Slay the Giant - The Story Behind the Title

Elizabeth Klodas, MD, FACC

A long time ago, before I went to medical school, my father, who is also a physician, recounted a tale he had heard at a medical conference. The story summarized the status of medicine at the time. Even then, the tale struck me as having incredibly profound implications and, 20 years later, it continues to affect the way I view medicine and how I care for my patients. Here is that story.

A couple of doctors were passing by a river when they noticed an injured man floating by. He was gasping for air and crying out in pain. The doctors rushed into the river and pulled the man out. They tended to his wounds and eased his discomfort. Just as they were about to go on their way, two more injured people came floating down the river. And slightly upstream, five more bodies were visible. The doctors started pulling these individuals out, but knew they needed assistance. So they called for other doctors to come and help with the wounded.

The stream of injured grew larger and larger. And more and more doctors came to help. They built hospitals along the river’s banks, and invented new methods to treat the patients more quickly. Whole cities and industries sprung up in an effort to treat all the ill individuals. Thousands upon thousands of doctors flocked to the riverbank to help.

The doctors congratulated each other on every saved life. Their patients were grateful, and the doctors really felt like they were making a difference. Their inventions were much celebrated in the press, and their heroism was an inspiration to one and all.

But no matter how efficient and sophisticated the doctors became, no matter how many fancy machines or inventions they had, they could never quite keep up with the flow of patients. More and more kept floating down the river. The system was overwhelmed, the doctors were exhausted and people were still dying.

Surprisingly, the doctors never walked upstream. If they had done this, they would have seen an angry giant clubbing people nearly to death and throwing them into the river. As it turns out, the real, lasting solution to the situation was not the complex one of investing time and resources into treating the injured, but rather a simple one: slay the giant.

Amazingly, this story, which highlights the pitfalls of treating disease instead of preventing it, is just as applicable to medicine today as it was in the previous millennium. We are so preoccupied with finding new ways to cure the sick that we expend relatively little effort on keeping people healthy.

We have thousands of ways to treat patients who suffer from heart disease. We have fancy tests and miraculous procedures, specialized surgery and lasers and pacemakers. And yet we have accomplished very little in terms of reducing the number of people who develop heart disease — in fact, these numbers are growing. Heart disease is already the number one killer and disabler in the United States. And if you think it’s an economic and social burden now, just wait until the baby boomers start hitting cardiologists’ offices.

When it comes to heart disease, it’s time for all of us to walk upstream. To help you do just that, I wrote Slay the Giant, published in conjunction with the American College of Cardiology. If you’re interested in buying the book, please click here.