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Something new has happened. There is a buzz in the air in medical meetings all across the country. It's a familiar andwonderful feeling. Where we are with heart disease in the year2003 is the same place we were with infectious diseases just beforethe discovery of penicillin, where we were with dentistryjust before the advent of fluoridation, where we were with polioon the eve of the Salk vaccine -- which is to say, we are on thecusp of an enormous breakthrough. We are about to treat peoplefor heart attack before they get sick. We are about to preventthem from dying. This is the work of the oldest brother in theChinese parable.
After the widespread introduction of fluoridated water, toothdecay all but disappeared as an American health problem. I'mtold dental income (for general practitioners, of course) droppedprecipitously, and that's why today everyone seems to be an orthodontist.With any luck it's going to be the same with cardiacspecialists. I run a cardiac surgery intensive care unit (ICU).Follow the program in this book and you can put me out of business. That's okay. In fact, I'd be thrilled. I've seen enough damage.I've seen enough people die before their time.
There are two distinct parts to The Heart of the Matter: thepremise and the promise.
The premise is this: Nobody has ever fully understood whatcauses heart attacks. It's surprising but true. And because wedidn't understand what caused them, we couldn't really get ahandle on how to prevent them. All that has changed radicallyand recently. The past few years have seen an explosion of researchpapers and presentations confirming the new heart attacktheory. We now know what causes heart attacks. The answer isprobably going to surprise you (it certainly surprised most doctors).And because we know what causes them, we know how toprotect you from them. I will show you what you need to do. It'san amazingly simple and straightforward program.
Through an astounding stroke of good fortune, our new understandingof heart attacks has occurred at the same time whenwe have found new medicines that can target the heart attackmechanism precisely and powerfully. Our understanding hasalso led us to use older medications in new ways, to turn off theheart attack mechanism.
The promise is this: Ours will be the last generation to die ofpremature heart disease in this country.
Bold talk? Not really. In this book you'll find an easily administeredself-test -- so that you can assess your own susceptibilityto heart disease -- as well as a formula for beating thedisease and a clear, concise explanation for why this formulawill work.
To understand how excited I am about this new program, youneed to "walk a mile in my shoes" and see heart disease as Ihave seen it during my career. By training I am an internist and an anesthesiologist. That makes me an intensivist. My specialtyis cardiac care. As a director of the open heart intensive careunit at Columbia Presbyterian Hospital in New York, I witnessdaily the destruction wrought by heart disease. I see the devastationand debris caused by the major killer known to humankind,and it sickens me.
Each day as I make rounds I see the shattered lives and devastatedhopes and dreams of people who are just like you andme. They have wives, husbands, children; they have plans.They have wept at weddings, cheered at football games; theyhave spilled food on the Thanksgiving tablecloth. Now they areat the brink of death. They depend upon ventilators to breathe.They depend upon powerful medications to circulate theirblood. Many will not survive. When people do not take care ofthemselves, or their bodies malfunction despite their best intentions,I see the sad results: patients who need heart transplants,artificial hearts, open heart surgery; patients who are desperately ill.
I see people like Jose Rodriguez, who told me one daythrough a weary, postsurgical smile that he now knew what it feltlike to have an elephant sit on his chest. Two days later, despitethe love of his family and the best efforts of medical science,Jose was dead.
People like Josephine Smith, who showed up in the ICU a fewhours after collapsing in the produce aisle of her local A & P. OrHoward Martin, a man in his late forties whose weekly round ofgolf was interrupted by a massive coronary. Imagine the shock!You're out on a sun-splashed par five in the middle of the afternoon,and the next thing you know, you're hooked up to a heart-lungbypass machine. It's that traumatic, that disturbing.
I have seen too much of this. I speak to patients, and I hear a familiar story: "Everything was fine, and then all of a sudden, Igot this pain." I speak to families and I hear it again: "He wassuch an active, vigorous man. Now look at him. I don't knowhow I'm going to get through this."
As I spoke to those patients who could speak, and as I soughtto comfort the families of those who might die, I became angry. Ididn't know where to direct my anger, at first. It seemed easy toblame the victims. After all, they had smoked or eaten fatty foodor rarely exercised. Eventually I realized anger wasn't going toget me anywhere. If I wanted to help my patients, I needed to focuson the real culprit: the disease itself ...
The Heart of the Matter
Excerpted from The Heart of the Matter: The Three Key Breakthroughs to Preventing Heart Attacks by Peter Salgo, Joe Layden
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
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