Along with smoking and poor diet there are other factors that can endanger one’s health and longevity. Although not cardiac in nature, one man’s poor lifestyle choices led him to call 911 for chest pain on several occasions. His heart problems began when he complicated his life by sharing a 700 square foot apartment with the three girlfriends he was juggling. “I’m a man who loves too much,” he would say. “I can’t help it. No one woman could handle all that I have to give. My heart is just too big.”

“He’s having a heart attack,” said one of the girlfriends as we arrived. She said it with no great urgency, just matter-of-fact, and directed us behind her. We entered an apartment whose decorating scheme centered around large storage container boxes doubling as furniture. In addition to the containers being used as tables and stools, one held a small toddler who would be pushed around the apartment by 5 or 6 other small children while we were there, all happily oblivious to the events going around them. The place was already chaotic and we hadn’t even met all the wives yet.

We found our 42 year old male sitting in a chair flanked by the other two women in his life. They were each holding an arm and stroking his hair. He was hyperventilating and clutching his considerable belly. A plethora of prescription bottles were found on a bright red plastic storage container that doubled as an end table.

“Please,” he said looking back and forth to each woman with a pained expression on his face. “Please get me a cold wet rag for my forehead.” The two ladies looked at each other for a few moments before one of them reluctantly got up. She must have known doing so would cause her to lose her spot. When she got up the woman who had answered the door took over the left arm position which clearly annoyed the woman getting the wet rag.

As we cleared some space for our equipment a chubby little arm attached to a curious little girl stretched out with a lollypop for me. As I declined, I told our patient, Miguel, how cute I thought his daughter was and how we shared a proclivity for sweets.

“Oh she’s not his.” said one of the girlfriends. “Only three of these are his, two with me and one with her,” pointing to the other older girlfriend.

“And another on the way,” said the youngest one, proudly patting her belly.

As we extended our congratulations we noticed the other two women looked at each other and rolled their eyes in displeasure. The younger woman saw this and smiled even more. There was definitely and underlying dynamic going on here.

“I got other children too,” said Miguel. “They just don’t live with me.”

This man had quite an extensive love life, obviously. What kind of charm did he hold? He definitely wouldn’t be considered attractive in the conventional sense. He was overweight and missing a front tooth in a set of broken yellow teeth. Hygiene didn’t seem to be an priority, including the food clinging to an oddly shaped handlebar moustache. How did this man have three women fighting over him?

And what of these women? What was in this for them? Were things that grim in the dating world? I felt that they could probably do better. They were more than moderately attractive with pretty faces. It seemed that Miguel had a ‘type’ in that all three of the ‘wives’ looked as if they could be sisters, or at least related.They were on the tall side, taller than Miguel, heavy-set and had long curly hair. Two of the women were probably in their late 30’s. The younger one was in her early 20’s.

As I attached our cardiac monitor to Miguel and took some vital signs my partner approached one of the older women and asked if they could assist by providing some basic information. The other older woman shoved her out of the way and said “Ask me. I’ve been with him 11 years. I know him better!”

The first one then shoved her way back over and said “Well I’ve been with him NINE years! So you should ask me!” Perhaps she was just bad at math or maybe the seniority rules worked differently over here. The two argued briefly over who should be giving out his information, each insisting that they were more knowledgeable, based on their many years clutching his arm and providing wet rags. Another tangent they went off on centered on how slow the other was in obtaining the damp rags and not holding the arm supportively enough. My partner looked over at me with the same pained expression Miguel had when we walked though the door. The younger one walked over with an ID or Medicaid card and attempted to hand it to my partner. One of the other ladies took it out of her hands and threw it on the ground.

“Stay out of this!” she told the newest wife. She shrugged and walked away, resuming her seat on a futon.

“Good luck,” she told my partner.

“I get heart attacks all the time.” Miguel said to me. He handed me his latest discharge paper from the local hospital. It was dated only a few days earlier.

“ACUTE ANXIETY” was the diagnosis. The paper showed he was prescribed another anti-anxiety drug with instructions to “reduce stress.”

“It feels the same now as it did then?” I asked. He nodded. “What was going on when this came on?”

“They was fighting.” he said casually.

“Ahhh…” I said.

“Oh that’s nothing,” he said. “They always fighting. Every day. This is nothing new.” Then he took off the oxygen mask we had given him and said very loudly towards the women, “But I love all my wives EQUALLY!”

The woman kind rolled their eyes a little but the nine year veteran looked at the younger one and said “That’s right! We are all EQUAL”

The youngest just patted her belly and nodded with a sly expression that made me think that she had a slight advantage over the other two.

I went through the medications that were next to the lamp on the storage container table and noted they were all for anxiety and acid reflux.

“Oh yeah,” Miguel said. “I get a lot of anxiety. And acid from anxiety. I had it a long time. I get disability for it.

“So you don’t work.” said my partner, not as a question but as a statement. “And you’re home all day. Here. With the wives. And they’re home all day too. With you. And each other. And you’re all just together. Here.”

Miguel nodded. The wife with 11 years pointed out that she and the 9 year wife don’t work either. “We are here all the time to take care of him,” she said. “He’s a very sick man. He needs help. That’s our job. But she works. She’s out working a lot of the time.” she said pointing to the youngest with contempt.

“Hell yeah!” said the youngest wife. “And be here with you all day? How do you think we pay for this place? And your QVC habit?”

The tension had just gone up a few notches. “Take me to the other room,” said the 11 year wife to the 9 year wife, “before I get arrested for slapping down a pregnant woman.”

“You do like the QVC.” the nine year wife told her as she walked away.

With the exam wrapped up all signs pointed to another anxiety attack, with some possible GI issues as well.

“So I don’t have to go?” asked Miguel.

“Oh no,” yelled my partner from the other side of the room. “There’s no way we are leaving you here.”

Miguel’s symptoms seemed to decrease considerably when we left the apartment. I found it strange that none of the women offered to accompany him but I learned later that a previous crew had made this a rule and it seemed to work out better for all involved to not have anyone go instead of having a huge fight over who would stay with the children and who would go to the hospital.

We returned to the same apartment a few months later on Valentines Day. The three wives had gotten into a brawl over the gifts Miguel had chosen for them. As another testament to his high desirability he had made sure it was the thought that counted, rather than the price of the gifts. The three women had each gotten some kind of NYC tourist trinket, the kind sold by street vendors. A clock highlighting the Statue of Liberty lay broken on the floor. Miguel’s love for NYC, or perhaps just NYC souvenir items, was an unsaid point of consternation, I felt. There was also a difference of opinion on the amount paid for each item with the consensus being that the little replica NYC taxicab cost more than the clock and the “I Love NY” t-shirt, which was 2 sizes too small for any of them. An argument ensued regarding the t-shirt with the recipient implying it was meant for one of the others as a hint that she was getting too large. It seemed lost on her that all three of them would have been considered too large by that reasoning. It was the same woman who had been confused about whether 9 or 11 was a longer duration of time.

Despite some scratches and disheveled hair none of the women wanted to go the hospital. Miguel did though. He practically ran to the ambulance. We suggested that his toxic home life may be to blame for his numerous hospitalizations and he acknowledged that it did. But he simply said “There’s nothing I can do about it. I am a lover. I cannot choose who I am.”