Saturnino P. Javier, MD, FPCP, FPCC, FACC
Dr. Saturnino P. Javier is an interventional cardiologist at Makati Medical Center and Asian Hospital and Medical Center. He is a past president of the Philippine Heart Association (PHA) and past editor of PHA’s Newsbriefs
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This 54-year-old marketing executive arrived in the Emergency Room complaining of severe chest pain, difficulty of breathing and excessive sweating. He had a blood pressure that precipitously dropped to 80/40 mm Hg and a heart rate that lingered at 40 beats/min (the normal heart rate is 60-100 beats/min). The 12 lead electrocardiogram showed changes consistent with an acute heart attack – which meant a blood vessel of his heart had a significant blockage.
In no time at all, he was wheeled from the Emergency Room to the Cardiac Catheterization laboratory where an interventional procedure (like balloon angioplasty and stenting) to open up a clogged blood vessel could be performed. The attending physician was a close friend and colleague – who was apologetic for ‘inviting’ me to join him in this obviously life-threatening situation. The apologies were borne out of the fact that this was two days before Christmas eve – when the mood should not be somber and depressing but instead ought to be celebratory, jubilant, hopeful and euphoric.
But my friend and I were staring at a life-and-death situation. The wife was in tears – as she pleaded – “Please do everything you can.” (So, forget the celebratory mood. As a physician, one needed to rise to the occasion and respond to the call of medical duty.)
Expectedly, the main clinical problem was an occluded left artery – that cut off a substantial amount of blood flow to his heart. While in the laboratory, he went into cardiac arrests with life-threatening heartbeat irregularities five times which required electrical shocks. Each time he deteriorated onto the precipice of death, the electrical shock would bring him back.
In the end, the team was able to restore blood flow to his heart. A pumping device was inserted to support his blood pressure and rest his heart. He was connected to a mechanical ventilator. Medications were started to support his blood pressure and heart function. He managed to complete the procedure and was transferred to the Intensive Care Unit
Eventually thus, the nearly catastrophic situation became a huge and solid reason to be jubilant for my doctor friend and I, as much as it became a joyful Christmas moment for the spouse.
The narrative of saving one’s life as everyone awaits the coming of the Ultimate Life Giver strikes a poignant and humbling note. Every physician invariably strives to save a life whenever a threat comes – all within the limits of human capabilities and medical advancements, but boundlessly aided by Divine intervention – by Him from Whom it comes and flows.
This calls to mind a similar Yuletide situation a few years ago. On Christmas eve, I sounded off to my trainee that I was already off for a holiday break. Then a call came requesting me to attend to the husband of a colleague anesthesiologist who was in severe chest pain after a shopping spree. My initial response was to ask the trainee if the patient was aware that I was on a break. ‘Yes, but please just try to check, if he is still around to do an angiogram urgently, ” the physician wife pleaded to the trainee.
I remained consistent with my initial pronouncements – “Please tell them I am not available.” That could have been the easy end to the situation. But I tossed and turned on my bed, as I dealt with the guilt that I lied and that I could have taken the call of duty in response to someone in need.
In a few minutes, I called back the trainee to retract my initial statement and instructed him that I would be in the hospital soon – to do the coronary angiogram (a radiologic procedure of examining the blood vessels of his heart). The husband had severe coronary artery disease that needed emergency bypass surgery. He went through surgery very well (and remains in the pink of health up to today). Thus, it was a most opportune retraction that ultimately helped save a person’s life.
I refer to both merry Christmas anecdotes as good ‘saves’ – lives that were saved just right in the nick of time – and lest we forget – with the aid of the Divine Life Giver.