How not to have a heart attack

US Health Care isBullShit : Part 1 of 8

“It could have been worse.” — Book by A.H. Benjamin

Life is a brittle, ephemeral phenomenon with a series of seemingly random events that we build a narrative around to keep us sane. My sanity came into question during the events I am about to describe. This is a story of missed opportunities, mishaps, misdirection, and unpredictable consequences. A story that encapsulates and epitomizes life. You rarely get second chances — seize them, don’t let them slip away.

According to friends, family, I am a passionate person with fortitude, grit, and scrappiness. Attributes that help me get shit done. I do like to talk about myself, and you do have to ‘relax your brain’ when you are around me. Two characteristics that a close friend Rudy so aptly pointed out to my son Slade. I have done a lot of stupid shit. My life is riddled with mistakes, which makes for entertaining banter.

My significant other, Natali, loves to incite me, and participate in making stupid shit happen. Fun, stupid shit happens when you relax your brain. Natali and I manufacture a vicious story telling fly wheel of new experiences. As my son Slade says, “I am the fire, and Natali is the gasoline.”.

I am fanatical and maniacal about health, fitness, diet, learning, exploring, reading, and traveling. I surround myself with people that challenge and stimulate me intellectually, physically, spiritually, and psychologically. I was diagnosed with ADHD later in life, as things like ADHD, chronic fatigue, fibromyalgia, anxiety, PTSD, and panic disorders did not exist in a small town in Wisconsin where I grew up. You simply drank, worked, and partied harder to numb the pain and avoid the tribulations of life, and life was good!

I have an addictive, impulsive personality. My first ‘born again’ episode commenced on Feb 11, 1998. This awakening happened over the course of twenty years; being born again is typically not lightening in a bottle — it takes time, perseverance, and patience. I woke up on Feb 11, 1998, and decided to quit drinking. It took another five years of therapy, meditation, and undoing innate, natural destructive behaviors (eradicate being a ‘dry drunk’) to start the journey of being a more self-aware, compassionate, caring person that knows the true meaning of loving a friend, having unconditional love for my sons, and real loving (along with truly erotic, connected sex) the one I am with (aka Natali).

Addiction and ADHD are good things — keeping with the positive attitude of my ‘country boy’ (Natali inside joke) Wisconsin roots. These redeeming ‘diseases’ (neither are diseases — for another blog post) led to novel and exciting endeavors like going vegan for 100 days, spending ten minutes day after day in 36 degree ocean water (Wim Hof anyone), paddle boarding twice to the Isle of Shoals (28 miles round trip), waking up at 5 AM to participate in testosterone laden battles of cycling conquest with the Carpe Diem club, lift weights so viciously as to form permanent shoulder blade bruises, hiking Mountain Washington in only shorts and hiking shoes in November, partaking in an Ayachausa induced spiritual retreat deep in the Peruvian jungle, completing Grand Canyon Rim cubed three weeks after a marathon, and co-author of five books only a handful of geeks read.

No adventure is too large or too small for me. I love to scuba dive, mountain bike, do yoga, play tennis and pickle ball, golf, shoot pool, and play horse shoes. Anything to get my adrenaline, epinephrine, dopamine, and serotonin pulsating. I don’t smoke or drink, don’t do drugs (well, hard drugs), have limited stress at work, sleep well, avoid sugar and processed foods, meditate, have a disdain for fast food, and drink plenty of water. I am not a rose colored glasses person, but maintain a glass half full perspective. A plethora of co-workers called after the heart attack to express bewilderment that the “healthiest person they knew” had a massive heart attack. If it happened to me, they considered themselves doomed.

One of the best quotes that describes my personality is on Linkedin — Yong Su Kim — “Tom was very focused and disciplined in his approach to everything and he always delivered. Although he can be intense, he got along well with everyone, both professionally and socially, and it was always a pleasure having him on the team.”

Up until I was writhing in pain in the parking lot of my primary physicians on the morning of April 20th, 2021, I was told dozens of times, over two years, everything was fine with my heart. I was told six times by nurses, doctors, physician assistants, and paramedics during the heart attack that I was well, and nothing was wrong. A sense of doubt and distrust in medical professionals still permeates me today.

Two years before the heart attack I experienced latent chest pain — a sporadic, subtle annoyance to the right of my heart. The pain was not noticeable during vigor and rigorous biking, hiking, paddle boarding, or any other physical exertion. The pain was not sharp or persistent, however, it did cause me to take notice and mention it to my primary care provider every time I saw them for two years. A myriad of test where administrated including a couple of chest Xrays, swallowing test, stress test, numerous EKGs, and an MRI. I was told that my heart was fine. I continued with my fanatical ways of travel, work, and fitness. I paddle boarded five miles in the ocean, and hiked twelve miles with 3K of vertical climb in 90 degree heat two weeks before the event. My cath lab nurse girlfriend (Natali), who’s number I got in exchange for a used TV, eventually insisted I ‘phone a friend’ who is chief cardiologist at a prominent heart center in North Carolina.

Two days before the heart attack, and a week too late, I was scheduled to have a batter of tests including a nuclear stress test in Raleigh. The morning of April 19, 2021 was a gorgeous day in Hampton, NH with the sun beaming off the ocean. I dropped off my car for an oil change, and phoned a coworker I had not talked to in five years. I felt euphoric and sanguine as I strolled down the beach to my home a couple of miles away. I then strapped on my running shoes to run three miles to my annual physical. It was not uncommon for me to literally ‘run my errands’.

The signalling of imminent crisis ramified itself immediately during the run. I had to stop running after about a half mile in as I was out of breath, sweating, and experienced a sensation of low blood sugar. The low blood sugar feeling seemed to be my cardiac ‘tell’ as I also felt the identical sensation two weeks prior on a short hike in the Santa Cruz mountains. My first comment to the physicians assistant when she entered the exam room was, “Something is definitely wrong.” I recounted the symptoms I experience during the run over, and repeated several times, “I (we) know something is wrong with my health/body.” She ordered an EKG which I was told came back indicating my heart was fine. I furiously paced in the examination room feeling anxious and short of breath with intensifying feels of low blood sugar. The physicians assistant asked if I wanted her to call an ambulance. I thought, “You are the expert…(silent) expletive, profanity, expletive.” Suddenly an uncontrollable surge of ‘fight or flight’ overwhelmed me; I rushed out of the doctor’s office. The last think I remember hearing was something about not checking out and a copay.

Running down the stairs I felt like I was suffocating, and was compelled by an insatiable urge to be outside. I stumbled out the back door, immediately collapsing, writhing on the ground in excruciating, untenable pain. Moments later two physicians from another practice called out to me, “Are you OK?, Are you OK?, Do you want us to call an ambulance?, Are you OK?”. They called 911 as I muttered some unintelligible words.

The ambulance arrived within five minutes, and the physicians assistant immediately came down. It would have been better if she had stayed put. She advised the paramedics I was having a panic attack and was prescribed Clonazepam for anxiety. The first statement was an egregiously incorrect medical diagnosis, and the later assertion a lie — on rare occasions I took Clonazepam as a sleep aid which was prescribed as such by a neurologist. Apparently taking all precautions, still under the allusion I was having a panic attack, I was placed into the ambulance. Proceeding with the false physician assistant narrative, one of the paramedics asked how often I had panic attacks, and if I had taken my Clonazepam that morning. Exasperated by the myth and seeking an expedient resolution, I screamed, “I am not f***in having a panic attack and do not take daily medicine!” The next thing I heard was, “Shit, this guy has tombstones, turn on the lights, we need to get him to the hospital pronto”.

My first ride in an ambulance commenced with a vice grip on the paramedics hand, and asking him, “Am I going to die?” I thought ‘this is not good’ when there was no response. Pumped full of fentanyl and nitroglycerin I was felling no pain when I arrived at Portsmouth hospital. A familiar crew of perplexed nurses greeted me in the emergency room; Natali worked as a traveler (traveling cath lab nurse) here. My sense of time was distorted. There was no time to say no, or discuss options, my left anterior descending (LAD) artery was 90% blocked. A heart attack induced by LAD artery blockage is appropriate called a widowmaker; the survival rate is twelve percent. Soon my chances of survival would plummet — not a good day to play the lottery.

My first semi-lucid recollection after the stent procedure was laying on a bed in excruciating chest pain as two nurses attaching EKG leads. One of the nurses calmly told me I just had a stent put in, and was experiencing discomfort from this procedure. I recall telling her, “Something is wrong, my chest is f***ing hurting….”. Acute stress response imbued me, and I attempted to escape from another unsafe situation. I came to life an hour later in a hospital room feeling like I had been run over by a Hunt Brothers semi-truck, five tubes sticking in my arms, and EKG machine incessantly beeping. I vividly recall one incident during the stent procedure.

The massive wall of liquor was exquisitely displayed on a floor to ceiling mirror backed glass shelf. The bar tender was dressed in vintage speakeasy attire with his back to the door. The bar was illuminated by natural light that consumed the room, but was not overwhelming or repulsive. One patron was in the bar. She sat at the mahogany bar half facing the doorway holding a whiskey with two cubes of ice. It was my mother who passed away a couple of decades ago. She was not beckoning me, or gesturing for me to leave. She had an ambivalent look on her face — an appearance of impartiality. Then my body violently convulsed on the metal table. Was that the after life, was it a vision induced by DMT coursing through my body, or was it a post temporal lobe phenomenon as Dr. Squee (a close friend) so eloquently portrayed.

What the hell just happened? Well, a lot. The bar vision, another incident of fight or flight, and oscillations between Vtach and VFib for eight minutes during cardiac arrest. After twelve jolts from a defibrillator, my ejection fraction (EF) measurement was fifteen, and my heart struggled to maintain rhythm. The attending nurse indicated, “You immediately became priority one in the hospital.” The stent was not adhered to the artery wall properly. This instigated a rethrombosis; the blockage went from 90% to 100%. Instead of being released from the hospital that afternoon, I would be agonizing over my heart ‘flipping a bit’ (Vtach), and incessantly ruminating that another heart attack was imminent.

An apt antidote is the most effective and impactful method of illustrating how I looked, felt, and acted during the six days in the hospital. A friend Rob had come to visit me while I lay in waste. A couple of years after the heart attack Rob, myself, and Bob, a mutual friend, where recollecting the heart attack. Bob bemoaned the fact he never came to visit me in the hospital. Bob then reluctantly admitted that Rob advised him not to come. Rob confessed that he told Bob I looked physically feeble and frail, “best not to visit Tom in his bleak condition.”

Laying in the hospital bed there was zero possibility of sleeping or relaxing for a moment. My ‘monkey mind’ was in overdrive. I was incapacitated physically, emotionally, mentally, and spiritually. Tormented by the thought of a recurrence, clinging to a lingering despair my heart was irreparably damaged. My demeanor was solemn, morbid, and petulant. I was irritable, irrational, incoherent, and demoralized. I was convinced the best was not to come, and at any moment my body would succumb to the erratic heart beat and depleted state of being. One night of two hours of restless sleep was enough to demand some Valium. This was reluctantly prescribed, and four hours of sleep ensued the second night.

The consistent stream of visitors and night nurse was what kept me in the game. Friends and family provided distraction, deflection, and inspiration. It helped me formulate a false positive narrative that allowed me to persevere. The night nurse spent hours with me. He was incredible; a sincere, honest, open, and compassionate human that was at the right place at the right time.

There were several more baffling, inexplicable, and horrifying health care moments while recuperating. The first happened two days after the heart attack. My heart was still consistently missing a beat; I could feel it. The hospital PA entered the hospital room to indicate I was going to be taken off two of the drips I was on. One of the drips helped abate the irregular heart beats — unsustained VTach. I was in distress, and immediately began to cry uncontrollably. I thought “what the f**k, this is not good.”. I flashed back to the ambulance when the paramedic did not respond to my question regarding my impending demise. “We are going to “roll the dice”, the hospital PA cavalry stated. She declared it was standard operating procedure (aka protocol) at the hospital. I don’t like, or believe in rules, this seemed to be a stupid rule to me.

The second agonizing incident occurred on the third day when I was cautioned by hospital staff there was a high probability I would need a pace marker. This was a repercussion from the cardiac arrest. Perhaps it was the cold plunges in the New Hampshire ocean in February, the obsession with dietary regimens, or the hours spent on a meditation cushion, my EF had risen from 15 to 30 by the sixth day in the hospital. I was triumphantly capable of walking a down a long hallway and up a flight of stairs, with a break. I was ready to be released! A few hours before release, the nurse nonchalantly mentioned, “You are lucky. This is the third time this has happened (rethrombosis) in last two weeks. That is strange.”. I was released with a LifeVest that was costing me $3K a month as my insurance company decided it was not a necessary expenditure — I felt otherwise.

The arrival home was accompanied by balloons, a visit from the paramedics, and a multitude of friends and family. Help had arrived! The first friend to arrived came immediately after his son poignantly indicated, “If not now, when?”. It was sensational, inspiring, and comforting to be surrounded with love, kindness, and compassion from friends and family calling, sending gifts, and dropping off food. The power of connection was evident from dusk to dawn.

The first cardiologist doctor visit was devoid of caring, or even infinitesimal sensitivity and diligence. It was an abject failure. I did not see, I did hear him, the attending physician from the hospital. The visit started with the nurse asking, “Who are you, Why are you here?”, “Are you sure you are in the correct office?”. I politely described the incident at the hospital, and the reason for the visit. She then left the room, and came back with a blank sheet of paper and a pen, exclaiming, “We have no record of you, can you explain everything in detail?”. My girlfriend and I were despondent and disgruntled, but without recourse.

Next on to the primary care provider to get my records released. I was not interested in continuing care with Dr. Gregory Morrissey, and I desired to share my medical history with my friend that is chief cardiologist at Duke. The first attempt to obtaining my records was with my friend Tom from Stevens Point, WI. I filled out the appropriate paperwork, and he returned it to the office to no avail. Natali stepped in with multiple calls, emails, and visits to the office — the office maintained they had 30 days to execute on the request. The elusive records were released after a threat of lawyer intervening was made.

PTSD, anxiety disorders, or panic attacks were imaginary disorders to me. Now I am a believer. Sleep was implausible, daily panic attacks were persistent, and anxiety was pervasive throughout the day. PTSD consistently arose three times a night — my deceased mother ‘visited me’ on a few occasions. Natali was not allowed to leave my side, even when in the shower, napping, or taking a shit. She became proficient at watching me rest. I refused to do anything on my own. Walking two blocks to the beach was debilitating, and seeing the grossly unhealthy beach goers frolicking in the water, downing beers, and hitting the vape pipe added to my angst. My first encounter with a grocery store ended at the produce section; I am going to die was my thought as I rested on a crate of bananas.

Hope is restored, as my EF reaches fifty, and the vest is gone after one month. A miraculous recovery thanks to persistent twice daily three mile walks on the beach, sleeping twelve hours a day, breathing exercises, impromptu visits from friends, meditation, hours of gin rummy with Natali, and absence of work stress — work, what career? I even ventured out for lobster in Maine with my sister, and traveled an extravagant, apprehension filled (where is the nearest hospital was an obsessive thought) excursion for dinner at a forest restaurant with Tom Jones and Natali. Life was good!

The unfortunately mantra of the move to Arkansas via Raleigh was “You are as nervous as cat on a hot tin roof.” A refrain reiterated by Natali. The first panic attack transpired in the Outer Banks. Natali and I hiked twelve miles in 90 degree heat to view the Corolla Wild Horses. We were not disappointed, and even had an encounter with the beach patrol for viewing the wild horses from the sand dunes apex. The euphoria came to an abrupt end during an early dinner. I felt the low blood sugar sensation evident prior to the heart attack, my heart began to race, and my mind spun like a top into a vortex of despair. I was eager to leave the Outer Banks, and get closer to a hospital, and Raleigh. Why Arkansas? — for a subsequent blog post.

Why the detour to Raleigh during move to Arkansas? Haymaker, the high school friend and chief cardiologist at Duke, insisted I visit Duke University to review the results of the stent procedure and echo-cardiograms. His ulterior motive I imagine was to witness first hand how I looked, felt, and sounded. Haymaker set up an appointment with an interventional cardiologist; he only did the easy stuff — transplants and bypasses. Bob, interventional cardiologist, reviewed the video from the stent procedure, echo-cardiograms, and hospital notes. He explained I was fine, and had learned from experience highly active people sustained the most distress during recovery. This only made me somber, and I began to cry.

The second panic attack occurred during a stop over in Nashville to visit a college roommate. The onset occurred during an early dinner, perhaps I needed to discontinue early dinners. Natali and I abandoned dinner, and headed to our hotel. A concoction of clonazepam, xanax, and THC gummies, along with deep breathing, meditation, and a cold shower, muted the panic for a few hours. I awoke at 11 PM convinced I was having a heart attack.

Natali drove me to the closest hospital. It happened to be a hospital she had worked at, had a maligned reputation along with vexing treatments of heart conditions according to Natali’s personal experience. The night turned into day, and we were finally released. During our stay, I endured multiple troponin tests, one person died and lay in the hallway for a few hours, a heroin addict had a seizure, and a person that had recently returned from the Congo was diagnosed with a rare contagious disease — fun times. We insisted on leaving after the doctor on call recommended I undergo an exploratory cath.

I felt a sense of abundance, rejuvenation, and newness when Natali and I rolled into NWA. The sense of tranquility was infectious as we hiked on Tweety Bird, caught catfish from our dock, engaged in our nightly routine of Rummikub, and lived an ephemeral life of leisure. My career was on hiatus. The equanimity was fleeting. I needed a permanent resolution - reassurance my heart was fine. Haymaker and Bob conversed with me on a daily basis. It was not long before I was back at Duke University. It is helpful to have friends and acquaintances in “high places”.

Standing outside of Duke Hospital with Natali waiting for the valet to arrive felt surreal. I was infused with the empirical evidence that I was physically healed. Bob explored my heart for over two hours. He concluded my arteries were unobstructed. I was fortified by the empirical evidence my heart was physically OK.

Back in Bella Vista, the nightmares, distress, and indignation persisted. The emotional and mental recuperation was fleetingly. Did my intellect get impaired while in cardiac arrest for 8 minutes? Was my balance impacted by the lose of blood flow? I questioned my cognitive and physical coordination. Playing card games, darts, chess, shooting pool, or any activity invariably led me to question my ability to function at the same level I did prior to the heart attack. Taking life sustaining heart medication was aggravating. I took pride in “not being on anything” before the heart attack.

My Id would not stop telling me, ‘Help me please!’. Four years of exposing inner demons to psychologist (Anthony) enlightened me to the potency of the metaphysical. Another round of mind massaging (aka therapy), along with a cocktail of pharmaceuticals, was necessary. A behavioral therapist, James, encounter lasted six sessions, after Natali overheard my Covid induced virtual sessions. Natali was perplexed regarding who was the therapist and who was the patient. James desired coaching from me regarding a patient who was unmotivated to wake up, get out, and be productive during the day. Grasshoper had quickly snatched the pebble from the muses hand. I missed the session with James. He was affable, and always greeted me with a smile, and asked “How is the world’s most interesting man?” What is not to like about getting your ego stroked ?

Prozac then Pristix were the elixirs to instigate a subconscious renaissance. The prozac lacked the serotonin and epinephrine initiators required to take me to the other side. Feeling spry, and perhaps delusional from the pharmaceuticals, I embraced an attitude of “whatever it takes”. This frame of mind led me to attending an Art of Living SKY Breath Meditation course. The weekend session was insightful, powerful, soothing, impactful, and transformative. It was an amalgamation of meditation, therapy, transcend being, ayahuasca / psychedelic odyssey, hypnosis, and, of course, breathing. A another pivotal moment in my subconscious recovery. Thanks to Bakish for gifting me this monumental (virtual) convocation.

The mantra for the first year of recovery was, ‘This shit has to stop.’. Eradicate trepidation from life, and embrace a perspective of breaking all the rules. Even better — not see any rules to break, as there are not any rules. I resolved to start mountain biking beyond the 1.7 mile Tweeter Bird green trail circle. It was imperative to saturate myself in everything I had enjoyed before the heart incident. Natali and I embarked an odyssey of scuba diving, hiking, motorcycle riding, snowboarding, four wheeling, snowmobiling, biking, and dancing in exotic distance lands and right at home in NWA.

Getting back to ‘normal’ — a new normal. This viewpoint made me happy, joyful, and optimistic the second year post heart attack. There is a time of play, a time to be born (again), a time to sow, and a time to reengage. My impulse after the heart attack was to say “f*** it” to work, and abandon all aspects of ‘normal’ life. Resisting the temptation to be controlled by the prefrontal cortex proved to prudent. Life, including work, now had a purpose beyond achieving temporal success and pleasure. I took the time to appreciate those around me at work and play, and relax into the moment.

Three years post heart attack; life is, and will never be the same. I often recollect the salient, potentially inflammatory, comment a close friend Ale said to me in the Catskills during a visit to his place a couple months after the heart attack — “Maybe this was a good thing”. His compassionate candor was the truth. I would never wish what happened to me upon anyone. Living through a death defying experience changes you, your life, your perspective of work, your connection to friends and family. If it doesn’t, you are suppressing your emotions or in denial. If you don’t embrace a normal, you are squandering an unprecedented, epic opportunity.

Life will never be the same — thankful. I am (still) here. On medicine, continuing to push the limits on a mountain bike, unwavering in my conviction, and resolute to challenge the conventional. Physically and emotionally more vulnerable and fragile — a good thing. There is merit to being able to overcome adversity, like a heart attack, but I am sure it is accompanied by a depletion of body and brain cells.

The intent of this blog post is not to garnish sympathy. I am privileged as a white male in a country established by a Constitution written by, and for, the benefit of over educated, affluent, land owning white men. The blog is a mechanism to share, inform, seek the truth (within), and tell the truth as I experienced it. As a leader at Amazon told me, “Some people are truth seeker, very few are truth tellers like yourself.”.

Truth seeking and telling mandates a list of lessons learned — a set of patterns, anti-patterns, and best practices. I innately employ a conversational, whimsical writing style. The writing dogma that I adopted toiling at Amazon dictates that I write in concise, narrative fashion. Bullets, weasel words, and verbosity are strictly prohibited — a frugal, data-driven narrative. Let me know if there is a narrative style to convey these lesson learned:

• Life is ephemeral and delicate : Prior to the heart attack I lived as through I was invincible, indestructible, and eternal. Life is fragile, precarious, and temporal. Cherish every moment with friends and family. Treat time and knowledge as the two most precious elements of life.
• Coping mechanisms are essential to recover : Physical activity was, and is, my dominate coping mechanism. It is demoralizing when your primary coping mechanism is no more — it has come back for me. Have more then one happy place, and more then one coping tool is crucial.
• Mind and body are one : Tales of the power of the mind, mind over matter, and broken heart syndrome are prolific. I have used will power, and possess the capacity to ignore pain, to achieve things. Psychosomatic symptoms were foreign to me before the heart attack — now am a believer.
• PTSD and panic attacks are real : Humans best exhibit genuine empathy when they experience something themselves. I never had a PTSD incident or panic attack prior to my heart attack, therefore, these conditions didn’t exist in my ‘glass house’. Experiencing PTSD and panic attacks every day and night for months changed my perspective.
• Just breath : The power of breathing is unfathomable and baffling. The daily mid-afternoon, dusk, and night time panic episodes were usually abated and subdued by using the Apple Watch breathing application, or simple rhythmic breathing. I would lay down in quite, dark location and breath for ten to thirty minutes. My heart rate would plummet from over 100 beats a minute to 50, and my blood pressure would decrease from approximately 140/90 to 120/80.
• Get help, more help, and additional help (from professionals) : Friends and family are critical. A team consisting of a psychologist, physical therapist, psychiatrist, and cardiologist was essential. I can not phantom recovering mentally, emotionally, and spiritually with out the assistance of an SNRI. Resilience, positive thinking, meditation, breathing, spiritual retreats, cold showers, fishing, hiking, mountain biking, tenacity, and perseverance were momentous. Mind medication was the requisite ingredient to ‘bring it all home’. The teams at Dauntless Psychiatry and Northwest Rehab & Wellness — Bentonville were integral to the speed and magnitude of my mind and body recovery.
• Connection matters : Friends help with the physical, mental, and emotional aspects. Life without uninhibited, unconditional connection is a life devoid of warmth, pain, caring, suffering, giving, pleasure, receiving, and happiness.
• Adjusting to medicine takes time : Taking medication for the rest of my life is depressing enough. The medicine does effect you. It effects you physically, mentally, and emotionally. Try different regimens, different brands, and swap mornings and evenings. Some people will tell you it has been proven certain medications have side effects that are worse than the remedy. This definitive, factual (mis)information most likely comes from social media posts, podcasts, pseudo physicians, and charlatans. Without the medicine, I will die — that is the truth.
• Accountability is rare, apologies are even rarer : There is limited truth telling in the health care field. Why should the health care field be any different than any other vocation? Mistakes need to be suppressed, or people lose their livelihoods. Leaders and ‘experts’ in particular are sensitive to exposing themselves to, and distancing themselves from, mishaps. Don’t expect anyone to say sorry, or ‘I made a mistake’.
• Get a hair cut and dress nice : I was asked at most every doctor’s visit if I was employed and/or had insurance. I was even asked if had a home a few times. All because I have long hair, an earring, and wear a t-shirt, shorts, and chucks. Prejudice is rampant. People will treat you differently if you don’t look and act like they do. Fortunately, I know people that know people that respect me for me.
• Financial and career safety net matters : Amazon has been gracious and supportive. The conventional financial wisdom is to have six months of monetary safety net. I adhere to the dogma of a one year safety net. I built a reputation for delivering results and delighting customers — career security. Not having to worry about paying for out of pocket expenses, not the having the pressure to work, and having the luxury to spend time recovering were essential. I witnessed too many people in physical therapy that had the added stress of paying the mortgage and working long hours to maintain their jobs.
• Friends in ‘high places’ : The adage “who you know is as important as what you know” is a maxim that resonated with me after the heart attack. Each individual in health care is literary a number. I take a ticket each time I visit the cardiologist. We are all snowflakes. The medical system treats each individual identically. Having people that know you, believe in you, and have the power to help you is mandatory.
• The US Healthcare system isBullShit : The US healthcare system is reactive, volume based, ‘show me the money’, and impersonal. Doctors don’t have the time to listen, and reluctant to do procedures not covered by insurance providers. The book Outlive: The Science and Art of Longevity is an expose that elaborates on the triumphs of modern medicine, and exposes the failures of the last 30 years. Medicine has not evolved much since the discovery that germs cause infection, and penicillin can stymie bacterial infections. Antibiotics have extended the average human lifespan by 23 years over the 100 years. US health care has made minuscule progress since the discovery of antibiotics.
• Taking it to fourteen, writing is cathartic : Writing has always been a creative, calming, and inspirational act for me. Writing about a personal calamity elucidates latent emotions of gratitude, regret, appreciation, kinship, and somberness. Recollecting and recounting a catastrophe is a means to move beyond, provoke a few daemons, and scare a few monsters in my head.

The primary lesson I learned is that it could have been worse — far worse. I am fortune to be able to tell this story. This health care saga is more nuanced then can be conveyed in one blog. This blog post is a prelude to another seven blog posts that recount and expound upon the seminal moments during my ‘how not to have a heart attack’ odyssey . The subsequent seven posts are: Your heart is fine!, He is having a panic attack — Heart failure in a parking lot, Two of my nine lives vanish in the hospital, Three months of terror, Get me off the struggle bus, It will be OK…I keep reminding myself, and, of course, ‘Born Again’. I look forward to publishing in other modalities — podcasts, live streaming, and Youtube. I am not a digital or social media native, recommendations on the preferred method of content consumption is appreciated. See you-all soon.