I am indeed the product of my environment. I am a cardiothoracic surgical nurse on one of the most renowned open heart teams in the nation, maybe the world. As such, I am immersed in a culture of cut, tie, repair, meaning, I look for the surgical remedy as 'the' remedy in regards to heart disease.

I thought of this 'immersion' or perhaps myopia when I read a book called, 'Journey to the Heart' by David Monagan. Within this informative book, I learned that the pioneers of diagnosing heart disease were (and still) are cardiologists. I realized from reading that book that I as a open heart nurse merely parroted what I thought was the remedy or treatment for persons needing some sort of intervention for their respective demonstrable heart disease.

Now, in all reality, I work in an institution (God, that doesn't sound good!) where the patients that present more often than not NEED surgical intervention. These patients are high acuity patients that are mainly, re-operative patients (2, 3, 4, 5...open heart surgery); they present with other disease processes in play other than the primary offender of heart disease, and these patients may have been refused surgical intervention at other facilities. In other words, many of the patients, we see, have been told to go home and die. Their presentation in our OR is usually their last hope.

That being said, there is a population of patients that may do well with stenting procedures if done by an experienced and savvy cardiologist, and granted that the patient is a prime candidate for the procedure. What I have learned from reading Mr. Monagan's book, is that heart disease and it's treatment is more of a commodity in some hospitals, with the proxy being the patient.

There appears to be essentially a 'gang-land' war going on over heart disease and it's treatment between surgeons and cardiologists. If you are the patient it is up to you to 'arm' yourself with facts relative to options for treatment, understanding your type of heart disease, and understanding what treatments will afford you the best quality of life!