Samuel A. Kojoglanian, MD, FACC, FSCAI
Tony is a hard working 45 year old contractor who loves his cheesecakes. He is 6 feet tall, weighs 223, is obese, and has high blood pressure. After a stress test last year, I recommended that he decrease his portions, lose weight, and undergo an angiogram. He gained weight, and refused the angiogram.
One year later, I visited him in the emergency room. He had stopped taking his blood pressure pills, and was celebrating his wife’s birthday at the Cheesecake Factory ®. His wife thought he looked a bit ashy, but he didn’t agree. When his heart started to flutter and his head began to spin, he had to concede to being sick and needing help.
His heart raced at 180 beats per minute, and medications were given to slow his rate down. Because he continued to have an abnormal and potentially dangerous rhythm on the second day of his hospitalization, I placed an ultrasound camera probe down his mouth and esophagus and took pictures of his heart, making sure he had no clots in his heart chambers. Then I placed pads of his chest and back, sedated him, and shocked his heart into normal rhythm. Tony jumped up and shouted, “Ouch! That hurt like a truck ran over me!” Once he was completely awake, he didn’t remember anything, including our 18-wheeler drive-by special.
To complicate matters, he was so dehydrated upon admission that his kidneys were not working properly. He was a diligent worker, but neglected his care, damaging the foundation of his future health. His wife was by his bedside every hour of every day, suffering with him. Since I shocked his heart into normal rhythm, I wanted to shock his senses into the truth, by asking, “Tony, if you want to kill yourself, that’s your business, but how about your family? Do you want to hurt them? Do you want to leave them behind?” He sheepishly said, “No.”
Upon discharge, Tony is now taking his medications and losing weight. He will soon get an angiogram, and thanks to our friendly 18-wheeler episode, he has found that being noncompliant and obese is a selfish act. It does not consider others. It is self-serving. It is self-seeking. And it is self-destructive. It fails at all counts, and it causes unnecessary pain for the patient and the whole family.
Anyone up for an 18-wheeler drive-by special?