John Hunter
During a meeting of the Board of Governors of St. George’s Hospital in London in 1793, John Hunter became involved in an angry dispute with the other members of the board. He suddenly stopped speaking, struggled to control his temper, then hurried into another room. He died within a few minutes.
John -Hunter did not, of course, have the advantages of today’s knowledge of angina. Emotions such as anger or fear can increase the heart rate and blood pressure well beyond that to which the angina-affected heart can adjust, and the result is sudden heart failure. John Hunter’s death is still a lesson today: Attention to the psychological and emotional state is important for anyone with angina (Rozanski, et al. 1988).
James Fixx
James Fixx is my next example. He was famous in the 1970s for his book, The Art of Running, in which he recommended exercise, and particularly running long distances, for people with angina. His book was a best-seller, and was very influential in establishing today’s fashion for marathons, half-marathons, and “fun-runs,” in which thousands of people take part.
For that we have to thank James Fixx, but sadly he became more famous still when he died during one of his runs—from a heart attack. Some people have used his premature death as an excuse for not exercising. “Exercise killed Jim Fixx,” they reason, “so it may kill me!” That is not strictly true. Exercise may have allowed James to live much longer than he otherwise would have, but he relied too much upon it, and too little on other ways to improve his health.
The facts about James Fixx are as follows: In his midthirties he had a heart problem diagnosed. He weighed 220 pounds, and became breathless when trying to run fifty yards. He took up running, and ten years later, in 1978, he had lost 55 pounds, had run a distance equivalent to going around the equator, had completed many marathons, and was running ten miles every day.
He died in 1989, in his late fifties. James’ problem was that he believed that he could “run through” his angina, and became so engrossed in his running schedule that he did not seek help for his increasing angina. He had, in fact, severe coronary artery disease, which was probably a leftover from his days of being overweight. His father had died of coronary artery disease at a young age, which suggests that there might have been an inherited tendency to very high levels of fat (cholesterol) in the blood.
James Fixx made the mistake of thinking that exercise is everything—that it could reverse all the problems that his previous lifestyle (and perhaps his genes) had laid down in his coronary arteries. Unfortunately it can’t. If he had slowed down a little, and asked for medical advice, things might have turned out differently. Even in the 1980s, there were effective ways to reduce cholesterol levels and to improve the coronary circulation. James might well have been a good candidate for coronary bypass surgery. With better circulation through his coronary arteries, he might still be running today.
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