See a woman realize she's out of breath from making the bed. Feel her disquiet as she remembers that her arm has been oddly achy, off and on, just lately.
“For all her knowledge and her vast skill set, she doesn’t ever discount anyone around her. She listens. She engages.” — Vickie Wingfield, Arkansas Heart Foundation director
• DATE AND PLACE OF BIRTH: March 29, 1945, Wooster, Ohio
• FAMILY: husband John Holtam, two sons and two grandsons
• MY NICKNAME: I don't have one ... not that I know of.
• MY FAVORITE VALENTINE IS my husband. He's my best friend.
• MY FAVORITE PLACE TO BE IS wherever he is. We love to water ski on Lake Ouachita.
• TO PREVENT FATIGUE I exercise. Walk. We probably do Two Rivers Park the most because it's the closest to the house. We always see deer when we go there, and I love that.
• CHOCOLATE IS wonderful. It's a necessity of life. Besides that, it has flavonoids in it and, in little degrees, it's good for you.
• MY CLOSET IS FULL OF red. Red for women and heart disease. I wear it all the time.
• I COLLECT hearts and unicorns (with mended horns because boys play ball in the house).
• ACCORDING TO MY HIGH SCHOOL APTITUDE TESTS I should be a forest ranger.
• IF I HADN'T BECOME A NURSE I WOULD: I would never, ever have not. I love it.
• THE THING THAT MAKES ME SADDEST IS when I see people trashing this state, throwing litter and cutting down trees that could be saved. I really love the nature and the beauty of Arkansas, and I hope people appreciate what they have.
• ONE WORD TO SUM ME UP: tenacious
The University of Arkansas for Medical Sciences College of Nursing is looking for donors to endow a chair in women's cardiovascular health. Donate $500,000, and you get to name it.
The fund, posted on the UAMS website Jan. 30, has raised more than $100,000. But a chair takes $1 million. To endow a professorship takes $500,000.
More information is at giving.uams.edu or call the development office at (501) 526-8950.
What do you think, should she get to the doctor right away?
Of course she should. It could be a heart attack. And we know that thanks to Jean McSweeney.
Nurse, nursing professor, scientist and research mentor at the University of Arkansas for Medical Sciences, McSweeney, 71, led a revolution in cardiac research that has saved countless women's lives.
"Her work has really been an impetus for change," says Patricia Cowan, dean of the UAMS College of Nursing.
Today it's old news that women's heart symptoms are more subtle and varied than men's. Combined with new jaw or arm discomfort, inexplicable fatigue is the most common warning women get in the weeks before a heart attack. Only a minority of women clutch at some gorilla crushing their chests and pass out.
But before McSweeney came along, women's symptoms weren't taken seriously -- especially not by women.
What the world knew about heart disease was "based on studies of males, primarily white males, and cardiologists and other physicians just assumed that the warning signs of a heart attack were the same for men and for women," says Cornelia K. Beck, who holds a doctorate and is a registered nurse and retired professor in the UAMS colleges of nursing and medicine.
Beck was associate dean for research in 1994 when McSweeney, who also holds a doctorate and is a registered nurse, joined the UAMS faculty as an assistant professor. Beck remembers a very determined woman. McSweeney had spent more than a decade squeezing in college between work and raising two sons, commuting from Oklahoma to Texas to earn a master's, going through a divorce. She'd gotten up on her feet as a single mother, taken a big gulp, moved to Texas to get a doctorate in nursing and remarried. And all that time, she was hearing disturbing stories from her female heart patients.
She was determined to find out what women's symptoms actually were, so doctors could stop them from dying of an undiagnosed disease.
Beck remembers a researcher who made friends easily, who was athletic and outgoing, very passionate about her field but also compassionate. Compassion wasn't only a personality trait: It was part of a powerful skill set.
"One of the things that we learn in the nursing career is listening skills -- not that every nurse is a good listener. I think Jean probably comes by that naturally by growing up in a little bit larger family and interacting with a number of siblings," Beck says, "but for the nursing profession, part of the curriculum is listening skills, because that's so important with patients."
Because she was a good listener, McSweeney asked questions that changed medicine.
Throughout the 1980s, as a graduate student, clinical nurse and nursing instructor, she worked one-on-one with people in cardiac critical care and in a heart transplant unit. She saw people who failed to change the behaviors that had made them sick. For her doctoral dissertation, she interviewed people who had been to cardiac rehab -- the best patient education available -- on the theory that they held the keys that help people change.
She met them in their homes. In Austin, Texas, she met a man who wasn't doing what he needed to do. "And I'm sitting there thinking, 'Huh. We've invested all this time, energy, money -- everything -- and you're still not doing it?'" She judged him at first. "But then he started to talk to me about his life."
His income was low. He could afford to run an air conditioner or buy healthier food -- not both. So one month he ran the AC and rode an old stationary bicycle indoors. The next month he bought the better food and struggled to walk outdoors, in the heat.
"I can cry even talking about this," she recalls. "How he tried so diligently to do what we asked him to do without us understanding his circumstances. ... He'd had to figure that out on his own.
"It hit me in the face, and in my heart, how we have to understand people's circumstances and work with them before we can improve their health situation."
She began asking patients about what they thought caused their heart attacks, what was their one, No. 1 risk factor? She listened as people described their catastrophes.
"My dissertation work just had one woman in it that had gone to cardiac rehab," she remembers. "She had a little bit different story than the men, and I decided just to talk to other women about their experiences with having had a heart attack. As I talked to those women, they started telling me what symptoms they had. How they had trouble getting diagnosed because their symptoms were different. They were put on anxiety medications!"
They clearly weren't showing doctors the "right" signs.
"And, I'll tell you, for a while I was really angry at physicians," she says. "I thought they weren't paying attention to women. But there was nothing but the literature to guide the physicians. ... Nothing."
She arrived at UAMS determined to document women's symptoms and well armed with evidence suggesting that they did have some. "I made the strongest cases I could," she says. "I interviewed women. I went to their homes." But "people kept arguing with me that I had to have men in my study, that I was never going to get funded without having men in my study."
Also, her methods looked iffy to other researchers.
"It's called qualitative research where you interview people, and I was the first qualitative researcher at UAMS," she explains. "So not only did they not know why I wanted to study women, they didn't know the kind of methods that I was using."
She can laugh about it now.
"I don't know if you know the history of research," she notes, "but in the '90s, U.S. Congress had to pass legislation twice, for two different years, that women, elderly, children had to be included in research."
But she competed for grants, and she got them -- including $55,500 from the American Heart Association.
"She was very determined," Beck remembers. "She was very thorough in her grant-writing abilities. She had the ability to tell some stories about women that she had known and make it very real-life, and she convinced the providers at National Institutes of Health that this was something that should be looked into."
In November 2004, the American Heart Association journal Circulation published the work she'd led documenting women's heart symptoms. That was front-page news in the Arkansas Democrat-Gazette and around the world. CBS Evening News visited UAMS to interview her; she was on CNN and radio shows.
In 2005, she won a $2.3 million grant from the National Institutes of Health for deeper study of possible cultural, age and racial distinctions in women's symptoms. Twelve years later, look up her curriculum vitae online and you'll find pages of grants won and women's health research published, led by her, co-authored by her, assisted by her and by her students.
"She's a beautiful writer," Cowan says. McSweeney's clear voice resounds throughout the Heart Association's most recent scientific statement on women and heart disease, "Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science," which carries "Jean C. McSweeney, Ph.D., R.N." first in the list of authors.
Because of her work, researchers today are gathering evidence that women, like men, are not one big homogeneous group. That ethnic and cultural traditions could affect how women experience and talk about their symptoms. Today's stent makers and drug manufacturers know there are true biological differences in the structure and function of the cardiovascular systems of men and women.
And physicians have a handy assessment tool to use when a woman is vaguely trying to tell them she thinks something's wrong -- the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey. (Yes, she's McSweeney.)
She has a pile of titles, of course. Fellow of the American Heart Association, fellow of the American Nursing Association, UAMS associate dean for research, professor in the UAMS College of Public Health and the College of Nursing, co-director of the nursing school's doctoral program. She was even interim dean of the College of Nursing for a year.
"She's delightful," says Vickie Wingfield, director of the Arkansas Heart Foundation. "For all her knowledge and her vast skill set, she doesn't ever discount anyone around her. She listens. She engages."
With her feet kicked up on her desk and midtown Little Rock spread out below the glass wall of her fifth-floor office in the College of Public Health, it's hard to imagine this dean as the child of a welder who never finished high school. That she became a nurse because her family couldn't send her to college.
WHERE THE HEART IS
"We had a huge garden. With six kids, we grew everything that we ate. We had chickens and cows," McSweeney recalls.
They were a sports family. "My dad loved all the Cleveland teams," she says, noting the sports memorabilia that offsets the pretty hearts and angel figurines in her office. "He wanted more boys, but unfortunately he had one boy and five girls. I and my sisters, the three youngest of us, we watched every Cleveland Indians game there was on TV. We could tell you every statistic."
Both parents came from families of 12, and aunts and uncles' farms abutted their six acres in small-town Ohio, cousins "everywhere."
Her father dropped out of school early because his family needed him to work. She knows he was smart. He led his welders union, and he helped her with homework, doing the math in his head.
"And my mother was very artistic and a baker. She really instilled my love of flowers. She could make anything grow, anything. She would have violets so big they would fall off the windowsills, I mean!" She baked every day and taught cooking for the county extension service.
When hobos crossed their farm, "we always fed them, always." And they baked cookies for the residents up at the county home.
"I grew up with that wanting to help other people," she says, and caring for others was instilled in her even though her parents worked long days.
"He would work 20 hours a day," she says of her dad. "It was intense work. I really admire how hard they worked. ... I can still hear their voices, and they're still with me in my heart."
Her demeanor today makes her look taller than her 5 feet, 5 1/2 inches, and so when she marvels that her uncles trusted a skinny first-grader to drive a tractor through a hay field before she was big enough to turn the wheel, it's easy to guess why. And she felt it, too, her competence. When a sister got hurt on the farm, or a girl she was racing with ran smack into a glass door and badly slashed her arm, young McSweeney calmly took charge. She knew how to help.
Ambidextrous and competitive, she weighed 83 pounds when she entered high school, 100 at graduation, and she excelled at sports. Her parents took seriously a gym teacher's suggestion that she apply for an athletic scholarship, but it wouldn't have paid her way.
"And so I ended up going to the nursing school in Akron," she says. It was a hospital's nursing diploma program, and unusual for the 1960s, it included one year of college. When she finished, she knew she wanted more education, a bachelor's degree maybe.
"I really did love it. And I have never ever wished I'd been anything else. I have always been a nurse. It's the most rewarding profession I think anybody could go into."
High Profile on 02/12/2017
Print Headline: Jean Catherine McSweeney