Philadelphia Medicine Spring 2020 - 18

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How I Became
a Better Doctor...
By Being a Cardiac Patient
By: Richard Cohen, MD

I

became a better doctor on the day I
became a cardiac patient. On that day
I experienced the helpless, vulnerable
and needy feelings of a patient's dependency
and blind trust on a physician who I did
not know. I suddenly realized how it feels
to be a patient.

During my entire life, I had been an athlete in excellent shape. My seven-day-a-week
schedule included seeing patients, being
an expert psychiatric witness for disability
cases, playing two hours of tennis, walking/
running for one hour, and ending the night
with one hour on a stationary bike.
I get to see my children all the time. I am so fortunate to get to
travel with them and play National Father-Son and Father-Daughter
Tennis Tournaments. We have been ranked #1 in the country many
times. I have won 16 gold balls in these tournaments, each symbolic
of a United States Championship.
As a busy Board Certified psychiatrist, I had been featured in an
article "Well Being: Tennis is Doctor's Favorite Medicine" by Art
Carey in the Philadelphia Inquirer posted May 2, 2011. The author
discussed my diet and exercise regime and how I used exercise to stay
healthy and to deal with the stress of being a physician.
At the end of 2018, I had a complete blood count performed
and the results indicated that I had a lipid panel of a healthy 30 year
old. My delusional bubble, however, burst in March 2019. I was the
number-one seed in a National Father-Daughter Tennis Tournament
in Chicago, Illinois. We were in the semifinal match. We had won
the first set, and we were up 3-0.
I fell, hit my head on the net post, and was feeling nauseated. I
checked for bleeding and continued playing, though I was not feeling
well. Five minutes later, I experienced symptoms of very extreme
gastrointestinal pain and nausea. I ran off the tennis court wanting
to vomit and get rid of the symptom so I could go back and finish
the match. I wanted to play in the finals the following day and try
to win the tournament.

18 Philadelphia Medicine : Spring 2020

The kind, competent, compassionate
and warm tournament director said I
looked gray and he promptly called
911. The paramedics came and said they
thought I may be having a heart attack.
I was in denial since I had no chest
pain and I thought I was super healthy;
therefore, I could not be experiencing
an acute myocardial infarction. I finally
agreed to let technicians perform an
EKG, and they told me that I had ST
elevation. Reality finally set in and I
realized I was having a heart attack. I
said, "Take me to the hospital."
At the Chicago hospital where I was taken, I told doctors and
staff I was a physician. To my surprise, they did not care. I was not
going to get any prioritized treatment. Despite all of my devotion
to medicine, I was not even getting their top physician to treat me.
I was being evaluated by a resident. I felt even more deflated.
In Chicago, they performed a cardiac catheterization and put
in one stent in one vessel in the right cardiac vessel. I had many
questions to ask, but everyone seemed very impatient and abrupt
with me, acting like this was just a very routine procedure. No one
ever adequately answered my questions. I was very disillusioned and
I felt very insignificant, scared and invisible.
I was discharged a few days later and was told my heart problem was fixed. I was instructed to follow up with a cardiologist in
Philadelphia when I got home.
The first night home I experienced chest pain. I was alarmed and
thought my stent may have collapsed so I went to the emergency
room of the Philadelphia-area hospital I knew had the best cardiac
staff. After another blood test, indicating raised troponin levels, I was
informed they needed to perform another cardiac catheterization.
I learned I had two more coronary artery blockages, each 95-99%,
in the left ventricle.
I was shocked. How could the doctor in Chicago make such a
significant mistake? What happened? I would never know.


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Philadelphia Medicine Spring 2020

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