I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got a call from one of these hospitals: A middle-aged engineer was in the ER complaining of chest pain. His electrocardiogram showed minor abnormalities, and he needed to be admitted for observation to rule out a heart attack. Back then, this meant several days of blood tests and repeated electrocardiograms. Uncomplicated heart attacks were treated with bed rest, sedation and blood thinners, followed by gradual ambulation and discharge.