The High Cost of Clutching Your Chest
By SAM ROBERTS

I NEVER wanted to die like Dr. Zhivago, at least not the way he did in my play-it-again-Sam memory of a middle-aged man with a neglected heart condition who dashes off a crowded bus and collapses, surrounded by strangers.

Which brings us to my wife's chest pains. And a morality tale that drove home the stark disconnect between the care that prudent medical professionals routinely recommend and what some insurance companies - apparently mine, anyway - seem willing, at least at first glance, to reimburse. This is not about a $15 co-payment.

We're talking expenses that might make the average person think twice before high-tailing it to a hospital for potentially lifesaving emergency care.

Dr. Zhivago succumbed to what the American Heart Association calls "the movie heart attack." In contrast, "most heart attacks start slowly, with mild pain or discomfort," the association says, adding, "Often people affected aren't sure what's wrong and wait too long before getting help."

So when my wife called me at work to say she felt an inexplicable heaviness in her chest and had for days, I told her to call our internist immediately.