Cardiologist and medical innovator Alfred Spivack dies at 87

Alfred Spivack, MD, a medical innovator who championed the deeper involvement of nurses in patient care, died April 23 at his home at Vi at Palo Alto, a retirement community. He was 87.

He died while swimming in the pool at Vi, but the cause has not been determined, according to his son, Peter Spivack.

A cardiologist and clinical professor emeritus of medicine at the Stanford University School of Medicine, Spivack is remembered for his tenacity in creating change within the world of medicine. He was a “doctor’s doctor,” his colleagues said, who was always working to improve patient care.

“He loved to challenge what others said was impossible,” Peter Spivack said. “In every sense of the word, dad was a teacher. He saw where there was a need and sought to fill it.”

Alfred Spivack founded and was the first director of Stanford Hospital’s coronary care unit, which opened in 1966. At the time, only a handful of hospitals had CCUs, and many physicians did not yet recognize their value. He founded the hospital’s hypertension-anticoagulation clinic and the medical school’s popular sports medicine training course.

“When he saw a need to do something, he just did it,” said his lifelong friend and colleague Stanley Schrier, MD, professor emeritus of hematology. “When other people might mull about, Al saw an opening, and he just did it.”

Spivack also served on Stanford Hospital’s board of directors and the medical school’s admissions committee, and mentored medical students.

He was among the first to encourage nurses to take a more active role in the care of critically ill cardiac patients, training them in intravenous therapy, electrocardiogram monitoring and defibrillation among other procedures that were primarily restricted to physicians at the time.

“Spivack was tireless in making us experts,” said Joan Fair, PhD, one of the coronary care unit’s original nurses who is now a cardiovascular researcher. “He really believed we could do these things, and that made us believe we could, too.” 

Boston native

Born in Boston in 1928, Spivack graduated from Temple University and Jefferson Medical College. (He received the Alumni Achievement Award from Jefferson University in 2014.) He completed his medical residency in internal medicine at Philadelphia General Hospital and then began a research fellowship in cardiology at Stanford. He remained connected to Stanford until his death, regularly attending the weekly medical grand rounds.

“Seeing Al sitting front and center every week at medical grand rounds was one of the highlights of my week,” said Robert Harrington, MD, the Arthur L. Bloomfield Professor of Medicine and chair of the Department of Medicine. “He always stopped to say hello and talk with me about the history of Stanford. We talked about art and literature, cardiology and diving medicine. Al had a grace and a humility about him that was wonderfully inspiring.”

“I’m deeply saddened by this profound loss,” said Lloyd Minor, MD, dean of the School of Medicine. “Al was one of the first people I met when I arrived at Stanford. He will be well remembered for his many contributions as an outstanding caregiver, health advocate and mentor to generations of students and trainees.”

Last year, Spivack, along with many of the nurses he helped train, were honored at a dinner celebration of the 50^th anniversary of the coronary care unit. He talked about the difficulty of selling the idea of a coronary care unit back in 1966 at what was then the Palo Alto-Stanford Hospital. Some couldn’t see the teaching benefit, and others thought the emerging technology of electronic monitoring for heart rhythm, for example, was gimmicky, Spivack said. “They thought it had no viable future,” he said.

Today, the role of director of the adult hospital’s coronary care unit belongs to Randall Vagelos, MD, professor of medicine at Stanford.

Seeing a need

“Al saw that the future of cardiology was headed toward an environment where patients would be intensely monitored in a high-surveillance nursing unit, where the sickest of patients could still get the best care,” Vagelos said. “He understood that all of this was going to depend on nurses. There were clearly not enough doctors to create that kind of surveillance.

“I have a role that he to some degree helped create,” he added. “He saw the need, and he just did it.”

Spivack had many interests, including scuba diving, underwater photography and collecting and creating art. He was a ceramicist and invented a new method of fusing clay and glass, resulting in works of art that were displayed both on the Stanford campus and abroad. Most recently, he worked as a consultant for Vivus Inc., a drug development company.

He swam regularly with his lifelong friend and colleague Saul Rosenberg, MD, Stanford professor emeritus of hematology. “He and I would swim in the mornings,” Rosenberg said. “I was in the pool with him the day before he died. He was an excellent swimmer.”

His wife, Anita Spivack, died in 2000. He is survived by his partner, Marjorie Crosby; his son, Peter Spivack; his daughter, Laura Garfinkel; and grandchildren Sarah and Amy Garfinkel and William, Madeleine, Grant and Taylor Spivack.