Commentary — September 2017
Tex Med. 2017;113(9):10–11.
By Anand Mehendale, MD
In December 2015, I survived a coronary event. I was vacationing in India and was getting on a plane to go to the coast when I experienced the worst chest pain imaginable. It was in my chest, left arm, left jaw, and back.
It was terrifying. The terror came from my soul, and I knew that I was dying. There was no question about it. I collapsed in the airplane seat, and the only thought that came to my mind was, "God, please let me see my children one more time."
Amazingly, at that moment, everything became beautiful. Beauty may not be the right word, but language isn't particularly well-suited to describe the experience of confronting one's end. Beauty is as close as it gets. It wasn't a sense of beauty like seeing a lovely painting or hearing a beautiful song. The beauty came from within my soul. I was overcome. The chest pain was there, but it was irrelevant. I began to lose consciousness, and I remembered the bottle of nitroglycerin in my pocket. Why I had chosen to carry it despite never experiencing chest pain in my life I couldn't tell you. Just a feeling, I suppose.
Maybe it was God. Who knows? I placed two nitroglycerin pills under my tongue and I was "normal" in 60 seconds. No chest pain, but unfortunately, the beauty was gone as well, and I was back.
The day before I got on that plane, I was shopping in Pune, India, and I saw a frail, old woman in a white saree with a blue border like a Mother Teresa disciple staring at me. I stepped out of the car to ask her why she was rudely staring at me, and she stepped forward and made a sign of the cross on my heart and left.
I came back to the United States and had a successful bypass to fix a 95-percent blockage of my left main coronary artery, the so-called widow-maker. The surgery was successful, and I started back at work about three months thereafter.
I was advised by my well-wishers to slow down. "You are too sick! Don't work so hard," they would tell me. I agreed with them and started off slowly. But as many physicians know, a medical practice doesn't function part-time.
I quickly went back to being consumed by my work, and people would shake their heads as they reprimanded me for going back on my pledge to take it easy on myself.
It has now been 18 months since that day on the airplane. In the morning, I may be a bit physically tired and psychologically exhausted, but as I interact with my patients throughout the day, I become more and more energized. Come time to leave my office, no matter how fatigued my body is, I am always spiritually uplifted.
This is not without precedent. It's a phenomenon I began experiencing long before my coronary event. You see, I'm also a recovering addict. As my recovery flourished, I noticed that my interactions with my patients became more meaningful. I became a better human ― more human, in fact.
The essence of the physician-patient relationship is the pain of one human being and an offer of hope by another. It is assumed that in the power differential of this interaction, the physician is the "giver" and the patient is a "taker." We doctors even call ourselves "caregivers" for that very reason.
But the truth is that both parties thrive as a result of this special relationship with the other. Oftentimes, I notice that I get a lot more out of these patient interactions than I ever give. My patients nourish my soul just as much as I care for them. This only dawned on me after I was destroyed by addiction, surrendered to God, and then recovered. Once addiction defeated me, I stopped thinking of myself as merely a doctor and started thinking of myself as a human. My coronary event served only to cement this outlook.
Now, in my medical practice, I am not fearful. I am not afraid of the medical boards, Medicare, the Drug Enforcement Administration, or the insurance companies. Those are just nuisances that intrude upon my relationship with my patients. They have no power to take anything away from that relationship. Today, I keep my eye on the ball. As long as there are those experiencing pain, I will be there to offer hope.
Anand Mehendale, MD, is a neurologist in Kerrville.