Practicing and preaching running and medicine.

New Hampshire-born Paul Thompson, M.D., grew up in Danvers, MA, which, he likes to say, "is 28 miles north of Fenway Park." Obviously this Red Sox fan couldn't be happier with the curse-breaking conclusion to the 2004 baseball season. And it seems his interest in athletics goes back a long way. The Olympics in particular grabbed his attention as a boy. "After watching the 1960 Olympics, I said, 'I want to go to those,' and went out and ran two miles," he reports. So started a love affair with running that, like Thompson himself, is still going strong.

After serving as captain of his high school cross country team, Thompson went off to attend Tufts University near Boston, where he continued as a competitive distance runner. He soon found himself enrolled in medical school there as well, not that this hindered his running. In 1972, while in his third year of medical school, Thompson qualified for the U.S. Olympic marathon trial.

Two years before, he had been profoundly affected by a summer of research with David Costill, Ph.D., an exercise physiologist at Ball State University in Muncie, IN (see "Book Review," page 14). Costill was performing glycogen loading studies in distance runners, and Thompson made a willing subject. "We would have a quadriceps muscle biopsy, run 10 miles, get another biopsy from the same site and do a maximal oxygen uptake run on the treadmill," he recalls. The grueling work was a fairly rare foray into exercise physiology; Thompson was hooked. In the early to mid 1970s, as stress testing was starting to become popular, one gateway to this burgeoning specialty was cardiology. He saw an opportunity and reached for it.

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After one year as a cardiology resident at Tufts-New England Medical Center, Thompson spent two years as a fellow at Stanford treating--and trying to prevent--heart disease. Meanwhile, he was still running competitively; in fact, for about 10 years, he rarely clocked a marathon time over 2:30:00. This was not, and remains not, a man who feared heartbreak on Heartbreak Hill. In 1976, Thompson finished 16th in Boston's notorious "Run for the Hoses," the year the temperature reached 96 degrees. His residency completed, Thompson next joined the faculty at Brown University in Providence, RI. There he studied sudden death during exercise with William Sturner, M.D., the State Medical Examiner.

Later, Thompson began measuring triglyceride and HDL levels in distance runners with lipids expert Peter Herbert, M.D. They were among the first to measure lipid levels in the days after a marathon. The team noted marked reductions in triglycerides the day after exercise and used this data for an NIH grant that lasted 11 years. Thompson began studying lipid metabolism in several distance-running friends. "I used them as guinea pigs," he gleefully notes. He and Herbert used fully anticoagulating intravenous heparin doses to measure lipoprotein lipase levels, intralipid infusions to measure fat clearance, and infusions of radioactive HDL to measure its catabolic rate. He found that distance running acutely lowers triglycerides and raises HDL levels. And distance runners, Thompson learned, clear HDL from their blood much slower than sedentary folks.

Today, Thompson is a Professor of Medicine at the University of Connecticut School of Medicine and Director of Preventive Cardiology at Hartford Hospital, where he has been on staff since 1997. He is presently immersed in the complex world of cholesterol-lowering drugs and how they can injure skeletal muscle. He sums up the current findings by stating, "These drugs make injury from exercise much worse." Not surprisingly, he says a high percentage of his patients are athletes.

Paul Thompson still runs Boston most years, often training on running trails snaking through his backyard in Simsbury, CT. Between rounds, research and running, Thompson of course teaches, and he also regularly gives talks to other medical professionals on new developments in preventive cardiology. Thompson delivered two well-received lectures in D.C. at the most recent AMAA symposium, held in conjunction with the Marine Corps Marathon. His frenetic professional life makes him the kind of person who often seems about to get on a plane. Nevertheless, he and his wife, Camilla, have found the time to raise four children and care for two pug dogs. Last November, he became a grandfather.

Thompson sees the emphasis on prevention as one of the most fundamental and important changes in cardiology since when he first entered the field. An adventurous yet disciplined pacesetter with a clear lust for life and all the knowledge to be acquired in it, Paul Thompson, M.D., continues to push forward in his search for better treatments, better medicine--leaving doubt in the dust like a crumpled water cup at the base of Heartbreak Hill.