A Piece of My Mind Section Editor: Roxanne
K. Young, Associate Editor.
The sound of a coffin hitting earth is a sound utterly
serious. —Antonio Machado, "The Burial of a Friend"
Give wine. Give bread. . . . Sit. Feast on your life. —Derek Walcott,
"Love After Love"
I think about him several times a year even now, more than 20 years
later. When I do it is with uncomfortable clarity and a surge of briefly incapacitating
sadness and guilt. He had come to the office at the age of 68, troubled by
exertional chest tightness and dyspnea. Intelligent and gentle, he was the
kind of person you would look forward to seeing over the years. His physical
examination revealed a long, late-peaking systolic ejection murmur suggestive
of severe aortic stenosis. My training, completed just months before, had
taught me that it was too risky to exercise such patients to assess whether
their symptoms were cardiac in origin. Rather, cardiac catheterization to
determine the severity of the stenosis and coronary angiography in preparation
for aortic valve replacement were appropriate.
Hergott LJ. Playing the. JAMA. 2002;288(20):2516–2517. doi:10.1001/jama.288.20.2516
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