Horace Who?

Horace Who?

My Dad was a Baptist Minister in Danvers, MA, about 20 miles north of Boston. On Wednesday nights he would often go to the Danvers Public Library to research his Sunday sermons, and my mother forced me to go along. I must have been around 10 when I started going. After reading all the dog books, I was bored until I found the books that the US Olympic Committee published after every Olympics. I always liked to run so I devoured the track & field sections, and by the time I was 12, I knew the names of every American who had won anything in the Olympics.

Fast forward at least 50 years and I am a cardiologist with a special interest in the cardiac problems of athletes. I am about to see a young weight lifter who has had several strokes, and one of the strokes occurred during weight lifting. I noticed that his last name was Ashenfelter, and I immediately thought of Horace Ashenfelter, a Penn State graduate and FBI agent, who had won the 1952 Olympic Steeplechase in Helsinki. When the patient came in, I introduced myself and said, “Before we begin, I must ask if you are related to Horace Ashenfelter, the 1952 Olympic Gold Medalist in the steeplechase. “ The patient seemed quite pleased and said something like, “They told me you were the sports cardiologist to see. That’s my grandfather!”.

The remainder of the clinical story and the clinical lessons are that he had previously had a trans-esophageal echo (TEE), which had not shown an intracardiac shunt. He had not had a transthoracic echocardiogram (TTE), and the sedation required for the TEE prohibits performing provocative maneuvers such as the Valsalva to identify the intracardiac shunting from a patent foramen ovale (PFO). I scheduled a TTE with contrast and Valsalva, which showed a PFO, which was ultimately closed.

But another clinical lesson is that almost everything you learn in life about non-medical things can help you establish better relationships with patients. So, it’s OK to spend your nights watching ESPN. Did you hear that, Camilla?

· Shared with written permission of the patient