 I was on a walk at Greenlake State Park with a friend when I said, I think the CBD gummy just kicked in, feeling a little light. One minute later, I'm stumbling towards the steps of a nearby cabin, not knowing how many seconds I have left before I lose consciousness. Call 911. Call 911. I beg my friend Mary, who had by now turned completely pale with terror. Or perhaps that was me. My phone's not dialing, she yelled, and in what felt like could be my last few moments on Earth, I pulled out my phone and dialed 911, and I handed it to her. Since Mary is not medically trained and was visibly flustered, I also told her to tell the operator. 33-year-old male with no medical history has sudden onset of dizziness, chest pain and numbness and nausea, just lost consciousness for no reason. I sat down on the steps and the warm waves of terror pulled back, and I could breathe again. But the sensation returned again, and again, as the ambulance sped toward the hospital. Six hours, normal lab results and normal EKGs later, I found myself at home, grateful for Mary's company so that if I must die tonight, at least I don't have to die alone. The next day was uneventful, I sat on my ass. The following day at work it all felt like a dream. I felt like myself again, drinking coffee and treating patients, helping those who sought my guidance and counsel and experience to alleviate their worries and symptoms, until suddenly sitting comfortably in a chair, I felt it again. A chilling, horrible, warm sensation, numbing my body as it traveled like Voldemort's serpent, moving down from my head to my neck and into my chest. The terror returned, as did the ambulance. Did you have another gummy? The same ER nurse asked as I was admitted for a second time in 72 hours. I'm so sorry for inconveniencing you, I told her in my head, as I simply said no, aloud. Discharged again with negative testing and a diagnosis of anxiety, I sit before you, reflecting on the situation. Hey guys, so was that dramatic enough? I thought I'd explore the Hunter S. Thompson style of telling my story. But anyway, if you're new here, my name is Boris, I'm a physician assistant, and two weeks ago, I had my very first panic attack. The first thing I want to say about this situation is that I'm not 100% sure that it was a panic attack. I still have to see a neurologist and a cardiologist in the next few weeks, so that's why I'm wearing this heart monitor. If you could see it through my shirt, it's actually kind of cool. You have to press the button every time you feel symptoms and then that correlates to your reading for your heart monitor. Got to wear it for two weeks and then I have to send it back. But anyway, as time goes on and I do more research and I think about my symptoms, it just makes more and more sense that it actually was a panic attack. Another thing I want to share with you is my experience going through something like this as a trained medical provider. But when a patient tells me about their symptoms, right, when I'm practicing as a PA, I consider their demographic information like age and sex, their social history, any chronic conditions, any medications that they may be taking. I then pay attention to what they're telling me and what they're experiencing and then I use all of that information in order to order testing that I think is appropriate, like labs and EKG and x-ray, other imaging, or I might have to refer to a specialist. And then hopefully after all of that, I'll have an answer for them and maybe even a solution. In this situation, at least in my mind, I was the patient and the provider at the same time. I know the demographic information, it's me. I know that I'm healthy, or at least I was. I know I don't take any medications. I don't have any chronic conditions. I've never had heart disease. I've never had a seizure. So suddenly passing out and feeling my whole face go numb really made no sense. In the moment, even though the symptoms are shocking and confusing, I know logically what these symptoms could mean. A sudden onset of numbness and lightheadedness could be a heart attack, could be a stroke or a seizure, or a number of other things. So being a provider and knowing these things actually makes the situation a whole lot worse because I know what the symptoms could mean. Then in the ambulance, I saw my blood pressure normalize. It started off at like 180 over 110, probably because I was so worked up or because something was going on with me physiologically, but more than likely because I was worked up from the anxiety. And I saw my blood pressure normalize from that all the way back down to like 90s over 60s and low hundreds over 70s. You know where it usually is. I was also reading my own EKG, which showed normal sinus rhythm, no ST elevation, no depression, normal rate. Everything was completely normal, which was a huge relief, but barely. And then at the hospital, when all my labs came back normal, it was an even bigger relief. And then the following time when I went to the hospital the second time, having a normal CAT scan of my head, CT, as well as CT angiogram, looking at all the blood vessels in my head and my neck. When that came back normal, that was the biggest relief. So basically it wasn't a heart attack, wasn't a stroke. I don't have an aneurysm. There's no major metabolic abnormality or at least not a common one that the routine blood work tested for. And also all the symptoms are going away, which in and of itself is valuable information, you know, the duration of symptoms. At this point, everything objectively is pointing towards a panic attack and some sort of anxiety. But why? I've never had a panic attack before. I'm 33 years old. Why would I have my first one at 33 years old? Makes no sense. Well, after doing some research, it actually started to make a lot more sense. If you'll allow me, I want to read one little quick paragraph from Dr. Scott Pax, The Road Let's Travel. And this is on page 301. Okay, so anybody has this book or wants to follow along, but if you haven't read this book, I strongly, strongly, strongly highly recommend you read this book. It's fantastic. It's like my Bible. I've been through it probably three times now and it's going to be more and more times in the future. So anyway, this paragraph. Psychiatrists and many laymen are familiar with the fact that psychiatric problems occur with remarkable frequency in individuals shortly after promotion to positions of higher power and responsibility. The military psychiatrist who is particularly familiar with this problem of promotion neurosis is also aware that the problem does not occur with even greater frequency because vast numbers of soldiers are successful in resisting their promotions in the first place. There are a great many low ranking career non-commissioned officers who simply do not want to become top sergeants, first sergeants or sergeant majors. And there are also large numbers of intelligent non-commissioned officers who would rather die than become officers and who often repeatedly reject offers of officer training for which by virtue of their intelligence and stability they would seem well qualified. What does all that psychiatric mumbo jumbo mean? What it means is it's not uncommon. It's very common for people who just got promoted who just increased their responsibility in their life whether it's in their career, in their family, in a relationship, in a hobby, something that some organization that they run, whatever case it may be that they just increase their level of responsibility in their life. So maybe had their first child. People tend to have their first panic attack when that happens or worsening anxiety, worsening panic when they become responsible for a human life, a child, when they become promoted to a different job or to a higher pay grade or something. That's what that means. So basically, according to Dr. Scott Peck who was an eminent psychiatrist, he said that this is not uncommon at all. When you get a new job, when you increase your level of responsibility, panic and anxiety tend to come up even if you've never really experienced them your whole life. Have I experienced anxiety throughout my whole life? Yeah, I mean like anybody else, maybe more, maybe less, probably like a low level anxiety because I'm a very type A person. I'm a very hands-on person, perfectionistic. So I definitely have some low level of anxiety just at baseline. But I thought until two weeks ago that it was pretty well adjusted. It was pretty well integrated into my life and I'm able to use that anxiety to accomplish things in my career to get through a very difficult graduate program, you know, to have a tough job as a PA. But apparently things kind of came to a head and you know, it was more than I could handle at that time, not even knowing about it. Anyway, so looking at my life objectively, I've taken on an immense amount of responsibility lately in the last couple of months. The most obvious one is my new job. I left my previous job as a primary care physician assistant in a small family-run clinic. And the job, you know, the old job had its stressors and of course a tremendous amount of responsibility being a licensed medical provider. But most people coming into the clinic are more or less healthy or at least stable. Almost nobody was actively having a heart attack or anything immediately life-threatening. And if anything remotely seemed threatening, we just call the ambulance. But almost nobody came in with anything dangerous. The best part of the whole job was that I always had my boss to fall back on. My boss was this incredibly talented, brilliant, knowledgeable, experienced physician with like 40 years of experience and the guy always had the right answer, man. Like, I've been lucky enough to know a lot of very brilliant physicians. He's probably, if he's not number one, he's number one or two, definitely in the top three. And like there's no hierarchy. I would just say they're like evenly brilliant in the top three. And actually when all of this happened to me, I called him and I called the other two of the most brilliant physicians that I know and they're lucky enough to like know me on a personal level. So they answered the phone and they actually talked me through what was going on, what they thought needed to be done. So that was very comforting too, getting there input. But basically my point is this guy was always there. He was always happy to help. He was always ready to solve any problem that I couldn't solve. And he is tremendously, tremendously brilliant. He always had the right answer. And I had that to fall back on. So my job was tough, but I always had that very, very, very strong safety net that was Dr. O. However, at my new job at the urgent care, that's not the case anymore. I will still have some support if I'm not working alone, that there's another PA or NP. There are on-call physicians, but they're usually busy. They can't always get back to you right away. So the level of responsibility is much more on my shoulders in this new job than it was in my old job in case anything goes wrong or in case anything is confusing and I don't know how to handle it. And also, the people coming into an urgent care, there's way more people with potentially life-threatening conditions, right? At an urgent care, you're kind of an unofficial triage for the emergency room. People go there because they don't want to go to the emergency room and wait 12 hours or six hours depending on the emergency room. So they go there hoping that it's nothing and they get someone like me to tell them if it's something or if it's potentially nothing. And so I kind of decide whether they go to the ER or not, which means the level of acuity, the potentially life-threatening patients coming in to my clinic to see me with very little support compared to my old job. Yeah. So it's a lot more responsibility. It's a lot tougher. It's a lot more terrifying. And I mean, I thought that I was handling it well, but if I'm going to be honest with myself and with you, I'm terrified. I'm absolutely effing terrified, which is a good thing because that means I'm going to be very careful and not make mistakes. But for me, yeah, it's scary. Aside from the career, I also made a few big decisions in my personal life and in my financial life. All of them are good and I'm excited about them, but also all of them come with, again, a lot more responsibility on my shoulders. So I'm not going to share all of them because some are personal, but basically I made a big purchase. I also started taking certain aspects of my life a whole lot more seriously than I had in the past and all of which just increases responsibility, which seems like a good thing on the surface. A promotion at work, you know, a better job with better pay, more time off, a new car that I'm excited about, a new kind of a more excited about the future, a little bit more solid with what I want to do with my life as far as my personal goals. But somewhere in the back of my mind, completely hidden from my conscious awareness, I was probably completely freaking out, you know, completely freaking out. And so out of nowhere, while I was literally taking a walk in the park, literally taking a walk in the park, it all came out. And at least what I hope happened was I had my very first panic attack. If anyone's ever had a panic attack, you know exactly what I'm talking about. You legitimately think that you're dying. The psychosomatic symptoms are very real just because they originate in your brain. Does not mean that the downstream effects are not physical. So you go into this very sympathetic state. Your circulation to parts of your body may decrease. That's why there's numbness. That's why sometimes you lose consciousness. That's why there's nausea. That's why these symptoms occur. And again, for those of you lucky enough to never have experienced a panic attack, let me tell you, you think you're dying. You legitimately think you're dying. And as somebody who is a trained medical provider, knowing that I, if it really was a panic attack that I wasn't dying, in the moment I felt like I was. I thought it could have been my last few seconds before I pass out or before I potentially am no longer alive on this planet. So yeah, in my 33 years on this planet, I've never ever experienced anything like this. I haven't been to the ER for over a decade. And that was, the last time was 10 years ago, was for back pain. You know, I pulled a muscle in my back. I'm deadlifting. So that was the last time. I'm not somebody who like freaks out all the time over certain symptoms. I'm not a hypochondriac. I am not someone who runs to the ER with every little condition or even to my doctor. Like, I'm not that guy. I'm not that kind of person. I know what I know and I know usually it's no big deal or if it is, I know the proper channels to get it done. I haven't been to the ER in a decade. And this was terrifying enough and it felt real enough to where I went to the ER twice in three days. Okay, so that's how real it feels in case you've never experienced a panic attack. And if you have, I want you to know that I have total sympathy for you because I experienced one if that really is what this ends up being. And it does feel very, very real. And I can only imagine as someone who's not a medical provider, not trained to know all this stuff, how it must feel to you because then it's just terrifying and confusing, not terrifying and I don't know, I guess less confusing. But anyway, in conclusion, the point is whether this whole thing is just a nothing burger and I'm perfectly healthy or if I really do end up with some kind of condition that needs to be treated or potentially something I have to live with for the rest of my life or worse, if you know, this really whatever the heck this is really is deadly. You know, like I said, I really don't think it is, but you know, it's not normal. I know that. I know it's not normal. So at this point, I'm still accepting the possibility that it could be something very wrong, you know, with my body. The point is this experience made me realize that I don't have as much time as I think I do. We don't have as much time as we think that we do, no matter how young or healthy we may be. So I don't know about you, but I am going to sit down and think about exactly what I want to do while I'm still here and can do that. I'm also going to prioritize my physical and my mental health a lot more. I really like the analogy that says life is kind of like being on an airplane. If something goes wrong, you have to put on your oxygen mask before you can help others. You can't just be running around taking care of anybody else before you take care of yourself. That's not selfish. That's just healthy. So doing things to take care of your body and also your psychological health, your mental health, making them a priority is a must, especially for those of us that assume a lot of responsibility. And I don't just mean career-wise because I have a very stressful job with a lot of responsibility for other people's lives. I'm talking about anybody who's got a lot of responsibility, anybody who's a parent. You're literally responsible for that kid or those kids' lives, much more so than I am as a provider. Like I see you or I see the kids in the clinic and I solve whatever problem or I direct them to the health that they need and boom, they're out of my care. Those kids are in your care 24-7, 25-8, it probably feels like. So I mean, anybody who's got a lot of responsibility in any way, shape or form, we need to take care of our physical health and our mental health. Okay guys, I hope you got something out of this video. Thank you for watching. See you in the next video.