Remembering a Pioneer in Cardiac Testing and Laboratory Medicine
On Thursday, April 4, Dr. Arthur Karmen, professor emeritus of pathology and founding chair of laboratory medicine at Einstein passed away. He was 88.
Arthur Karmen, M.D.
Dr. Karmen's signal contribution to the medical field was proving that cardiac damage, and the extent of it, could be indirectly assessed by testing for specific enzymes released from the heart when it is subjected to damage, such as a heart attack.
"Arthur was the first to discover and publish that the heart released enzymes during an attack and that these enzymes could be measured," explained Dr. Edward Burns, executive dean at Einstein. "Before then, you couldn't easily measure whether symptoms a patient was experiencing were the result of a heart attack. The test—using a blood sample—allows us to differentiate whether the pain is related to an event that endangers the patient or might be some other, more innocuous factor."
Dr. Karmen came to Einstein from New York University School of Medicine, in 1971, and was director of clinical chemistry at Einstein before founding the laboratory medicine department in 1973. As chair, he recruited excellent researchers and experts in laboratory medicine, including Drs. Richard Lent, Barry Wenz, Edward Burns, Joseph Furgiuele, Sam Reichberg, Jay Bock, and Janet Piscatelli to the department and deployed them to oversee clinical lab testing at Montefiore Moses, Montefiore Weiler, and Jacobi Medical Center.
Dr. Karmen also established important practices regarding the use of clinical lab analyses that continue to influence hospital medicine to this day. He originated the concept of providing lab data on patients that offered a longitudinal view; this allowed physicians to see lab data and how it changed over days, weeks, and months. Prior to initiating this practice, all lab reports indicated results only for the particular day in question, without the benefit of historical perspective for helpful comparison.
"Having such trend reporting available in one place made patient management easier and more precise," noted Dr. Burns. "Arthur created a best practice that is now part of nearly every lab computer system in the nation, and allows caregivers to pinpoint problems more readily."
Dr. Karmen also introduced the practice of having faculty evaluate new lab instrumentation from the companies providing them. "This allowed us to determine which instruments were the best to buy and gave us the opportunity to offer feedback that could help with refining and to improving the equipment," said Dr. Burns. "It also ensured that our labs had the most state-of-the-art equipment."
Laboratory medicine was eventually incorporated into the pathology department which is now responsible for all clinical lab testing, and Dr. Karmen continued as a professor, ultimately with emeritus status when he retired in 2012.
He graduated cum laude from NYU and received his M.D. from its College of Medicine in 1954. He completed his internship and residency at Bellevue Hospital-NYU, and then spent seven years working at the National Institutes of Health's National Heart Institute. In 1963, he moved to Johns Hopkins, before returning to NYU in 1968.
"He was larger than life," recalled Dr. Burns, who knew Dr. Karmen as an Einstein student before he became a colleague in laboratory medicine. "His contributions have aided generations of patients and their caregivers, and will continue to do so."
Posted on: Thursday, April 12, 2018