The Bet

I remember feeling shaken the day I may have saved a man's life because of a bet.

It happened on a holiday weekend while I was on call. I had arrived on the floors early, having promised my wife that I would try to get home in time for an afternoon party. I groaned when the admitting clerk told me that I had 12 admissions.

“Eleven,” corrected Mike, the second-year resident. He was standing at the nurses' station with Judy, one of the new interns. “One has signed out against medical advice.” “Good,” I thought, “less work.” “What's the story?” I asked.

“His name's John Pagano. He's this high-pressure New York businessman who's in town visiting relatives for the holiday. He came to the emergency room last night with about 8 hours of ‘heartburn.’ He had an abnormal EKG that corrected with nitroglycerin. His initial blood work is abnormal but shows nothing definitive yet. He's probably having a heart attack, but he's felt better since last night and insists on leaving—says he has to be back at work tomorrow. We spent a long time talking to him, Judy especially, but he doesn't listen very well. He's still in his room, getting ready to leave.”

“Damn,” I said. I wanted to get on with my day. “I'd better go talk to him.”

“I doubt you'll have much success,” said Judy. “This guy is tough.”

He was pacing around the room in his street clothes. He was a tall, overweight man who looked as though he enjoyed intimidating people. I introduced myself, shook his hand, and sat down. “I guess you know why I'm here,” I said.

“No, why?” he asked.

“I'm here to talk you into staying with us. My housestaff tell me there's a good chance you're having a heart …