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As I began assembling my notes, diary entries, and observations of myself, my colleagues, and my patients who have coronary artery disease and who have had various treatments for it, I recognized that to report on what I have learned, thought, felt, and believed needed a full monograph rather than a brief chapter. Nonetheless, I will attempt to report some of my thinking and feelings, recognizing that this is just the beginning of a study that has its antecedents in my previous research on psychosomatic specificity theory, stress-strain-coping investigations, especially as these have related to the mourning-liberation process, my own personal experience with coronary artery disease, coronary-artery bypass surgery, and subsequent activities in rehabilitation and intervention to prevent further problems. In this relatively brief report I will attempt to present bits and pieces of what I have learned and am learning, indicate how they relate to the role of the psychiatrist in the rehabilitative-preventive process, and pinpoint the areas that should be studied more actively.
The major clinical manifestations of patients with coronary artery disease are angina, myocardial infarction, or sudden death. General observations