I Owe, I Owe, It’s Off to Work I Go

Second Chance with Heart

What a near-death experience taught this 61-year-old practitioner about life — and how it brought a new sense of meaning to a professional life that had gone a little stale.

By Michael Gradeless, DDS

I never felt a thing when I died. That is usually the first question people ask. “Did you have any pain? What did you see? What did it feel like?” I have fielded these questions in all their variations countless times.

Nothing. That’s what I felt and that’s what I saw, absolutely . . . nothing. My universe was void and without form. I was only dead for about four minutes, and knowing death usually lasts for an eternity, I am okay with the idea that I was unable to reach any spiritual epiphanies or any great universal truth. While I didn’t learn much about death, I did learn some things about life that I want to share with my professional colleagues.

It was April 4th of 2016, I was 61 years old and I had just finished playing basketball at Lifetime Fitness. It was intense exercise with men half my age or even less. With no warnings of any kind, I experienced a sudden cardiac arrest. I simply fell to the floor with no heartbeat. Thanks to all my friends who immediately sought help and the superbly trained staff of Lifetime Fitness, after CPR and two shocks from an AED my heartbeat was restored. My cardiac surgeon later told me he calls my experience “sudden cardiac death.”

At the time I fell down, I had a 6% chance of making it to the hospital alive. Thankfully, I cleared that hurdle and by the time we reached the emergency room, my survival prognosis had climbed all the way to 50%. Eight days later, following two surgeries and some rudimentary lessons to learn how to stand and walk again, I left the hospital. I left with a bag full of medicines, a pillow to hold over my chest, a small instrument of torture to exercise my lungs, and sage words of wisdom from my cardiac surgeon.

His words were, “This is going to change your life.” Thank you Mister Obvious Man! Actually, his advice was much deeper than that. He also told me that this sort of life-changing event often leads people to re-examine their purpose in life. Some decide to retire. Some decide they have different work they want to do. Some find a totally new purpose in life. In any case he advised me to make no decision until I was fully recovered. Over the following months I spent some time studying issues and doing some soul searching about retirement.

I am happy to say that at this time after my cardiac arrest I believe I am fully recovered. It was very good advice to delay significant decisions about my future until full recovery, as my emotions and thought process have matured and changed with the healing of my body. Only through the passage of time and healing have I been able to realize that I am alive because of a series of miracles. It took some time, because at first it didn’t feel like a miracle. When I think of miracles, I think of loaves and fish, turning water into wine, or I see a televangelist place his hands on someone in a wheelchair and they stand up and walk. I look at stand-up-and-walk miracles with a jaundiced eye now that I know what it is like to stand up and walk after only a few days of incapacitation. Let’s just say I wasn’t dancing a jig on the way out the hospital door. At that time the pain, weakness, and the fog of medications kept me from realizing how many miracles I had experienced.

The first miracle was performed by Derek and Elizabeth. They are the two employees of Lifetime Fitness who flawlessly performed the emergency procedures as they had been trained. They started with CPR and then delivered two shocks from an AED to restart my heart. In four minutes of chaos, they actually performed as they had been trained and saved my life. My cardiac surgeon pointed out to me what a miracle that was. We all have staff members who have been trained and certified in BLS/CPR. Would your staff be able to save your life in under four minutes if you collapsed in the office? Do you have an AED in a prominent location, and do you have an up-to-date emergency kit?

Next is the miracle of the financial ramifications of my cardiac event. As a dentist, too often I think of the insurance companies as the Great Satan. I would also often complain of how expensive my health insurance was. We purchased our health insurance from the insurance trust through the Indiana Dental Association. The insurance was fabulous and my out-of-pocket expense was less than $10,000 for a total bill in the neighborhood of $500,000. I no longer complain about the cost of my health insurance. I also recognize that the insurance company didn’t pay the bill; the bill was actually paid by my colleagues who are also insured through our trust. This financial miracle is really about the strength of our profession.

I also must publicly thank my colleagues in my local study club who each gave up some of their time to staff my practice for the five weeks I was out of the office. At no charge, these wonderful dentists cared for my patients, kept my staff working, and maintained some cash flow during my recovery.

All of this talk of miracles is only a way to circle back to the question my cardiac surgeon asked me to consider regarding retirement. With my recovery, I was finally able to see that I had only reached this point in life through the efforts of many other people, and that I owe more to this world than I can repay by selling my practice and playing more golf. It is my opinion that at whatever point we are in our careers, we would do well to recognize that we are all standing on the shoulders of others who have gone before us. Many of our parents sacrificed to send us to school. We all had professors who could have made more money in private practice but chose to teach instead. The strength of our profession has been bolstered by all those who labored in our organizations to transform dentistry from the days of the barber college to a highly respected medical profession. All of the money in our retirement accounts has come directly from our patients with much hard work from our staff. In short, all this bounty that has appeared in our lives, and in my case life itself, comes from the labor of others as well as our own efforts. These realizations led to my new motto: I owe, I owe, it’s off to work I go.

While everyone hopes to someday retire, many of us are not concerned with this issue right now. There are some lessons in this we could all learn from. First, do you have an AED in your office, and is your entire staff trained in Basic Life Support? When you take your staff to BLS training, are they fully engaged, or are they just going through the motions in order to get their certificate? AEDs have become much less expensive over time. There are now reconditioned used models on the market for less than $1,000. Expense is simply not a valid excuse to not have the equipment needed to save a life. Having the proper equipment, training, and emergency planning in place is arguably a standard of care in dentistry, but this is something you do for you. No one spends more time in the office than you, so statistically you are the one most likely to suffer a cardiac event in your office. The life you save may be your own.

The second area to look at is your insurance coverage and your succession plans for your office. I purchased my first disability policy shortly after graduation. I made the off-hand comment to my insurance agent that I would of course never use it. He immediately bet me $100 that I would use the policy before I retired. I lost the bet.

My insurance policies were important, but not as important as the IGDSG, one of the study clubs I belong to. According to our bylaws, we pledge to work in our colleague’s office at no charge in the event of disability or death. I was out of the office for five weeks and my friends kept the hygiene department running and finished work in progress, enabling us to have some cash flow and keep the staff fully employed. We all know how long it can take dental insurance to pay some claims. Imagine how long it could take for an office overhead policy to evaluate your health records and then wait for accounting to determine what percentage of disability you have incurred, and then finally write a check. You are definitely not using this money to make payroll next week or even next month. We are all well-advised to be properly insured, but it is even more important for us to make other plans as to how our staff and patients will continue to be cared for in the event we are unable to work for some time. Your insurance agent will tell you that statistically the majority of us will have some event during our professional life that affects our ability to practice. Make some plans accordingly.

For myself, I never realized how much I valued the idea of a long and successful career until I saw how easily that could be denied to me. Before my cardiac event I was beginning to contemplate retirement, and my love for this profession was waning. I certainly didn’t need to cut another crown preparation on tooth #3, 14, 19, or 30 in order to feel fulfilled. Hiring and firing employees and having growth conferences no longer sparked joy in my life. I doubt that it ever did.

But when I realized that I owed more to my patients, my team, society, and family and friends, I found that my practice was not a burden. My practice is the vehicle through which I can meaningfully contribute to our world. If you are beginning to feel stale in your practice, it is time to change your practice and create your ideal life today. Do not wait for some future retirement life that may come with some health or personal challenges that you never anticipated.

I began changing my practice by joining the Paragon practice management group and by signing up for the two year Dawson Academy that I had long been interested in. There are multiple continuing education groups and management consultants providing education to our profession. While they may help you make more money, when you join these programs you will be surrounded by other dentists who are energized and successful and you will gain access to systems and knowledge that will help you build the practice of your dreams.

Finally I must thank my wife, Kathryn, and my friends and colleagues who helped and cared for me throughout my recovery. Kathryn cared for and encouraged me every day and kept the practice running. Friends brought food and some came by to simply take me out for a walk. My study club colleagues cared for my patients and mitigated my financial loss. All this made me very aware of how important it is to build relationships with our friends and family.

Certainly, my cardiac surgeon was correct. This did change my life. I work more closely with my medical doctors and track my health statistics. I track my heart rate, the miles I run, my sleep, my minutes of exercise, and calories burned. I track my weight and BMI and record my blood pressure daily. I have a new AED in the office and the tools needed to save a life. I am learning new skills in dentistry and improving the care for my patients. My practice is growing again after several years of stagnation. I am thankful for my family and friends and try to spend more time being kind than being right. Every morning as I go out to get the paper I take a moment to focus on gratitude for another day and all the miracles that made it possible. It seems odd to say that I am grateful for heart disease, but I think my life today is better than it might have been without the cardiac wake-up call. It is my hope with this story that you may find a few ideas for changes you might make that will also make your life better. It might even save your life.

Dr. Michael Gradeless practices dentistry in Fishers, Ind., and is a former editor of the Journal of the Indiana Dental Association. He may be contacted at [email protected].

This article was originally published in the Journal of the Indiana Dental Association, Vol. 99, No. 3. Republished online with permission.