I cannot overstate the value and importance of the support I have received from the VA system in my development as a physician-scientist. I believe that Dr. Montgomery

Bissell expressed this clearly in his Master’s Perspective article,13 when he said that at the beginning of a career as a physician-scientist, the young physician needs “80% of protected time for keeping a steady focus in research”. Thankfully, the VA Research Associate position permitted me 3-4 days a week in which I could focus on research. Because I was at the VA Medical Center, I was also free of certain university committee obligations that can consume much of a young researcher’s precious time. In 1979, I was promoted to Associate FK506 chemical structure Professor of

Medicine, but by then my laboratory was well-established and I could afford the time that departmental duties took up. My opportunity for collaboration with physicians and scientists throughout the world began in earnest when I returned to Yale. I am proud to say that my good ABC294640 price friends, Mario Chojkier, Andres Blei, and David Kravetz all collaborated with me in my laboratory at the West Haven Veterans Administration Hospital.14-17 We have remained close friends through all these years, meeting at every American Association for the Study of Liver Diseases (AASLD) and Digestive Disease Week meeting. Each now occupies a distinguished position in different medical

schools in this country; sadly, Andy Blei is no longer with us, and we miss him dearly By the late 1970s and for next three decades, the polyglot nature of my laboratory was established with a steady arrival of bright physicians coming from the United States, Argentina, Spain, Italy, Switzerland, Israel, India, Japan, Taiwan, South Korea, Brazil, Mexico, Turkey, and Germany. At times, the laboratory sounded like a “Tower of Babel”, where English was the common language spoken with many different accents (Fig. 3). It was a magnificent time not only as a scientific selleck screening library but also as a personal experience. Because of my past experience treating patients with arterial hypertension, it was clear to me that to make significant advances in the treatment of portal hypertension we needed to improve on the methods available to measure portal pressure. The only acceptable method available in the mid-1970s was the hepatic venous pressure gradient (HVPG) performed with a straight catheter that had to be advanced to the wedged position and withdrawn to obtain the free pressure in the hepatic vein. HVPG, the difference between the wedged hepatic venous pressure (WHVP) and the free hepatic venous pressure (FHVP) represents the gradient between portal vein and intra-abdominal vena cava pressure.