Optimism and interventional cardiology.

One day, a decade ago, I was trying to place a coronary stent. It wasn’t going well. I grumbled to Tammy, the cath technologist assisting me, that it looked like we were going to fail. Tammy looked me straight in the eye and said, “Dr. Blankenship, you really are a pessimistic person.” After the case ended successfully, her comment lingered. That night, somewhat defensively, I asked my wife, “I’m not a pessimistic person, am I?” She answered without hesitation: “Yes, you are.” Somewhere I had read that optimism is a choice. I swore at that moment to choose optimism. But that isn’t easy. We face pessimism every day. A 2013 survey by the Doctors Company found that 89% of physician respondents would not recommend a career in medicine to their children [1]. A 2014 Medscape survey found that only 44% of cardiologist responders are satisfied with their income, 39% would not choose a career in medicine again, and 41% would not choose cardiology as a specialty again [2]. Cardiac catheterizations and coronary interventions have decreased by 30% in the past decade, and it often seems that surgeons, payers and the media all think they should decrease further. The majority of cardiologists are now employed, and many mourn their lack of independence and chafe under the bit of hospital administrators. All of these factors might make us pessimistic. Yet I argue for optimism, for 3 reasons. First, opportunities abound in interventional cardiology. Second, optimism often proves to be right. Finally, optimism is good for you. OPPORTUNITIES IN INTERVENTIONAL CARDIOLOGY