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In the Land of Medical Wizardry : When a Loved One's Life Could Hinge on a New Heart, His Family Wishes for More Courage, Brains--and Money


TUCSON — Tragedy has lousy timing.

One minute you're assembling a wall unit in a New York City apartment, cursing the midsummer heat. The next, you're racing to catch a plane to Phoenix, where your brother-in-law has suffered a massive heart attack. Only 43, he's been haunted by cardiac trouble much of his life and had quadruple bypass surgery at 28. He could be dead before you arrive.

"Come quick," his wife says over the phone, fighting back tears. "Richie's in trouble."

Nothing ever prepares you for catastrophic illness in a family. You might know years in advance that someone is sick or dying, and you can brace yourself for bad news in the distant future. But when that day arrives, the shock is overwhelming.

Suddenly, the world of hospital bills, health insurance and medical mumbo-jumbo becomes real. A headache you've kept at arm's length invades your life--and transforms it overnight.

It's Saturday evening when I step off the plane into 110-degree heat. I'm scared for my family, also embarrassed to admit how little I know about health care. Yet in the next seven days--as Richard Evans fights to survive--I'll get a crash course in the technical marvels and financial shenanigans of American medicine. I'll meet bona fide heroes, good Samaritans, irritating bureaucrats and some of the greediest people who walk the planet.

For me, it'll be an eye-opener. Richie's education began long ago.

Like a poker player with rotten cards, he was born into a family with a long history of heart problems. His father died of cardiac disease at 68, and Richie inherited the family's high and deadly cholesterol counts. A native New Yorker, he first experienced chest pains at 25 on a basketball court and had his first heart attack 10 years later in 1985.

Now, he's had his second. I rush to the Scottsdale hospital where he's hooked to tubes, wires and beeping monitors, hanging by a thread. His ashen, unshaven face tells the story.

"Your brother-in-law's a sick man," one nurse says. "His heart is very weak."

So are his finances. Like 34 million other Americans, Richie has little or no health insurance. Unable to get full coverage because of a "pre-existing" condition, he's tried to tough it out, ignoring telltale signs of his failing heart. Meanwhile, his auto collision appraisal business has hit the skids, and his wife, Marcia, hasn't found good-paying work.

Gravely ill, he doesn't even have a cardiologist.

"Glad you could make it," he says weakly from his bed. "How 'bout them Yankees?"

It's what I've come to expect from my brother-in-law. He's raised denial to a high art and his tough-guy humor has become a trademark over the years. In the coming days, I learn secrets that he has taken great pains to hide from us; nights he went to emergency rooms, complaining of chest pains, but didn't want relatives to know.

Doctors warned that his bypass surgery would be good for only 15 years, but he never lived with a sense of danger. Now, faced with a crisis that could kill him at any minute, he's doing what men always do at tense and awkward moments. He's talking sports.

Raised in Queens, Richie dreamed of becoming an athlete. And even though his body betrayed him, the street-smart swagger remained. Tonight, I've brought him a souvenir he'll cherish--a baseball signed by New York Mets pitching great Tom Seaver. His face brightens.

" This is gonna bring me luck," he says, rubbing the ball. "Gonna need some luck."


A whole bunch of luck, it turns out.

Richie's condition remains critical and by Sunday morning he's under the care of a doctor who pulls no punches. Physicians need to know how badly his heart has been damaged, the doctor says. Yet the procedure to find out, an angiogram, could kill him.

Dr. Daniel Storch was supposed to be enjoying a quiet weekend at home with his wife and children, his first time off in six weeks. But that was before my wife in New York got him on the phone. A journalist who tracks down people like a heat-seeking missile, she reached Storch after getting his name from a respected Phoenix cardiologist. She had left an emotional message on his home answering machine: Could he find it in his heart to help her brother, or recommend someone who could?

While my wife works the phones back in New York, her sister, Barbara, has flown out from New Jersey to join Marcia and me for the vigil. We wait nervously for Storch to complete the angiogram, during which a catheter is inserted into Richie's cardiovascular system to determine how much his arteries are clogged and how badly his heart muscle is damaged.

Afterward, the doctor looks grim.

"I think your husband may need a new heart," he tells Marcia, showing us films on a video machine. "Three of the arteries into his heart are completely blocked, and the fourth is 99% blocked. Only a small portion of heart muscle seems to be working."

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