Raymond Bahr, MD, FACC, has just finished giving his early heart attack care educational training and is surrounded by people telling him their personal stories. “I became a nurse because I lost my mother to a heart attack,” shares one attendee. He listens, he sympathizes and he provides them with ways they can help recognize the signs and symptoms of a heart attack if there is a next time. They might have been unable to save their loved one, but they can help others and Bahr is there to help them. Many people who know Bahr have heard the story of “Jack the Tailor.” When he was 22, Bahr was working as a pharmacist at a drugstore when Jack, the local tailor, walked in to drop off lab coats. He didn’t look well and described mild chest discomfort. Bahr wanted to ask more questions, but it was a busy day in the pharmacy and Jack left the store. Sadly, he died of a heart attack later that day. “When people share their stories with me, I recognize their passion in preventing their friends from dying,” states Bahr. “They are thinking what I think every day – how can I prevent this from happening?" For Bahr, ensuring he didn’t miss another heart attack started with him becoming a cardiologist. He enrolled in the University of Maryland School of Medicine for medical school and did his residency at Johns Hopkins Bay view Medical Center and St. Agnes Hospital, both in Baltimore, MD. It was in these early years of his career in cardiology, that he became increasingly outraged at how many patients died an unnecessary death. Many patients entering the emergency department (ED) were told to go home when they presented with mild symptoms. “The ED attitude was ‘GOMER’ or ‘Get out of my Emergency Room’ unless you are having severe chest pain. The Coronary Care Unit was often on an upper floor of the hospital. If you had a heart attack, early or late, you were in big trouble,” Bahr explains. He knew that more needed to be done to improve heart attack care in the hospital and in the community. Working with noted cardiologists such as Paul Dudley White, MD, Bahr set up the first Chest Pain Center in the Emergency Room at St. Agnes in 1981. It was the first such center in the world and it offered a fast-track in the ED for patients presenting with early symptoms. “We did everything we could to prevent the actual heart attack,” Bahr explains. ”We changed the attitude of the ED Physicians to ‘TUFCIE’ or ‘Thank you for coming in early to check out your symptoms.’” However, the observation unit of the chest pain center movement came under scrutiny by the Health Care Financing Administration (HCFA), now the Centers for Medicare and Medicaid Services, because some hospitals embraced the message, but not the processes. “HCFA was going to remove the reimbursements for all hospitals because there was a perceived lack of processes.” Bahr says, “We proposed accreditation processes to HCFA in order to help hospitals that truly wanted to save lives.” Bahr recruited cardiologists and ED physicians who wanted to do more to improve heart attack care and started the Society of Chest Pain Centers, later to be known as the Society of Cardiovascular Patient Care (SCPC), which became the accreditation arm of the ACC in January 2016. Bahr was still upset by the number of heart attack patients who didn’t even make it to the hospital because they ignored the early symptoms. He questioned why patients were driving around the parking lot until they felt the “elephant on the chest” and wondered why they thought they couldn’t come to the hospital until their symptoms were severe. His answer to these questions was to create the Early Heart Attack Care (EHAC) educational program – a public education effort designed to raise awareness that “heart attacks have beginnings,” but also to have a community to get a patient to care. EHAC provides the early signs and symptoms of a heart attack, but there is more. “We want people to not only recognize the signs, we want them to spring into action and get immediate care,” explains Bahr. “If they suspect someone is having a heart attack, we want them to find an AED, provide hands-only CPR, and call 911. We want to save not only a life, but preserve heart muscle to preserve the quality of life.” Thus Bahr created the EHAC educational program and the EHAC pledge. When Bahr delivers his training, he asks everyone to stand and pledge their support to saving a life. “Those powerful words help people understand that they have a higher purpose – to save a life.” Today, there are over 600,000 people that have taken the EHAC course and have pledged not to leave the patient until help arrives. “We now have an army of early heart attack caregivers ready to spring into action should the occasion arise with a person in their midst experiencing these early chest symptoms,” states Bahr. Saving lives and educating people goes beyond heart attack care for Bahr. “Growing up, we were very poor,” says Bahr. His mother’s hard work and the fact that they were dependent on the kindness of others instilled a deeper sense of responsibility in Bahr. “It is everyone’s responsibility to help others and when you are a physician and in a position to know better (such as heart attack care), you should find a way to do better,” he explains. His kindness extends beyond the medical world. In his spare time, you can find him feeding the homeless every Friday night at his church, giving historical tours of Canton, MD, walking around the Baltimore Waterfront, cheering on the Orioles and Ravens, but above all, spending time with his wife and family. To learn more about SCPC and EHAC, visit SCPC.org.
Published by American College of Cardiology. View All Articles.