Three degrees of separation

This may be the most unique (life saving) diagnosis I’ve ever made.

So, I get a call from an esteemed acquaintance (around 9pm on a Saturday night). He was a constitutional lawyer (turned Professor) and Yale graduate with a very intelligent, metamorphic and unemotional character.

He tells me he’s depressed. My response was, “how long have you been depressed”? He said one day. I asked if he had any losses (family or otherwise)? He said no and had no family history of depression. He then went on to say “he was very tired, dropped a glass out of his hand and wanted to go to bed”. When he indicated hallucinating upon closing his eyes, I knew the diagnosis.

I told him if he goes to bed, he’s never going to wake up. I then said “you’re not depressed”. You have a third-degree heart block and your pulse is 15. I urged him to go to the emergency room and would meet him there. He was hesitant and said he had a brief on Monday. My response was, “you would never make it to Monday”. He finally acquiesced and agreed to go to the ER.

I got there first and waited for him. I told the nurses to bring him in for an EKG. When he got there, he looked faint. They took the EKG and found a third-degree heart block and a pulse of 15! I called a cardiothoracic surgeon and a pacemaker was implanted. He also had severe diabetes because he was overweight.

At any rate, he lived an extra 15 years and eventually died of cardiac problems. That night… I felt dazed, confused and couldn’t understand how I made this diagnosis?

It blew my mind and took days to recover.

This may not only have been the best and most unique diagnosis I’ve ever made but also the fastest.