An Entirely Benign Disorder

It all started when I was a child. I had a bad cold, and our family physician, a rather uncouth middle-aged matron, auscultated my heart. “Oh,” she exclaimed, “oh-oh, we are having a heart murmur. We should have a cardiac catheterization done. You know, my brother, the cardiologist, does them all the time. However, when I think of it, the last patient he did died of the procedure, so I think we had better forget about the catheterization and treat your infection.” For reasons known only to her, the well-meaning physician never mentioned the issue again. But she did manage to instill in me, early on, an ill-defined fear of heart catheters, heart murmurs, and heart doctors.

My next examination took place during the military draft. Again the cardiac auscultation resulted in instant shock. “Oh, my God, this is severe, significant,” cried the physician. “I must show it to the others!” Soon I was surrounded by a horde of military physicians who poked stethoscopes to my chest and glanced at each other excitedly. “Well,” came the unanimous conclusion, “you are certainly unfit for military service because you have a severe heart problem; moreover, you may call yourself lucky to make it to age 30.”

After this uplifting experience, I went to a cardiologist, who diagnosed me with mitral valve prolapse and minimal mitral regurgitation. He told me “not to worry too much” and then somewhat incoherently recommended prophylactic β-blocker therapy. After I asked whether lifelong pharmacotherapy was really called for in view of fact that he considered my disorder to be “entirely benign,” the surprising answer was that I could “of course” do without therapy as well. At this point, I began to suspect that I might do better without such expert advice.

Because I experienced no problems during medical …