[PHOTO CREDIT: iStock / ilkercelik]
(This Article was Published in LLN in May, 2010 — Issue No. 3 — and First Appeared in The Florida Bar News in October, 2004.)
I have wondered why attorneys refuse to recognize their risk for a heart attack. I think I’ve found the reason: day-planners. I’ve checked—there’s no section for down time due to heart attack. Whether you are a trial lawyer, office practitioner, government lawyer, or anyone else that the public relies upon to solve its problems, you are at risk. If you are reading these words and think that it could not happen to you, then you could stop now and go no further. Every semester new lawyers graduate to take your place.
I write to share a personal experience with everyone, man or woman, who practices law. I am not going to bore you with the usual litany of statistics about heart attacks. Really, who wants to dwell on the fact that tonight there will be 50,000 heart attacks in the United States, one-half of which will be fatal? What woman wants to hear that after menopause the rate of first-time lethal heart attacks matches those of men? So, rather than bore you with statistics, I decided to share my story with you.
I had been appointed as counsel, with another lawyer, in a double-homicide, death penalty case. On the eve of trial, Monday, August 4, 1997, I was handwriting an emergency motion seeking change of venue, and a motion to dismiss. The two newspapers serving the small rural county not only blanketed the prospective venire with the gory details of the case, but also mentioned two admissions of my client that had been suppressed. The fact that one of the deadliest prosecutors in the state was handing the case really guaranteed my recipe for stress. Really, it was and is no different from a thousand similar scenarios in most lawyers’ daily lives. It was only going to take me 30 minutes to pen these out. Over two hours later I was still writing. Trouble was brewing, but I had to finish my work.
In order to finish my work, I ignored what I have since learned are the traditional symptoms of a heart attack. My first response to the heart attack was denial, thinking to myself, “I’ve got no time for this!” Let me make you aware of what was happening.
The first thing that I noticed was the sweat. Even for mid-August this was too much. And I thought, “Just drink more water and it will go away.” The next symptoms were much harder to ignore, but being a persistent man, I tried anyway. To understand what happened, imagine this: Take your index finger and place it on your breastbone; move you finger two inches to the left and press with all of your might, until you can touch your shoulder blade from the inside. There, you have it! Take the worst leg cramp that you’ve ever had; you know, the ones that split your toes wide apart, and transplant that pain to your chest. It doesn’t go away. No matter how hard you rub, or stretch, or bend or pray: it won’t go away. In addition to this crushing pain, I noticed that I had a metallic taste in my mouth. Later I was told that this metallic taste could be a result of the iron molecules leaching out of my heart muscle, which was damaged. I still didn’t stop: I finished the motions. I knew that I had turned out some good work. You probably would have done the same thing.
That night I couldn’t stop sweating; I couldn’t get cool; the cramping wouldn’t stop. Others symptoms I experienced that night were a need to vomit and void. So there I was: sweating, cramping, “voiding,” all for naught. I thought, “Dying on the toilet like Elvis; what a way to go!” That’s when I knew it was time to go to the hospital.
By the time that I let my wife take me to the hospital seven hours had elapsed. That’s one hour over the maximum time that blood thinners can effectively be used to possibly dissolve a clot. As I lay on the emergency room gurney, the doctors and nurse diagnosed me even before the blood protein work confirmed the attack. They could tell by the way I walked into the hospital, clutching my left wrist against my chest, that I had suffered an attack. During the ambulance ride to the heart center, the technicians began ripping open all kinds of sealed bags with needles, monitors, patches and tubes. I imagined how the meds were going to print out.
If you’re fortunate enough to be awake for the angioplasty, you will get to observe a scenario something like this one: After they inject you with dye, you can watch the surgeon wind his way through your right femoral artery with a probe, to either open the artery or implant a stent. The five major arteries of your heart look like the roots of a plant. You’re told that you have five arteries, but you can only see four clearly. Where’s the other one? Then the doctor tells you that if he cannot clear the blockage the procedure is over. In my case, he couldn’t, and it was.
I was a sole practitioner concentrating on criminal and family law. At the time of the attack I was 44, nonsmoker, slightly overweight normal guy, father of three girls. My total cholesterol was 176 and my blood pressure was 120/80. I didn’t fit into the physical indicators for a heart attack, really. However, the doctor told me about a Harvard study from the mid-70s wherein they found that through unrelenting stress a person can, and probably did in my case, “flex” their heart. That flex dislodged some plaque buildup which formed the clot.
Like most lawyers, I took too few vacations and worked at least half-days on the weekends. When you have a heart attack everyone tells you “it’s a wake-up call.” I felt that I didn’t need a wake-up call; I needed more time to get my work done. I needed to solve those problems that had been entrusted to me by my clients. And as I lay on the hospital bed feeling totally sorry for myself, someone brought me a cell phone. And I found myself laying in ICU at Bayonet Point Hospital with an intravenous needle in the back of my right hand, using that cell phone to sign up a new client.
That was my wake-up call. What will your’s be? (For further information about these issues, please contact the American Heart Association, or call your doctor.)
Judge Richard “Ric” A. Howard was admitted to the Florida Bar in 1978. His legal career has included serving as Lake County Division Chief for Florida’s Fifth Judicial Circuit State Attorney’s Office, as well as time spent in the private practice of law. In the year 2000 he began serving as a Fifth Judicial Circuit Judge in Citrus County, Florida. [PHOTO CREDIT: Provided]