Circa 2010
Dr. Marc Wallack was a celebrated surgical oncologist and avid marathoner with a vibrant career. Then, unexpected symptoms of angina suddenly turned doctor into patient and changed his life and future forever. With the help of his wife, Fox News reporter Jamie Colby, Wallack has documented his experiences in recovery in Back to Life After a Heart Crisis, aiming to help patients navigate their experiences by melding medical knowledge with intimate experience and by emphasizing the role of a supportive caregiver. ABILITY Magazine’s Chet Cooper visited with the couple about their work, their marriage, and recovery.
Cooper: When did you get the idea to write a book about your experience?
Marc Wallack, MD: About three weeks after my surgery, I read Lance Armstrong’s book, It’s Not About the Bike, in which he basically recounted being diagnosed with cancer, undergoing surgery, and then having to go into intensive chemotherapy. He wrote that he began to recognize that if he survived, he had to get back on his bike and ride again. So that was one of my motivating factors: I wanted to write about how I was doing as I went through the different stages of my recovery.
Cooper: How did you pull Jamie into this?
Wallack: Jamie was involved right from the beginning. I had been running for four days in a row, training for the New York City Marathon. About seven minutes into every run, I was getting what I thought was just acid reflux. In actuality, it was angina. Each time it happened, though, I would make excuses for what it was and why it was happening. And with each run, I would just take more and more antacids or Xantac or Prevacid, trying to get this under control. But sure enough, every day at about seven minutes into the run, I would get this sharp pain in my chest. It didn’t radiate, though, and I didn’t really worry about it.
By the fifth day of this, I had convinced myself that the reason I was getting the pain was because I was running indoors and not outdoors. I began to change my routine, running uphill from our house and into Central Park. But as I reached the park, the pain started again—and this time it radiated into my chin.
I realized then that I had a decision to make. And Chet, I almost didn’t make the right decision. I almost decided, “The hell with it, this is nothing. I’m going to continue the run.” Had I done that, I would not be here to have this discussion. Fortunately, I stopped running. The very next day, I went to get a stress test and I flunked it for the first time. I brought Jamie in and she was there with me, so she can probably tell the rest better than I can.
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Jamie Colby: Well, at the time of all of this, I was working as an anchor on a CBS show called Up to the Minute. When Marc came in from his run that day, I was leaving for a Sunday bike ride after having gotten off of work, and Marc said to me, “You know, running didn’t feel so good, maybe I’ll go on the bike ride with you.” I didn’t know that he was having any kind of chest pain. He looked good.
But since he wasn’t feeling well, I said, “Why don’t you just lie down and relax? It’s Sunday. I’ll be back in an hour.” So I left. He called his cardiologist while I was out of the house, and the next day he went for the stress test. But as I got off the air the next morning, he called me in a very weak, quiet, child-like voice and said, “I need you to come down right away. They won’t let me walk the couple of blocks back to the hospital.”
So I really had to become an instant advocate. We were a young, active, healthy couple. Marc’s a marathoner and I’m in shape. We had our honeymoon at the Canyon Ranch. We were all about health, and at that time in our lives, the least likely thing for us to deal with was something like this. We both had to adapt to this.
I took a field trip to the cardiac intensive care unit the day before Marc’s surgery, just to see what someone in his situation might look like and to prepare myself for the future. I think it really takes two to make a cardiac comeback—whether that other person is your friend, your advocate, your lover, or even just someone to take note of what’s going on, to explain it to you, because chances are good you might not hear everything you need to hear.
Cooper: I love that your book includes pull-out advice sheets for caregivers. It seems that, even though the book is specific to your situation, it can really be useful to people who are going through other types of surgeries as well.
Colby: That’s the response we’ve gotten. We just got a note yesterday from a surgeon who’s providing our book for every surgeon in his department. You can only really know these experiences if you’ve gone through them. Marc isn’t just a physician, he’s also been the guy lying on the table in that hospital gown and looking at the ceiling. In a way, he can tell you what even your surgeon might not know how to tell you.
I hope the book gives people good ideas and strength, and I hope it also helps them dispel their own fear of speaking up when they have questions or are scared. The morning of Marc’s surgery, this big guy came in and grunted that I had to leave the room. I had just seen the movie The Green Mile, by the way, so I guess I was feeling a little scared in general. Anyway, I said “Okay,” and as I left the room, I heard the noise of a razor going on and on and on. The guy was shaving Marc. There was no reason why I needed to leave the room, you know? Even simply being at the other end of the room with the curtain closed between us would have been enough to allow Marc and myself some peace of mind.
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Cooper: Just to draw that strength from each other in the room.
Wallack: One of the things that I always emphasize to cancer patients I take care of is that it really is necessary to have somebody with you who is your advocate. Because once you hear someone say that you had angina or a heart attack or that you need surgery or that you have cancer, your mind shuts off. In that moment, there is no question that you are intelligent enough to ask. Because when you hear diagnoses like that, the first thing you think is, “I’m gonna die.” The curtain comes down. So it’s important to have someone there when it happens, whether it’s a friend or a relative or a significant other.
Colby: And some of the people who were closest to us didn’t really want to be around us anymore. Sometimes I’d say, “I’m really trying to get Marc out of the house. What do you think about us all going out for dinner together?” And some people would be like, “You know what? That would be so depressing for us right now.” So you find yourself dealing with that aspect, too. Alienation.
Even at the hospital, some people were telling Marc he couldn’t be viewed in the leadership capacity he had held. I know that a lot of people who get sick like Marc did end up being alone. So I really wanted people to see that maybe we are the faces of the people that give strength.
Cooper: Can you talk a little about that, Marc? The concerns the hospital had about having you in a leadership capacity?
Wallack: I was chief of surgery at a major institution, and I had essentially been recruited from the outside to take a hospital and bring it into the now—which, at the time of my hiring, was the early 1990s. Obviously, a job like that is totally consuming. I was organizing the operating room, organizing surgery, developing a practice, organizing the medical residents to teach them how to learn, organizing medical students, sustaining a relationship with the medical school, developing relationships with all of the other physicians who were both inside the department of surgery and outside of it. And I was a Connecticut Yankee in King Arthur’s court. I was the guy brought in from the outside, so I was always going to be an invited guest.
So expectations were high. And any time you are less than what is expected, once someone sees a weakness, the game changes. Maybe in my case they started to feel that I wasn’t going to live too long, that I wasn’t as strong as I once was. Maybe I wouldn’t be capable of running the department the way I needed to. And so the people who were there who wanted my job ultimately began to rise up and began to get ready to take some shots.
I think that’s human nature, no matter how many friends you have at work. Plus, people in leadership positions rarely make friends at work because their responsibility is making decisions, and friendships can compromise those decisions.
Cooper: And you were operated on in the very hospital where you were a leader.
Wallack: Yes. So, naturally, there was this flood of more information than anybody needed to know. If I had had my operation at Cornell or Columbia, none of my coworkers would have known anything more than that I had had open-heart surgery. But that wasn’t the case at all.
Colby: And the level of performance that Marc had given at the hospital prior to his health problems was so superb that no one else at the time was right for the job. The position was untouchable.
Wallack: Anyway, when I got back to my life after surgery, I knew that if I couldn’t run, I couldn’t live. I knew that in order for me to be able to run, to get back to the kind of person I wanted to be inside, I would have to do some intense rehab.
So I did. That level of rehab took two hours out of my day, and it would leave me so tired that I would have to take naps in the middle of the day on a pretty frequent basis. But there was nobody that I could explain this to. I had told human resources that this regimen is what I needed to do, thinking that maybe that sort of disclosure would provide some protection, but that was not the response I got.
Colby: It almost worked in reverse. It blew their minds. When Marc’s coworkers saw that he had gotten out of the hospital on the third day after a quadruple bypass, and that he had come back to work within six weeks and was also juggling rehab, they flipped out. They couldn’t understand why he was able to do it and why it was worth making a commitment to him. I suppose they thought he should be a couch potato for the rest of his life. They really lashed out at him for trying to get back to where he was.
Wallack: And the worst part was, when I ran the marathon, several individuals came into my office and basically said to me that my judgment and capabilities were impaired because I had run the marathon. Can you imagine? This should have been a celebratory event, but instead it was given a negative spin because my coworkers actually didn’t want me to recover.
Cooper: Maybe all physicians should go through some major surgery so they have a better understanding of what it’s like.
Wallack: Oh, man, you have no idea. There is no question that it changed my approach in taking care of patients. I suddenly understood what kind of pain some of my patients were going through, both physical and mental, in a very real way. I knew how to provide for their pain. I knew medication-wise what they needed. And I was much more empathetic. It made me a better physician.
Cooper: I’ve interviewed many people who have acquired a major health condition or disability who say the experience has awakened in them so many new ways of looking at life, of understanding the value of life and the value of themselves and their ability. The challenge, though, is getting people to understand these awakenings without going through the specific experience.
Wallack: Right. I don’t know the answer to that, I really don’t. But I’m hoping that the book that Jamie and I wrote can help bridge some of that gap. Even as someone who has experienced these changes and these social or physical challenges, there are times that I forget them. And then I have to come back and try to get myself centered. Because I’m still alive.
I should be dead, to be very honest with you. If I had run another 20 yards, they would have found me at the edge of Central Park and they wouldn’t have been able to resuscitate me.
Cooper: That would’ve made for a pretty awkward interview.
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Wallack: (laughs) Well, maybe I could have sent this all to Jamie telepathically. Your readers would have said you were a little bit out there, but it could have been credible.
Colby: You know what’s interesting, Chet? Before this whole experience, Marc wasn’t funny before. He had no comedic timing, he didn’t know how to tell a joke. And yet humor played such a tremendously huge part in his recovery.
Cooper: Yeah, I noticed that in the book, you actually listed movies you enjoyed. I thought that was an interesting element.
Wallack: You know something? Before this whole experience happened, I watched a lot of dramatic, heavy movies—stuff that had to do with gunplay or whatever, because it would excite me or charge me up. But while I was going through my recovery, I couldn’t handle any movies that had anything to do with death. I moved over to romantic comedies, mostly.
Colby: Tell him about Marley and Me.
Wallack: Oh, my God, Marley and Me. That one is good for at least six boxes of tissue.
Colby: Our dog Maddie was a really special part of Marc’s health and wellness. Some of the things she did would just blow our minds. Three weeks after I had laid Marc on the couch in some kind of Oxycontin fog, Maddie got up onto his chest and laid herself across his incision. She had never done that before.
And then, about a year later, my son told me that Maddie used to lie across his head when he would have migraines. Somehow the dog knows these things. So when Marc saw Marley and Me, he was inconsolable.
Cooper: Good thing you had some medication around.
Wallack:(laughs) Right.
Cooper: Marc, when you’re dealing with a patient who uses drugs to manage pain, and you know the patient will not live beyond a certain time period, why is there still such a concern about getting the patient addicted on the medication? Shouldn’t the patient be allowed to use as much as he likes at that point, if he is not likely to survive anyway?
Wallack: That’s a good question, and the paradigm for dealing with that kind of a situation is slowly shifting. When I was in my residency, in my first years of practice, we all had the same question that you do. But in respect to my patients, I really didn’t understand the importance of making sure that they were comfortable in their last days, because I still had hope they’d come through the other side of the experience all right. In my mind, I was some kind of savior, so why would I drug the people I intended to save?
But realistically, when we’re dealing with patients with advanced cancer, the question eventually becomes one of dignity. And dignity, for me, involves being able to keep them comfortable with moderate medication. Today, for patients with terminal cancer, we provide a pain management service in our hospital. But I can totally understand what you’re saying.
Colby: I think Marc’s own experience with his health has helped him realize there is a big difference in treating physical pain and emotional pain. He’s better now with figuring out if a patient’s pain is physical or psychological, which I think is a big victory.
Cooper: Your book also addresses issues of depression and post-traumatic stress disorder, which is not something most people think about when they think about surgery.
Colby: To be brutally honest, Chet, there remains such a stigma about depression, and Marc experienced some of that himself. People would say, “We don’t want him in our hospital. He’s depressive. He’ll depress us. He won’t be able to handle the pressure.”
Wallack: I went through it, yes, and the depression was very severe. A lot of crying. I spent the first six weeks at home, and I couldn’t even talk on the phone, because when I tried, when I said hello, after that I started to cry. Obviously, my appetite decreased immensely, and I went down to about 135 pounds, where before I was about 150, so it was a pretty severe change. This was all due to feeling like I was having my legs cut out from under me at a time in my life when I didn’t expect it.
Colby: You know what restored life for Marc? Running again. Running is such a huge part of who he is and his strength and his inner core. And his post-traumatic stress came into play when he ran back into Central Park for the first time.
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On top of that, Marc had people at work and in his daily life treating him like he couldn’t be more than he was. But every patient, I imagine, feels somewhat diminished initially. And it’s really important to find something in your life, something physical, to help you overcome those feelings, not only to prove to yourself that you’re alive, but to show everybody else around you that you are. But ultimately it cost Marc his job. I don’t know what was worse for his coworkers: that he got sick, or that he got better.
Cooper: I interviewed Christopher Reeve several times, and one of the last times I met him, he was on the show The Practice. He was not only acting, but directing that part as well. So he got back to a place to where he was able to do what he had always done. He was at a place where he felt empowered.
Wallack: A very good example.
Colby: Not to be too out there, but Marc and I have discussed whether an emotional trauma can maybe accelerate disease, and he does think that maybe there is a connection. We have some statistics in the book, too, that caregivers end up oftentimes developing heart disease and other illnesses because of the stress.
I truly believe that Dana Reeve, having gone through what she did with her husband, and having watched someone she loved so much go through so much, may have gotten sick from a broken heart, at some level. It’s so traumatic for a caregiver to watch someone she loves—especially someone with Christopher Reeve’s kind of fighting spirit—lose. I feel really lucky that we were blessed enough to have Marc here and to have made it work. But it’s very hard.
Cooper: And today caregivers are becoming even more important, especially as baby boomers retire and deal with their own parents. As medicine actually gets better, people will be living longer with more illness.
Wallack: Absolutely. That, I think, is a really critical point. I tell my residents and my medical students that in their practices going forward, they’re going to have 90-year-old patients come in who are going to ask for elective surgery and expect to come out of it okay because they don’t expect to die at 91. It’s really important to be aware of these changes.
Also, in respect to changes in health care policies, we can expect to see a whole other population of insured patients who will collectively put a tremendous weight on the medical complex. It used to be that end-of-life care was being given at maybe ages 75 to 80. But there’s good reason to think it may now extend so that elective care might go until somebody is 90, 95. Nobody’s talking about this, and I’m not sure anybody’s even bringing it up, but it’s obviously a big issue.
Colby: Well, in our case, we’re both just really thankful God gave us some more time together, because we almost didn’t get it at all.
