Surgeon, have you murdered my patient? The first telephone call on Monday April 27, 2007, was from Mrs. Emma, and as soon as I picked up the telephone, she said, "Dr. Lomeli, Mark has died!" Mark was 51-years-old. Mark had called me just three weeks before sounding well and cheerfully asking me for a medical consultation. He even said to me, "Just talking to you makes me feel better." Since he said it was not urgent, I referred him to a doctor that now takes my patients, but instead, Mark went to a private cardiologist. Mark was a hard worker and his company had grown to over 40 American workers. Mark was a very anxious and hyperactive person and for some years had been an alcoholic. Once he developed diabetes, which was compounded by the toxic effects of alcohol, he stopped drinking. His visits with me were anything but simple. It would take an hour as I he would say to me, with a big smile, "tell me another story." Three years prior to his death, a quack doctor promised him a magic cure for his diabetes. The doctor injected fetal pork cells ("stem cells") into his right arm for a significant fee, but there was no cure. (Today, there is no immediate rule of law whereby such doctors can be immediately thrown into jail for falsely invading our sacred bodies.) At this time, I was clinically certain that he had coronary artery disease as his electrocardiogram showed inferior Q-waves and his chest film revealed a mildly enlarged heart. His only risk factors were his genetic predisposition and diabetes. His LDL cholesterol was usually less than 130 mg/dL and his good cholesterol, HDL, was usually in the upper limits of normal. When I was in the U.S. Army, I was diagnosed, as having a "Sinus Arrhythmia" which I now have come to believe may be cardioprotective. A sinus arrhythmia is normal and the heart rate increases with inspiration (breath in) and is more commonly seen in children. Mark's ECG revealed a very fixed beat-to-beat variation thus having less diastolic rest between beats. Medicine is too busy making money on procedures that often yield no benefit or premature death rather than to study the true Art and Science of Medicine (Reference: Fractal Geometry). When Mark chose to see the Cardiologist, his fate became readily sealed. The cardiologist offered the usual, CARDIAC CATHERIZATION to find the obvious, diffuse coronary artery disease (CAD). (I encourage medical students to study "Bayes' Theorem, which applies to medicine. If a doctor subjects a 70-year-old patient to a cardiac catherization, though asymptomatic, he is likely to find CAD. Any intervention may not only be costly, but is likely to harm the patient. In other words, if you go fishing at a commercial pond where you pay per fish caught, you're going to catch a lot of fish). After the catherization, Mark was subjected to Heart Bypass Surgery (using leg veins) and died a day later. Mark was not offered optimal medical therapy that may have included low dose aspirin, Clopidogrel, Lovastatin (an inexpensive "Statin" unlike Lipitor®), Nitrates, ACE inhibitor), low dose beta-blocker (Atenolol or Metoprolol/both are generics and inexpensive) and/or sedative (Diazepam), since he was relatively stable. Some may argue that I am using "hindsight," but I am applying scientific principles and true medical science. This information is highly technical and is directed to properly licensed physicians. Luis Lomeli, M.D.