She was an active patient, who I am still trying to see once a week until I direct her in how to survive and flourish in the universe. She was in her forties, depressed and anxious.  She had “a little panic attack,” some chest pain and the feeling her breath was cut off. I wasted no time sending her to an Emergency Room, (or, if she really did not feel it was that bad, to an Urgent Care — what we used to call it a “doc in a box”) because it is cheaper, sounds less foreboding, and any doctor who is sentient and has a pulse and is on duty would send her to an Emergency Room if anything was really wrong.

Chest pain or tightness or shortness of breath or a “tight feeling, like a vice” could always be a heart problem, and could always be life threatening until proven otherwise.  I tend to send  even the most mild discomforts of this nature, that people had for years to primary physicians for a “cardiocentric examination.”  For “auscultation,” the old fashioned Latin-origin word for a good listening to the well as generally an electrocardiogram and sometimes even an echocardiogram.

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