Lately we’ve had a run of middle-aged men in our unit, and the outcomes were not very good. One hadn’t been to a doctor in years. One day he was out driving, and started to feel funny. He pulled over and called 911. Diagnosis: a bleed into the brainstem. Cause: undiscovered and uncontrolled hypertension. If he’d been to see a doctor, the high blood pressure could have been diagnosed and treated. Instead, he will live out the remainder of his days in a sub-acute facility (kind of one step above a nursing home), unable to move one side, unable to talk or eat. On a good day, he can communicate somewhat by moving one arm and blinking, but I hadn’t seen him answer or indicate that he understood more complex conversations. He has an incredibly supportive family, but they have lost their husband/father/uncle/brother in a very heartbreaking way.

The other patient had been ignoring chest pain for years. Yes, I said years. His family tried to get him to go see a doctor, but he adamantly refused. Consequently, his heart stopped while sitting at the kitchen table one day, and he has never regained conciousness. He never will. He is not brain dead, so it’s difficult for his family to “pull the plug” so to speak. He was a big, strong man just a little while ago, working a very hard and physical job.

The changes these families have gone through in a very short time are staggering. Their breadwinners will never go to work again. They’ll never go on family vacations again. She’ll never wake up next to him, and the kids will never again ask him for the car keys.

Sometimes illnesses are very sudden, and sometimes they give out vague warnings. What I have witnessed with these two families is heartbreaking. The worst part is – both situations could have been preventable. A simple blood pressure pill. A trip to the cardiac lab, maybe a day in the hospital. I can only speculate why our patient decided to ignore his chest pain for so long. Maybe he was afraid of what would be found. Maybe he was concerned about finances, was afraid of surgery or hospitals, or felt like he didn’t have time to go get checked out. Maybe because the pain persisted so long without any major catastrophes, his denial fooled him into thinking it wasn’t serious.

Where did all of that get him? A life that is over and a family that is devastated. The first patient I described can look forward to a minimally responsive mental state; probably just enough to realize what has happened.

Medical care can be extremely beneficial when the patient presents early with their problem. I’m not saying that you should run to your nearest ER with every ache and pain. But I think that if more people took the time to get to know their bodies, they’d be more clued in when something starts going wrong. Rely on your intuition; I have a feeling that most people know that something isn’t quite right, but wait for it to pass. If you have a vague feeling that something is wrong, make an appointment to see your doctor. If you have chest pain (even if it goes away when you sit down), go to the ER and get it checked out. Sometimes heart attack symptoms are atypical; sometimes you’ll just feel more out of breath, or you’ll feel like you have a weird tooth/jawache that doesn’t feel like other toothaches you’ve had.

What I really want to drive home is this: if you’re lucky enough to have “warning” symptoms, pay attention to them. Do something about it. Denial does not buy you time.