All the sacrifices of time and energy put into studying in college to get the grades to get into medical school. All the sacrifices of time and energy studying in medical school to learn the art and science of medicine. All the sacrifices of time and energy taking call every fourth night in internship and residency with the 60, 70, 80 hours per week to refine the knowledge. Two years of sacrifice serving my country in the army. Not now, after all the long, hard work and sacrifice of becoming a psychiatrist. I couldn't die now.

I checked my pulse. It was 90 beats per minute. My heart felt like it was going to jump out of my chest. I felt hot. I was sweating, and my fingers felt numb. My hands were shaking. I was so scared that I felt nauseous and thought I would vomit. My breathing was shallow and rapid. I had to get to the emergency room. I felt so dizzy. Time seemed to stand still. Everything was in slow motion.

I was sitting up in bed. My wife rolled over and asked me what was wrong. I didn't want to scare her, so I told her I didn't feel well and was going out for a drive. I'd never done this before and she was both surprised and concerned, but I reassured her and told her to go back to sleep. I didn't want to die in front of her. I felt like a fool, and I didn't want her to see me like this. I quickly got dressed and drove to the hospital 5 minutes from my house. I left the car outside the emergency room door and ran in. I grabbed the first doctor I saw who happened to be a friend and told him to hook me up to an EKG. I was having a heart attack and was sure I was dying. We didn't even bother checking me in through admissions. He grabbed a nurse and had her help him set up the EKG. I felt a little relief that I had made it this far. At least if my heart stopped, there was a chance I could be revived.

My friend looked at the EKG. I was waiting to hear the bad news. He said it looked fine! What? There must be some mistake! The chest pain was now gone, and my heart rate was down to the low 80's, but I was still frightened out of my wits, and I knew I was dying. I asked him to recheck the EKG, and I asked to look at it. Again he said it was fine, and I could find no abnormality either.

What was going on? How could I be having a heart attack, know I was going to die and yet have a normal EKG? He suggested that I just lie back and relax, and he would continue to monitor me.

I began to feel embarrassed and foolish. I still felt frightened, but the fear was beginning to subside. The numbness, dizziness, nausea had gone away. The only thing left was fear and that continued to subside.

My friend continued to check on me. He asked if I had been under any stress lately. Of course I had and explained the tar baby I was entangled in. He said that what I was experiencing was stress. There was nothing physically wrong with me. I argued how could that be. I was a psychiatrist and understood stress and its symptoms. Besides I had experienced lots of stresses in my life, and nothing ever felt like this did. The shame and embarrassment continued to grow until that made me feel uncomfortable enough to want to get out of there. It was 1 ½ hours later. The symptoms were gone, and I was no longer fearful that I was dying.

I went home. My wife was worried sick. She asked me what happened. I told her. She was bewildered that I would drive myself to the ER rather than letting her take me. What if I lost consciousness while driving?

I didn't want to listen to her logic and told her I was feeling okay now. Whatever it was, it was all over or so I thought.

I cut back on the 4-5 cups of coffee I was drinking each day figuring that I had to reduce my stress levels. I tried to spend a little less time at the new house, but there were always decisions to be made and problems to be solved. Fortunately, my practice slowed down a little, but that added a different kind of stress. How could I afford the house if I wasn't working full time? Well, I just wouldn't think about it. I would do my best and let the chips fall where they may.

I found it difficult to get to sleep. Somehow I became fearful that I would again awake in the middle of the night panicky. That never happened again.

Six weeks later, I was driving from my house to my first hospital to make rounds. It began to start all over again. The tightness in my chest. The severe chest pain, rapid heart beat, hot and sweaty, rapid and shallow breathing, numbness in my fingers, nausea. I knew I was going to die this time. I was 15 minutes away from the hospital in the middle of an expressway. I'd never make it. Slow motion returned.

I hoped I wouldn't accidently run my car into anyone else and hurt or kill them if I blacked out. I began to cry for fear of my wife and children having to get along without me. I knew I was going to die. But this is what had happened before, and there was nothing wrong with my heart. It was just stress.

I took my pulse, and although it was about 90 beats per minute, it was regular and strong. I had no pain in my left shoulder, neck, jaw or arm. The kind of pain that a heart attack generally causes. Could this be stress again? I sure didn't want to embarrass myself in front of my colleagues again.

By the time I got to the hospital, the overwhelming fear was gone. What remained was a less pervasive lingering fear. I put on the best mask I could and walked into the ER and asked one of the nurses to hook me up to an EKG. I told her I had a small bout of chest pain, and although I didn't think it was anything, I just wanted to make sure it wasn't. She looked concerned and hooked me up. After running the full EKG, she unhooked me and I read it. It looked okay to me. One of the ER doctors had come over to check me out. He reassured me the EKG was normal. I thanked them both and slowly walked to the doctors' lounge to think.

This was getting weird. I thought I must be going crazy. I couldn't live like this, but what could I do?

I decided to call a psychiatrist friend in Chicago. Maybe he could help explain what was happening to me. I called him that night and described the symptoms. He said, "You had two panic attacks." I had known them as anxiety attacks or hyperventilation syndrome. But the only symptoms were anxiety, a rapidly beating heart and hyperventilation. These were just beginning to be defined in the early 1980's with the new "DSM-III", "Diagnostic and Statistical Manual of Mental Disorders". This text was a major breakthrough in diagnosis because it clearly listed all the possible symptoms of each disorder. It described the usual age of onset of each illness and listed other illnesses which could mimic it. It made diagnosis more of a science than a guess, and it standardized the diagnosis of mental disorders.

Stress was too vague a term to grasp. So I got all the material I could relating to Panic Disorder and began to learn in depth what I had experienced.

I began diagnosing, treating and understanding Panic Attacks, Panic Disorder and Phobias. Although I have since had several minor bouts of anxiety, fortunately I have never experienced another panic attack again.

My experience of having had two full blown panic attacks humbled me and sensitized me to the plight of those who have not been as fortunate as I and had just a few episodes of panic attacks. I became more understanding and compassionate to those who have become phobic.