Consciously or unconsciously many persons go on deceiving themselves. That way seems easier, and like the proverbial ostrich, they persist in ignoring realities. Our nation was greatly upset by the report of the then President Eisenhowers heart attack. To most persons this came as a terrific shock, since the then President had had regular check-ups and was always reported to be in fine condition. The U.S. News & World Report in its September 23, 1955, issue stated that while the numerous reports about the Presidents good appearance and robust health made some persons wonder whether these reports might not have been deliberately exaggerated, the fact was that President Eisenhower was in peak condition. The New York Times, September 27, 1955, pointed out that a check-up on August 1, 1955,failed to detect any hint of arterial disease.

And yet, a coronary attack like Mr. Eisenhowers does not develop suddenly. We keep building up to it, and a superficial appearance of what is usually regarded as robust health is not an indication that a heart condition may not be developing.

Dr. Paul Dudley White, called in consultation on the Presidents case, said rightly that though it is not always easy to diagnose the thickening of a coronary artery before an attack, that thickening may occur years before the thrombosis.

This disease is about the commonest important illness that besets a middle-aged man in this country today, Dr. White pointed out and added that the average age is about fifty in this condition. Since the Presidents age was nearing sixty-five, he was fifteen years ahead of the game from the standpoint of that type of illness.

We were pleased to note that Dr. White, in discussing causes of the disease, specified stress and strain, diet, alcohol, and tobacco among the factors that might contribute to its development. However, wa. couldnt but wonder why, if the onset of this disease is to be controlled or checked, these factors arent stressed ahead of time, as a measure of prevention ?

Because of the Presidents illness, coronary artery disease became a subject of wide discussion, and scientific writers quoted authorities to the effect that the disease is not nearly as dangerous now as it was in the past, and that a greater number of sufferers recover now than formerly.

We should all be grateful for this. However, an investigation will disclose that whatever progress has been made has taken place not because of any new remedies, but because there has been a vast improvement in the handling of these cases, which are now treated very much more in line with the approach advocated in this volume.

We note that the President took no food except orange juice for the first few days, and then was kept on a very careful diet. The use of oxygen is, of course, standard procedure and was necessary in the Presidents case. But we still ask, why werent the factors enumerated by Dr. White as possible causes of hardening checked before the attack occurred to make certain that the Presidents case would not progress to the point where an attack became unavoidable?



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