The Other Side of the Stethoscope
medical experience to a new level, she says. She likens the experience to having children. "You know you like kids," she says, "but when you have them you find out what it's really like. Nobody tells you it's a love affair!"
Because of the shortage of useable organs, the UNOS does not test donor organs for cytomegalovirus (CMV). "All of these surgeries are urgent," Conry-Cantilena explains, "so you can't worry about things like that when the most important thing is giving you a life-saving organ." As it happens, she received her new lungs from a CMV-positive donor and has had some problems as a result.
"I have to keep reminding myself that I'm a patient now, not just a doc," she said. "These little setbacks keep you humble."
After a few "horrible" months fighting the CMV infection, Conry-Cantilena finally became CMVnegative early this year. She still performs a daily saline infusion to keep her creatinine levels and renal function in line. "I will always have the virus, but it won't always be active," she says.
Some of her NIH patients have HCV, and she recalls how she used to try to allay their fears. Today she truly knows what it means to be afraid of what's going on in your own body.
In the months just before her transplant, she was so weak she had to rely on her oldest children for transportation and could barely speak above a whisper. Today, the Bronx native happily drives—and yells, whenever she needs to.
To keep up her strength, Conry-Cantilena works out on an elliptical bike every day or takes walks along the Chesapeake and Ohio Canal near her home. She has put on some weight (before the transplant, she was down to 86 pounds on her 5'6" frame) and has even gone skiing. But the risk of infection means she's had to give up pets, gardening, and helping out at her youngest daughter's school. Her condition also dictates that she forgo a few other
"I used to pride myself on being very sensitive," cardiologist Bell says. But since his own heart attack, he believes he's better at both teaching and taking care of patients. "I would have sworn I was already compassionate," he adds.
activities that she has had much less trouble giving up—vacuuming, taking out the trash, and handling anything moldy. She also avoids airplanes, subways, and crowds. Otherwise, she leads a relatively normal life because, as she puts it, she can't live "in fear of setbacks."
James Bell, DMS cardiologist
Physicians tend to assume they'll never be patients—in part because "doctors are supposed to know better than get sick," quips Dr. James Bell, an associate professor of medicine at Dartmouth.
"That's part of the mystique." There's anelement of embarrassment, mixed with a large dose of denial, he says, when a
physician falls victim to an errant piece of plaque, an out-of-control cell, a weak muscle, or a common bacterium. Whatever malady a doctor helps patients avoid or survive, he or she should be immune to—or at least able to get rid of quickly. Right?
Bell, who practices cardiology at the Dartmouth-affiliated VA Medical Center in White River Junction, Vt., realizes now that his family history may have ignited his own interest in heart disease, since his father died after a heart attack while Bell was in medical school in New York. He has since then devoted more than 30 years to cardiology, in practice and in the classroom. It's safe to say that he knows the level of his own risk as well as he knows his own name.
"I've often said, 'If you have something, you go into that field,'" Bell comments.
For years at Dartmouth, Bell has given a lecture to medical students on the emotions that patients experience before, during, and after a heart attack. He mentions the power of mind-body interactions, the fact that anxiety can play a role in heart conditions, and the psychological reactions, including depression, that patients often have after a heart attack. Never doubting that he would recognize and take control of the situation should he experience the symptoms of a heart attack himself, Bell says today that "I thought I was mentally prepared." A practicing Buddhist, he went so far as to meditate on his own death, taking himself mentally through each step of the heart attack that might one day end his life. Nonetheless, his actual myocardial infarction came as a shock.
There he was, in his own home, watching a football game, when the very event that threatens the lives of his patients threatened him. His wife called an ambulance, and at that moment, Bell realized there was a 20 percent chance he would not make it through the next hour.
He did make it, however, spending four