December 9, 2011

Back in the  70’s, comedian Redd Foxx had a recurrent routine on his sitcom “Sanford and Son” in which he would feign “having the big one” while clutching his chest during times of stress. Everyone understood what the implication of his action was. Two Saturdays ago when I clutched my own chest, I was not feigning. I thought it was “the big one.”

It began as a typical Saturday with breakfast out with my wife and a stop at the farmer’s market for some fresh produce. We then took our normal neighborhood walk on that beautiful morning, but as we arrived back at our house, I felt it, this frightening pain in my chest like nothing I’ve ever felt before. Only one thought crashed through my brain — heart attack. It felt as though a giant hand had reached inside my chest cavity and squeezed mightily.

My wife, a nurse, immediately knew something was drastically wrong. I was pale, cold, and sweating, and could not mask the fear in my eyes. She rushed to get me an aspirin and called 911. I slumped on a living room chair fearing the worst.

The ambulance arrived, and though the grip had loosened, my symptoms dictated that I be taken to the emergency room. Upon arriving, I was hastily examined and hooked up to monitoring equipment — not at all how I envisioned my Saturday morning. It seemed as though the immediate crisis had passed; however, tests needed to be done.

The next several days brought a procession of doctors: the ER attending, a young Ethiopian nephrology fellow, a female Indian endocrinologist, a Vietnamese resident, the nephrology resident, and two cardiologists, each questioning, poking, and prodding me. The blood tests were so frequent my arm felt like a pin cushion. The first major test, a “perfusion scintigraphy at rest and post-exercise,” requiring an injection of radioactive substance, twenty minutes of scanning, resting, stress testing on a treadmill, a second radioactive injection, and a second scan, proved inconclusive due to “movement caused by breathing.” One wonders how one can endure two twenty-minute scans without breathing, a point I futilely raised with the Pakistani tech. This led to the decision to do a cardiac catheterization, a rather invasive (in my opinion) procedure with risks involved, but one that would be definitive. After a day of delays, this was accomplished. Results? No heart problem of any kind.

Then what the heck was it?

“Well,” the cardiologist said, “we don’t really know what it was, but we did rule out the one thing that it wasn’t, and since that was the deadly one, we’re in good shape.” He  speculated that it was most likely something called an esophageal spasm, a physiological occurrence that mimics a heart attack but is basically innocuous (except for the fear involved).

The day following my hospital release, I went for a follow-up visit with my own doctor. He reminds me of Conan O’Brian both in looks and demeanor, which made the story he told me as I sat on his examining table all the more humorous.

After graduating medical school, he became the only doctor in a small town in the middle of nowhere in the Nevada desert as part of a deal to pay  off his government loans. One day he decided to visit Las Vegas. Being a Jersey native and having heard so much about it, this seemed like the time to go if ever he was going to. The one hundred fifty mile drive through the desert in one hundred degree heat drained him, so as he reached the outskirts of the city, he saw a welcome oasis in the form of a Mexican restaurant, and there he stopped.

He entered the cantina, plunging into the cool darkness of the air-conditioned joint. Sitting at a back table of the empty room, a large bowl of taco chips with an accompanying saucer of spicy salsa was delivered, which he devoured in short order, as he did the Margarita that followed close behind.  Suddenly, his chest felt as though a five thousand pound elephant had sat on it. He couldn’t breathe. He was sweating so profusely that it poured off his forehead and dripped on the table. There was no one around to help.

Well, he thought, either I’m going to die alone right here, or it will pass in a few minutes. Luckily, it was the latter. As he sat there, mortified at the thought of being a doctor in this situation, he concluded that the rapid temperature change and the sudden ingestion of a large amount of chips, spicy dip, and a cold drink triggered an esophageal spasm. “So,” he said in smiling camaraderie, “you’re not alone! It hadn’t happened before, and hasn’t since,” he chuckled, “but now I have a good story to tell my patients.”

He told me he had been as scared as I was, but there were no real medical repercussions. This was reassuring, and after all, I didn’t have to go all the way to Nevada to experience mine.

And now I have a story to tell, too.



  1. So what did you buy at farmers market??? Oh by the way, glad its was only a esophageal spasm.

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