The call came Sunday morning, just after I had returned from a bike ride on one of those rare, glorious, sunny Cleveland days.
"It's your doctor," my wife said, as she handed me the phone. Never a good sign, your doctor calling on a weekend.
I had recently seen him for my routine physical, where I had been found to have high blood pressure. I tried to explain it away, blaming the morning traffic as I dropped off my children at camp, drinking a tall cup of coffee and running to my appointment. But my wise doctor ignored my attempts to minimize it and had referred me for a stress echo, an ultrasound of the heart, followed by a run on the treadmill, followed by another ultrasound of the heart. I had completed the test just two days earlier.
"Your resting echo images" — the ones before I exercised — "showed wall motion abnormalities in the left circumflex distribution," he said. "You need to see a cardiologist." Translation: Your heart muscle isn't moving in a region fed by one of the three main blood supplies to the heart. You've had a silent heart attack sometime in the past.
I sat down in the living room, the only sounds being those of the wood clock on the mantelpiece, and the distant murmur of my wife and children chattering away in the other room. Time passing, and family.
"I'll e-mail him and copy you right now, to get you in," my doctor concluded. I thanked him, my brain too jolted to generate any clarifying questions.
A heart attack. It was official. My dad, his father and my great-grandfather did not bother to pass down to me their good looks, but they had managed to secure in their patrilineage coronary artery disease: All three had died suddenly, of cardiac arrest. I was on deck.
True to my doctor's word, the e-mail came across my iPhone within the hour. And then I waited for a "reply to all" from the cardiologist.
And waited.
And checked my e-mail more times than I'm comfortable admitting publicly.
I revisited past illnesses, trying to identify the one concealing a heart attack: the upper respiratory tract infection that left me short of breath; the chest pain a couple of days after a vigorous upper body workout at the gym.
That afternoon I called a friend who is a cardiologist, and she kindly reviewed my echo report.
"It's probably just an error – this doesn't make any sense at all. Don't worry," she said.
That helped for a few hours, until it didn't. I later talked to a friend who specializes in cardiac imaging, who was much more blunt.
"You're being an idiot," he told me. "This has to be a bad test. Why are you letting this bother you?"
Because the men in my family die from heart attacks. And while I can modify my lifestyle to avoid eating gribnitz — fried chicken fat — spread on rye bread like my grandfather, and can exercise regularly unlike my father, I can't escape their genes.
A couple of days passed without an e-mail from the cardiologist. I called his office and left a message. My wife noticed I was distracted.
"You're not letting this bother you, are you?" she asked.
I told her I was.
She reminded me that when one of my patients calls, concerned that they have leukemia because of a low platelet count, that I always reassure them that the test was probably wrong and that they should get it rechecked. "You've had two doctors tell you the same thing. Why can't you follow your own advice?"
Because this is emotional, not logical.
The next day I called the cardiologist's office again, and he scheduled a more detailed ultrasound. I underwent the test and saw him the following day.
"Your repeat echo was stone-cold normal," he told me. "The first one was probably just a technical error, involving where the probe was held." He brought up the images on the computer to show me the differences, and was very apologetic.
It happens. Medicine is not an exact science, and even routine tests have variability.
That night, back home, we had a celebratory dinner, butter and cheese be damned. The phone rang during the meal, and I let it go to voice mail. I listened to the message as we cleaned up, from a distant cousin.
"I got some news today, from my doctor," he said, sounding nervous. "I have prostate cancer, and I'd love to get some advice on what to do next."
I called him right back. I didn't want him to have to wait to hear from me one second longer than necessary.
