Every time I meet a new doctor, there is a moment of hesitation when they try to reconcile what they have read about me in my chart and what they see standing in front of them.  Yesterday, was no different.  I was at Mayo for a consult with Joerg  Herrman, the founder and director of the Cardio-Oncology department at Mayo. He literally, wrote the book on Clinical Cardio-oncology.  In 2021, he made Stanford's list of the top 2% of scientists. He sees patients only by referral and it takes months to get in to see him.   I think this referral was made sometime last fall.

He rushed in, holding papers with hand written notes.  He started to introduce himself and then paused.  Looked at his papers, looked at me, looked back at his papers, took a deep breath, leaned back in his chair and said, "Wow, age can be so hard to gage!"  We had known each other for two minutes and he was already waxing poetic.

Then, it was right to business.  He turned the computer screen towards me and began to show me the results of scans he had already tabbed in my chart.  "Yes. I see it.  Let me show you. Here it is in the CT scan in October, here it is in the Pet scan in August.  Here it is again and again."  He pulled up more examples of my scans. " Left atrial enlargement.  Quite common with R-chop. What's done has been done.  It's not something we can really undo."

"But here's the thing.  The damage to your heart does not seem to be impeding the function of your heart.  Your numbers are good, your labs are good, you sound good, you look good, the echo was good, the ECG from 20 minutes ago was perfect. So, what does the director of Mayo Cardio-Oncology that you have been waiting months to see recommend we do?  NOTHING.  I am going to do NOTHING.  Now, I could order a battery of tests and medications and put you through the torture of multiple stress tests-but it's not going to give me any information I don't already know."

"You.  Are a ticking time bomb". You have already had multiple episodes of atrial fibrillation, multiple pluminary embolisms, by pass  five years ago. . . One day, you are probably just going to skip a beat and whether or not we catch it really depends on you.  I am going to give you the advice my mother gave me when I was a little boy in Germany who wanted to be a doctor, 'Joerg, she would say,'PAY ATTENTION!"

"PAY ATTENTION!  Don't ever let a day go by that you don't pause and listen to what your heart is trying to tell you.  So many people come in here and tell me that they knew something was happening-but they didn't think it was worth telling me. And I hear my mother's voice questioning, 'Are you PAYING ATTENTION?"

He reached into the drawer beneath the computer to pull out his card.  As he was handing it to me he offered, "If anything feels weird or different at all.  Give me a call.  I'm on your team now.  You're on my radar.  This may very well kill you one day, but that day is not today."

As he escorted me down the hall toward the waiting room, he cautioned, "You know that story you told me about feeling dizzy when you were shoveling the snow off the roof? Don't.  Just don't.  Time to let someone else do the roof shoveling."