The Yin and Yang of Interventional Cardiology: Physician and Proceduralist

Jaya Mallidi, MD, MHS

Monday morning, 7:10 AM. I am late for the weekly cath conference. Again. I see the long queue at the coffee shop and decide against getting my morning drip coffee. I hurry up to the second floor, open the conference room door cautiously, and peep inside. All heads are turned to the large screen at the center of the room, projecting the coronary angiogram of the patient being presented. I tiptoe softly to the back of the room and take a seat. The arteries filling with the black dye against the whitish-gray background appear smooth, dancing like the tentacles of a hydra to the rhythm of the beating heart. On the next image, I see a transparent catheter with a dark tip extending into a pigtail, joining the dance synchronously with the arteries. Another Impella case.

I do not register any of the clinical details of the patient being presented. My thoughts start drifting to the patients I consulted on the previous call night. I feel the weight of the fuzzy, jumbled ball of clinical decisions I made in my head. I remember the white pearl bracelet and the manicured, auburn-red-polished nails of my patient as I took her hand and felt her thready pulse.