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GP7Apr04: Heart Attacks and Aftershocks 1984-2004, Part I

Our friend and consulting colleague Brian McBain, in a comedic and tear-inspiring account, lays out what he’s done to keep his ticker beating, even if it took a pause or two just to teach him a lesson.  We’ve split his letter into two decades, so you will read the rest of his travails next week.  His brush with death, not unlike that of radio’s Don Imus, has made his wit a little more penetrating and made him see, with more clarity, just what’s important to him.  Mortality does that:

“Years ago, in 1984 (hmm) at the tender age of 45, I was skiing in Sun Valley with family and friends after a particularly frantic week being hectored by the office, the home office, assorted clients and others. On the second or third day after skiing we all went to the local après ski venue—forget the name—to view—I remember the name—The Varnettes, a bawdy female trio who billed themselves proudly as the official snack food of the 1984 Olympics. Quaffing a local brew, I felt a tightening in my neck, akin to my collar being too (much too) tight. It went away and I shrugged it off. It happened later, well into the evening, and again I shrugged it off. “Must be altitude,” I assured myself.

The next day was our last day and after a particularly exhilarating run, we all met up at the lift, jumped on and lofted skyward. Sitting in the quad, I experienced another neck-tightening and I attributed that to altitude as well. After all, we were higher on the mountain and had exerted ourselves.

The vacation ended and my family went back to New York with our friends, and I traveled on to Los Angeles to visit with clients and a prospect. An old friend picked me up at my last appointment and we drove to dinner at the Sunset Grill and then to LAX to catch the redeye. A few hours into the flight, at the end of a forgettable movie, I was struck by a series of these neck tightenings. The last couple, just prior to landing, were so powerful they lifted me out of my seat. Quite literally, I had to stand to get relief and, would you believe, the Flight Attendant said, “Excuse me sir, please sit down, the fasten-seat-belt light is on.”

I was nervous, frightened and clueless as to what was going on. I grabbed a cab (5:00 am) gave him my office address on 61st Street and sat numbly until we arrived. I paid, opened the office, put my bags in my office, locked the building and flagged down another cab. He said, “Yes?” I said, “Hospital.” “Which one?” “New York” (both sons had been born there). “Where is that, Sir?” I’m embarrassed to recount my handling of the situation, so I won’t. I stumbled into the emergency room and made my way to the desk labeled (only in New York, folks, only in New York) “Triage.” The nurse asked how she could help me. It seemed as though I had begun to say, while grasping my neck, that I was experiencing a tightening something like being strangled, when I was upended onto a gurney and wheeled away. A nurse unbuttoned my shirt and placed Saran wrap with a gel on it (nitroglycerin, I learned later) on my chest and they began putting in an IV, drawing blood and all sorts of other things while asking me to recount all of the above in excruciating detail.

Then, as mysteriously as the attendants had appeared, they disappeared. I was left alone no more enlightened than when I had arrived. I didn’t even know enough to be scared, though, I must admit, I was apprehensive. But I was not experiencing strangulation. Sometime later (I’m not to be trusted with time measurements here) a kid, who I don’t believe shaved, because he didn’t need to, came in and said, “Hi, I’m Ted. The good news is we don’t believe you’ve had a heart attack.” Well I damn near had one then. He then explained that he was a cardiologist doing research on clot-busting drugs and that he rushed in (to the hospital) as soon as they called him. Apparently everyone was instructed to call him with cases where possible clots could be busted.

Ted stayed a good long time. He realized I was cardiologically ignorant and took a good long time to catch me up on the art and science of angina (he said that I had increasing unstable angina), heart attacks, the state of cardiology, clot-busting drugs and the various recourses for my situation. (I realize this detail is not really necessary, but bear with me as I, for one, find it fascinating, these many years later.) For me he said that he wanted to do an angiogram, probably in the next day or so. (Back then, scheduling such relatively new procedures was a challenge.) Did I want to call my wife, he asked.

No need to describe what that phone call was like nor the stir it caused among all our friends. Okay, okay, I’ll cut it short. I had the angiogram where they discovered one partially blocked coronary artery. Ted was right there with a running commentary for my benefit while an Israeli tech (I think he was a former tank commander) was complimenting himself on his skill at every turn of the catheter and how lucky I was to have gotten him. Ted affirms that I have one nearly-blocked coronary artery and that they would probably do angioplasty in a day or so (i.e., insert a catheter with a balloon to the blockage, inflate the balloon, squeeze the stuff to the side, and clear thereby clear the blockage).

They wheeled me back and left me in a hall awaiting a bed. I remember drifting off to sleep. The next thing I can recall was waking up with what felt like someone’s fist in my mouth. And there was Ted staring intently at me saying, Brian, can you hear me?” I guess I was pulling at the breathing machine in my mouth and Ted yells at the 500-pound day nurse, “For christsakes get that thing out of him, can’t you see he is awake!” He then calmly and very reassuring sat down on the edge of the bed and described what had happened. My heart had stopped. I had flat-lined. The blocked coronary artery had collapsed, shutting down the heart. They injected digitalis (I think), externally massaged the heart and whipped me into emergency surgery where they performed a single bypass.

As an aside, my wife had just been arriving at the hospital for the first time and on my floor where she was stopped and told, “You can’t go in there now, they’re working on someone.” The door to the ward then opened and Ted, various attendants and me covered in betadyne (that ugly orange stuff) came flying out. A nurse pointed out my wife to Ted. He sent the others with me to the operating room and took a few minutes to greet her and tell her what was happening.

This was my first personal experience with the health care system and in my mind, there was nothing better in the world. Similarly, Ted had taken on the status of a living God with me. We had had a harrowing experience with our oldest son when he was a 6-month fetus and the experience was similarly marvelous.  Afterward, the bills came and we were fully covered by Guardian Life. I believe it was an indemnity health care policy we had through my work. No muss, no fuss.

Those were the halcyon days. Doctors cared. Nurses cared. There was no managed care to speak of. Health care coverage covered health care. I had not been asked for my insurance card until after I had been greeted by Ted that first jaw-dropping time. Similarly, both of our children’s births were efficiently taken care of. Psychologists and apologists can parse the whys and wherefores, but, net net, the system worked and beautifully in all aspects and dimensions.”

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