Carlos Ayers: A life in the clinic

Photo: Ian Nichols Photo: Ian Nichols

Carlos Ayers isn’t sure exactly why it dawned on him when it did, but he knew at age 15 that he was going to be a doctor.

“I was just waltzing along, and all of a sudden it came over me that this is what I wanted to do,” he said. That was 1947, when he was still living on a small West Virginia farm. He finished high school a year later, and 10 years after that, he graduated from the School of Medicine at the University of Virginia.

Fifty-five years later, he’s technically retired after a long and distinguished career as a cardiologist that included 46 years as a faculty member at his med school alma mater. But Ayers isn’t ready to stop being a doctor. At 81, he still spends two evenings a week giving preventive cardiac health consults at Charlottesville’s Free Clinic.

There was some sense behind his choice of medical specialty. His paternal grandfather died of a diabetes-related infection, and both his grandmothers and his father died of heart disease—his father at the age of 54 —“so there was plenty of stimulus for me to be concerned about cardiovascular disease,” he said.

Ayers has been witness to and taken part in a great deal of medical advancement in the decades he’s worked as a doctor. Hypertension, or high blood pressure, had essentially no effective treatment when he started his residency at UVA. “We did a lot of research in hypertension in the ’60s and ’70s, and we learned more about it,” he said. “Clinical trials came out in abundance. By the late ’70s, we really had a handle on it. That was very exciting, and rewarding, and something I participated in heavily.”

Later in his career, his focus shifted to preventive health. He was awarded a five-year grant in 1980 to pilot a preventive cardiology clinic that aimed to reduce patients’ risk factors for developing heart disease through various lifestyle and drug treatments—at the time, still a novel idea.

“More and more work had come out on atherosclerosis and its causes—the role of lipids and a lot of other factors. I saw that as a potential area. And that’s what I did the rest of my career.”

And it was successful beyond anyone’s imaginings at the start. In a recent pool of more than 2,000 patients, the incoming expected rate of cardiovascular health-related events was about 60 per year, he said. The clinic ended up seeing only three to five events per year—a risk factor drop of 90 percent.

That’s part of why he didn’t want to quit.

“I was still interested in what I was doing,” he said, so he moved his preventive work to the free clinic, helping low-income people avoid the diseases that killed so many members of his own family.

He’s happy to have more time with his wife, Mary Joe. He walks the dog, plays tennis, works in the garden. And he thinks matter-of-factly about the eventual end of his career.

“It’s fulfilling, and I think it serves a useful personal purpose,” he said—it keeps him sharp. “But when I feel like my mental situation is such that I’m no longer doing a good job, I’ll stop.”

Hopefully not too soon, though. “When you learn to do something really well, it stays with you,” he said.