Interventional Cardiologist Promotes Lifestyle Medicine to Transform Patients' Lives

Many might believe being in the right place at the right time to be luck or mere coincidence. But Richard Guynes, MD, feels otherwise.

Many might believe being in the right place at the right time to be luck or mere coincidence. But Richard Guynes, MD, feels otherwise.

Guynes, board certified in internal medicine, cardiovascular diseases, and interventional cardiology, and the primary physician for the Dean Ornish Program for Reversing Heart Disease at St. Dominic’s Hospital in Mississippi, was volunteering in the medical tent at the Boston Marathon 2 years ago when the 2 bombs planted by the Tsarnaev brothers exploded.

“I honestly don’t choke up that easily, but those were the most intense few hours of my life,” Guynes recalls. “People say to me, ‘You were in the wrong place at the wrong time.’ But I think I was in the right place at the right time. I think that’s where God wanted me to be that day.”

Guynes says he always thought of himself as a caring person, and a compassionate physician, “but an event like that changes you, and changes you for the better.”

A Planned Career

Guynes didn’t just happen onto the medical scene; it was a dream and a plan he had since childhood. No one in his family was particularly influential, although he does offer up one source of inspiration.

“I don’t know if it was from watching too many episodes of M.A.S.H., and Trapper John,” he says. “It was in my plan, or my hope, ever since elementary school.”

Guynes completed his undergraduate degree at Vanderbilt University before earning his medical degree from the University of Mississippi School of Medicine. An avid runner, he has become extremely passionate about lifestyle medicine, noting that three-quarters of the conditions he treats fall into the category of lifestyle-related diseases.

“So many cancers are related to lifestyle and choices that we make,” he says. “So, anything that I can do on the lifestyle side in terms of exercise, nutritional choices, convincing people of the harm of tobacco products is absolutely critical to saving them.”

As an interventional cardiologist, Guynes makes a living inserting stents to open clogged arteries, but acknowledges that the procedure is not the solution to the nation’s problem of poor lifestyle choices and related health conditions. He illustrates the problem at speaking engagements with a cartoon slide used by Dr. Ornish. The cartoon shows 2 people furiously mopping up a floor rather than turning off the nearby faucet.

“After 16 years as a cardiologist that’s how I feel,” Guynes says. “Somebody has a heart attack, you put in a stent. One year later they come back for another one. Two years later it’s bypass. We’re doing great things, and treating with high-tech devices and pharmaceutical products, but we’re not really turning off the faucet.”

Fueled by a Passion

Guynes’ dedication to lifestyle medicine is fueled by his passion for running. He competes virtually every other month, and has run in everything from 5K races to marathons. He calls running “my stress relief, usually where I do my best thinking,” and says he feels poorly when he misses consecutive days of exercising. That’s the principle he believes in, and attempts to teach in clinic and at the hospital.

“An important pillar of the Ornish program is to get people more active and less sedentary,” he says. “And to have it become an enjoyable part of life, not something that they have to do. Once you get into it and start to get in shape, you feel better. That’s what feeds the sustainability of this program. When it makes you feel better you’ll want to continue doing it, whether it’s eating better or exercising more.”

But Guynes is realistic. He says that even if healthier lifestyle choices became a national movement, as he wishes it would, the trend toward obesity and the comorbidities that come with it isn’t going away over night.

“I would be delighted to see us putting in fewer stents, and see people living into their 80s and living well with fewer medicines,” he says. “But it’s going to take a while to reverse this trend. I think there’s plenty of job security for the next few generations.”

Positive from a Negative

Guynes ran in the Boston Marathon in 2005, but in 2013 he was there specifically to volunteer in the medical tent. Three people died and more than 260 were injured as a result of the 2 bomb blasts, and Guynes recalls the day as a remarkable experience and an emotional event.