A Doctor’s Journey

On Wednesday, September 19, I received an email informing me that US News and World Report named me as one of America’s top doctors.  On Sunday, September 23rd I had a mild heart attack.  Today, September 26, 2012 is my 58th birthday.

Where do I start?  How about with the good news?  Being named one of US News and World Report’s top doctors came as quite a surprise (link).  The magazine says this places me in the top 4% of doctors nationwide!  If you read the process they use to choose their top doctors, you will see that they do not allow input from the candidates and the nomination was made by my peers.  That is true.  I had no knowledge that I was nominated.  It is quite an honor and I am truly humbled.  While it is certainly a validation of all of my work in my professional life, it is also a standard that I will work hard to maintain.

What is a “mild” heart attack?  Is that like being a “little” pregnant?  It may seem mild to some but it was major to me!

Having a heart attack, or in medical parlance, acute coronary syndrome, should not have happened to me!  I know everyone says that but I have no risk factors.  My blood pressure is normal, I don’t have diabetes, I don’t smoke, my cholesterol is normal and I don’t have a family history.  OK, I am male and that is a risk factor, but there is nothing I can do about that.  What about my lifestyle?  I exercise 4 – 5 times each week, I eat healthy, am in a stable, happy marriage with a great home life and I even meditate every day.

This past Sunday, I dropped my son off at his apartment and went to fill my car with gas.  I noticed some chest discomfort while walking from the car to the pump.  It was like nothing I had ever felt before and it is impossible to describe the sensation.  When I wasn’t moving, I had no pain.  I finished pumping the gas, got in my car and pulled it away from the pump so I could assess the situation.  I reviewed my symptoms, which included the chest pain that went to my left shoulder, upper arm and left jaw.  I was sweaty and had a little nausea, but no shortness of breath.  The following is the conversation I had with myself:

“Wow, is this feeling in my chest real?  Could this be cardiac pain?  No, it is just some chest wall pain, go home and take some Advil.  Yeah, but with the left arm and jaw pain this could be significant.  Remember what they taught in medical school, when patients complain about jaw pain?  When that symptom comes with chest pain it is almost always associated with the heart, so take that complaint very seriously.  Ahh this can’t be happening to me, I don’t have any risk factors.  I’m too young for a heart attack, oh wait, I’m 57, a perfect age.”

I then realized two things; that I was trying to talk myself out of doing the safe thing and if any of my patients had called me and described these symptoms, I would, without hesitation, tell them to go to the nearest ER.  So I decided to take my own advice and go to the nearest ER, which fortunately for me, was Hoag Hospital in Newport Beach.  During the few seconds that I took to reflect, my symptoms subsided, I felt better and decided to drive myself to the ER.  Some may question that decision, but I was not convinced that I had a serious problem and I was already feeling better.  I drove slowly in the right lane, knowing I could pull off the road at any time and was not a danger to others.  I also knew that I could be at the ER quicker than if I had called the paramedics because in the time it would take them to get to me and load me in the ambulance, I could already be receiving care.

I pulled my car up to the ER, handed my keys to the valet, walked slowly to the woman at the check-in desk said, “Hi, I am a doctor on staff here and I’m having chest pain.”  The staff then went into overdrive!  They quickly hooked me up to an EKG machine.  I could see the diagnostic changes quicker than the computer had and pointed them out to the nurse, “Ah, look at lead 3.”  Before I knew it I was in the cath lab.  I had 100% blockage of one coronary artery.  Fortunately the cardiologist was able to open the artery completely and restore blood flow.  I stayed one night in the CCU, one night on the telemetry ward and then was discharged home yesterday.

I have a new reality in my life.

I have much to be grateful for.  I made the right decision to get myself to the ER ASAP.  At all times my vital signs were stable and there was never any lack of blood flow to my brain.  I had access to the best medical care available and was treated by very competent, caring individuals who all put my needs above their own.  I have a loving family who were at my bedside starting in the ER and have been there every step of the process.  My medical partner and office staff continue to be very supportive so I can take the time I need to heal.  My close friends were there to provide much needed support to my family and me.  My cardiac function remains normal.  Clearly it could have been worse.

I honestly don’t know what I could have done differently to avoid this.  There are things in life that are simply out of our control.  I know there are lessons here, the most obvious one being to enjoy each and every day because life is a gift not to be taken lightly.

Going forward, things will change for me but I am not yet sure what they will be.  Having had the time to reflect, I can say that I will not change those things that I enjoy and that make life, for me, worth living.  This includes my close relationship with my loving wife and children.  I intend to learn, in greater depth, what I can do to prevent this from ever happening to me again.  Since the practice of medicine is something I love, I look forward to returning to the office and sharing my experience and newfound knowledge with my patients to help them attain optimal health.  I intend to enjoy each and every day I am blessed to walk on this earth and will work hard to stay one of America’s top doctors, with even more determination toward preventative medicine.  I am only 58.  I still have a lot of years left!

James M Weiss MD

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