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I have followed the work of Joe Piscatella (Figure (Figure11) for years and had the opportunity to interview him recently when he gave a presentation at Baylor University Medical Center at Dallas. This interview covers some aspects of his life; the companion article in this issue of Proceedings provides more details on his focus on lifestyle changes for heart health, as well as his own health story.
William Clifford Roberts, MD (hereafter, Roberts): Mr. Piscatella, it's my understanding that you had unstable angina pectoris at age 32 and shortly thereafter had a coronary artery bypass grafting operation. Since then, you have been preaching heart health and a heart-healthy lifestyle. Let's start way back. Where were you born? What were some of your early memories? Describe your parents and siblings.
Joseph Charles Piscatella, BA (hereafter, Piscatella): I was born in 1944 in Hartford, Connecticut, and was raised in Bloomfield, a suburb of Hartford. My brother, John, is a year younger than I am. We were raised in the typical fashion of the 1950s and 1960s. We were encouraged to eat a lot of red meat and drink a lot of whole milk for strong bones and healthy teeth. So, of course, I did. I played sports in high school and college. In those days when college was finished, so were the physical activities. I played a little social golf or social tennis, but that was it. Aerobics had not appeared. I never smoked, but I grew up in Connecticut where the doors and windows were closed 7 months of the year, and both of my parents smoked. I don't blame them because they didn't know, but I think I paid a serious price for secondary smoke. I was under stress, as everyone is in the USA. One did not have to be a corporate executive to be under stress. The most stressed-out person I knew was a young mother at home with two children under the age of 3.
After discovering I had aggressive coronary heart disease at the age of 32, I ate better, exercised, learned about stress management, and stayed away from smoke. The results were so good that my physician said that I should write this down for other patients because they would benefit from it. Unbeknownst to me, my physician sent the draft to Dr. Denton Cooley, who said it would make a terrific book. I wrote Don't Eat Your Heart Out, which was one of the first books in this country on diet and cholesterol for lay people, and Dr. Cooley wrote the foreword. Everything changed on a dime. My lifestyle changes worked so well for me that they gave other people, particularly heart patients, hope as well. My career for the last 25 years has been writing and lecturing about heart health.
Roberts: You had a coronary bypass at age 32, and now you are 65. You have no symptoms of cardiac disease presently?
Piscatella: In 1992, when I was 47, there was a problem with my saphenous vein conduits, and they were replaced with mammary arterial conduits. That second operation needed to be done because those veins were not going to hold up.
Now I have no limitations other than my age. I remember an early argument I had with my primary care physician about jogging. He did not recommend it. I said it was my heart so I was going to jog. I bought those Nike Waffle Trainers and 6 months later at my physical, things looked so good that I convinced my physician to start jogging himself. I still jog or walk.
Roberts: Let's go back to your childhood. What kind of home did you grow up in? What were your father and mother like? Were you close to them?
Piscatella: It was a great place to grow up. We were middle class. Both of my parents worked. My dad was a blue-collar factory worker; my mom worked part-time for an insurance company. They both needed to work to support the family adequately. We grew up in a home filled with love; we were around the dinner table every night. There was a great emphasis on hard work because neither of them had been able to go to college. It was a foregone conclusion that my brother and I were going to go and we would have to make sure our grades were good. Sports were emphasized. My dad was a sports fanatic. We played baseball in the backyard. A work ethic was instilled early. We were pushed to work toward a goal we set, whether in sports or in school.
Roberts: Were your parents born in the USA?
Piscatella: Yes. They were first-generation Americans. We had a heavy Italian influence. It was an extended and close family with a lot of cousins, aunts, and uncles. We had the big Italian family meals. The food was very much Italian. (I am a big proponent of the Mediterranean diet.) My mother cooked the meals from scratch. There was little coming out of cans, boxes, or packages. Take-out was unheard of. Eating in a restaurant was rare. We had plenty of fruits, vegetables, and whole grains. What Italian Americans did was add an inordinate amount of meat to the basic diet. Our portion sizes were bigger than what was historically served in Italy. I went to school in Italy as an exchange student for a year, and our concept of Italian meals in the US is not accurate. It's probably the same as what we do with food from other nationalities; we “Americanize” it! That means more meat, bigger portions, and more frying.
In any event, my extended family was a close one. We supported one another. I was the first in the extended family to go to college. Probably 80% of my cousins went to college.
Roberts: When you brought home a report card from school, what would your parents say to you?
Piscatella: We would go over the report card and they would tell me what they liked and didn't like about it. We were New York Yankee fans living in Red Sox nation in the days when the Yankees didn't lose. It was the best! Every year, if my grades were high enough, we went to the Old Timer's game, so I got to see not only the modern Yankees but guys like Joe DiMaggio also. I missed one game. My dad held to the agreement, and I know it killed him because he had already bought the tickets. I never missed the game again.
Roberts: What sports did you play?
Piscatella: Soccer and baseball. I played all kinds of street games growing up, but soccer in the fall and baseball in the spring were my two favorites.
Roberts: What position did you play in baseball?
Piscatella: Shortstop. In college, I played second base, because my arm wasn't that good. I had hopes at one point to play professionally, but I didn't have the physical skills.
Roberts: Did you get a scholarship to college?
Piscatella: I got a partial scholarship, but I still took out student loans. I had to pay them back, and that took 7 or 8 years.
Roberts: Were you a good hitter?
Roberts: Were you the lead-off batter? You look fast.
Piscatella: In college I batted first or second; in high school I batted third, fourth, or fifth.
Roberts: What was your playing size in college?
Piscatella: I was about 165 pounds and 5′10″ tall.
Roberts: Did you have to study hard to make good grades, or did that come relatively easy for you?
Piscatella: It depended on the subject. Math was my worst subject; I hated it. From the first day I walked into Algebra 101, I knew that was not a path I wanted to take. The sciences—chemistry and physics—didn't interest me much either. In college I needed a math or science course to graduate. To avoid math, I ended up in a sophisticated premed biology course and did well. I had a strong interest in history, English literature, and political science. I graduated magna cum laude and had the highest grade-point average for the political science department when I graduated. My first job out of college was with United Airlines. I eventually became part of their legislative affairs team. We lived in Chicago. I enjoyed it very much.
Roberts: How did you get that position after college?
Piscatella: I was in the Air Force Reserve and was called to active service for 1 year during the Vietnam era. A United representative came to the base, and I talked to him. Then I went through an interview process when I got out of the service and they hired me. The problem was living in Chicago and starting a family there. My wife was from the Northwest, where her family lived. She really preferred to be back there. There wasn't anything I could do for United in that area, so I left the company and we went back to the Pacific Northwest. It was a quality-of-life decision. I then partnered with a fellow there and created a hotel-operating company, operating hotels that we didn't own.
Roberts: What was the name of your business?
Piscatella: Lodgco. We were involved with hotels that were in financial trouble. We took a percentage of the gross operating profit, which meant that the ownership had to make money or we didn't make money. It was very high stress because entrepreneurial individuals are often difficult to deal with. They have no qualms about calling you up at 11:00 pm to go over the numbers. You are the hired gun. Eventually we sold the company and I moved on to other business positions. When Don't Eat Your Heart Out was published in 1982, it sold a million copies. That success allowed me to write and lecture full time, which I found less stressful than business. I had believed from the beginning that stress was a real coronary player, and I feel even more strongly about it today.
Roberts: How many books have you sold?
Piscatella: I have written 11 books and they have done pretty well (Figure (Figure22). I've been very fortunate. What I have added in my new book—Positive Mind, Healthy Heart—is the impact of positive thinking and a positive mindset on dietary and exercise compliance. I have seen that today people know quite a bit about diet and exercise, but we have very poor compliance rates, as evidenced by the high rates of obesity and hypertension, type II diabetes mellitus, and heart disease. I became very interested in what has permitted me to stick with it for 33 years. My effort was very much aided by an optimistic, hopeful, and positive mindset. I kept a notebook of motivational sayings, quotations, and stories that would help me commit to living healthy that day. This gave me a needed edge because healthy change is hard. Even as a heart patient who had survived coronary bypass and was extremely thankful and happy about it, there were days when a hot dog called my name or I didn't want to get out of bed to exercise. I wanted to minimize those days. I finally figured out that I have no interest in yesterday, that it's gone; if I messed up, so much for that. I am not going to be fearful of tomorrow because it's not here yet. All I want to do is figure out how to make a commitment to healthy living today.
I think we put too much emphasis on genetic heritage. My last name ends in a vowel. My heritage is Italian. Italians living in Italy infrequently have heart attacks, but Italian Americans do. I live in the Pacific Northwest where there is a huge Japanese American population, and the Japanese living in Japan have low levels of heart attacks, but the Japanese Americans are falling over with heart disease the way the European Americans do. Either our genes changed when we crossed the ocean or we changed something else. What we changed was our diet and our physical activity. That's where I have hung my hat, and it's worked for me for 33 years and I think I've got a lot of living left to do.
Roberts: Talk about the Institute for Fitness and Health, which you started.
Piscatella: It's an educational institute, not a medical clinic or institute. We don't have medical staff on board. It's an umbrella organization and under the umbrella are the books that I write, the television specials I do for PBS, and the talks I do for hospitals, medical organizations, associations, and corporations. While I'm in Dallas this week, I'm presenting at Raytheon as well as Baylor Dallas. I talk to companies that are interested in employee wellness. Anything that will help to educate people about heart health falls under this umbrella.
Roberts: How many talks do you give a year?
Piscatella: Historically I have done 50 to 60 talks at hospitals and maybe another 25 to corporations and associations. In all, it is about 75 or 80 talks a year excluding talks to Rotary clubs and those types of groups.
Roberts: How many air miles do you travel a year?
Piscatella: In the hundreds of thousands on United Airlines and probably another hundred thousand on Alaska Airlines. Those are the two big ones I use.
Roberts: How many nights are you away from home a year?
Piscatella: About 100. Sometimes my wife comes with me. She is with me in Dallas this week. Now that our kids are grown and have families of their own, it's easier for her to get away and come with me.
Roberts: Do you have any hobbies?
Piscatella: Yes. Anything to do with the water—sailing, boating, or rowing a scull. And I love outdoor stuff—skiing, hiking, snow shoeing, and golf—as well as collecting wine and reading. Surprisingly enough, I still love traveling for vacations. I coached my kids' soccer teams and baseball teams for a long time, and now I'm working with my grandchildren.
Roberts: What do you read?
Piscatella: I like well-written books. I just read The Help, an absolutely excellent book. It's about Jackson, Mississippi, during the 1950s and 1960s. I mostly read fiction and autobiographies.
Roberts: How many books do you have in your house?
Piscatella: A couple of hundred at least. I never give up a book. If I pick up a book, I always finish it. I often read two or three different kind of books at the same time.
Roberts: Thank you for sharing your life story with our readers.