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Coronary occlusion, denial and dissociation

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A doctor puts emotions aside in an emergency, but dissociation does not help when the illness is in the family

The speedometer reads 160 km/h. I am driving. My husband Anthony is in the passenger seat. He groans and writhes clutching his chest in that classic closed-fist gesture. We are two rural general practitioners in personal crisis. It is only 45 minutes since he won a bike race in the mountains.

The paramedics know we are coming. We round a bend. There is the ambulance. Both vehicles stop. His blood pressure is 80/40. His pulse is 42. They do an electrocardiogram and hand it to me. “Oh, no ST elevation,” I say, relieved. One. They snatch it back. “There’s elevation everywhere.” I am dismissed.

The paramedic regional manager arrives. He says they’ll thrombolyse here. Anthony is saying, “I want a hot cath.” This is ridiculous; soon the charade will stop. He is not having a heart attack. Two.

Our adult children who followed in another car are here now and standing on the roadside like white posts. I return to the ambulance. The paramedics are injecting tenecteplase intravenously. They have given morphine. Anthony’s groaning continues. They give more morphine, antiemetic, morphine, close the doors and drive the 5 minutes to the hospital where the protocol is completed. His myocardium throws off some cardiac arrhythmias…

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