Medical events in the life of William K. Nasser, MD

I entered Indiana State University, Terre Haute, Indiana, in 1951, but my education was interrupted 2 years later when I was drafted into the Army. After serving as a machine gunner in Korea, I returned to Indiana State University in 1955, and graduated with a BS degree in 1957. I received my medical degree at Indiana University School of Medicine in 1961, which was followed by an internal medicine residency and a cardiology fellowship at Indiana University Medical Center. I was an assistant professor of medicine on the Indiana University Medical Center medical staff from 1966 to 1973. Beginning as a solo private practitioner of cardiology at St. Vincent Hospital in Indianapolis, I helped build a group practice of 40 cardiologists and 30 primary care physicians in locations throughout Indiana. In 1999, Nasser, Smith & Pinkerton Cardiology, Inc., merged with Northside Cardiology at St. Vincent Hospital and Storer Schmidt Cardiology at Methodist Hospital, Indianapolis, to form The Care Group, which today consists of 88 cardiologists, 48 primary care physicians, and 780 employees at 37 sites in Indiana. In 1960, during my junior year of medical school, I was diagnosed with infective endocarditis. I was hospitalized and treated with antibiotics for 6 weeks, but I then developed severe aortic insufficiency. Dr. Charles Hufnagel at Georgetown University in Washington, DC, with Dr. W. Proctor Harvey as the cardiologist in attendance, replaced my defective congenitally bicuspid aortic valve with 3 silicone leaflets. Due to recurrent aortic insufficiency, the new aortic valve was replaced with an aortic homograft by Dr. John Kirklin in Birmingham, Alabama, in 1967. During this second open-heart procedure, I sustained an embolus to the brain, which left me with a left hemiparesis. After a complete recovery, I underwent a third aortic valve replacement in 1979 due to recurrent severe aortic insufficiency. This time, Dr. Kirklin implanted a Bjork-Shiley mechanical prosthesis. Following each surgical procedure, I returned to my cardiology practice, where I continue to be active. Forty-one years after my first open-heart procedure, I am probably the longest survivor of an aortic valve replacement in the world. On New Year’s Eve, 1980, 1 year after implantation of my third aortic valve, I went scuba diving off the Florida Keys with my 2 sons and a nephew. After a successful dive off Tennessee Reef, our 16-foot rented fishing boat, with a 25 HP Evinrude motor, was swamped by a sudden storm 7 miles from shore. Because it was only 1 year since my aortic valve had been implanted, my 19-yearold son and 22-year-old nephew decided to swim back to shore to get help. My 15-year-old son Tony stayed with me as we bobbed in the waves for the next 8 hours. Around midnight, my older son and nephew noticed fireworks in the night sky, and estimated that they had swum about 6 miles and were only 1 mile from shore. By this time, however, I was severely hypothermic and had lost consciousness. Tony took off his life preserver, placed it on me, and treaded water in the cold, black, windy ocean. My other son and nephew finally made it to shore at approximately 3:00 A.M. My oldest son, also hypothermic, was saved because my nephew helped him swim. They telephoned my wife and daughter, and alerted the Coast Guard that Tony and I were still in the ocean. Coast Guard helicopters searched, but were unable to locate our 2 dark-haired figures on this black night, in a black ocean, with almost zero visibility. At approximately 8:00 A.M. (16 hours later), the Coast Guard finally spotted Tony and me about 1 mile from shore. We were taken to land, where an ambulance transported us to Fisherman’s Hospital in Marathon, Florida. Because I was severely hypothermic, my heart rate was 30 beats/min, my pH was 7.2, and I had noncardiac pulmonary edema due to salt water in my lungs. I responded to a warm-up period, and spent the next 36 hours in the hospital before being discharged. My family returned to Indianapolis, and I returned to work a few days later. In 1997, I had 2 syncopal episodes that required implantation of a cardiodefibrillator after documentation of ventricular tachycardia. I responded well, with no recurrent ventricular tachycardia. In 1999, I experienced increasing fatigue and was diagnosed with hepatitis C, which had been contracted from the blood transfusions performed 40 years earlier. I underwent a successful liver transplant at Mayo Clinic in Jacksonville, Florida. During the initial medical treatment after my liver transplant, some immunosuppressive agents were cardiotoxic to the myocardium, resulting in severe cardiomyopathy and congestive From The Care Group, Indiana University School of Medicine, Indianapolis, Indiana. Dr. Nasser’s address is: The Care Group, Indiana University School of Medicine, 8333 Naab Road Suite 400, Indianapolis, Indiana 46260. E-mail: dmargason@ thecaregroup.com. Manuscript received July 30, 2002; revised manuscript received and accepted August 23, 2002.