Events like this can really mess you up for a long time. For emergency physicians, STEMI’s and SAH’s and their attendant morbidity stop abruptly ‘at the door.’ They simply vanish into someone else’s care and out of our lives. The other side of the door was new to me. Soon after the STEMI, I bumped into a doc in the hallway who had suffered an MI in his early 40s. I asked him, “How long does this mess with your head for?” His reply was two years, and so it has proven to be. Fearful of straining on the toilet, of carrying a bag of groceries, of doing a push-up, of getting angry, of having sex … fearful of anything. Glued at the hip to my nitro spray and BP monitor. Six months before daring to eat an egg. Now, I simply remember that it will take me longer to get on or off the mountain because I am B-blocked, to have my spray in the pack and to have my cellphone charged.
Life is inherently risky. My coronary angios showed no lesions, so I remain to this day largely an unknown quantity – albeit one with presumed ‘crème brulee’ patches on my arteries inherited from, well, everyone in my family tree. Likewise, I have an aneurysmal remnant pulsing with every heart beat that needs regular follow-up. But, truth be told, my biggest daily risk remains trying to make a left-hand turn on the way to work. It’s just a real head-wrap to trust in that truth and get back in the saddle.
No one gets through in life for free, and none of us is getting out of this alive. So we might just as well have fun with it along the way. In the ED, I have enough colleagues and staff now with stents in their chests to form a Walking Dead Club – momentarily lurching past each other whenever we cross paths in the hallway.
“Not if, but when,” my cardiologist says. And he’s on my side. No one knows when their first, or next, event will occur. So, sure, prepare for your future event (e.g.,) have your ‘Green sleeve’ in order, but live in the moment. Be intimate, present and engaged. That way, no one you love can say after the fact, “Meh, he was never really there.”
These events affected my family and our close friends greatly. Unexpected and imminent mortality right in their faces. I needed to be present for their reality as well, and they needed to feel daily that I was OK. And I really needed them. Robustness, resolve and resilience can only carry you so far – leaning on those closest to you provides the courage needed to return.
The real question: Why go back at all?
I had a good disability policy at the time of these events. I am near the end of a career in medicine. I could have been written up as totally disabled and walked away. But for me, emergency medicine has proven to be the greatest adventure ever. Where else would I want to be in the time remaining?
Oh … and where else would I rather be when my next event occurs than in my own emergency department?