The 67-year-old man dropped heavily into the plastic chair inside the Alta Mountain resort in Utah. It was his third day skiing the Rockies but his first at Alta. He had been excited to try these new slopes, but his run that morning was brutal. It was a clear, cold day, and the sharp mountain edges stood out crisply before the bright blue sky, so different from the slopes back East where he lived and usually skied. About halfway down an intermediate-grade slope on his first run that morning, the man started to feel bad, as if he were coming down with something. He rested for a few minutes and when that didn’t help, headed back to the lodge. The trip down was miserable. He felt a strange exhaustion and had to stop every few minutes, as if he were running up the mountain rather than skiing down. It was so bad that, at one point, he worried he would have to be taken in by the ski patrol. But he made it. Finally.
As he entered the warmth of the lodge, he was greeted by the usual scent of coffee and the cinnamon charm of freshly baked pastries, but he wasn’t hungry. Sitting by the fire, he tried to figure out what was wrong. He wasn’t out of breath anymore, and that was a relief. But now he had a strange ache in his chest, a few inches below his right clavicle, as if he pulled a muscle. And he was sweating like crazy. He could feel the cool of the saturated undershirt against his chest. He could see the dark dampness as it seeped through his turtleneck. A door opened, and the cold air chilled the sweat on his face. He just sat there, unable to do anything more. It was nearly an hour before he started to feel better; the ache in his chest was still there but the crazy sweating had stopped. And he felt well enough to return to those beautiful slopes.
But first he had to buy a new shirt; the one he was wearing was soaked, and he would be cold out on the mountain. Finally dry and relayered, he grabbed his skis and headed toward the lift. On his way, he saw the first-aid building. He felt OK now but was worried — was he well enough to ski? A young woman was working behind the counter. He described the strange and sudden fatigue he had on the slopes and the drenching sweats and chest pain he had in the lodge.
Out of nowhere a young man appeared. “I need you to come back with me,” he said, then introduced himself as the doctor on duty. The man needed an EKG, the doctor told him, and led him to an exam table. He placed the sticky tabs on the man’s chest, arms and legs. “You’re having a heart attack,” he explained gravely as the spikes of heartbeats moved across the screen. “No, I’m not,” the man replied promptly. He had never had a heart attack, but he knew what they were supposed to feel like. He had no chest pressure, just this ache. And it wasn’t even on the left side, where pain from heart attacks usually occurs. The doctor was insistent: The EKG clearly indicated a serious myocardial infarction. The man resisted. “Call my son,” he said. “He’s a doctor. He’ll tell you I’m not having a heart attack.”