Office of Education
Yale University
School of Medicine
367 Cedar Street
300 ESH
New Haven, CT
06519 USA

Case author: Frederick D. Haeseler, M.D.

Todd Hunter: Introduction

Todd Hunter was glad to be out on the road again, his Asics beating a steady rhythm on the damp pavement. It had rained hard the day before, and he’d missed his usual run. As he ran past the far corner of their property, he noticed that Katherine’s yellow begonias had begun to bloom. Winter in the islands was very pleasant, but it was always good to get home to Connecticut.

Todd felt energetic and in synch. Really, it wasn’t hubris to say he was in exceptional shape for a 64-year-old man. From the way women looked at him, he felt sure he was still attractive, too, not that he would try to prove his hypothesis. Katherine looked equally good for her age. She could pass for a woman in her early 50s. Worst case, mid-50s.

Todd began ascending the hill on Totoket Road. Not only did the hill mark the midpoint of his three-mile run, but reaching its crest provided a reward: you could see the Sound, and up the coast to Thimble Islands Marina where they kept the boat. That view always made Todd feel expansive, happy.

But today, as he pushed a bit to get up the rise, he felt a twinge of dread. Ever since -- Easter, maybe? he’d felt a squeezing sensation in the center of his chest when he hit this hill. He knew it wasn’t a heart attack, because he could make the squeezing stop. If he slowed down to a walk for two or three minutes, about as far as Harbison’s mailbox, he always felt fine again.

But he could no longer make the loop in 30 minutes, and that irritated him. To tell the truth, the very possibility that something might be wrong angered him. He had made it to 64, had passed the watershed year of 60 when Dad had died of his coronary, 12 years after his first heart attack.

Not that Todd really worried. He took care of himself. He hadn’t allowed himself to get a belly like most guys his age; he ate sensibly even when they dined out; and he rarely had more than a single, civilized glass of Scotch before dinner. His annual examinations and blood tests had always been perfect, including a diminutive cholesterol of 150. He and Katherine had a very good life.

Next: Patient interview