Our Patients. Their Stories. Jeff Sharlet.
Before he had a heart attack at age 44, author and Dartmouth English professor Jeff Sharlet admits that not only did “I not like living healthy, but I was also, to a slight extent, disdainful of people who did live healthy. Walking was boring and I thought, ‘I don’t have time to exercise.’”
However, after having a non-ST segment elevation myocardial infarction (NSTEMI) in mid-October 2016, Sharlet did a 180-degree turn. “I changed everything,” he says. “I exercise every day and I’ve lost 70 pounds. I was 240 pounds and now I’m 170. I went to cardiac rehab, which is something that everyone should absolutely do after a heart attack. And then I joined the gym after cardiac rehab was over.”
An NSTEMI is a type of Acute Coronary Syndrome, explains Gregory A. Dadekian, MD, Sharlet’s Dartmouth-Hitchcock Medical Center (DHMC) cardiologist. “It’s a very urgent situation but it’s generally not an emergent situation where a patient is rushed to the cath [catheterization] lab in the way they would be if it was an ST segment elevation myocardial infarction (STEMI),” he says. “It’s something we treat with medicines right away and usually proceed with coronary angiography within 24 to 48 hours. For a STEMI, the timeline for angiography and intervention is much shorter.”
Thanks to the cardiac care he received and the healthy lifestyle he has adopted, Sharlet’s prognosis is excellent. “On the other hand, my prognosis was excellent before I had the heart attack—I had a normal stress test just the week before,” says Sharlet. “But I was pretty fortunate. There was some permanent damage, but not much. So my heart is functioning at a good, healthy level.”
"I had the background of my mother dying of cancer when she was young and I was young; I was only 16. I watched her struggle with that for three years. And I knew how important it was to her to see my older sister and me graduate from high school. She almost made it, but she didn’t make it. And I remember lying there in the heart attack…I had a very short period of anger with myself and recrimination…and then I just remember making a decision and it floated away. I have a job, which is to see my kids through high school, and hopefully much longer, and probably much longer. But I said, 'That’s my mission,' and then everything else after that gets evaluated in terms of does it serve that mission. Now I say, ‘I’ve got to get a walk for exercise today, but I also have to answer these emails. Which thing is going to help me be there for my kids?’ Not the emails. So I go and walk." Jeff Sharlet
Sharlet’s motivation to embrace healthy living is driven largely by the fact that he and his wife Julie have two young children. As he discusses in this video, he lost his then-47-year-old mother to cancer when he was a teenager. So he knows how painful it is to lose a parent, especially at a young age. “I have a job, which is to see my kids through high school, and hopefully much longer,” Sharlet says.
Dadekian, who has been a physician for more than 10 years, is “totally and utterly impressed” by Sharlet’s transformation. “I can’t think of another patient who has done as much to improve his own health as Jeff has,” he says. “He’s like a poster child for what people should do after a heart attack. When I bump into him at the gym, he looks like a completely different guy. I’m immensely proud of him.”
D-H Today talked to Sharlet at his Vermont home, about six months after his heart attack.
I had my heart attack over a period of days. That was one of the first discoveries for me—heart attacks don’t always happen the same way they do in movies and TV, with someone clutching their heart and falling down. Mine was more of a, “Hmm… what’s going on here?” It seemed like it was either two heart attacks or one that went on for 36 hours, with low points and high points.
I sat through the first six hours, which were pretty bad, thinking it was acid reflux. I actually called a nurse at the hospital [DHMC] and said, “I’ve got this really bad acid reflux. I’m going to see my doctor tomorrow, but what do I do to get through tonight?” After I described my symptoms, she said, “That doesn’t sound like acid reflux, it sounds like a heart attack.” So I went to the hospital, and it was a good thing I did because by the time I got in that evening it was moving toward a fuller and much more recognizable heart attack.
That night I did manage to fall asleep, and when I woke up—they always speak about the elephant on the chest—but I felt pinned like a butterfly on a board. I felt like both my arms were somehow pinned to the bed so I was glad I was in the hospital. I was overweight and wasn’t physically fit before my heart attack, but as Dr. Dadekian said, I didn’t have any indicators of this. So now I encourage people, even if you think you’re being paranoid, go with that and call your doctor.
While I was in the hospital, I found it important to remember that doctors are not doing something heroic for you; they are doing their job. So Dr. Dadekian did his job. And he had a manner that I could understand. I think he knew when to take my fears seriously and when not to, and ultimately you realize you can’t be so stressed out about it. I do remember saying, “I’m going to be okay, right?” And they would reply, “We’re going to do the best we can.” But to them it’s not an alarming situation. Every single day they deal with much worse and bring people through that as well.
Cardiac rehab was great. Even if you are a fit person—and I saw people there who were already fit—you learn a lot about what kind of exercise you can and should do. The day after a heart attack, no one thinks, “I’m going to run 5 miles.” But they build you up to that. My age made me a bit of an outlier, though, because I was 20 years younger than everyone else who was in cardiac rehab.
After my heart attack, it felt very much like, “Okay, I lived for 44 years, and that life is over. That’s done.” It feels like such a fact. I don’t regret things I did, I’m not sitting here saying, “Why did I eat that hamburger?” I did what I did and now I’m in this new life.
In addition to exercising and losing weight, I changed my eating. I became a mostly tee totaling, mostly vegan, low sugar/no processed sugar, low sodium eater of vegetables. Trust me, it’s not as bad as you think. It’s quite good and I never go hungry. I just eat fruits and vegetables and healthy things. And when you cut salt out of your diet you get so much taste back. Those were the easier changes in a way.
The bigger thing for me was the nature of the work that I did and the stress that was involved in it. I’m a Dartmouth English professor but I’m also an investigative journalist [he’s a contributing editor for Harper’s Magazine, Rolling Stone and Virginia Quarterly Review, and won a 2015 National Magazine Award for his GQ article, “Inside the Iron Closet.”] So there are some specific stresses to investigative journalism, like spending time with dangerous and bad people. Before my heart attack I had tentative plans to do reporting in Nigeria about the Nigerian civil war, and I was planning to go to Lebanon to meet a gangster who already didn’t like me. And I’m not doing those things anymore. But that’s sort of obvious—don’t go to places where they’re going to point guns at you if you have a cardiac condition (he laughs). But there are also stresses involved in being a mail carrier and stresses to being an accountant, so reducing stress can be the bigger change that people have to make.
My work was very exhilarating to me; I loved it. I felt like I got exercise from doing it, which is what you feel like if you’re one of those people who sleeps four or five hours a night. You feel like you’re getting exercise because you are going, going, going and you’re adrenalized and then exhausted. But that’s not exercise and it’s not good for you.
After my heart attack, I started doing short walks because that was all I could do and then expanding the walks. Then I started doing gym exercise. But I found that I still liked walking on these dirt roads around my house. It’s a little corny, but in this meditative, reflective way I like it. I move a little slower now, but I want to find out what I see when I move more slowly. And it just became very peaceful for me to walk. I’m not prescriptive of anything except to take it seriously if you have chest pains, but walking worked for me. In the same way writers need to find a way to get out of the normal flow of time, I think cardiac patients need that, too. A heart attack gives you the gift of perspective. And a walk can be a time to remember that this day is a gift, and it was not a given that I would experience this day.
I want to move back into normalcy but at the same time I want to make sure that every time I leave home I say goodbye to my kids. God forbid, what if that’s the last time? You don’t want to have a heart attack, but you take what you can get from it. Live every day like it’s your last! Maybe not quite that extreme, but be very grateful for every day. I’m only six months out so maybe I’m still in the euphoria of being alive. And while it sucks to get a heart attack, you have to find the gift within it.