Not long ago, David S., now a patient of mine, was rushed to the hospital after he had collapsed during a meeting of his newspaper's editorial board. He had had a heart attack. The people who work with Dave, and those who knew him well, were astonished and a little frightened. "He's younger than I am," said the publisher apprehensively. "And a real dynamo. Best city editor I ever had. I didn't know he had heart trouble." Dave didn't know it either. There were some premonitory signs of trouble, it is true. But Dave ignored them or dismissed them lightly. That morning, for instance, he had come to the office a little earlier than usual to make sure his paper didn't miss any newsworthy angles in the running story of a big forest fire that was raging not far from his city. The telephones were ringing constantly; there were instant decisions to be made in covering the day's fast-breaking news; there were several appointments with important people - a luncheon engagement with the chief of police, and an afternoon editorial meeting.
Dave was only 41. He had climbed fast in his profession because, as his publisher said, he was a dynamo. He felt that he had to keep the flow of news moving like a Niagara of copy into the presses. During the past week he had not been feeling as well as usual. He felt a little tired, and had to keep himself going by sheer force of will. It was just that he needed a little vacation, he told himself. He was a little too tense, that was all. That's why he "bounced back" when he got a chance to relax a bit over the weekend.
Dave was late getting back to the office after his luncheon with the chief of police. The official had been detained, and that had thrown Dave's schedule off completely. So he ate rapidly and discussed his business with the chief as he forced down his food. He was not very hungry, but he ate a hearty meal on the theory that he needed the energy to keep going. By the time he got back to the office, Dave was a little short of breath and somewhat dizzy. Also, he was annoyed by a pain in his chest that occasionally ran down into his left arm and hand. He barely had time to see the fourth edition out before hurrying into the editorial meeting. In the meeting he relaxed a little in his chair and felt somewhat better until the national advertising manager made him angry by charging that the paper was losing revenue because the editorial department would not support advertisers with local newstories.
At that point, Dave jumped up and began a heated oration on the responsibilities of the press. And just as his remarks had reached fever pitch, Dave suddenly felt a sharp, pressing pain deep inside his chest, under his breastbone. Beads of perspiration broke out on his forehead. He felt nauseated and very weak. His voice faltered and he collapsed to the floor. In his quiet room at the hospital, after the administration of oxygen had made his breathing easier, and an injection of medicine had relieved the pain in his chest, Dave began to realize what had happened. As a reporter he had once been assigned to the city's receiving hospital, and he recognized his own symptoms. He had suffered a heart attack. But what was going to happen now? Patients who had not died at the hospital or who had not been dead upon arrival, were always sent to other hospitals and he never had had occasion to follow up the story to see what happened afterward. Was he going to die? Or would he be an invalid the rest of his life, a burden to his family and an object of pity to his friends and colleagues?
A generation ago Dave's doctor probably would have given him only slight encouragement. For when coronary thrombosis first began to be accurately diagnosed in the mid-twenties, medical authorities regarded a three-year survival period as the best of good fortune. Today the average survival span, which includes the extremely bad cases as well as the good, may be about 10 years. So when I later discussed Dave's own case with him, I could cite from my own medical experience cases of patients who are in good health as much as 30 years after the attack.
