Open Heart (56 page)

placebo effect with,
154

Barker, David,
30

Barnard, Christiaan,
281

baseball,
11
,
13
,
190
–
91
,
235
–
36

basketball,
13
–
14
,
17
,
80
,
120

Baycol,
133

Bay State Hospital (Springfield, Mass.),
8

beating-heart surgery,
33

Beck, Dr.,
70
,
71

beta-blockers,
69
,
70

Bible,
116
–
17
,
212

Big Man
(Neugeboren),
77
,
213
–
14

Black Panthers,
189
–
90
,
192

blood clots,
29
,
43
,
70
,
94
,
258
,
See also
plaque

blood platelets,
70

blood pressure

levels of the author prior to surgery,
5
,
56
,
69

rise due to medical exam,
251

as risk factor,
5
,
24
,
249
,
251

blood vessels

collateral,
6
,
130
,
131

reaction to chronic high blood pressure,
251

body.
See also
mind-body connection

ability to heal itself,
34
,
161
,
264

feelings of dissociation,
121
,
123

temperature during surgery,
4
,
279
,
280

brain

damage.
See
neurological conditions

effects of aging,
222

endorphins released by,
155

inability to heal itself,
87
,
162
,
216
–
17

wonders of the,
15

breast cancer,
28

breathing difficulty

with angina,
246

of the author: prior to surgery,
49
,
51
,
52
,
55
–
57
; two years after surgery,
122
–
23

with viral heart disease,
248

breath strength test,
56

Bronx State Hospital (Bronx, N.Y.),
19
–
20

Brooklyn Dodgers,
11
,
13
,
190
–
91
,
235
–
36

Brumlik, Dr. Joseph V.,
242
–
43

bypass.
See
coronary bypass

Cabin, Dr. Henry

angiogram by,
3
,
6
,
80
,
83

background,
3
,
22

initial visit with,
1
–
6
,
8
–
9

postsurgery checkups with,
22
,
127
,
130

views: on being “cured,”
233
; on postsurgery Norvasc,
123

calcium channel blockers,
123
,
263

cancer.
See also
Hodgkin's disease

breast,
28

cervical,
32

chemotherapy and life expectancy,
99
,
112

future scenario for treatment,
116

genetic aspects,
117

Li-Fraumeni cancer syndrome,
274

limitations in medical knowledge,
91

mortality rates,
91
,
111
–
13

MRI for diagnosis,
231

P53 system and the aging process,
272
–
75

prostate,
33
,
300

radiation therapy,
77

risk factors,
111
,
113
,
116
,
117

screening and prevention activities,
112
,
113
,
116
,
117

trends in types,
112

cardiac auscultation,
35
–
36

cardiac care unit,
14
,
43
,
94
,
243

cardiac electrophysiology,
263

cardiac resuscitation,
27
,
38

cardiology

historical background,
92
–
93

limitations of medical knowledge.
See
medical knowledge: limitations in

multidisciplinary nature of,
277

nuclear,
33
,
263

quality of care.
See
managed care; physicians: relationship with the patient

cardiomyopathy,
70
,
82

cardioversion,
38

caregiving

by the author,
5
,
13
,
58

author's anxiety about,
42
,
58
,
65

for chronic conditions, 1990 data,
172

Care of the Psyche
(Jackson),
158
–
59

CAT scan,
95
,
118
,
133
,
222
,
230
–
31

Centers for Disease Control and Prevention,
46

cervical cancer,
32

Charyn, Jerry,
80

chest pain or discomfort

author's symptoms prior to surgery,
50
,
51
,
52
,
55
,
59
,
64

heart attack with lack of,
28

stopping movement until it recedes,
65

as symptom of heart disease,
5
,
246

childhood diseases,
86
–
94
,
109
–
10
,
See also specific diseases

Chlamydia pneumoniae
,
259
,
260

chlorpromazine,
268
,
269

cholera,
102

cholesterol.
See also
cholesterol-lowering medications

author's blood level: after surgery,
134
; prior to surgery,
5
,
59
,
69

heart disease with normal levels,
29
,
259

LDL and HDL,
29
,
132

risk of death with low,
30

cholesterol-lowering medications,
29
,
31
–
32
,
99
,
133
,
260
,
262
–
63

cholestyramine,
262

Christopher Reeve Paralysis Foundation,
269

Chronic Care in America: A 21st Century Challenge
(Robert Wood Johnson Foundation),
171
–
72

cigarette smoking.
See
smoking

clinical science

limitations in,
33
,
175
–
76

rise in the influence of,
168
–
69

clozapine,
150

cognitive losses, risk with coronary bypass,
9
,
44

colchicine,
140
,
141
,
143

collateral blood vessels,
6
,
130
,
131

Columbine High School,
234

The Coming Plague
(Garrett),
255

communication in relationships, men vs. women,
125

compassion,
20
,
212
,
265
–
66

computed tomography.
See
CAT scan; CT screen

conflicts of interest,
37
,
261
–
62
,
290

Cooley Dickinson Hospital (Northampton, Mass.),
68

coronary bypass

of the author: diagnosis,
4
; exercise in the hospital after,
14
; “last words” before,
13
; procedure,
13
,
83
–
85
,
179
; scars in penis due to catheterization,
140
; symptoms prior to,
5
,
8
,
47
,
49
–
62
; timeframe of surgery,
13
; use of his own arteries,
84
,
123

beating-heart,
33

cost of surgery,
43

definition,
4

effects of cholesterol-lowering medications,
29

mental decline from,
44

no cure for,
21
,
22

number of patients annually,
118

number performed annually,
5

percent of patients who need second,
43

risks and benefits,
9
,
43
–
44

unnecessary overuse of,
37

use of heart-lung machine,
4
,
13
,
277
–
80

coronary disease.
See
heart disease

cortisone,
268

C-reactive protein,
258
–
59

CT screen,
132
,
133

cultural aspects of

disease transmission, vs. biology of organism,
183
–
84
,
194

of infant mortality,
181
–
82

influence on values,
45
,
237

not showing fear,
48

of poverty,
184
–
85

cystic fibrosis,
250

cytomegalovirus,
260

Dalai Lama,
263

Darwinian medicine,
252
–
57
,
259
,
271
,
272

The Deadly Truth: A History of Disease in America
(Grob),
86

death.
See also
life expectancy

author imagining his,
78

coming to terms with,
73

end-of-life care,
163
,
289

medical data.
See
mortality preparations for,
82
–
83

as a series of preventable diseases,
98

defibrillator,
38
,
95
,
243
,
290

Demetri, Mrs.,
89

depression

clinical judgment in diagnosis,
204

following a heart attack,
154

of Friedland's father,
196

impact of new treatments,
43

placebo effect with,
154

postsurgical,
48

rank in global burden of disease,
204

DeWood, Marcus,
92
–
93

diabetes

coexistence with heart disease,
28

complications,
107

incidence rate,
107

inflammation and,
272

preventive measures,
106
–
7

risk factors,
106
–
7
,
249

type
2
,
106
–
7
,
249

diagnosis

as an art: importance of listening.
See
listening to the patient; role of instinct,
101
,
105
,
247
; role of judgment.
See
physicians: judgment skills; role of technology,
32
,
34
,
43
,
95
,
147
,
233
; uncertainty and probability,
292
,
296

of the author: Dr. Flynn's analysis of the echocardiogram,
70
; Dr. Flynn's analysis of the EKG,
69
–
70
; Helfant's analysis of the echocardiogram,
82
; for Hodgkin's disease in college,
76
; “missed,”
8
,
24
,
28
,
31
,
47
,
74
; possible viral infection,
8
,
70
,
71
,
247
; reaction to,
3
–
4

categories, changes over time,
92

danger of dependence on technology.
See
technology: vs. listening to the patient

heart disease

cardiac care unit,
14
,
43
,
94
,
243

difficulties and limitations,
16
,
28
–
29
,
30
-
31
: test results,
32
–
34
,
248
; evaluation of heart sounds,
35
–
36
; “missed,”
29
,
32
,
248
–
49

percent of information in patient history,
38

physician conflicts of interest,
37
,
261
,
290

diet

of the author,
134

as risk factor for cancer,
116

as risk factor for heart disease,
24
,
106
,
260
–
63

as risk factor for type 2 diabetes,
107

digestive system,
91
,
109
,
156
,
See also
peptic ulcer

digoxin,
86

diphtheria,
90
,
109
,
110
,
271

direct-to-consumer marketing of drugs,
26
,
96
–
97
,
260
,
261
–
62
,
290

disease.
See also
infectious disease