Volunteer EMT skipped his own checkups – until chest pain knocked him to his knees

TJ Smith knew better than to let a decade pass without seeing a doctor.

After all, he was a volunteer EMT in Powhatan, Virginia. He dealt with health scares all the time. And, truth be told, he'd let himself get out of shape. Ever since the COVID-19 pandemic, he rarely exercised and often ate fast food.

He no longer had the energy to finish mowing his lawn. The quarter-mile walk from his front door to the end of his cul-de-sac completely winded him. On ambulance trips with patients, he sweated heavily.

But health insurance was expensive. As a contract software engineer, he opted against buying it.

Finally, though, he decided to schedule a checkup.

A week before he was to see a doctor, Smith was awakened by an "anyone available" rescue call. While rushing to help someone having chest pain, his own chest felt on fire. Then came the sensation of "a flower blooming" inside his chest. He went down to his knees.

He remembered that his EMT bag had a nitroglycerin pill, the exact thing he would put under the tongue of a patient with his symptoms. He took it and immediately, he said, "I felt like a million bucks."

He went on the call with his team, took the man with chest pain to the hospital, then went home and back to sleep.

A few hours later, he called to move his appointment up. A stress test revealed major problems: One artery was 99% blocked, two others were 97% blocked.

"The doctor was glad I had taken the nitro pill," Smith said. "He told me I shouldn't even be alive."

Smith underwent triple bypass surgery in October 2023. He awoke in all sorts of pain because of his breathing tube. In addition to the usual discomfort of such a thing, part of it was taped down so much that it was affecting his blood pressure. It took about four hours for him to get relief. During that time, he tried focusing on something else: photographs of his 6-year-old grandson, Oliver, taped all over the walls of his room, courtesy of his wife, Jesse.

"The only reason I didn't panic was because I saw his face," TJ said. "That started a mantra in my head: Don't panic, don't panic, don't panic."

TJ asked doctors when most people go home after surgeries like his. Told five to seven days, the fiercely competitive TJ was determined to go home in four. Which he did.

But recovery was difficult.

"I'd just stare at him to make sure he was OK," Jesse said. "He was afraid to sleep next to me because he was scared I'd touch his chest, which hurt for a long time. Just being able to sit up from a lying position was excruciating."

TJ said he felt weak; he felt broken.

"You don't realize the core of your ego and strength as a man – the core of your identity – derives from the strength of your chest," he said. "I was the guy who always got the heavy end of the couch, the guy who could lift two bags of concrete, no problem. After surgery, though, I couldn't lift anything heavier than a pillow."

What he and Jesse did do, though, was start getting healthy again. Slowly but surely, short walks after dinner turned into longer ones. TJ bought a virtual reality headset and loaded it with fitness apps. He began swimming, too.

"He doesn't do anything in a small way," Jesse said. "For TJ, it's all or nothing."

The two of them try not to eat anything with an ingredient list, focusing instead on fish, chicken, fruits and vegetables. TJ only drinks coffee and water.

They've lost weight and feel good. His doctor has confirmed that his heart is doing great.

Now 52, TJ is sharing his story in hopes of giving other people the nudge he needed to give himself. "If I had only gotten annual checkups," he said, "I wouldn't have had to go through this."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.