Paul Zoll Story in Retrospect

Epilogue

In the winter of his years, Paul Zoll retired from clinical practice. When a close colleague suggested that Paul continue to conduct experiments in the laboratory, he answered, “No, it was the patients, always the patients that powered the research.” When his cousin, Elliot Mahler asked, “Do you have any regrets?”, Paul answered, “I did so little…there is so much more I should have done.”

In the current context—although his work was unfinished: his impact will be unending.

Paul Zoll retired in 1993 and died from pneumonia on January 5, 1999. Since then, there has been unrelenting progress in electrical suppression of life threatening arrhythmias which might have advanced at a much slower pace had Paul died from his first episode of pneumonia on Sitka Island during World War II.

Growing numbers of later day investigators are intent on reducing worldwide arrhythmic deaths, confronting an annual death toll that remains as high as an estimated 450,000 lost lives annually in the USA alone. The research format for new therapies has dramatically changed from that followed by Paul Zoll during most of his career. Current investigations require collaboration among multiple disciplines within the same institution, hundreds or thousands of subjects, multiple institutions – at times with an international registry. Funding for these studies requires major commitments from government, industry or private philanthropy. Some senior investigators have limited, minimal or no patient responsibilities. Some grind out publications by the score from an institutional headquarters where they strategize and coordinate far flung efforts.

Paul influenced the direction of cardiac therapy while he filled his 18-20 waking hours devoted to work, family and a limited number of friends. Applying his broad vision and a laser focus for detail, Paul approached research projects from the perspective of the challenge he faced from unsolved patient problems. He often approached hazardous arrhythmias  with closed-chest electrical therapy, which was Paul’s proven point of entry for therapeutic success; Success with those methods created a world-wide paradigm shift towards his point of view.

He remained committed to closed chest techniques because they had stood the test of time and they worked well in his hands. Paul Zoll was more interested in patient safety at any cost than the cost effectiveness of a device or a treatment. He was more interested in his patient’s welfare than personal advancement or financial gain. To many, he appeared to be rigid, reactionary and unaccepting of change. But rather than a weakness, his unwavering commitment was an important constituent of strength. It stemmed from unflagging faith in his methods, unwillingness to readily accept or be distracted by new ideas simply for their novelty and ability to refine, re-invent, or newly invent a device to support his wide-angle view of arrhythmic death-threats and their therapies.

 Paul’s vision and style demanded that he lead a band of colleagues that believed in his mission. They bonded in purpose and in mutual loyalty. He led by indefatigable example, commitment, and a long work day with little need for sleep. Paul Zoll had an infectious optimism for a solution to each patient or research problem confronted in the trenches of the hospital wards or in the research laboratory. Although Paul worked and lived long enough to fulfill his primary mission, he believed that he should have done more, that his work was unfinished. Consistent with his modesty, Zoll did not realize that his footprint will be everlasting.

Because there are pervasive new models of medical practice and research by committee, there may never be another like Paul Zoll.