After reading about it, I didn't see how I could subject myself to the procedure. At the same time, I realized that if I didn't, I might never know the truth about my arteries, and I couldn't live with the uncertainty. How could this be happening to me, of all people?
I was a runner. I hadn't smoked even one cigarette in my life. I had the blood pressure of a college oarsman (110 over 70) and my recent cholesterol count of 133 was well below the national average. I was selling myself to myself, whistling past the graveyard, so to speak.
The newspaper stories on Fixx's death had said that his father had suffered a heart attack at 35 and died at age 43. As far as I knew I had no such problems with heredity, but with the dangers of high-fat diets now medically accepted, I began wondering about my yearlong peanut butter obsession, only recently overcome, and my even longer-lived obsessions with ice cream and cheeseburgers back in the days when cholesterol was a word for The New York Times crossword puzzle. In 1974 my cholesterol count had been 282. Had I clogged up my arteries then?
I decided that before my emotional roller coaster ran off its tracks I'd better get some advice—the more the better. I wanted a consensus, especially about the need for an angiogram. I sat down and detailed my plight in a letter, photocopied all 19 pages of my test results, enclosed my telephone number and sent the bulging parcel off to 10 physicians. Among them was George Sheehan, cardiologist, author and running guru, who had once sent me a two-page letter in response to a question about orthotics (special shoe inserts). The nine other cardiologists, their names collected from friends and from the Yellow Pages, included both doctors who specialized in cardiovascular testing and "new age" preventive-medicine types. I had no idea if I would get any responses, but it felt good just to make the effort.
Five days later, Sheehan phoned. He said that having seen my stress test/EKG, he would never have administered the thallium, and added that "You can continue running, as long as you don't race, and you'll probably be all right." He paused. "But you might not be comfortable living like that, and the only way to really free your mind is to have the angiogram." He referred me to a Dr. Ralph Oriscello, a cardiologist and director of Critical Care Medicine at the Elizabeth (N.J.) General Medical Center. "Ralph is a national treasure," Sheehan said. "He's a runner and he's well versed in everything going on in cardiology today." It was Friday, Nov. 16, and I immediately made an appointment with Oriscello for the following Monday. But later on Friday I kept an appointment I had made earlier with Dr. Judith Hochman at St. Luke's Hospital on Manhattan's West Side. I hadn't written to Hochman; a Massachusetts doctor friend had given me her name. When I'd phoned to make the appointment and told her about my case and that I was continuing to run, she'd suggested I might be better off taking "a nice walk." Given my increasingly suggestible state, she may as well have said, "You're his nurse? Well, if it's a nice day you might wheel him around the yard a bit, but make sure that he's bundled up."
At St. Luke's, Hochman, director of the Cardiac Care Unit, examined me, then lingered over my test results, apparently weighing her words. Finally, she said, "You seem to be the kind of person who would want to know the facts."
I began to experience a barely perceptible buzzing in my ears. I took a very deep, slow breath and asked, "What is it?" From some place far away, I heard the words, "high likelihood" and "coronary artery disease." Suddenly, I thought that it wouldn't matter very much if a 10,000-pound safe came crashing through the ceiling. It wasn't that I believed my life was in imminent danger, but my sense of myself certainly was. For the first time in my life I felt frail. Hochman seemed to sense my reaction and said, "Nine out of 10 people with this condition lead normal lives."
I looked down and away from her, my mind a jumble of thoughts: "Normal lives? I didn't want a normal life. I've run marathons. I want to run one when I'm 90. I've been good to myself. I haven't eaten an egg in years."
Hochman suggested that I begin taking a daily aspirin, a therapy popular with some physicians as a possible hedge against stroke and heart attack, and she offered me a prescription for nitroglycerin tablets for the vague tightness I'd been feeling at the top of my chest and in my throat. She called the tightness angina. I shook my head no. She seemed offended. She did suggest that I have the angiogram because, as she later explained in a letter to one of the other doctors I consulted, I was "so anxious about the whole issue and [seemed] to have a personality that could deal better with certainty than uncertainty."
The next day was Saturday, so I was surprised to hear from another of my 10 doctors, Stephen Scheidt of New York Hospital. When I'd phoned for an appointment, the secretary told me I would have to wait three weeks. That was before Scheidt had read my letter and seen my records. Now, on the phone, he said, "There are some inconsistencies [this word would soon become a major theme of my little drama] here. You've done an extraordinary amount of work in these tests." I thought I heard him shuffling my papers. "And yet, it's inconceivable that you have the disease described here." Scheidt agreed to see me the following Wednesday.