Problem: Most research on cardiovascular disease in Hispanic populations treats people from a broad range of ethnic and cultural backgrounds as a single, homogeneous group. But Carlos Rodriguez, M.D., M.P.H., a cardiologist, understood that such a narrow approach completely ignored cultural, ethnic, geographical and social differences among the many groups of people referred to as Hispanic in the United States.
Pursuing that theory, he published “Left Ventricular Mass and Ventricular Remodeling Among Hispanic Subgroups Compared with Non-Hispanic Blacks and Whites,” in last January’s Journal of the American College of Cardiology, breaking new ground in the field. He documented, for the first time, that the complex cultural and ethnic diversity among Hispanics required careful attention when studying heart disease. His new work will dramatically advance this premise.
Background: While Rodriguez is now known as one of the most important new researchers in his field, his path to a career in medicine was long and extraordinarily challenging. He says that faith, the love and support of his family and his passionate desire to understand the health problems that plagued him as a child, enabled him to realize his dreams – and also to escape the cocaine epidemic that destroyed so many kids in the Washington Heights section of Manhattan where he grew up in the 1980s.
“I feel so fortunate that I was able to keep some perspective,” Rodriguez now says. “Looking back, I just somehow knew there was something more to life than what I was experiencing in an impoverished urban environment, so I kept trying.”
As a little boy, Rodriguez was introduced to medicine in a world dramatically different from the universe in which he practices today. “I was born with a heart murmur in the Dominican Republic. My Mom was an orphan and we really had no resources, so she was worried sick about me all of the time. It was basically a third world county. The doctors could do little more than listen to the murmur and tell my Mom to keep me from doing too much,” Rodriguez recalls. “But I was fascinated. It was all so vague…I wanted to know what was happening to my heart.”
That curiosity stayed with Rodriguez as his family moved to New York City to begin a new life in Washington Heights. “I remember a warm, friendly neighborhood where everyone said ‘hello,’” Rodriguez recalled. “But all of that changed when drugs and gangs brought crime.” Close to his family and his Seventh-Day Adventist Church community, Rodriguez focused on life beyond Washington Heights, but he was not sure how to move forward. “I did not do well in high school, particularly in the sciences,” he recalled. “Still, I went on to the Seventh-Day Adventist College associated with our church. Yet within a year, I flunked out because I was unprepared for college-level academics.”
Rather than quitting, Rodriguez found work, took two years off from school and tried to figure out what do to next. “It was really important to me to try again, so I enrolled in a two-year community college, even though at that point, I had given up on medical school. I just didn’t think I had what it took to succeed,” he said. But this time, his perseverance paid off.
“I did well there and got into the University of Massachusetts Medical School summer pre-med program. It changed my life—the doctors, advisors and other students gave me back the idea that I could be a doctor. There, I saw my first trauma cases and attended courses similar to medical school.” Rodriguez thought he was on his way, but after transferring to Amherst, he found himself on academic probation in math and science.
Unwilling to let go of his dreams, he tried a new approach. “I humbled myself and said, ‘I am going to have to start from the bottom.’ I obtained tutors in calculus and high-level math and decided to acknowledge my weaknesses. Once I got the hang of it, things were much better—eventually, others came to me for help.”
As his grades improved and medical school became more of a reality, Rodriguez began to think about returning home and attending Columbia University, so he turned to his University of Massachusetts pre-med advisor for guidance. “That was not a good experience,” he recalls. “The advisor told me not to apply to Columbia—I’ll never forget it. He told me I’d be wasting my time—that I would never get in. But I’d grown up in Washington Heights and I wanted to return on my own terms. I would not have been able to live with myself if I didn’t try. That year, when I went home to visit my Mom, I walked into the Columbia Office of Minority Affairs and showed them my transcripts. They said, ‘we think you have a chance to get in.” ‘A chance,’ that was all I needed to hear,” Rodriguez said.
Now an assistant professor of clinical medicine and epidemiology at the Columbia College of Physicians and Surgeons /Mailman School of Public Health, Rodriguez received both his M.D. and M.P.H. from Columbia and hopes his story will be an inspiration to other young people who may doubt that they can realize their dreams. “My career did not happen overnight,” Rodriguez said. “I spent almost nine years flunking out and finding ways to survive. But I think it’s important for young people today—especially minority kids—to have a vision of what you want. Don’t allow your dreams to be shaped by the outside world. I was not going to let other people’s opinions be the last word for me.”
Rodriguez also credits the tremendous encouragement and advice he’s received from his many mentors with helping him on his way. Among them, the late Thomas Pickering, M.D., his mentor during his time (2007-2011) in the Harold Amos Program. “I had the good fortune to work with him,” Rodriguez recalls. “He helped me formulate my research on what harms the cardiovascular health of minorities, as did Shunichi Homma, M.D., my co-mentor and the director of the Echocardiography Laboratory at Columbia University Medical Center. The Harold Amos Program was sort of like my summer, pre-med program at the University of Massachusetts years ago. It exposed me to academic life and people who wanted to see me succeed. The program taught me that I could do well in academia.”
Solution: A perfect 10—that’s the best description of Rodriguez’s most recent achievement--obtaining an R01 grant from the National Institutes of Health (NIH) by submitting a research application that earned NIH’s top impact/priority score of 10 points. “I’ve been given over $2.9 million over four years to conduct a national study across five medical centers looking at cardiac structure and heart failure risks in different Hispanic populations. It will be the first time a study of this size will look at Hispanics as a heterogeneous group with distinct biological and cultural differences,” Rodriguez explains. “We will look at acculturation, psychosocial factors such as stress and how these things affect heart structure and function.”
The RWJF Perspective: The Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program (AMFDP) was created to make it possible for scientists and physicians from historically disadvantaged backgrounds to advance to senior positions in academic medicine. The four-year, AMFDP, post-doctoral research awards are offered to physicians who are not only committed to building careers in academic medicine, but who hope to serve as role models for other students and faculty members from disadvantaged backgrounds.