Dr. Stafford Warren, a leading Charleston cardiologist, will retire the end of this month. Sort of.

After 35 years, he doesn't have the heart to bow out cold turkey. Instead, he's sliding into retirement. He will still practice, just not as long and as hard as he used to.

Drawn to Charleston in 1976 by cutting-edge cardiac care, he infused the program with progressive contributions of his own, most particularly as a champion of balloon angioplasty and other techniques that avert the need for major surgery.

He practiced for years with a prominent cardiology group, then worked for CAMC, before stepping into the directorship of the catheterization lab at Thomas Memorial.

In the soft, calm voice that has reassured so many patients, he talked about his still-evolving career and the revolutionary advances that keep him riveted to his specialty after more than three decades.

"I grew up in Chapel Hill, N.C. I was an all-conference basketball player in high school and state table tennis champion for four years. We had a table on our back porch at home, and my father taught me how to play. I won the state table tennis championship at 14. The champion of South America was giving an exhibition at Davidson. He said he would spot anybody 19 points against him. I won two games and he won eight, but he asked if I would tour with him around the country.

"Dad was in business and was home on weekends. My father had wanted to be a physician. He had two grandfathers who were physicians. But it was during Depression when he was in college, and he dropped out after two years because he was supporting his mother. His father died in his 50s, leaving nine children. So maybe there was something there about fulfilling unfulfilled dreams on my father's part that made me think medicine would be a good career.

"I went to Davidson College after high school, and then to the University of Rochester School of Medicine. I went to medical school with psychiatry in mind, but I felt I could accomplish more in internal medicine than psychiatry. You saw results quicker, and it was less emotionally draining.

 "I went into cardiology after I finished my medical residency at Case Western Reserve at Cleveland, then did a cardiology fellowship at Duke.

"Bill Carter was responsible for me coming here in 1976. He wrote a letter to the senior clinical cardiologist at Duke and mentioned what they had here - the most up-to-date equipment and technology and expertise that I found in any of the opportunities I looked at in the Southeast.

"I spent two weeks here, then looked in the Southeast for a place closer to Chapel Hill with the same advantages. I couldn't find any. I was very impressed with Carter and his partner, Hal Selinger, their openness to new ideas and emphasis on excellence.

"Dr. Carter said, 'Everyone who comes here has to bring something new to us. So I brought a blood test that is a sensitive marker for heart attack. It was being done at a few centers around country, but not anywhere in West Virginia.

"There was an early tradition in Charleston of keeping on the cutting age of cardiology. Dr. Selinger, the first full-service cardiologist here, every new technique that came out, he would go to one of the first courses and bring that technology back.

"I went into practice with them. The three of us were given the best-teacher award in the '70s from the WVU senior med school class, the first time the award was given outside of Morgantown. Our Charleston Cardiology Group grew into 11 cardiologists and finally dissolved. I worked at CAMC as a physician, then came to Thomas to direct the cath lab.

Dr. Stafford Warren, a leading Charleston cardiologist, will retire the end of this month. Sort of.

After 35 years, he doesn't have the heart to bow out cold turkey. Instead, he's sliding into retirement. He will still practice, just not as long and as hard as he used to.

Drawn to Charleston in 1976 by cutting-edge cardiac care, he infused the program with progressive contributions of his own, most particularly as a champion of balloon angioplasty and other techniques that avert the need for major surgery.

He practiced for years with a prominent cardiology group, then worked for CAMC, before stepping into the directorship of the catheterization lab at Thomas Memorial.

In the soft, calm voice that has reassured so many patients, he talked about his still-evolving career and the revolutionary advances that keep him riveted to his specialty after more than three decades.

"I grew up in Chapel Hill, N.C. I was an all-conference basketball player in high school and state table tennis champion for four years. We had a table on our back porch at home, and my father taught me how to play. I won the state table tennis championship at 14. The champion of South America was giving an exhibition at Davidson. He said he would spot anybody 19 points against him. I won two games and he won eight, but he asked if I would tour with him around the country.

"Dad was in business and was home on weekends. My father had wanted to be a physician. He had two grandfathers who were physicians. But it was during Depression when he was in college, and he dropped out after two years because he was supporting his mother. His father died in his 50s, leaving nine children. So maybe there was something there about fulfilling unfulfilled dreams on my father's part that made me think medicine would be a good career.

"I went to Davidson College after high school, and then to the University of Rochester School of Medicine. I went to medical school with psychiatry in mind, but I felt I could accomplish more in internal medicine than psychiatry. You saw results quicker, and it was less emotionally draining.

 "I went into cardiology after I finished my medical residency at Case Western Reserve at Cleveland, then did a cardiology fellowship at Duke.

"Bill Carter was responsible for me coming here in 1976. He wrote a letter to the senior clinical cardiologist at Duke and mentioned what they had here - the most up-to-date equipment and technology and expertise that I found in any of the opportunities I looked at in the Southeast.

"I spent two weeks here, then looked in the Southeast for a place closer to Chapel Hill with the same advantages. I couldn't find any. I was very impressed with Carter and his partner, Hal Selinger, their openness to new ideas and emphasis on excellence.

"Dr. Carter said, 'Everyone who comes here has to bring something new to us. So I brought a blood test that is a sensitive marker for heart attack. It was being done at a few centers around country, but not anywhere in West Virginia.

"There was an early tradition in Charleston of keeping on the cutting age of cardiology. Dr. Selinger, the first full-service cardiologist here, every new technique that came out, he would go to one of the first courses and bring that technology back.

"I went into practice with them. The three of us were given the best-teacher award in the '70s from the WVU senior med school class, the first time the award was given outside of Morgantown. Our Charleston Cardiology Group grew into 11 cardiologists and finally dissolved. I worked at CAMC as a physician, then came to Thomas to direct the cath lab.

"I've seen incredible progress. The most common kind of heart disease is coronary arteriosclerosis, where you have blockage in the artery from plaque that clots on top of plaque, the major killer in the U.S. Coronary bypass graft operations, coronary angioplasty, stents and drug-coated stents have revolutionized the care of cardiac patients with blockages.

"I went to five courses taught by the person who started angioplasty, Dr. Gruentzig, before he was tragically killed at age 46 in a plane crash. Dr. Carter did the first angioplasty in the Valley, and probably in West Virginia. I did the second one. I've done about 6,000 angioplasty/stent procedures.

"Before, if someone had blockage, the only choices were medication or bypass surgery. Angioplasty allowed us to open an artery without major surgery. We started off with balloons to widen the artery, but about 25 percent re-narrowed because scar tissue would grow inside the artery. Then stents, metal scaffold devices like fine chicken wire, could be deployed attached to a balloon. The balloon would open the stent. Once the balloon deflated, the expandable metal would stay expanded and keep the vessel open.

"Now, we have drug-coated stents. The drug inhibits production of scar-like tissue in the artery. Instead of a 25 percent chance of re-narrowing, the chance is less than 5 percent.

"I think I've been very fortunate to practice medicine for 35 years and participate in people's lives when they are in crisis in a way that makes a difference, sometimes in terms of survival, and many times in terms of quality of life.

"One woman had 14 cardiac arrests on her way from Logan to Charleston. Several years ago, she required a permanent pacemaker. She is doing very well. Another person, I did CPR on for 43 minutes, came through that and said he remembered being in a tunnel, and I was pulling him in one direction, and he was being pulled in another direction. He remembers kind of crossing over and finally coming out of it. He ended up with a bypass operation and is doing well.

"Before 1960, many residents carried knives. If a person had cardiac arrest, they would open the patient's chest with the knife, reach in and massage the heart. In 1960, doctors found they could do it by pumping on the chest.

"Now we have pacemakers so sophisticated we can modify them externally. Implanted devices can shock the heart if it goes into what would otherwise be sudden cardiac death, make the pace faster if it's too slow or slow it down if it's excessively fast.

 "I've always tried to use the Golden Rule in taking care of patients. That sounds easy, but it's more difficult than that. What you would do might not be what someone else wants done for them. You need to be empathetic with patients to the point where you understand what they would like, and you do that for them. And being able to teach patients about their illness and what they can do to avoid problems is an incredibly valuable role. I've enjoyed doing that.

"Sue, my wife, is medical director of Hospice. She practiced oncology with David Lee for 17 years. We met at Case Western Reserve University, so we came as a team. She will probably retire next year.

"I'm at a point where I would like to continue to work, but not full time. I'd like to travel. One thing I'd love to do is volunteer with Doctors Without Borders, a French organization that places physicians in a variety of places around world. I'd like to continue cardiology in some way, but on a more limited basis. It's difficult to give up completely. When you are involved in something for 35 years, not counting training, it really becomes part of who you are.

"Working 60 to 80 hours a week doesn't allow much time for other things. Years ago, I did get into canoeing. When I asked a resident what hobbies he had, he said he liked to competitively canoe. One slow afternoon, he said, 'Let's go canoeing.' I mastered the strokes he showed me and we raced to the 35th Street Bridge. He invited me to do a 34-mile race with him. There were 100 boats in the race, but we won our division. When you win something first time you do it, it hooks you. I've been to four national canoe races since then. I finished first with my son in one of them."

Reach Sandy Wells at 348-5173 or

e-mail san...@wvgazette.com.