The End of My Addiction

severe coronary heart disease.
    As part of this work, I often read EKGs and twenty-four-hour monitors known as Holters in a windowless room in the heart station. The room had only one door, and I sometimes experienced a rising sense of anxiety as I sat there. It wasn’t claustrophobia. Rather, if someone came in suddenly, there was no way for me to dart out without being seen. That was a problem not because I was avoiding work, but because I felt subject to scrutiny without notice and I was always ready to think that I would then be found inadequate. I was sure that the only reason people were nice to me was that I was a novelty, the French guy.
    One day Paul Kligfield came around with a woman from the Payne Whitney Psychiatric Clinic and said they were interested in heart rate variability in people with panic attacks. It was the first time I had heard the term panic attack , which was not yet widely used. When they told me the diagnostic criteria for susceptibility to panic attacks, I realized I fit the bill.
    To calm stage jitters before a talk, some of my colleagues used beta-blockers, which reduce symptoms such as heart pounding and shakiness. Beta-blockers did nothing to ease my anxieties, however. Valium and Xanax worked somewhat better. But I never liked how I felt on benzos, and it is best not to take them too much because they induce dependency and impair memory and other cognitive function. The result was that I sometimes paged myself out of meetings in order to avoid possibly revealing the extent of my anxiety.
    Day to day, I worked most closely with Paul Kligfield. We developed a friendly rapport, and when I lived in a sublet on West 60th Street we usually walked part of the way home together. I actually walked a few blocks more than necessary, doubling back uptown at 57th Street, because I enjoyed our conversations so much. On Friday evenings Paul often invited me to join other colleagues and him for a beer. I did so a few times, confining myself to soft drinks, but the point of a bar is booze and I soon stopped going.
    During my first years at New York Hospital–Cornell, a few of my research colleagues encouraged me to make research my lifelong career. They said, “You’ll have a good salary, you’ll have manageable hours, and you won’t have to put up with patients calling you in the middle of the night to ask if they should take Tylenol or aspirin. We’re allergic to patients.”
    “But I like seeing patients,” I said.
    They thought I was crazy, but I really enjoyed treating patients. The ability to help people with their heart problems gave me tremendous joy and satisfaction. For that reason I was keen to do clinical fellowships and an accelerated residency at New York Hospital–Cornell—accelerated because of the residencies I had already done in France. I wanted to start treating patients again. That was the best part of medicine for me.
    Interestingly, I never experienced anxiety during patient consultations or panic during medical emergencies, because they took all my attention off myself and engaged my mind solely on the patient’s problems. In fact, being on the front lines of cardiac care was the best antipanic medicine for me. I functioned best in crises when quick decisions had to be made to stabilize or save a patient.
    I continued to do research for several years, but in the summer of 1986, on completion of only one year of a normal two-year American clinical fellowship in cardiology, I was promoted to assistant professor of medicine at Cornell University Medical College and assistant attending physician at New York Hospital. My workload became about a third research, a third treating patients, and a third teaching.
    This was the beginning of a golden period in my life. I was doing a job I loved and I was exactly where I wanted to be. The next year my social life also took a turn for the better. I began seeing another physician at New York Hospital. And I began playing the piano regularly at parties.
    Through the woman I was seeing, I met Murat Sungar, who was then Turkey’s consul general in New York. Murat was an enthusiastic musician, and he loved the songs I wrote. He began arranging them, and we began recording them in rough and ready fashion with a soundboard that I bought but that Murat was much better at using.
    Murat gave great parties, glittering affairs that brought together the elite of Turkey’s diplomatic corps and expatriate community among other guests, and