March 20, 2025 • 20 mins
What happens when a successful surgeon suddenly finds himself on the operating table? Dr. John Mason shares his extraordinary journey from Olympic-caliber rower to heart surgery patient in this revealing conversation that bridges the gap between physician and patient perspectives.
Dr. Mason's story begins with his background as a Division I collegiate rower who competed at elite levels, even trying out for the Olympic team. Years later, while carrying his toddler up a hill at a family picnic, he experienced what he thought was a bug in his shirt—actually atrial fibrillation signaling a serious heart valve problem. Despite being in heart failure, his exceptional physical fitness masked his symptoms so effectively that he continued winning rowing competitions right up until his diagnosis.
The psychological impact of facing open-heart surgery as a young surgeon with small children offers profound insights into the vulnerability all patients experience. Dr. Mason candidly discusses his decision-making process, complications that required a second surgery, and the humbling recovery that transformed his approach to medicine. "I was as weak as a cat afterward," he reveals, describing how rebuilding strength took not weeks but nearly a year.
This experience fundamentally changed how Dr. Mason treats his own patients. Rather than offering vague recovery instructions, he now provides concrete guidance: "Get outside, feel the sunshine, feel the wind blow, hear the birdies sing." His personal mantra—"keep your legs moving, your belly full, and your chin up"—encapsulates his holistic approach to healing. When patients claim he can't understand their situation, he can genuinely respond, "I know exactly what you're going through."
Listen to this powerful conversation that reminds us how personal struggles can transform professional practice, and why compassion from healthcare providers means everything when facing life's most challenging moments.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello, this is Jason Edwards and this is Doc
Discussions.
I'm here with Dr Mason JohnMason, our Chief of Surgery, and
this is our second episode withDr Mason.
How are you doing, sir?
Speaker 2 (00:09):
Just fine, thanks for having me again.
Speaker 1 (00:11):
This is great.
And so, after our first episode, when we turned the mics off,
you and I had a very interestingconversation and I thought you
know, this is something weshould probably record you were
a collegiate athlete in rowing.
Is that right?
That's correct.
And where were you rowing?
(00:36):
At UC Santa Barbara, and that'sa Division I college, yeah, and
not all colleges have rowing,and so I'm sure I would assume
that the ones that do areactually, you know, have fairly
good rowers, because there's Ingeneral.
Speaker 2 (00:44):
Yeah, it's a significant commitment for all
the equipment.
And you know, I think mostprograms that have a rowing
program, you know they're notjust going to get like you know,
sort of one or two boats.
It's a little bit of an all ornone proposition.
So it's either they're going tohave a rowing program or not.
It's interesting Rowing isactually the oldest
(01:09):
intercollegiate sport in theUnited States.
Speaker 1 (01:12):
Okay, I would assume Harvard's one of the first
colleges and they probably hadit.
Speaker 2 (01:15):
Yeah, the first, and not just of rowing but of any
sport included baseball,basketball, football, everything
.
The very first athleticcompetition between two schools
was rowing.
Okay, and it was Harvard-Yaleback, I think the year was 1846.
Speaker 1 (01:31):
Okay, so before some of these sports were even
invented.
Oh yeah, yeah exactly.
And so I'm going to fastforward a little bit.
So after college you wereactually in the Olympic trials,
Is that?
Speaker 2 (01:41):
correct.
Well, yeah, so I didn't quitemake it that far.
So during my collegiate rowingI rowed three years in college.
I unfortunately developed ashoulder injury during my third
year that required surgery.
But after my second year andafter my third year I tried out
for the national team and therewere sort of three tried out for
(02:08):
the national team and therewere sort of three, um, uh well,
three modes of assessment, ifyou will.
You did six minutes on a rowingmachine, okay, and this was
kind of a bizarre rowing machineto say.
Rowing machines are verycommonplace now, especially the
concept two, which we have onehere in the first floor of this
building, thanks to uh, and thatis, and that's, um, you know,
crossfit gyms use the concept torower.
I mean, you know, you see themin gyms and people's houses
(02:29):
everywhere.
Um, this was, you know, the mid80s in.
Concept two was that companywas just starting and I can't
even remember the name of therowing machine, but the, the
coach, the united states olympiccoach, was a guy named Chris
Korzenowski who was a Pole, hewas from Poland, spoke, you know
, sort of OK English and he hadthis Polish rowing machine that
(02:52):
he kind of brought over.
It's like oh no, this is whatwe will test all the athletes on
.
So we had to do a six minute,you know piece, or six minutes
on the rower.
You know try and you know pullas hard and fast as you could
over that six minutes.
And then you had to do what'scalled a bench pull, basically
where you're laying on a benchand you, you know it's basically
(03:13):
weightlifting, kind of a bentover row, but on a bench, facing
prone, facing down with 90pounds in six minutes.
See how many times you could dothat.
And then the other componentwas flexibility.
Just seeing how flexible youwere and everything.
So you made it somewherethrough the process.
I did very well in theflexibility and on the, the
rowing, uh, with the barbell, my, my rowing machine, time was
(03:35):
was kind of okay, but it but itwasn't competitive enough to
make it to the next.
You know, that was sort of thescreening yeah, thing.
You went through that initialscreening and then, if you made
it past that, then they invitedyou back to philadelphia, which
was sort of the screening thing.
You went through that initialscreening and then, if you made
it past that, then they invitedyou back to Philadelphia, which
was sort of the center of UnitedStates rowing at the time.
I think currently it might evenit moved to Indianapolis and
Oklahoma of all places.
(03:55):
I'll be honest, I'm not surewhere.
I think it's in Chula Vista,california now.
They go to kind of bizarreplaces.
Speaker 1 (04:02):
So in any places, and so you were rowing and staying
very exercising a lot.
And then you were like at afair or at a park and you
noticed you were having someheart issues.
Speaker 2 (04:13):
Yeah, this was many years later.
So, yeah, just you know I kindof joke around that maybe the
shoulder injury I got, you know,was sort of the best thing that
happened, at least to mysurgical career.
I was sort of toying with theidea of medical school at the
time and then it's like, well,okay, I have to set up my senior
year of rowing.
What else am I going to do?
I mean, the book's hard andstudy for the MCAT, got into
(04:33):
Washington University formedical school, came here and
then, you know, did med school,residency and so on, enjoyed
rowing, and there's actually sothat going to to Wash U of
course meant that I moved fromum, california to St Louis.
So I've been here ever sincethen.
But there is a rowing club herein St Louis, a very good one,
uh is as, especially as far asthe high school program, but
(04:54):
they have masters rowing too.
So I rode with them for manyyears and then, um, yeah, right
around me turning 40, um, uh, Iwas um with a, um, a group of
guys we're really competitive.
I, I was, you know what one ofmy at age 40 we would have these
, um, uh, indoor rowingcompetitions, which is kind of a
(05:15):
big, big thing and we did itwith washington university and I
beat all the college kids, youknow.
So I was very proud of that.
But shortly after that, uh, yeah, I was at a picnic with my
family.
My son was you know who'sbigger than I am now, you know
was a you know that littletoddler.
I was carrying him up this hilland I thought a bug flew in my
shirt.
Uh, it's like, oh, what's thisshaking in my shirt?
(05:36):
You know, something's in there,and I was in atrial
fibrillation.
Um, went to st luke's.
I I was, you know, a surgeonhere at St Luke's at the time
Went to the ER and they did anEKG and said, oh, sure enough,
you're natral fibrillation, andthen subsequently got an
echocardiogram and I had mitralregurgitation, so one of my
heart valves was leaking prettysignificantly, but I had no
(05:58):
symptoms.
That's what really kind ofsurprised me.
I had no shortness of breath.
In fact, not only did I have noshortness of breath, I was, you
know, competing competing inrowing, which is a very, you
know, aerobically demandingsport, and I felt spectacular.
So I almost didn't believe theresults.
Speaker 1 (06:14):
Yeah.
Speaker 2 (06:15):
Uh, but I get you know.
But the AFib was, you know,atrial fibrillation kind of
convinced me, okay, well,something's going on, um.
And so I saw um, saw one of ourcardiologists here, dr Davison,
who I'm still good friends withyeah, sure, glenn, he's a great
cardiologist, total character,Yep, yep.
And he said, well, you knowyou're doing well.
And he put me on somemedication that got me out of
(06:35):
atrial fibrillation.
Thankfully I did not have to beanticoagulated.
So he said well, you know whatyou're doing, fine, minimal
symptoms, let's just watch youfor a while.
We'll get anotherechocardiogram in six months,
okay.
So it's like okay.
And then I never went back intoafib.
Actually, to this day I'venever gone back into afib, you
know, thankfully, um.
But had the echo six monthslater.
And I continued to bephysically active, continued to
(06:56):
do rowing races.
In fact I won a single skull,one person boat competition down
in atlanta, which was, you knowor no, actually it was
Chattanooga, okay, really hugecompetition.
I was, you know, justabsolutely thrilled.
And then I had my repeat echoand they said, oh, it's gotten
way worse and you're actually inheart failure now, which I just
(07:17):
couldn't believe because Istill felt completely fine.
So the writing was on the wall.
I had to get the valve repairedum so this is an open heart
surgery.
Speaker 1 (07:26):
Yeah, yeah, this is no small surgery, correct?
Speaker 2 (07:28):
yeah, this was 2005 or no, I'm sorry, 2006.
So there were, you know, someinstitutions were just kind of
exploring kind of less invasiveways, a catheter based right,
right.
Speaker 1 (07:41):
But so so take me to your mental state.
Now you've got, you're a doctor, you've started your practice
and now you've got a beautifulwife and you've got two children
that are tiny and this has tomake you consider your own
mortality, probably for thefirst time.
Speaker 2 (07:56):
Yeah, you know, it's funny.
You mentioned that I really thereality of it didn't sink in
until the day of surgery and Iremember talking to the
anesthesiologist like, and Iended up having it at Missouri
Baptist, nothing against StLuke's Great Heart Program.
I'd been here maybe three yearsand I felt very I had these
weird visions of you know, Idon't know me, like dying in the
(08:17):
intensive care unit and I waslike, okay, I don't want to die
in the hospital where I work.
And I knew Dr Kachoukis from myresidency training really well
and I just said you know what?
I think it's best if I just gooffside.
Speaker 1 (08:29):
It's also awkward too , because in the OR you're
completely naked too, and beingaround people you work with
completely naked, you wouldthink as a doctor it's not that
big a deal, but it's not themost fun thought.
That played into it as well, alittle bit right.
Speaker 2 (08:43):
Yeah, kind of the privacy aspect of it For sure,
for sure.
Yeah, that was part of it.
And so, yeah, the morning ofthe heart surgery, I remember my
wife drove me to the hospital.
I remember there was a prettyrainbow and it's like, okay, I
think things are going to beokay.
But again, just the wholereality.
It just seemed so I felt fine.
(09:04):
It really took a leap of faithfor me because I, you know,
usually you have some hugeoperation, you know you have, I
don't know, blood in your stoolor you're losing weight, or you
feel terrible or something'sgoing on.
Speaker 1 (09:17):
But you were in such good shape that your body was
able to compensate for it.
A mere mortal would havesymptoms Correct.
Speaker 2 (09:24):
Yeah, yeah, I think, I think that was probably the
thing.
So, um, so, in any event, yeah,um, yeah.
I remember meeting theanesthesiologist, who's just an
extremely nice guy, and it'slike, oh, wow, this is real.
And then, uh, yeah, then hadthe surgery, uh, everything went
fine, went home, I think, infour days, but then, um, I did
have, um, uh, pericardialtamponade about post-update 10
(09:46):
or so, and I'm going to explainto people what- that is.
Speaker 1 (09:48):
So there's a sac around the heart and that's
where blood gets into that sacand starts putting pressure on
the heart from the outside in,so the heart's not able to pump
as effectively and so you havedecreased blood flow throughout
the body.
Speaker 2 (09:59):
Correct.
And here is where I was theexception.
Again, I remember I started notfeeling well.
It was a Saturday night.
I again I remember I startednot feeling well.
It was a saturday night.
Um, I was, you know, I'd beenhome for about you know five,
six days, taking my daily walks.
Everything was great.
And it was a saturday.
My wife had a birthday party togo to.
I remember she felt really bad,just like, okay, I'm gonna go
(10:20):
to this party for about twohours, are you okay by yourself?
And I would.
It was just me and the two kids, and my son was, I think, a
year and a half or two.
At the time he'd already goneto bed, so my five-year-old and
I were just hanging out, um, andlike, oh, we're fine, we'll be
fine you know lauren will takecare of me.
And um, yeah, I I remembergetting up and was walking
(10:40):
across and I start gettingnauseated and I collapsed and my
five-year-old was there and shelike ran and got like a
washcloth and I kind of came upand she's like, oh, are you okay
?
Are you okay?
And um, and she called my wife,who came home right away.
You know, this is, you know,early cell phone days and then I
kind of felt better.
It's like okay, yeah, I'm notsure you know what's going on,
but I think I'm okay.
(11:01):
And then started throwing upduring the night.
No chest pain, no shortness ofbreath.
Speaker 1 (11:05):
Can I stop you?
Here for a second, Peoplesurgeons have this kind of a
soldier on mentality whichserves them well in their
training and through tough cases.
Yeah, but on a personal levelsometimes it does not serve you
well, Correct?
Speaker 2 (11:22):
And I think that's what's going on here.
Speaker 1 (11:24):
And it can't.
It's kind of a you know airlinepilots.
They talk kind of.
In a way it's surgeons kind ofact in a way like that and the
training ingrains that in withinyou, which is good.
But this is probably what'shappening here You're soldiering
on and not paying attention tothe obvious signs.
Speaker 2 (11:40):
Right, yeah.
And then the next morning,sunday morning, I still felt
pretty terrible and you knowwe're thinking maybe I have a
stomach flu, but my wife is, youknow, we're going back to the
hospital.
So we went to the, you know,went to the emergency department
.
It's a Sunday morning, there'snobody around and at the ER doc
happened to be someone my wife'salso a physician, someone that
(12:00):
my wife trained with at Jewishhospital when Jewish hospital
was its own entity.
Yeah, dr Brown, a wonderful guy, mary, why are you here?
It's like oh well, john just hadsurgery and I remember I'm
sitting there in the waitingroom and my main symptom was
nausea, and so they kind oftriaged me.
You know I'm there and likethere's, you know, teenagers
with, you know, sprained anklesgetting in ahead of me and I'm
(12:22):
sitting there, you know kind ofnauseated feeling, you know
terrible, but no chest pain orshortness of breath.
And then she said, well, hejust had heart surgery.
Well, is he having chest pain,shortness of breath?
No, oh, okay, he can go sitover there.
Yeah, you're on the back burnernow yeah.
And so thankfully, this ER docsaw us and kind of got us back
there, back to the, and then thePA of my heart surgeon, you
(12:45):
know, came to see me and it'slike, well, okay, my heart
surgeon, you know, came, came tosee me and it's like, well,
okay, you know, I, you know, youseem to be all right.
Liver enzymes were up a bit, sothey admitted me to the
hospital, got an ultrasound ofthe gallbladder they were
thinking that was that.
Then I started vomiting again.
They put an ng tube in, uh, andthen that we didn't get an echo
for whatever reason, for abouta day and a half.
Yeah, yeah, they got anechocardiogram.
(13:06):
They're like, uh, you got somefluid around your heart and so I
had to go back to surgery justto get a chest tube put in,
basically to drain that fluid.
And my heart surgeon came like,uh, that's the biggest
diffusion I've ever seen.
So yeah so I felt better, but ittook a long time to bounce back
from that this makes me thinkof two things.
Speaker 1 (13:23):
One is, um, this is the advantage of being in good
shape.
Yes, you know like, if you arestrong, if you're healthy,
you're able to sustainsignificant medical issues and
get past it.
And so that's the reason youneed to keep yourself in good
shape.
When you do get sick whicheverybody will you can say well,
I've done everything right.
(13:43):
Why am I sick?
And the better way to look atit is you know what I'm strong
going into this.
I've kept myself in good shapeand that will help me get
through this better, correct?
The other thing is absolutelybeing married and having a wife
to tell you hey, we're going tothe hospital is so I encourage
young men to get married becauseit typically leads to a longer
life.
Oh yeah, yeah, that's verypredictive as.
(14:04):
So take me through how you feltlike mentally and emotionally,
as you're going through that,and when you considered the
prospect that this may limit thelength of your life.
Speaker 2 (14:24):
Yeah, you know, I don't think I ever really felt
necessarily like, okay, this isgoing to shorten my lifespan.
I did have some heart surgeonssay and so the original surgery
I I had thankfully the my valvewas so they're able to repair
the valve.
So I had what's called a mitralvalve repair.
Okay, I did not have to get aprosthetic valve.
(14:46):
Now they did what's called anannuloplasty, basically the kind
of circular area where the,where the valve resides, was a
little bit wider than it shouldbe.
So they tightened that up witha ring anuloplasty, basically a
little Gore-Tex ring but there'sno prosthetic valve.
So I did not have to beanticoagulated and in theory
that should be kind of alife-lasting repair.
(15:10):
I initially had actually one ofour heart surgeons here who's
not here anymore say oh yeah,you're going to have to have
that redone in five or 10 years.
And here we are, 20 years later, there's always a naysayer.
Speaker 1 (15:19):
There's always a naysayer, yeah.
Speaker 2 (15:21):
And so for that moment that led, that kind of
ruined my lunch that day, I'mlike what so?
Speaker 1 (15:26):
haters going to hate.
Speaker 2 (15:27):
But.
But.
So I would say I didn't then,nor do I now, feel like, okay,
my life's going to be shortenedbecause of this.
But having gone from what Ifelt like I was in tip-top shape
and I'm kind of on top of theworld, you know, kind of with my
job great job, you know, youknow.
You know as long as you haveyour health, you have everything
right and you know.
So that took a hit in the sensethat after the surgery,
(15:49):
obviously a huge operation, andthen the second surgery to
require it to drain that fluidaround the heart, and I was just
, as the saying goes, as weak asa cat afterwards, and that was
difficult, that was really hard,yeah you got young kids, you
want to play with them and youcan't.
(16:10):
And it was six to eight weeksand I'll say at that point I was
88% to 90% recovered.
And then it was another six to12 months till I really felt
like kind of at the 100% level,maybe even a little longer than
that.
It took a long time.
Speaker 1 (16:22):
This is one thing concept that I remind people of
all the time.
When you lose strength andstamina so quickly when you're
in the hospital, I don't carewho you are, and it takes a long
time to build it back up.
And Warren Buffett has a jokeon this.
He says you can't get ninegirls pregnant and have a baby
in a month.
Speaker 2 (16:40):
Some things just take time.
Speaker 1 (16:43):
And that's.
And so it's good to berealistic and patient and say,
hey, I will get stronger byprogressively overloading myself
and doing a little bit moreslowly, and get back.
Do you feel like it made you abetter physician going through
this?
Speaker 2 (16:56):
all, without question , it's good because I can tell
my you know, if you know, havingeither a urinary catheter or a
chest tube or an ng tube, youknow, nasogastric yeah, I've had
all those things, yeah, andthey're like, well, you don't
know what it's like and I trynot to be that guy that's like,
oh well, let me tell you mystory.
You know, it's like, you knowwhat I, I know exactly.
I actually do know exactly whatyou're going through.
(17:17):
So I, you know, I think youknow not that I would want any
of my fellow physicians to.
You know, um, you know, againsttheir will, go through anything
like this.
I, I think there used to betimes during um medical student
training that they put ng tubesin each other.
Oh really, I think.
Thankfully those days are gone.
But no, I, I think, having gonethrough that, there was no
(17:38):
question.
It made me a lot moresympathetic to the plight.
And again, obviously I'm asurgeon, that's my main focus.
But I don't just leave it atthat.
I try and figure out, okay, howcan we get these people active
again, what's the best way.
For sure, in the short term,let's set up a very specific
plan, not just like oh yeah, youknow, don't do anything for six
(18:01):
weeks, it's like, okay, well,that's not very helpful, yeah.
So I tell almost all my patients, if they're good enough to go
home, they're good enough for adaily walk.
Yeah, and I'm not, you know,since I'm, you know, focused on
abdominal type stuff.
They can usually get out of bedand bear weight and so they can
get outside.
As I tell them, get outside,feel the sunshine, feel the wind
blow, hear the birdies sing.
You know, just, you know it's,you know, you know all those
(18:24):
things are very positive, and ifyou just make it to the
neighbor's mailbox and back,that's great.
Yeah, that's the first day.
The next day, make it to twoneighbors, uh, a ways yeah, just
a little bit of the strengththat counts is the lower
extremity strength.
Speaker 1 (18:38):
Oh yeah, you know doing curls at the gym
indefinitely will do nothing foryou in life, but having strong
legs and your glutes and yourcore strong that will get you
through a hard time andpsychologically.
Just going for a walk andbreathing the fresh air and
feeling the sunshine is so goodfor you, and so I do the same
thing with my patients too.
(18:59):
I have kind of a mantra.
I say keep your legs moving,your belly full and your chin up
because I'm trying to fatten mypatients up because they're
going through cancer treatments.
And then the other thing thatyou know, being a patient and
realizing if you have a gooddoctor when I've been a patient
(19:20):
I was fortunate enough to havevery good doctors and just the
their, their confidence, thereassuring me, it, it it like
meant the world, because I was.
Speaker 2 (19:32):
I was afraid.
Speaker 1 (19:32):
I mean I was trying to pretend like I wasn't but
like I was afraid, and havingsomebody come in and put their
hand on me and say, hey, youknow we're going to be okay here
.
We've just got to kind of gothis way or that way.
But just hang in there, right?
You know, when you say it as adoctor, you're like I don't know
if that resonates with anybodybut man as a patient you're like
, thank God that this guy's herefor me.
Speaker 2 (19:51):
Yeah, no, I agree completely.
Well.
Speaker 1 (19:54):
John, I appreciate you sharing your story with us.
I think it's a uniqueperspective when you're a
physician and then you become apatient, especially when it's
something so significant, and Ithink there's kind of plenty of
lessons to be learned.
Speaker 2 (20:07):
Yeah, well, thank you , thanks for having me.
It's always a pleasure, yeah,thanks.
Hello, this is Jason Edwards and this is Doc
Discussions.
I'm here with Dr Mason JohnMason, our Chief of Surgery, and
this is our second episode withDr Mason.
How are you doing, sir?
Speaker 2 (00:09):
Just fine, thanks for having me again.
Speaker 1 (00:11):
This is great.
And so, after our first episode, when we turned the mics off,
you and I had a very interestingconversation and I thought you
know, this is something weshould probably record you were
a collegiate athlete in rowing.
Is that right?
That's correct.
And where were you rowing?
(00:36):
At UC Santa Barbara, and that'sa Division I college, yeah, and
not all colleges have rowing,and so I'm sure I would assume
that the ones that do areactually, you know, have fairly
good rowers, because there's Ingeneral.
Speaker 2 (00:44):
Yeah, it's a significant commitment for all
the equipment.
And you know, I think mostprograms that have a rowing
program, you know they're notjust going to get like you know,
sort of one or two boats.
It's a little bit of an all ornone proposition.
So it's either they're going tohave a rowing program or not.
It's interesting Rowing isactually the oldest
(01:09):
intercollegiate sport in theUnited States.
Speaker 1 (01:12):
Okay, I would assume Harvard's one of the first
colleges and they probably hadit.
Speaker 2 (01:15):
Yeah, the first, and not just of rowing but of any
sport included baseball,basketball, football, everything
.
The very first athleticcompetition between two schools
was rowing.
Okay, and it was Harvard-Yaleback, I think the year was 1846.
Speaker 1 (01:31):
Okay, so before some of these sports were even
invented.
Oh yeah, yeah exactly.
And so I'm going to fastforward a little bit.
So after college you wereactually in the Olympic trials,
Is that?
Speaker 2 (01:41):
correct.
Well, yeah, so I didn't quitemake it that far.
So during my collegiate rowingI rowed three years in college.
I unfortunately developed ashoulder injury during my third
year that required surgery.
But after my second year andafter my third year I tried out
for the national team and therewere sort of three tried out for
(02:08):
the national team and therewere sort of three, um, uh well,
three modes of assessment, ifyou will.
You did six minutes on a rowingmachine, okay, and this was
kind of a bizarre rowing machineto say.
Rowing machines are verycommonplace now, especially the
concept two, which we have onehere in the first floor of this
building, thanks to uh, and thatis, and that's, um, you know,
crossfit gyms use the concept torower.
I mean, you know, you see themin gyms and people's houses
(02:29):
everywhere.
Um, this was, you know, the mid80s in.
Concept two was that companywas just starting and I can't
even remember the name of therowing machine, but the, the
coach, the united states olympiccoach, was a guy named Chris
Korzenowski who was a Pole, hewas from Poland, spoke, you know
, sort of OK English and he hadthis Polish rowing machine that
(02:52):
he kind of brought over.
It's like oh no, this is whatwe will test all the athletes on
.
So we had to do a six minute,you know piece, or six minutes
on the rower.
You know try and you know pullas hard and fast as you could
over that six minutes.
And then you had to do what'scalled a bench pull, basically
where you're laying on a benchand you, you know it's basically
(03:13):
weightlifting, kind of a bentover row, but on a bench, facing
prone, facing down with 90pounds in six minutes.
See how many times you could dothat.
And then the other componentwas flexibility.
Just seeing how flexible youwere and everything.
So you made it somewherethrough the process.
I did very well in theflexibility and on the, the
rowing, uh, with the barbell, my, my rowing machine, time was
(03:35):
was kind of okay, but it but itwasn't competitive enough to
make it to the next.
You know, that was sort of thescreening yeah, thing.
You went through that initialscreening and then, if you made
it past that, then they invitedyou back to philadelphia, which
was sort of the screening thing.
You went through that initialscreening and then, if you made
it past that, then they invitedyou back to Philadelphia, which
was sort of the center of UnitedStates rowing at the time.
I think currently it might evenit moved to Indianapolis and
Oklahoma of all places.
(03:55):
I'll be honest, I'm not surewhere.
I think it's in Chula Vista,california now.
They go to kind of bizarreplaces.
Speaker 1 (04:02):
So in any places, and so you were rowing and staying
very exercising a lot.
And then you were like at afair or at a park and you
noticed you were having someheart issues.
Speaker 2 (04:13):
Yeah, this was many years later.
So, yeah, just you know I kindof joke around that maybe the
shoulder injury I got, you know,was sort of the best thing that
happened, at least to mysurgical career.
I was sort of toying with theidea of medical school at the
time and then it's like, well,okay, I have to set up my senior
year of rowing.
What else am I going to do?
I mean, the book's hard andstudy for the MCAT, got into
(04:33):
Washington University formedical school, came here and
then, you know, did med school,residency and so on, enjoyed
rowing, and there's actually sothat going to to Wash U of
course meant that I moved fromum, california to St Louis.
So I've been here ever sincethen.
But there is a rowing club herein St Louis, a very good one,
uh is as, especially as far asthe high school program, but
(04:54):
they have masters rowing too.
So I rode with them for manyyears and then, um, yeah, right
around me turning 40, um, uh, Iwas um with a, um, a group of
guys we're really competitive.
I, I was, you know what one ofmy at age 40 we would have these
, um, uh, indoor rowingcompetitions, which is kind of a
(05:15):
big, big thing and we did itwith washington university and I
beat all the college kids, youknow.
So I was very proud of that.
But shortly after that, uh, yeah, I was at a picnic with my
family.
My son was you know who'sbigger than I am now, you know
was a you know that littletoddler.
I was carrying him up this hilland I thought a bug flew in my
shirt.
Uh, it's like, oh, what's thisshaking in my shirt?
(05:36):
You know, something's in there,and I was in atrial
fibrillation.
Um, went to st luke's.
I I was, you know, a surgeonhere at St Luke's at the time
Went to the ER and they did anEKG and said, oh, sure enough,
you're natral fibrillation, andthen subsequently got an
echocardiogram and I had mitralregurgitation, so one of my
heart valves was leaking prettysignificantly, but I had no
(05:58):
symptoms.
That's what really kind ofsurprised me.
I had no shortness of breath.
In fact, not only did I have noshortness of breath, I was, you
know, competing competing inrowing, which is a very, you
know, aerobically demandingsport, and I felt spectacular.
So I almost didn't believe theresults.
Speaker 1 (06:14):
Yeah.
Speaker 2 (06:15):
Uh, but I get you know.
But the AFib was, you know,atrial fibrillation kind of
convinced me, okay, well,something's going on, um.
And so I saw um, saw one of ourcardiologists here, dr Davison,
who I'm still good friends withyeah, sure, glenn, he's a great
cardiologist, total character,Yep, yep.
And he said, well, you knowyou're doing well.
And he put me on somemedication that got me out of
(06:35):
atrial fibrillation.
Thankfully I did not have to beanticoagulated.
So he said well, you know whatyou're doing, fine, minimal
symptoms, let's just watch youfor a while.
We'll get anotherechocardiogram in six months,
okay.
So it's like okay.
And then I never went back intoafib.
Actually, to this day I'venever gone back into afib, you
know, thankfully, um.
But had the echo six monthslater.
And I continued to bephysically active, continued to
(06:56):
do rowing races.
In fact I won a single skull,one person boat competition down
in atlanta, which was, you knowor no, actually it was
Chattanooga, okay, really hugecompetition.
I was, you know, justabsolutely thrilled.
And then I had my repeat echoand they said, oh, it's gotten
way worse and you're actually inheart failure now, which I just
(07:17):
couldn't believe because Istill felt completely fine.
So the writing was on the wall.
I had to get the valve repairedum so this is an open heart
surgery.
Speaker 1 (07:26):
Yeah, yeah, this is no small surgery, correct?
Speaker 2 (07:28):
yeah, this was 2005 or no, I'm sorry, 2006.
So there were, you know, someinstitutions were just kind of
exploring kind of less invasiveways, a catheter based right,
right.
Speaker 1 (07:41):
But so so take me to your mental state.
Now you've got, you're a doctor, you've started your practice
and now you've got a beautifulwife and you've got two children
that are tiny and this has tomake you consider your own
mortality, probably for thefirst time.
Speaker 2 (07:56):
Yeah, you know, it's funny.
You mentioned that I really thereality of it didn't sink in
until the day of surgery and Iremember talking to the
anesthesiologist like, and Iended up having it at Missouri
Baptist, nothing against StLuke's Great Heart Program.
I'd been here maybe three yearsand I felt very I had these
weird visions of you know, Idon't know me, like dying in the
(08:17):
intensive care unit and I waslike, okay, I don't want to die
in the hospital where I work.
And I knew Dr Kachoukis from myresidency training really well
and I just said you know what?
I think it's best if I just gooffside.
Speaker 1 (08:29):
It's also awkward too , because in the OR you're
completely naked too, and beingaround people you work with
completely naked, you wouldthink as a doctor it's not that
big a deal, but it's not themost fun thought.
That played into it as well, alittle bit right.
Speaker 2 (08:43):
Yeah, kind of the privacy aspect of it For sure,
for sure.
Yeah, that was part of it.
And so, yeah, the morning ofthe heart surgery, I remember my
wife drove me to the hospital.
I remember there was a prettyrainbow and it's like, okay, I
think things are going to beokay.
But again, just the wholereality.
It just seemed so I felt fine.
(09:04):
It really took a leap of faithfor me because I, you know,
usually you have some hugeoperation, you know you have, I
don't know, blood in your stoolor you're losing weight, or you
feel terrible or something'sgoing on.
Speaker 1 (09:17):
But you were in such good shape that your body was
able to compensate for it.
A mere mortal would havesymptoms Correct.
Speaker 2 (09:24):
Yeah, yeah, I think, I think that was probably the
thing.
So, um, so, in any event, yeah,um, yeah.
I remember meeting theanesthesiologist, who's just an
extremely nice guy, and it'slike, oh, wow, this is real.
And then, uh, yeah, then hadthe surgery, uh, everything went
fine, went home, I think, infour days, but then, um, I did
have, um, uh, pericardialtamponade about post-update 10
(09:46):
or so, and I'm going to explainto people what- that is.
Speaker 1 (09:48):
So there's a sac around the heart and that's
where blood gets into that sacand starts putting pressure on
the heart from the outside in,so the heart's not able to pump
as effectively and so you havedecreased blood flow throughout
the body.
Speaker 2 (09:59):
Correct.
And here is where I was theexception.
Again, I remember I started notfeeling well.
It was a Saturday night.
I again I remember I startednot feeling well.
It was a saturday night.
Um, I was, you know, I'd beenhome for about you know five,
six days, taking my daily walks.
Everything was great.
And it was a saturday.
My wife had a birthday party togo to.
I remember she felt really bad,just like, okay, I'm gonna go
(10:20):
to this party for about twohours, are you okay by yourself?
And I would.
It was just me and the two kids, and my son was, I think, a
year and a half or two.
At the time he'd already goneto bed, so my five-year-old and
I were just hanging out, um, andlike, oh, we're fine, we'll be
fine you know lauren will takecare of me.
And um, yeah, I I remembergetting up and was walking
(10:40):
across and I start gettingnauseated and I collapsed and my
five-year-old was there and shelike ran and got like a
washcloth and I kind of came upand she's like, oh, are you okay
?
Are you okay?
And um, and she called my wife,who came home right away.
You know, this is, you know,early cell phone days and then I
kind of felt better.
It's like okay, yeah, I'm notsure you know what's going on,
but I think I'm okay.
(11:01):
And then started throwing upduring the night.
No chest pain, no shortness ofbreath.
Speaker 1 (11:05):
Can I stop you?
Here for a second, Peoplesurgeons have this kind of a
soldier on mentality whichserves them well in their
training and through tough cases.
Yeah, but on a personal levelsometimes it does not serve you
well, Correct?
Speaker 2 (11:22):
And I think that's what's going on here.
Speaker 1 (11:24):
And it can't.
It's kind of a you know airlinepilots.
They talk kind of.
In a way it's surgeons kind ofact in a way like that and the
training ingrains that in withinyou, which is good.
But this is probably what'shappening here You're soldiering
on and not paying attention tothe obvious signs.
Speaker 2 (11:40):
Right, yeah.
And then the next morning,sunday morning, I still felt
pretty terrible and you knowwe're thinking maybe I have a
stomach flu, but my wife is, youknow, we're going back to the
hospital.
So we went to the, you know,went to the emergency department
.
It's a Sunday morning, there'snobody around and at the ER doc
happened to be someone my wife'salso a physician, someone that
(12:00):
my wife trained with at Jewishhospital when Jewish hospital
was its own entity.
Yeah, dr Brown, a wonderful guy, mary, why are you here?
It's like oh well, john just hadsurgery and I remember I'm
sitting there in the waitingroom and my main symptom was
nausea, and so they kind oftriaged me.
You know I'm there and likethere's, you know, teenagers
with, you know, sprained anklesgetting in ahead of me and I'm
(12:22):
sitting there, you know kind ofnauseated feeling, you know
terrible, but no chest pain orshortness of breath.
And then she said, well, hejust had heart surgery.
Well, is he having chest pain,shortness of breath?
No, oh, okay, he can go sitover there.
Yeah, you're on the back burnernow yeah.
And so thankfully, this ER docsaw us and kind of got us back
there, back to the, and then thePA of my heart surgeon, you
(12:45):
know, came to see me and it'slike, well, okay, my heart
surgeon, you know, came, came tosee me and it's like, well,
okay, you know, I, you know, youseem to be all right.
Liver enzymes were up a bit, sothey admitted me to the
hospital, got an ultrasound ofthe gallbladder they were
thinking that was that.
Then I started vomiting again.
They put an ng tube in, uh, andthen that we didn't get an echo
for whatever reason, for abouta day and a half.
Yeah, yeah, they got anechocardiogram.
(13:06):
They're like, uh, you got somefluid around your heart and so I
had to go back to surgery justto get a chest tube put in,
basically to drain that fluid.
And my heart surgeon came like,uh, that's the biggest
diffusion I've ever seen.
So yeah so I felt better, but ittook a long time to bounce back
from that this makes me thinkof two things.
Speaker 1 (13:23):
One is, um, this is the advantage of being in good
shape.
Yes, you know like, if you arestrong, if you're healthy,
you're able to sustainsignificant medical issues and
get past it.
And so that's the reason youneed to keep yourself in good
shape.
When you do get sick whicheverybody will you can say well,
I've done everything right.
(13:43):
Why am I sick?
And the better way to look atit is you know what I'm strong
going into this.
I've kept myself in good shapeand that will help me get
through this better, correct?
The other thing is absolutelybeing married and having a wife
to tell you hey, we're going tothe hospital is so I encourage
young men to get married becauseit typically leads to a longer
life.
Oh yeah, yeah, that's verypredictive as.
(14:04):
So take me through how you feltlike mentally and emotionally,
as you're going through that,and when you considered the
prospect that this may limit thelength of your life.
Speaker 2 (14:24):
Yeah, you know, I don't think I ever really felt
necessarily like, okay, this isgoing to shorten my lifespan.
I did have some heart surgeonssay and so the original surgery
I I had thankfully the my valvewas so they're able to repair
the valve.
So I had what's called a mitralvalve repair.
Okay, I did not have to get aprosthetic valve.
(14:46):
Now they did what's called anannuloplasty, basically the kind
of circular area where the,where the valve resides, was a
little bit wider than it shouldbe.
So they tightened that up witha ring anuloplasty, basically a
little Gore-Tex ring but there'sno prosthetic valve.
So I did not have to beanticoagulated and in theory
that should be kind of alife-lasting repair.
(15:10):
I initially had actually one ofour heart surgeons here who's
not here anymore say oh yeah,you're going to have to have
that redone in five or 10 years.
And here we are, 20 years later, there's always a naysayer.
Speaker 1 (15:19):
There's always a naysayer, yeah.
Speaker 2 (15:21):
And so for that moment that led, that kind of
ruined my lunch that day, I'mlike what so?
Speaker 1 (15:26):
haters going to hate.
Speaker 2 (15:27):
But.
But.
So I would say I didn't then,nor do I now, feel like, okay,
my life's going to be shortenedbecause of this.
But having gone from what Ifelt like I was in tip-top shape
and I'm kind of on top of theworld, you know, kind of with my
job great job, you know, youknow.
You know as long as you haveyour health, you have everything
right and you know.
So that took a hit in the sensethat after the surgery,
(15:49):
obviously a huge operation, andthen the second surgery to
require it to drain that fluidaround the heart, and I was just
, as the saying goes, as weak asa cat afterwards, and that was
difficult, that was really hard,yeah you got young kids, you
want to play with them and youcan't.
(16:10):
And it was six to eight weeksand I'll say at that point I was
88% to 90% recovered.
And then it was another six to12 months till I really felt
like kind of at the 100% level,maybe even a little longer than
that.
It took a long time.
Speaker 1 (16:22):
This is one thing concept that I remind people of
all the time.
When you lose strength andstamina so quickly when you're
in the hospital, I don't carewho you are, and it takes a long
time to build it back up.
And Warren Buffett has a jokeon this.
He says you can't get ninegirls pregnant and have a baby
in a month.
Speaker 2 (16:40):
Some things just take time.
Speaker 1 (16:43):
And that's.
And so it's good to berealistic and patient and say,
hey, I will get stronger byprogressively overloading myself
and doing a little bit moreslowly, and get back.
Do you feel like it made you abetter physician going through
this?
Speaker 2 (16:56):
all, without question , it's good because I can tell
my you know, if you know, havingeither a urinary catheter or a
chest tube or an ng tube, youknow, nasogastric yeah, I've had
all those things, yeah, andthey're like, well, you don't
know what it's like and I trynot to be that guy that's like,
oh well, let me tell you mystory.
You know, it's like, you knowwhat I, I know exactly.
I actually do know exactly whatyou're going through.
(17:17):
So I, you know, I think youknow not that I would want any
of my fellow physicians to.
You know, um, you know, againsttheir will, go through anything
like this.
I, I think there used to betimes during um medical student
training that they put ng tubesin each other.
Oh really, I think.
Thankfully those days are gone.
But no, I, I think, having gonethrough that, there was no
(17:38):
question.
It made me a lot moresympathetic to the plight.
And again, obviously I'm asurgeon, that's my main focus.
But I don't just leave it atthat.
I try and figure out, okay, howcan we get these people active
again, what's the best way.
For sure, in the short term,let's set up a very specific
plan, not just like oh yeah, youknow, don't do anything for six
(18:01):
weeks, it's like, okay, well,that's not very helpful, yeah.
So I tell almost all my patients, if they're good enough to go
home, they're good enough for adaily walk.
Yeah, and I'm not, you know,since I'm, you know, focused on
abdominal type stuff.
They can usually get out of bedand bear weight and so they can
get outside.
As I tell them, get outside,feel the sunshine, feel the wind
blow, hear the birdies sing.
You know, just, you know it's,you know, you know all those
(18:24):
things are very positive, and ifyou just make it to the
neighbor's mailbox and back,that's great.
Yeah, that's the first day.
The next day, make it to twoneighbors, uh, a ways yeah, just
a little bit of the strengththat counts is the lower
extremity strength.
Speaker 1 (18:38):
Oh yeah, you know doing curls at the gym
indefinitely will do nothing foryou in life, but having strong
legs and your glutes and yourcore strong that will get you
through a hard time andpsychologically.
Just going for a walk andbreathing the fresh air and
feeling the sunshine is so goodfor you, and so I do the same
thing with my patients too.
(18:59):
I have kind of a mantra.
I say keep your legs moving,your belly full and your chin up
because I'm trying to fatten mypatients up because they're
going through cancer treatments.
And then the other thing thatyou know, being a patient and
realizing if you have a gooddoctor when I've been a patient
(19:20):
I was fortunate enough to havevery good doctors and just the
their, their confidence, thereassuring me, it, it it like
meant the world, because I was.
Speaker 2 (19:32):
I was afraid.
Speaker 1 (19:32):
I mean I was trying to pretend like I wasn't but
like I was afraid, and havingsomebody come in and put their
hand on me and say, hey, youknow we're going to be okay here
.
We've just got to kind of gothis way or that way.
But just hang in there, right?
You know, when you say it as adoctor, you're like I don't know
if that resonates with anybodybut man as a patient you're like
, thank God that this guy's herefor me.
Speaker 2 (19:51):
Yeah, no, I agree completely.
Well.
Speaker 1 (19:54):
John, I appreciate you sharing your story with us.
I think it's a uniqueperspective when you're a
physician and then you become apatient, especially when it's
something so significant, and Ithink there's kind of plenty of
lessons to be learned.
Speaker 2 (20:07):
Yeah, well, thank you , thanks for having me.
It's always a pleasure, yeah,thanks.
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