The Untimely Death of Tim Russert
By Alen J. Salerian, MD
Tim Russert, the popular NBC television reporter and the host of “Meet the Press,” an award-winning program, died of a heart attack on June 13, 2008. What we don’t know at present is whether his death was preventable.
Of course, it is easy to speculate. Yet, there is something unnerving about a 58-year-old man who has been receiving good medical care to die of an acute heart attack, what modern medicine would define as a sudden cardiac event from a thrombotic occlusion of the coronary arteries. By now, we know that cardiac disease including high blood pressure, high cholesterol and coronary insufficiency are diagnosable and treatable.
We may never know what truly happened to Tim Russert and his particular problems. As somebody who has not only treated but participated in the care of VIPs – for however it is defined, whether this is synonymous with wealth, power or success – one impression has been predominant. VIPs, not only in the United States but at any other place on our planet, get imperfect care. This may sound surprising for the most privileged not to get perfect care. Yet, it is also true. It was almost too late, for instance, for President Clinton to get cardiac surgery for his long recognized problems of coronary artery disease and hypercholesterolemia. Other presidents have had the misfortune of getting second-class care, perhaps the most notable being President Roosevelt’s mediocre care before his hypertensive‑induced cardiac problems. Problems which had been grossly neglected by his personal White House physician, Dr. James McIntyre. Of other not so fortunate U.S. presidents, Ronald Reagan stands out for his delayed diagnosis of Alzheimer’s.
Whether you are the head of a multibillion dollar entity or a President of a country or a Hollywood star or just simply privileged, watch out. Medical care is compromised because VIPs are often successful people who insist on dictating their own care and their physicians may overly accommodate their personal wishes at the risk of reasonable medical treatment or diagnosis.
For the physician to be effective, he must not only be good but he should feel he is in charge of the diagnosis and treatment, and in the doctor‑patient relationship, the patient’s VIP status often has an adverse impact.
This is, of course, all speculation when it comes to sudden death and cardiac disease. Anyone with alarming symptoms suggestive of heart trouble must consult an expert in cardiology. Various medical tests are considered standard and they include electrocardiogram, stress test, blood homocysteine and C-reactive protein levels. Evidence is compelling that even in highly ambiguous situations, angiograms with visualization of coronary arteries and heart scans can be particularly effective in correctly diagnosing an otherwise dormant cardiac abnormality. So for any heart attach victum VIP or not, some questions and answers of course would help; such as did the victim have a heart scan or a angiogram or any other study visually establishing his or her precise health.