Sarnoff Corporation

John Mercuro

Charles Dennis: Deborah

James Clingham

Galaxis USA

Corrections or additions?

This article by Tricia Fagan was published in U.S. 1 Newspaper on June 16, 1999.

All rights reserved.

Heart Attack: Assessing the Big Wake-Up Call

Jim Clingham walks into the conference room in the

second floor offices of Galaxis USA Ltd., exuding the energy and robust

good health of a man who is living well. In summer chinos and golf

shirt, his face and arms already boasting an admirable tan, he settles

comfortably in an office chair and turns a bright blue-eyed gaze on

the interviewer. He looks ready for — well, for anything. There

is nothing in his looks or manner to indicate that less than five

years ago Clingham survived a major heart attack — a wake-up call,

he points out, that challenged him to change for the better the way

he lives his life.

In November of 1994, Clingham was senior vice president of corporate

affairs at the David Sarnoff Research Center. He had been with Sarnoff

for eight years, since the company had moved out of RCA Laboratories

to become an independent research business. For him the excitement

of getting a start-up company off the ground was irresistible. "I

had been at RCA, and had several other job opportunities, but the

challenges involved in starting up Sarnoff were the kind of things

I’m constantly attracted to. The Sarnoff Center is an absolutely marvelous

institution, a leader in many advances in telecommunications. So when

I had a chance to work with some really brilliant guys to get Sarnoff

off the ground, I jumped at it."

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Sarnoff Corporation

He worked as general counsel for Sarnoff, headed up licensing efforts,

helped in the development of three spin-off companies, served on multiple

boards, and was eventually named vice president for corporate affairs.

By late 1994, however, he was beginning to consider different options.

"It was a tough business," he says, "and I had been at

it for eight years. For a variety of reasons, it was time for me to

move along."

On a Thursday in November, 1994, Clingham met with the president of

Sarnoff and gave notice that he would be leaving. Although the decision

was mutual, Clingham admits that it came at some personal cost: "I

don’t care how macho you are or how much self confidence you have,

something like this hurts. How do you leave a place you put your heart

and soul into? There was also the fear of what to do next. I wanted

to be useful to people. Would I have to go back to practicing law?

I knew I didn’t want to do that. There was a lot to think about."

That following Tuesday he had a meeting with the chairman of Sarnoff’s

second spinoff company. Business concluded, they decided to get some

lunch. "We walked over to the cafeteria," Clingham says, "and

I remember that we both ate macaroni and cheese. Boy, it looked good

then — but today I won’t touch it!" He returned to his office

and almost immediately knew that something was wrong. "I can’t

describe it," he recalls, "except that it felt like I was

having a heart attack. I didn’t know what the hell a heart attack

felt like, but my arms hurt, I was full of gas, I started sweating,

My secretary suggested it was probably heart burn, but this felt like

something else."

Clingham usually worked through any ailment, but luckily he listened

to his instincts this time. He walked over to the company nurse who

took one look at him and said, "You’re having a heart attack."

Within minutes she had an emergency team and ambulance on site. For

Clingham, time went into slow motion. "Everything was a blur,"

he says. "It seemed to take hours before we got to the medical

center."

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John Mercuro

His luck held in the Princeton Medical Center emergency room, when

he met his cardiologist, John Mercuro, for the first time. Something

about the doctor gave Clingham an instant sense of confidence. "From

the moment I saw him, I knew it was going to be fine. Here’s this

wiry, short, impeccably dressed man whom I had never met — the

cardiologist who happened to be at the hospital when I came in. I

could see he was intelligent, a fighter — like a Napoleon. I had

complete trust in him."

Clingham admits with a rueful humor that once he knew

he was going to live through the heart attack, he found himself worrying

about the future in a way that surprised him. "You know, you’d

like to say you thought of a lot of things — like my wife, of

course I thought about her, we’ve been friends for a long time. And

my kids. But to tell you the truth, what I worried about the most

whether I was going to be stuck in a wheelchair from then on —

whether I would ever be able to get out and play golf really well.

Golf became my focus, my goal. I think it goes to the fact that there

was no Sarnoff to go back to — that I had already made my decision

there. When I was in alcohol rehab, there was an RCA to go back to;

I’d be in the program worrying about what was happening there, who

was taking care of things while I was out. I think golf became so

important because I wanted to feel I could do something viable when

this was all over."

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Charles Dennis: Deborah

A sense of self worth is indeed an essential component in a successful

recovery from a heart attack, says Charles Dennis, chairman of the

department of cardiology at the noted Deborah Heart and Lung Center

in Browns Mills, and president of the regional affiliate of the American

Heart Association. He devoted the 1980s to a series of studies on

facilitating recovery after cardiac events: cardiac surgery, heart

attacks, and angioplasty. These studies were funded by two National

Institute of Health (NIH) grants aimed at helping people who had experienced

uncomplicated heart attacks return to work.

Dennis notes that the medical community’s understanding of heart attacks

and recovery has improved immeasurably within the past 10 or 15 years

— and part of that understanding involves, at least for most men,

the importance of returning to some type of viable work situation

as soon as possible.

He describes one study, affectionately nicknamed the "Honey, It’s

Time to Start Taking Out the Trash Study," that examined the self

confidence measure of heart attack patients and their wives (until

very recently almost all heart research was done using white male

patients) when it came to variety of daily activities. They rated

them both before and after the patient walked a treadmill test. Before

the test, both patients and their wives uniformly rated themselves

fairly low. The subjects were separated into three groups. In one,

the wife sat in a separate room but spoke to her husband after he

walked the treadmill. The second group watched their husbands walk

the treadmill, and the third group watched, but then they actually

walked the treadmill at the highest level attained by their husbands.

"We found," Dennis says, "that the self confidence of

both the patient and the wife were higher when the wife watched, but

even higher still when the wife walked on the treadmill herself. In

fact, in that group, the wife had more confidence in the husband’s

ability than he did. The study made us realize that we not only had

to influence the patient, but we also the significant other, and the

employer — as well as the primary care physician whose natural

tendency was to say: `Don’t do anything for three months, just sit

around.’ We got people involved in a program of physical exercise.

It built self confidence, and also put them into a social situation

with other people who were recovering, letting them see people at

the end of 10 or 12 weeks of physical therapy who were doing great."

"Until very recently," Dennis says, "heart attack patients

were treated as if something else bad was going to happen to them.

That was medically, psychologically, and occupationally very disabling

to people. Many people think that you’re disabled after a heart attack,

that it takes a long time to recover, but the average uncomplicated

heart attack patient is physically able to go back to most jobs within

a week. Conventional wisdom might say, `Gee, it’s so stressful for

people to go back to the workplace.’ But we measured stress levels

for people with heart attacks and found that the average man working

at the time of his heart attack was more stressed at home, worrying

about what was going on at work, than he was at work."

"We tell people at low risk of future heart incidents that we

need to manage their risk factors: cholesterol, diabetes if they have

it," he says. "If they’re smoking, they have to stop. And

they need to get back into a program that rebuilds their physical

strength and confidence to go back to their occupational work. In

general, the physical recovery in most uncomplicated patients is the

least of their problems. It’s the psychological recovery, and getting

the recognition by other people around that this person is going to

be okay — and sustaining their motivation to support a healthy

lifestyle — that’s far more difficult."

Dennis explains that when it comes to evaluating future

risk and developing a recovery plan, heart attack patients fall into

one of two general categories: uncomplicated or complicated. "Uncomplicated

means they didn’t have bad things like congestive heart failure, unstable

chest pain afterwards, or require angioplasty, or have bad heart rhythm

disturbances that may require additional intervention. Fifty percent

will have uncomplicated heart attacks."

Clingham, whose treatment included an angioplasty, fell into the complicated

category, but his initial recovery still went relatively smoothly.

Maintaining contact with the outside world was important, and the

immediate outpouring of support and concern he experienced while still

in the hospital definitely got him off on the right foot. "It

was a wonderful phenomenon. I had 332 physical representations of

people’s interest in and concern about me when I was in the hospital

— cards, flowers, visits, gifts. It was unbelievable."

For Clingham, concerned about the direction his professional career

was going to take even before the heart attack, an early hospital

visit from an associate at Sarnoff went a long way towards shoring

up his self confidence. He explains: "It was the second day I

was in the critical care unit at Princeton Medical Center. Clark Herman,

a dear friend of mine who had been the chief lobbyist on labor issues

at Sarnoff, was one of the first people whom I had informed —

a day before the heart attack — that I was moving on. He convinced

the nurses that he was my brother, because, of course, only family

was allowed to see me — it was typical Clark. He was concerned

about me personally — but he also wanted to let me know that he

had had dinner the previous Friday with a guy from Germany who badly

needed my help. I was half asleep, thought he was nuts, but knew in

my heart of hearts that here was a message that when I was ready,

all sorts of people would be ready to use my talents."

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James Clingham

Returning to viable work of some sort was a strong motivating factor

in Clingham’s recovery process. "Let’s face it," he says,

"work’s really important to driven people like me, with these

type A personalities." He readily traces his drive to excel back

to his Catholic-school boyhood in Providence, Rhode Island, where

his father worked for the Internal Revenue Service and his mother

was a schoolteacher.

"From the time I was a kid, being first in the class, competing

with the other guys like Tommy Fogarty or Austin White, getting accepted

at LaSalle High School, making it to captain of the C.Y.O. basketball

team — that was what was important to me, and that was what was

demanded of me when I went home. I mean, my mom didn’t want to hear

that Austin White had done better at something." The fact that

his one older brother excelled at school set the standards even higher.

That competitive energy continued through the University of Rhode

Island, where he received his B.S. degree in 1964. "I started

out to be a journalist when I graduated from college," he says,

"I loved it, but I never saw it as a real job." While pursuing

a law degree from Catholic University, Clingham was an editor of the

Law Review. He also spent time in the military, serving in the Dominican

Republic and in Vietnam as an infantry captain. Before moving to New

Jersey, he practiced law in New York, Washington, D.C., and Rhode

Island. He also worked for both GE and RCA before it became Sarnoff.

Fifteen years ago, Clingham — a recovering alcoholic

— used that same drive to get himself off alcohol. He believes

that some of the discipline he developed in fighting that battle has

helped him in recovering from his heart attack. "My highest priority,"

he says, "continues to be staying sober. The combination of those

two wake-up calls — 15 years ago that I had to stop drinking,

and five years ago that I had to do something about my lifestyle —

have led me to be much more aware of my life. I don’t have to move

at a thousand miles an hour. Staying focused on helping other people

is primarily what drives me today. If my whole focus in life is on

a job, it becomes stressful. If I focus more on working with other

people, for example in my work with recovering alcoholics, it’s not

stressful at all. Sure, there are frustrations once in a while when

somebody doesn’t get it, or I’m not doing it that well, but it’s not

stressful."

Clingham credits his family for their support during the heart attack

and recovery period — and through his life transitions. "I

have a wonderful son, a beautiful daughter — they’re both great.

My wife, Deanna, and I have been married for 35 years come October.

She deserves an enormous amount of credit, particularly for some of

the bad times with my drinking. Our experience with that motivated

her to get her master’s degree in alcohol and drug counseling. Now

she’s out saving the rest of the world — doing wonderful, amazing

work with people. Her stories at the dinner table are so much more

important than mine."

Clingham believes that — in addition to watching physiological

problem areas like weight, cholesterol, the need for more regular

exercise — stress reduction was an important part of his recovery.

Once he realized that he was going to be okay, Clingham reevaluated

his career plans. "My original intention was probably to get back

into the large, corporate world. The heart attack forced me to rethink

whether I actually should do that. I found I had lost interest in

going back into the kind of environment where you spend hours at long

meetings — probably necessary for the operation of big corporations

— but those meetings drove me crazy. They added huge amounts of

stress."

An important first step in this decision-making was his recognition

that financially he was in a good position to make alternative career

choices. "It took me a little while to realize that I could still

live well making less money" he says, "that I wasn’t going

to have to eat pizza off paper plates for the rest of my life in order

to survive.

"Was I in a position to just say, `The hell with you all, I’m

going fishing?’ Not really. For one thing, it would have been irresponsible

of me to walk away from some of the groups I was involved with at

the time. I was chairman of the Chamber of Commerce and was very involved

with the Private Industry Council — now Workforce Investment Board

— and these groups meant a lot to me. And I was also personally

committed to a number of community service things. In order to stay

involved, I felt I needed a position which allowed me a decent cash

flow, an office, and a little bit of ego-driven work, so I could stay

involved with the Chamber and my other commitments."

During the first six months, he worked as a consultant out of a home

office, working with a number of clients that included Galaxis Holding,

a German company involved in the worldwide research, manufacture,

and distribution of consumer electronic and satellite products. "My

average morning might involve taking two or three phone calls, taking

care of two or three pieces of immediate business. But then I’d get

in my hot tub and read the sports page. Around 10, 11 o’clock I might

decide to get dressed, have lunch with someone I’d set a meeting up

with — or maybe not. That’s the way I started my recovery, and

it set a mindset that said: `If I decide to start working for anyone

else, it’s going to be at my own pace.’"

In hindsight, Clingham feels that his heart attack actually facilitated

his transition from Sarnoff. "If I had left there without having

had the heart attack, I might have felt a huge loss — because

no matter what I did next, no matter where I went, it couldn’t have

been as exciting as those first few years of helping Sarnoff get off

the ground. Having the heart attack changed the focus from all that

ego stuff. The focus became, how am I going to survive? What are my

choices?"

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Galaxis USA

Clingham currently holds the position of vice president, international,

for Galaxis, and also maintains his own management firm. The arrangement

suits him. "Here I’ve been able to set my own pace, make my own

hours," he says. "Sure, there’ve been problems, huge frustrations

along the way. But now I have much more control over how I balance

things. If a conference meeting is called off at the last minute,

I can make the decision to take off at noon and go play golf. Arguably

I could have done that at Sarnoff, but I would have known that I was

walking away from some management issues, that I was possibly letting

some of my staff down. There’s not that type of pressure here."

He likes and respects his staff, thinks it’s great to have his office

on Nassau Street, "It’s so Princeton — I love being part of

this community."

Clingham firmly believes — as do many doctors — that stress

contributes to cardiac problems. But Deborah’s Dennis insists that

the medical world has yet to identify any scientific relationship

between stress and heart attacks. "It’s a really a tough area,"

he says. The data based on the "Type A" personality type is

out of vogue now. "What was learned from that, though, was that

there is probably an underlying anger and a hostility component in

some people who are type A. And that research indicated that people

with that type of anger or hostility component seem to die earlier

or have more complicated courses of recovery," says Dennis.

"I always tell patients who say they have a lot of stress that

it’s probably not so much the stress itself, but how you react to

and channel the stress in your life — productively or destructively,"

says Dennis. Measurable physiological factors, he believes, are much

more important — particularly when it comes to maintaining cardiac

health and preventing heart attacks. "The physiological factors

are clear and treatable," he says. "Are they smokers, do they

have high cholesterol, do they have high blood pressure, do they have

diabetes? We have very good treatments now for most of these indicators.

We can change prognosis for a future heart problem dramatically just

by getting cholesterols down to a very low level by putting patients

on protective medicines, or by getting them off cigarets and so forth."

Despite his apparent robust health, Clingham knows that maintenance

and vigilance are important. Shortly after his initial heart attack,

Mercuro discovered that one of his arteries was almost completely

blocked and brought him in for another angioplasty.

A year later, in Florida on vacation with his wife, Clingham woke

up "hurting like hell . . . It was the first time things had been

really painful."

His physical the next week confirmed that the artery

was once again blocked up. "I made Dr. Mercuro promise that when

he went in this time, that he would do everything that needed to be

done — whether it was open heart surgery or what," Clingham

says. This time a stent was inserted in the artery.

Clingham has felt fine since, but now recognizes that things will

never be back to "normal." Says Clingham: "I understand

now that this is an on-going process. Still, knowing what guys like

John Mercuro can do, I don’t worry. Someday there may be the need

for them to do open heart surgery on me, but every day the medical

procedures get better and faster — so if that time comes, I’ll

still be confident."

He acknowledges that his recovery regimen still isn’t perfect. "I

probably need to do more exercising. I should probably cut back on

this stuff (indicating his second cup of coffee). I’m playing a lot

of golf, but I should really be doing it more to enjoy myself, not

just for the score." He even admits to a real no-no — sneaking

an occasional cigaret. Dennis agrees that maintenance is the most

difficult challenge for most people. "When people haven’t been

living a healthy lifestyle, heart attacks are a great wake-up call.

They tend to get religion. The question is, how long are they going

to keep religion?"

While admitting that there’s always more he can do, Clingham also

reflects on the significant changes he has made in the past five years.

"I think people will say that I do things differently now. There

was a long time, in my drive to get ahead — beating out the Austin

Whites, being a better military officer, etc., etc. — when I didn’t

give a damn about the other guy or what they thought of me. That’s

not true anymore.

"In the long run, I think it comes down to the joy of living.

Some days I’m really tired, I’ve been beat up by one thing or another.

But I think that if, at the end of the day, you feel that you did

whatever you were doing pretty well, then you’ve had a great life."


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