Alexander Shaknovich doesn’t break for lunch. A Harvard-MIT trained cardiologist, his career includes a position as Chief of Interventional Cardiology at New York Hospital-Cornell Medical Center. He is currently in private practice and divides his packed 12 hour-plus workday between seeing patients and doing procedures.
Who: Alexander Shaknovich, M.D. Where: Ritz Diner, 1133 First Avenue, New York
On the Menu: Lox, bagels and cream cheese and planning for a full, active life.
Instead of a lunch, Shaknovich agrees to have an early breakfast at the corner diner down the block from his East 61st Street office. Even ordering the top item on the menu, a bagel with cream cheese and lox, he is by far the cheapest guest since this column has been in existence.
And probably the most matter-of-fact one. We just have time to sit down and accept a splash of black coffee into chipped diner mugs, before he gets right to the point.
“Cardiology has been a major beneficiary of the immense resources this society devotes to medical care. Cardiovascular disease is still the No. 1 killer in this country, but now it can be managed. The secret among cardiologists is that their patients can now pretty much live forever.”
Forever may be an exaggeration, but life spans reaching well into the nineties and beyond have become routine. A hundred years ago, Shaknovich points out, living a long life was largely a matter of chance. If you assign values to three major factors in longevity — patient’s behavior, physician’s skill, and fate — fate would have probably been responsible for 95 percent of the outcome. By “fate” is meant not only genetics, geographic location and exposure to infections, but diet and exercise, since little scientific evidence existed until recently linking fat, salt and cholesterol to heart disease.
Today, fate still plays a role — since there are incurable diseases — but physicians have been given technological tools to prevent, diagnose, treat, cure and manage a wide range of previously fatal diseases. Patients can now live with chronic medical conditions such as diabetes and cardiovascular disease.
Only recently, Shaknovich asserts, blood pressure readings of up to 140 over 90 were considered normal. Now, the ceiling for normal has been lowered to 120 over 80, because medicine has the wherewithal to bring the patient’s blood pressure into this range permanently.
“When patients ask me what is the difference,” says Shaknovich, “I tell them it is a new game plan. The old game plan was to live to 70. The new game plan entails a much longer life span, so you have to adjust how you get there.”
When I tell him that longevity, and more specifically concern about outliving one’s savings, has become a major issue in the financial planning industry, he leaps on the analogy.
“When you go to a financial advisor, you don’t expect him to perform miracles. He has the training and the technological tools at his disposal to manage your portfolio within certain parameters. He gives you the kind of investments that meet your financial goals.”