Author: wellthy

Participating in a patient’s first heart attack can be an extremely stressful event. Forty years ago, I was an ER doc.  At the end of a typical shift, I would come home to my wife and, often, would remark about how nervous family docs got when dealing with emergencies like heart attacks.

Many years later, I was the family doc and heart attacks were unnerving.  Yes, I knew what to do.  We had an emergency protocol and handled heart attacks well.  Even though we never lost a soul, it was still unnerving.  In an article published nationally in 2012 I wrote:

Today’s heart attack was textbook perfect.  I’m in room one with a patient.  Three rapid and insistent knocks on the door and the door opens.  “Doc, I need you in room three now!”  The look on Ginny’s face said it all.  The patient in room three was conscious, pale, sweaty, and in pain.  It takes 90 seconds to ask a rapid-fire procession of questions.  Heart attack, for sure.  Rapid fire orders, nurse one brings oxygen, aspirin, and nitroglycerin: all lifesaving treatments in a heart attack.  Nurse two is on the phone with the paramedics.  The front desk gathers information the paramedics will need and won’t have to waste time collecting on their own.

After reassessing vital signs, 325 mg of aspirin are given to the patient.  “Chew this please.  It will taste lousy.”  Oxygen canulas in place, nitroglycerin given.  “You are going to get the worst headache you’ve ever had.  How’s your chest pain?”

Minutes seem like hours, but Lake Zurich’s paramedics arrive promptly.  They go into action.  Monitor, IV’s, EKG done efficiently.  Lake Zurich’s paramedics are, literally, a lifesaver.   Their training, skills, and equipment make them indispensable.  Heart attack confirmed; ER notified of “cardiac alert.”

Time is of the essence as prompt care preserves heart function.  “Cardiac alert” is the equivalent of “Defcon One.”  The cardiac catheterization lab goes into motion.  The on-call cardiologist is notified and is in transit.  The ER gears up for incoming.  As the ambulance rolls into the ER, everything is in place.

When it all comes together, it’s a beautiful thing.  The call comes in from the cath lab.  The patient is stable; the blocked artery is open.  All is well.  I finally can breathe.

Time is of the essence. Paramedics are well-trained (actually, they are incredible) and drive around in a mobile intensive care unit.  If you think you are having a heart attack, stay where you are and call the paramedics.  The minutes you save may well be what saves your life. Remember, please don’t drive.  Please don’t take a “wait and see” attitude.  Make sure you survive your first heart attack by acting quickly.  Then work hard on being healthy so that you don’t experience a second one.

Now, in retirement, it all seems like a dream. In reviewing my past articles, I came across this one.  For the briefest of time, I found myself back in room one.  The young and vital Dr. Segal doing what I was trained to do, doing what I was destined to do!  For that brief moment, I was alive again!  Then reality sets in and I’m old and fairly useless.

I write in hopes that someone who needs care finds it in my words.  My hope is that you, the reader, will share this article with your loved ones and perhaps, since time is of essence, will save another life.

(Editorial note: He is not old and useless.  Yes, we have gotten older; but we are still valuable human beings with vast knowledge from our many years of knowledge, education and experience. Dr. Segal still has much to offer, even if he can’t practice medicine as he did in the office as a younger man.  I thank God every day that he is my man and partner in this journey called “life.”)

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Why?  Why won’t you tell me why?  I need to know!  If I know, I can help!  I’ve been practicing medicine more than half of my life.  You would think I would know why, but I don’t.

I’m frustrated.  I’ve learned so much, studied so hard and worked all my life to provide the best care I can.  No matter!  Unless I can find this last piece of the puzzle, it may all be for naught.  Why?  Tell me why!

Why won’t you take care of yourself?  Is a little exercise too much to ask for?  Is cutting back on bacon and salt so hard that it’s worth cutting your life short?  Life is so precious!

Why must you harm yourself?  Sure, smoking is an addiction.  Shouldn’t living “well” be an addiction?  Isn’t the risk of cancer enough of a threat?  Tell me why you won’t listen to your body.  You cough every morning.  You’ve been coughing for months.  You want a cough medicine.  You’ll take a cough medicine, but you won’t stop smoking.  Why?

I’m frustrated.  I don’t get it!  You’ll take medicine for your diabetes, blood pressure or emphysema but you won’t take care of yourself.  You’ll suffer through surgery and chemotherapy for your cancer, but you won’t take care of yourself.

Proper diet and exercise is the one prescription you won’t follow.  Why?  Why suffer at your own hand?  Why make your family suffer?  Why?  Please tell me why.

Is exercise really good for you? I’ve spent the last 40 years encouraging patients to exercise on a regular basis.  My brother owned a gym and exercised every day of his life.  He swears by it. I have exercised off and on for years.  I swear at it!

It seems that every time I exercise, I get hurt.  The latest episode started when I started back in physical therapy.  The therapist has me doing bridges and I sprained my right groin and hip area last week doing bridges at home. My gait was already poor from Parkinson’s and the addition of a limp from the right groin sprain has flared my back.  If exercise is good for you, you certainly couldn’t prove it by my experiences. Is it any wonder I hate to exercise?

My brother who has exercised his entire life had a stroke anyway.  Now, if you are a proponent of exercise, you’d say that exercising for a lifetime has allowed him to survive his stroke and recover faster.  You might be right.  (Certainly, exercise did not keep him from stroking.)

On the other hand, some of my patients believe that you have a fixed number of heartbeats to use in your lifetime and that when you run out, you die.  They would argue that exercise uses up their precious heartbeats faster, ending in a quicker demise.  I wish I could agree with them.  By agreeing with them, I could eliminate my need to exercise. (Of course, sex elevates my heart rate.  If they are right, at least I’ll die smiling.) The main problem I have is that if I don’t get back to exercising, my weight will continue its upward spiral and either I’ll have to give up eating or get a crane to help me get into bed.  Frankly, I love eating almost as much as I love sex so I can’t give up eating. I guess I’ll take a walk. 

Eating and napping are the two tasks I have become expert at and the only enjoyable things left since retiring and getting old.  With advancing age, my third love, sex, is starting to resemble exercise.    Renee, it’s time to exercise.  I think I’ve got a few heart beats left to spend!

Here’s your joke and a song. 

The only reason I would take up jogging is so that I could hear heavy breathing again.

WHY?  Over the 40 years I practiced medicine, the most difficult questions to answer were always the “why” questions.  Why me? Why her? Why him?  The what, when, and how questions were straight forward, all you had to do was follow the science.   The “why” questions were the ones that haunt you.  They were also the ones that needed answering the most.

We started asking “why” during our childhood.  Mommy, why is there a moon?  Why do you have to go to work?  Why can’t we have a dog?  If you have raised children, you know what I’m talking about.  In early childhood, whys grow in intensity and while the answers are relatively easy, they are rarely satisfying to the inquisitive mind.  Why? Why? Why? It seems every answer provokes another question.

As we age, most of us become less interested in the why and more interested in the practical solutions to the why.  Confused?  I am.  As a physician/scientist, the “why” is just as important as the who, what, when and where questions.  As a physician, being able to answer the “why” is often critical.  The “why” I referred to above, the most difficult one is the one that starts with “why do I/she/him/they have to have Parkinson’s/cancer/diabetes/stroke/etc?”

Sooner or later, shit happens to most people. For this article’s sake, shit is synonymous with whatever disease ails you. Why me/you/etc. appears to be a universal question and almost never has an answer.  The question, “Doc, why does he have cancer?” is almost always followed by a statement that I can only define as a defense attorney’s summation.  The preamble is, “He is a loving husband, father and the best friend you could ever have.”  This statement is followed by the story of a saint who doesn’t deserve whatever illness is destroying him.  Does there have to be a reason we are stricken?  Did I do something to deserve Parkinson’s?”

As a physician, how do you answer this universal question?  Do you stand silent?  Do you turn to God? Do you apportion blame?  “I told him if he kept smoking it would be the end of him!”  Or do you simply tell the truth?  The truth is that no one knows why!  In reality, each choice is right for someone and figuring out how to console your patient and their family and friends takes a great deal of care.

Personally, I like the concept I learned while studying in Mexico.  In Spanish, the word for why is “Por que?”  The word for because is “porque.”  They are pronounced the same. When I asked my teacher “por que”, the answer as almost always was, “porque”.

Why? Because!”

Why do I have Parkinson’s?  Because!  Why does he have cancer? Because!  I’ve got to believe that getting sick is not punishment for prior acts.  Unfortunately, the real answers await us on the other side, if that exists.

The next few articles will further explore the “why’s” having to do with health.

No jokes today!  Here’s something to listen to. 

Liar, liar, pants on fire.  Remember when we were kids and chanted, “Liar, liar, pants on fire?”  As adults, it’s often difficult to tell who is lying!  Certainly, the political ads are full of incriminations.  If you listen to the ads, it’s apparent that all the politicians are lying. Personally, I think being a good liar is the primary skill a politician needs to get elected.

What I’m really interested in is not which politician is lying but are the numbers of individuals infected by the Corona virus true and reliable or is the pandemic really not as bad as it’s made out to be.  It seems that a large percentage of our fellow Americans think that the statistics surrounding the pandemic are wrong and have been blown out of proportion by our government or some other hidden organization. 

Perhaps the mask makers consortium is behind the Corona virus outbreak.  Perhaps the plexiglass manufacturers of America are using the media to sell more of their product.  Whichever conspiracy you use to justify not wearing masks and partying late into the night with hundreds of others is not important to me.  What is important is getting you to ask one pivotal question.  “What happens if I’m wrong?”

Let’s assume that you are right.  Let’s assume the figures are blown way out of proportion. Let’s assume that the actual odds of you getting infected are 1 in 500,000.  If you’re the 1 in 500,000 who end up in the ICU or gives it to your aging parent, was not wearing a mask worth it?  I can guarantee you it was not worth it!  Over the last 40 years, I’ve seen patients play the long odds and lose!  Not a single one of them was happy.  Some of them died, some were left handicapped but alive with lots of suffering and regrets.

No matter what you think, wear your damn mask!  Sure, data on various masks is lacking but the predominance of the data still says a mask is better than nothing.  Some of you are anxiously awaiting a vaccine.  Some of you already have decided you won’t take a vaccine.  Again, conspiracy theories are flooding the internet.

I’ve yet to see any data on the vaccine.  What I can tell you is that once the vaccine is approved and that I’ve digested the data dump that accompanies the vaccine, I’ll decide if I’m going to take it or not.  I don’t understand how anyone can categorically state that they will not take the vaccine when they know nothing about it!  

Now you know why I haven’t written in weeks. I’m disappointed and I’m mad. We shouldn’t need the government to encourage or force us to wear a mask.  Wearing a mask should be an automatic response to an infectious threat.  Not only should we want to protect our families, we should want to protect each other.

In the old days, I used to finish my articles with, “The life you save may be your own.”  Now it’s the life you save may be your own or a loved one!

Here’s your music for the day and a joke. 

Three little old ladies were sitting in the park on a bench when suddenly a naked man jumps out of the bushes and flashes them. Well, two of the old ladies had a stroke the third one couldn’t reach.

It’s almost over!  Another few weeks and we will have a new president.  There will be winners and losers.  Will the losers accept the loss and make the best of it?  I doubt it!  I hear that many businesses in large cities are boarding up and getting ready for riots.  What’s happened to us?  

Certainly, the political rhetoric has gotten more inflammatory over the years.  Certainly, the journalistic divide between CNN, FOX and MSNBC stoke the fire.  Certainly, the internet adds fuel and conspiracy theories to the mix.

Doomsday seems to be right around the corner.  Anxiety is at an all time high!  Remember the predictions of disaster with the beginning of the millennium.  People prepared for disaster which never occurred.  There have been lots of predicted disasters that failed to develop.  Will this election lead to one disaster?  Will we really become The Socialistic States of America?  Will President Trump peacefully turn over the government if he loses?  How high will taxes go up?  Will the economy collapse?  Will Covid prove to be the beginning of the end?

These are all questions I’ve heard my patients ask.  No one will know the answers until we have arrived at our destination.  Our destination is the future and, as always, nobody knows what the future really looks like.  So, take a deep breath and try to relax.  VOTE!  For my former fellow Chicagoans, vote only once and only if you are alive.

Then, realize that every generation has had its own unique problems to conquer and we are no different.  It’s almost over!  Once the election is over, it’s up to us to heal the wounds and divisions that are dividing us.  It’s up to us to put fear aside and work at normalizing our lives.

Now, more than ever, we need God to bless America.

Here is your joke for today and your music.

The year is 2028 and the United States has elected the first woman, as well as the first Jewish president, Sarah Goldstein.

She calls up her mother a few weeks after Election Day and says, “So, Mom, I assume you’ll be coming to my inauguration?”

“I don’t think so. It’s a ten-hour drive, your father isn’t as young as he used to be, and my arthritis is acting up again.”

“Don’t worry about it, Mom, I’ll send Air Force One to pick you up and take you home. And a limousine will pick you up at your door.”

“I don’t know. Everybody will be so fancy-schmantzy; what on earth would I wear?

Sarah replies, “I’ll make sure you have a wonderful gown, custom-made by the best designer in New York.”

“Honey,” Mom complains, “you know I can’t eat those rich foods you and your friends like to eat.”

The President-to-be responds, “Don’t worry, Mom. The entire affair is going to be handled by the best caterer in New York; kosher all the way Mom, I really want you to come.”

So Mom reluctantly agrees and on January 20, 2029, Sarah Goldstein is being sworn in as President of the United States. In the front row sits the new President’s mother, who leans over to a senator sitting next to her and says, “You see that woman over there with her hand on the Torah, becoming President of the United States?”

The senator whispers back, “Yes, I do.”

Mom says proudly, “Her brother is a doctor.”

Halloween used to be my favorite holiday.  When my kids were young, the local Lutheran church used to build and staff the most amazing haunted house I’d ever seen.  They sold admission tickets and made a bundle.

The church’s architects, carpenters and electricians built an intricate structure with hidden rooms, obstacles, turns and dead ends.  My family ran the operating room.  Prior to opening, the makeup artist would work their magic turning me into a mad scientist/MD and my kids into ghouls.  Spaghetti was dyed with red and green food coloring and oil was added to make it slimmy, looked exactly like worms.  Lisa would sit in the corner slurping up and puking out worms.  I would operate with a gas-powered chain saw.  

We were so scary that one patron actually ran through a wall.  Others literally soiled their pants.  I always thought it was weird that a church celebrated a pagan holiday, but I loved being a participant in the haunted house.  I also enjoyed handing out candy at home.  The kids used to take a lot of pride in their costumes and loved getting candy, especially the full-sized bars we tended to hand out.  

When I was a kid, I remember walking several miles to a house where the owner handed out homemade candied apples.  Her neighbor served up hot oatmeal cookies.  Candied apples and hot oatmeal cookies were yummy, yummy, yummy in my tummy, tummy, tummy. My friends and I never felt threatened.  The candy you collected didn’t need to be checked.  The world was a safer place to live.

I also remember volunteering to x-ray candy when I was an ER doctor.  By the time I started to practice medicine, the world had already begun to change for the worst.  Fast forward to last night, and Halloween is on life support.  The “trick or treat” when kids dressed in costumes rang the doorbell was replaced by unattended bowls of candy left on tables at the end of the driveway.  It was sad!  The handing over of candy was devoid of human interaction.

Covid-19 continues to suck the life out of us.  While social distancing is necessary, it trades human touch for disease avoidance.  How important is disease avoidance?  Very!  How important is human touch?  Is it more important than disease avoidance?  Is it going to cause psychologic damage?  These are questions you should ask yourself.

I find myself wondering if 25 years from now my grandchildren will fondly remember unattended bowls of candy waiting for them at the end of the driveway and tell their children how it used to be in the good old days (in 2020.)

Here’s your music and a joke. 

Q: Do zombies eat popcorn with their fingers?
A: No, they like to eat the fingers separately. 

Here’s a multiple-choice question for you.  Pick the most accurate answer if you can:

A. Yesterday was a good day.

B. Yesterday was a bad day.

C. Yesterday was an average day.

While this appears to be an easy question to answer, it’s not!  What makes the answer difficult is that the answers are often determined by many factors.  Here’s how my day went.

The morning hours were good.  I wrote an article I was pleased with.  Physical therapy went well and I was “On” most of the morning.  Yesterday morning was an “A.”

At noon, I sat down to eat lunch and review my Facebook page.  On my high school page was a death notice.  A kid who sat next to me in math died.  While I haven’t seen him in years, I felt the loss.  Anytime one of my classmates dies it’s a reminder that I’m on the downhill side of life.  Yesterday, at noon, was a “B”.  

Yesterday afternoon, my doctor did a shave biopsy on my back.  Renee was worried about a mole that was changing so Dr Rosen biopsied it.  I’m blessed to have found Dr, Rosen.  Her skill set is excellent and the biopsy was painless.  She got an “A+.”

Last night, I received several calls from former patients.  Reminiscing with them was enjoyable, so I called a couple of other patients to check on them.  Last night would have been an “A” if my back hadn’t hurt.  The surgical site ached.  My lower back hurt as well.  Last night was a “C.”

If I look at any given day on average, “C” is the correct answer.  The point of this exercise is that every day has its good points, its bad points and its average points. If you’re having a bad day, wait it out knowing that an average or good day is coming. 

Sometimes, when things are bad, knowing that good days are bound to come helps.  Conversely, while good days are great, recognizing that bad days are bound to come lessens the impact of the bad day.

I often imagine that life is a roller coaster, with ups and downs:  the higher the up, the sharper and scarier the down.  In the end, the ride finishes on solid ground.  If you know that there are ups and downs ending on flat ground, you can enjoy the ride.  If you have no idea what the ride does, it’s going to scare the shit out of you and be a bad experience.  

Have a great ride.  Click here and listen to the music.  It fits today’s article to a tee.

Roller coasters are like your first-time having sex.

For the amount of time it takes to get there, you wish it lasted longer.

WOW, it’s almost over! No, not Covid, the Election Virus.  Yes, the Presidential election acts just like a virus and is every bit as dangerous as Covid. It spreads over the airwaves, infecting every household across America.  It turns normally sane individuals into devote radicals who attack anyone who doesn’t agree with them.  Rather than planting flowers, infected suburbanites plant signs in their yards professing allegiance to whichever virus has infected them.

The Election Virus attacks the civil, truthful area of our brains.  If you don’t believe me, just watch TV for a couple of hours.  Watch the virus grow as it proclaims that a particular individual (fill in any name you want) is an unfaithful cheat, liar, and is going to ultimately destroy the universe as we know it.  She’s really a socialist who is going to kill our democratic state. 

Her opponent is equally as bad.  He has allied himself with the devil and anybody who supports him must be evil and willing to sacrifice the elderly and the young to get him elected.  He’s a liar as well.  In fact, if you listen to the commentators, all candidates are liars, hiding the truth about their

 intentions until after they are elected.

How do you know a candidate is lying?  His lips are moving!  Proof positive of the premise that they all lie can be found in the Presidential Debates.  The moderator asks a question and the candidates go into a 2-minute speech that doesn’t answer the question.  The candidates banter back and forth (still avoiding giving an answer) spewing forth hatred and inuendo but never answering a single question.  The virus seems to penetrate deep into the brain, killing off civility and decorum. 

Unlike Covid-19, we have a cure for the Presidential Virus.  It’s called elections.  Yes, go out and vote.  Elect whichever scum bag you believe is the least likely to destroy the universe as you know it; and, miraculously, the signs will go away, the fliers in your mailbox will disappear and the airwaves will be sanitized, removing those hateful advertisements.

Unfortunately, the damage is done and the divisiveness caused by this horrendous virus will linger a longtime.  Then, as always, it will return on its predestined 4-year cycle.  What a pity!  Covid kills people. The Presidential Virus kills our faith in others and our ability to tell the truth from the lies that make up the heart of politics.

I honestly believe that good hearted people go to Washington with the best of intents and then get infected with the political viruses that have devoured our hearts and souls.  What a pity!

Only 5 more days!

Here’s your song.  Listen to it and you’ll realize how well it portrays today’s political environment.  Here’s your joke.  Who’s on first?  It is a perfect example of the debates!

I just read an article on KevinMD that took me back in time to my first meeting with what was to become America’s Grandmaster, the insurance industry.  Most of you remember a time when there was no insurer standing between you and your doctor.

Yep, you paid me and then, if you had insurance, you submitted the bill to your insurer, and he reimbursed you.  School physicals were $15-20.  Office visits were not much more.  Lab and x-ray done in the office were at bargain rates.  So, what happened?

One day I was working in my office when two suits asked if I could spare them a few minutes to talk about the future of medicine and the insurance industry.  Their cards revealed that they worked for one of the larger insurers.  I had some free time, so I had them brought to my office.

To cut to the chase, they offered me the first insurance contract I had ever seen offering me access to their insured patrons for a discounted rate and a new rule book.  I thanked them and promised to review the contract and let them know if I was going to sign it.

“Oh, you’ll sign it!” is one of those statements you try to forget but that eventually resurfaced.  He continued stating that, if I didn’t sign the contract now, I would probably not be able to get future contracts.  He inferred that his company would put me out of business.

Summing up my youthful arrogance, I reached in the draw and pulled out my tape recorder.  I asked him to repeat what he just said so that I could go to the States Attorney and he responded with, “You obviously don’t know how big we really are, you should sign the contract.”

I showed them the door.  Later, I told Renee I would never sign their contracts. We would practice as before.  Boy, was I young and stupid?  I really didn’t realize how big and all powerful they would become.  I get a little nervous anytime I write anything negative about the beast.

Oh yeah, they are the beast and it’s almost impossible to find a medical practice that has not been consumed by the beast and his contracts.  So, what can you and I do?  Nothing! 

Well, there is one thing.  Thank your physician for the care they give you. While thanks will not make up for their cut in pay on a monetary basis, it will shore-up their emotional side and keep them practicing.

Here’s your music and joke for a day.

Four insurance companies are in competition.

One comes up with the slogan, “Coverage from the cradle to the grave.” 


The Second one tries to improve on that with, “Coverage from the womb to the tomb.” 


Not to be outdone, the third one comes up with, “From the sperm to the worm.” 


The fourth insurance company really thought hard and almost gave up the race, but finally came up with, “From the erection to the resurrection.”