rob Harper has been on a mission to make sure that no one else dies in a dentist’s office. Rob is the definition of a lifelong patient advocate and champion for public safety.”
Harper filed a formal complaint with the N.C. Board of Dental Examiners, questioning the dosage of general anesthesia medicines administered and the dentist’s failure to recognize and act when Henry Patel’s airway became compromised.
Shital Patel adds, “Rob has spent hundreds of hours researching, speaking in front of the dental board, conducting television interviews and online interviews with industry leaders. … He has also worked tirelessly with our state legislator to write a bill entitled Henry’s Law, to enact lasting and life-saving change.”
The measure remains in a state Senate committee after being filed this spring.
“We have helped to raise awareness, so important absent effective legislation,” Harper said. “From our interactions with the oral surgeon community in North Carolina, we’ve learned that in the last six years there have been six deaths from deep sedation complications.
“We keep hearing that these sedation complications happen very rarely, which is not good enough,” Harper added. “If we realize our goals and save one life, it will be the highlight of my life.”
Emma Dill - Nov 27, 2023
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