The Flight

As an interventional cardiologist, I routinely perform risk-laden procedures on patients. Coronary angiograms, angiolplasty and stenting are to name some. Theses procedures have inherent risk including bleeding, infection, perforation, heart attack (ironically), stroke, kidney failure, limb loss and even death. These risks are rare with risks ranging from 1% to 1:10,000.

Akin to taking a flight which has inherent risks of being late, engine failure, landing in water, crashing into a mountain and even death, there is always an alternative which is not flying in the first place. However, sometime one needs to fly regardless of the plane's mechanical condition, regardless of the weather and regardless of risks beyond one's control. What risks an individual takes to proceed are really up to the individual.

I liken the patient to the plane and myself to the pilot and my team to the crew. No one wants a failed or complicated flight as no one wants a procedural complication. No one wants a plane crash as no one wants for the patient to suffer. However, there are inherent risks. Even the best pilot and plane can hit birds and end up in the Hudson.

We try to optimize risk by taking extreme measures but despite this we can not negate risk to zero. One thing that remains certain, when risk benefit is calculated appropriately and the indications and alternatives are explained, flying remains the safest mode of transportation.

Youth is wasted on the young

Assume life was $100 bill. So crisp, so hard earned. Realize how carelessly, we move through and spend the first twenty dollars. The next thirty is spent cautiously, but quickly in preparation for spending the last $30. However, too often we discover that the last 30 can quickly be robbed from us...poof.

Youth is indeed wasted on the young.

The $100 Bill

I often discuss with my patients the issue of the $100 bill. When one has a crisp new $100 bill, one is fearful of breaking it. Through difficulty the bill is broken into fragments. Quickly, we use the first $20 without much concern as there are plenty residual notes.

The next $30 is spent more thoughtfully and with intent. However, the remainder $50 is more stingily parted with. The first $20 of the remaining ($50 to $70) is spent with much thought and consideration. But the last $30 is quite difficult to part with as if knowing one is running out.

Well, we all at best have 100 years to live. Although the average life span is the 80's. Youthfully, we spend our first twenty years of life as if we were living forever, invincible. From our 20's to our 50's we toil and struggle and plan life and spending the remainder of the years in retirement. Sadly, many of us never get the "guaranteed $100 or even $80 as we die prematurely from heart disease, cancer, or other unforeseen death.

Since, the majority of my patients are above 50, I emphasize the stingy nature and careful spending of the remaining notes and years. Valuing individuals, moments and treasuring people in our life gain the most importance, knowing that we could be robbed at any one moment....permanetnly.