A Storyteller’s Heart-Quad bypass gives PR executive “an inside look”

He’s known as one of Knoxville’s corporate public relations experts, a premier communicator whose storytelling skills have shaped opinions, guided consumer choices and built corporate reputations for decades.

But Alan Carmichael, 70-year-old chief operating officer and president of the public relations firm Moxley Carmichael, is telling his story from a new perspective since receiving a quadruple bypass at Parkwest Medical Center.

“I’ve said Covenant Health was a great system from the beginning,” said Carmichael, adding that Covenant has long been one of the top clients of the firm he built with his wife and company founder, CEO Cynthia Moxley. “Personal experience adds to the ability to say that Covenant Health is a great system and patients should use it. I have recommended it to friends who are looking for good care and good treatment.”

It was last Easter weekend when Carmichael, who had grown increasingly short-winded during morning walks from the State Street garage to his Gay Street office, checked into Parkwest for a heart catheterization with interventional cardiologist Nicholaos Xenopoulos, MD.

At worst, he suspected he might need more stents like the two Dr. Xenopoulos had placed in his right coronary artery in 2015. At that time an abnormal stress test had showed ischemia, or inadequate blood supply, in the inferior wall of the left ventricle. He also had moderate disease of the left anterior descending coronary artery but it was not considered “hemodynamically significant,” meaning the artery was less than 50 percent blocked.

But two years later, while there was no blockage in the stents or the right coronary artery, Dr. Xenopoulos found marked progression of disease with significant blockage in the left main coronary artery and left anterior descending coronary artery. A bypass would be required.

“I’d always said to myself, ‘You’re going to have a bypass at some point,’” said Carmichael, whose father died of a heart attack at age 48 when Alan was only 14. “I knew it was going to happen sooner or later, so I had a chance to process it and be ready for it. If I’d just walked in one day and they said, ‘You’re going to have to have a bypass,’ I probably would have been scared to death. There was a little anxiety, but I had great confidence in Parkwest. So, I said, ‘Let’s get it done.’”

Cardiothoracic surgeon Michael Maggart, MD, opened Carmichael’s chest with the intention of doing two bypasses. But before closing, he discovered the need for two more bypasses.

“I wasn’t familiar with my surgeon, so I asked the nurses, ‘What about Dr. Maggart?’ And they all said, ‘He’s great! He’s one of the best.’ Everyone at Parkwest did a great job, from the nurses on the cardiac floor to the surgeon and the surgical team. Dr. Maggart said he thought the grafts would be fine. He told my wife, ‘I think he has 20 years on those grafts.’”

Word of Carmichael’s surgery spread among friends in Knoxville’s business and arts communities. Moxley’s Facebook post about his surgery received 658 likes and 314 comments, and he also got an in-room concert by Knoxville Symphony Orchestra cellist Stacey Nickell, whose performance drew a crowd outside his room. “It was really gratifying that so many people wrote and wished me well,” he said.

Now he’s in cardiac rehabilitation, going through the same 12-week program he joined after his first two stents. “I took it very seriously the first time, but this time I’m taking it even more seriously in terms of following my diet pretty strictly, doing the rehab and exercising.” His wife said he’s not just a “compliant patient,” but a “model patient.”

Sometimes even that is not enough, particularly if a patient is genetically predisposed toward heart disease.

“Being a model patient decreases the likelihood of recurrence or progression of heart disease but does not eliminate the risk,” said Dr. Xenopoulos. “Half of all myocardial infarctions [heart attacks] occur in patients with no identifiable risk factors. However, in Mr. Carmichael’s case, his LDL cholesterol was still elevated despite maximal therapy.”

“I’m just a cholesterol-making machine,” Carmichael said, jokingly. “If I could bottle it and sell it, I’d be rich.” He does what he can by eating right, exercising and taking his cholesterol and blood pressure medicines. When all that failed, he chose Parkwest for his bypass surgery.

“We knew we were going to go there based on our experience with the stents and also the reputation that Parkwest has for being a good hospital for treating heart conditions,” he said.

Carmichael shrugs aside suggestions that he had a hand in building Parkwest’s reputation for excellence.

“Maybe I helped a little bit, but I think the best thing I offer is personal experience,” he said. “When somebody goes to a hospital or a doctor, has a good experience and tells others about it, that’s always a valuable recommendation. I know Covenant Health has a good reputation overall because I see the measurements and recognition, and I’ve seen [President and CEO] Jim VanderSteeg’s commitment to excellence and getting everyone focused on making sure the patients are receiving the right kind of care.

“When you are faced with a situation and you need a hospital and medical care, decision making becomes important,” he said. “But if you’ve got personal experience and knowledge of an organization and how well it does, it’s a lot easier to explain to others why they should go there.”