feel your own mortality.

For the past few days, I have seen so many young people come in with heart attacks. It's amazing how in one simple day your life can change. I had that experience myself in a different capacity several months ago when I had a needle stick at work. I watch people, some with no prior medical problems, others who are obese, smokers or alcoholics absorb their close brink with death. It's made me think a lot more about prevention than I already do. Our way of life is integral to our health.

Last night, I took care of a patient who collapsed at home after arguing with family members. She has an underlying abnormality in her cardiac conduction system, called long QT syndrome. She had a pacemaker placed several years ago and was lost to follow-up. A sudden catecholamine surge such as arguing in her case can cause a person with this underlying medical condition to go into V.fib arrest, which is exactly what happened to her. The rather sad and unfortunate circumstance in her case is that her defibrillator did not go off and that's because her 'battery' literally had no life. She was overdue for replacement of her defibrillator. In talking to the family, there was no reasonable explanation why she did not continue to follow with anyone. My thought is that she did not understand the significance of her disease. This likely could have been prevented, which is utterly disturbing and sad to me. She came to me intubated, on pressors and bradycardic...essentially very sick. She's only 56.

When we think of prevention, we typically think of preventing the onset of disease which in the medical world is called primary prevention. There is also secondary and tertiary prevention, which is aimed at treatment and preventing complications of pre-existing disease. This is something that has recently began to interest me, inspiring me to spend a lot of my time empowering patients with knowledge about their medical condition. My experience last night only confirms this need and importance. If I can impact at least one life, my efforts will have been worth it.