Parsing medical truth in the Bernie Sanders health statement
political disclosure: I vote Democratic. Medical and legal disclosure: I am not Bernie’s doctor and I have no insider knowledge of his condition, so this essay is speculation.
**Update: it’s official, as confirmed by a report in the NY Times, my speculative essay written below was precisely correct**
In 2019 plain old-fashioned straight talk is tough to come by. Remember the old days, when you’d get fired, instead of “downsized” or “outsourced?” Couples used to divorce but then they started “deciding to separate” and now some just “consciously uncouple”. I don’t ever expect sincere talk from President Trump, but I was disappointed by the egregiously understated and minimizing statement released by Senator Sanders’s camp today.
So permit me, a straight-shooting ER doc, to interpret this brief statement.
“Sanders ‘experienced some chest discomfort’ during a Tuesday evening campaign event. Following medical evaluation and testing he was found to have a blockage in one artery and two stents were successfully inserted. Sen. Sanders is conversing and in good spirits. He will be resting up over the next few days.”
He “experienced some chest discomfort”. He was having chest discomfort, which was the primary symptom of him having a heart attack. Heart attacks present with chest pressure, chest pain, or chest discomfort. The use of the word “discomfort” downplays the symptoms and in reality, he was feeling bad enough to be rushed to a hospital.
“Following medical evaluation” refers to the EKG and troponin test the ER would have hurried to do. This is done STAT because heart tissue was dying.
“He was found to have a blockage in one artery.” You don’t need an ER doctor to interpret this line, just use dictionary.com. Blockage of a coronary artery IS the definition of a heart attack. Maybe it sounds like great news that there was a blockage in only one artery, but since there are just 2 arteries — a right coronary and a left coronary — it is still very dangerous.
So there it is: Bernie Sanders had a Heart Attack.
“Two stents were successfully inserted. Sen. Sanders is conversing and in good spirits.” This is very good news that the stents were inserted successfully, and that Senator Sanders is in good spirits after surviving a heart attack. Unfortunately, it leaves a few questions unanswered (see next statement)
“He will be resting up over the next few days.” Yes, hopefully, he does get some rest but his next few days in the hospital are really going to be spent answering the big questions: How much heart muscle died during this heart attack? Are there are other subacute blockages that will need stents, or even bypass surgery? What will the Senator’s tolerance for activity be for the next few months?
As a Physician, I owe it to my patients to be straightforward and clear because it helps ensure an honest conversation and sets realistic expectations. My good friend can be considered voluptuous or even well-fed, but for a patient with the same BMI the word obese is the correct medical term. Or, while that spot in Grandma’s lung sounds nicer when called a mass or a tumor but it’s cancer, so shouldn’t I use the “C” word? That way she and your family can start wrapping your heads around the next steps in her care.
In a similar fashion, Bernie didn’t have just a common heart procedure, Senator Sanders suffered a heart attack and was rushed to a lifesaving procedure. His supporters and voters deserve to understand the gravity of the situation so that we can start wrapping our heads around the next steps this election cycle will take.