ChesterCountyMedicine Spring 2018 - 24

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The Art of Chester County
Second Chances
Doctor's story

BY MIAN A JAN, MD, FACC, CHAIRMAN DEPARTMENT OF MEDICINE,
PENN MEDICINE CHESTER COUNTY HOSPITAL

t was a cold day in January when I received a call from the
emergency department at Penn Medicine Chester County
Hospital, an ambulance was bringing in a 53-year-old unstable
male with a massive myocardial infarction. In my long career as
an interventional cardiologist I have gotten hundreds of calls like
that, but it has never become a routine for me. Each call results
in a rush of adrenaline and apprehension but at the same time a
feeling of exhilaration that I cannot explain, and I think only an
interventional cardiologist would understand. Not knowing what
you are going to face, because it's not a car off an assembly line
but a living, breathing human being who just a few hours ago had
aspirations, hopes and plans and is now fighting for his life, and I
will be playing a part in this. It's not just the patient but his family,
wife and children and everyone he has gotten in touch with in his
fifty-three years that will be affected by what happens in the next
twenty-four hours.
I actually got to the emergency department before the ambulance, and soon after my arrival John Madarasz was brought in by
EMS. This was my first contact with John, who looked ashen but
younger than his 53 years. His history revealed relatively few risk
factors, no hypertension, no diabetes and no smoking. Other than
being overweight his only major risk factor was that his father had
died of a massive heart attack in his forties. I explained to him and
his wife the cardiac catheterization procedure and he was feeling
so poorly his wife signed the consent. We immediately took him
to the lab where he promptly had a ventricular fibrillation arrest
which reoccurred several times and required multiple shocks.
Fortunately, we were able to stabilize him and proceed with the
angiography [fig 1, 2, 3 & 4] which revealed one of the three main

24 CHESTER COUNT Y Medicine | WINTER 2018

arteries in the heart was totally occluded. We were able to extract
the thrombus with an extraction device and then dilate the lesion
with a balloon and place a stent, which completely reestablished
flow in the artery. John's symptoms completely resolved and his
hemodynamic status improved. Afterwards, I spoke to John and
then his wife. One of the great joys for me is talking to the family
after a successful completion of our intervention and to be able to
see the joy on their faces that their loved one is doing well.
These patients become your friends forever. In John's case I
found out that he was a master coppersmith, a great artist and a
genius sculptor.
In the next few months as John recovered I got to see his
website and his work; I was impressed by the exquisite detail of his
work. We often spoke of art and one of his sculptures was especially haunting; he called it "No Second Chance,"and it was from a
particularly dark time that he made that magnificent sculpture. As
time passed we talked about it some more and his new found inspiration to create a companion piece to the "No Second Chance"
sculpture. More recently John and his wonderful family have been
in a particularly good place and he showed me his latest creation...
"Second Chance-The Cardiologist" which resulted in our collaboration for this article. He told me it was created to convey a
"Second Chance"...the one that the surgeon, the doctor, the EMT,
your neighbor, your friend gives you in those sacred moments; a
second chance to try to live a better life and tell each other how
much we love them before we find ourselves in a place where we
may have no second chance.

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ChesterCountyMedicine Spring 2018

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