Sarah Casalan remembers some clear details from her night heart attack two years ago: At first she always thought she had indigestion from the hamburger she made for dinner the night before, although that was unusual given her “iron stomach.” But then she felt so terrible that she lay on the bathroom floor, sweaty and nauseous, for over an hour – and found she couldn’t get up.
“The alarm bells rang, even though I couldn’t even imagine that I had one heart attacksaid Casalan, president of UPS Store Inc. and a single mother of two boys, ages 6 and 7 at the time. After all, she was only 47 years old, active and generally in good health. “And why would I think I was having a heart attack without having chest pain?”
Casalan eventually got up and went to her mother, who happened to be visiting that evening, and from then on, “a total of about five minutes passed between the realization that I might be having a heart attack and the moment I passed out.” that she suffered from a complete blockage of her left ascending artery, which resulted in a heart attack called a “myocardial infarction.”Widowmaker“—which has only a 12% survival rate for women outside of hospitals. (Doctors have since theorized that it could have been brought about from an “overly inflamed” heart after a bout of COVID.)
What followed were several cardiac arrest– sudden cardiac arrest – which required resuscitation and life support to her heart and lungs.
“My family was advised to make their preparations and say goodbye,” she says Assetsand they were told that their best chance of survival would come from one Heart transplant. She was placed on a waiting list.
Today, Casalan, who has led the 5,700-store network since 2021 and who shared the stage with the company’s CEO and CMO at a conference just days before her health crisis and felt “ready to take on the world,” has come You on the other side of a long road to recovery riddled with setbacks. But she also wants to talk about it because “helping women at work,” especially mothers, is a “personal passion,” she says — and it is Health equity.
“So it’s just a great extension of two things that I’m so passionate about,” says Casalan, 49, now board chairman of the American Heart Association of Chicago. “How can we model for women how to be successful in the workplace and successful mothers? Being successful single mothers? To do all of these things, you have to be a healthy mother.”
Below, Casalan shares just some of the valuable lessons she learned from her near-death experience—about leadership, Parenthoodand setbacks.
Have some faith in medicine
Casalan remained on life support for many days and suffered initial setbacks, including when she developed a blood clot that eventually cut off the blood supply to her leg and foot and required extensive surgery to save her. She remained in the hospital for over two weeks.
“I was sent home with a life jacket, an external defibrillation device that predicts your higher risk of cardiac arrest,” she says, and went into cardiac rehab. “The idea was, hey, if you survive the first 90 days, maybe we can kind of move past this transplant idea… And I’m here today to tell you that I have my own little heart.”
Casalan has restored most of her heart function. “My message is: Science is important. Medication is important.” At a recent appointment with her doctor, she was told, “Listen, you can do anything.” Lifestyle things. You can complete all intervention tasks. But the drugs and the science got you here.”
Listen to your body
Since her heart attack, Casalan has discovered through emerging science genomic risk analysisthat she actually carries a risk that is 70% higher than average Cardiovascular diseases. If she had known this, she might have lived differently years ago.
“I lived in New York City for 15 years. I worked in the fashion industry. I was single. I lived the most extraordinary, fulfilling, interesting life, subsisting on caffeine, bagels, M&Ms, etc Diet Coke“, she says. At the time, she remembers, her mindset was: “I’m just going to be there with everything and everyone and everywhere and I don’t have to take care of myself.” At the same time, she had “a little bit of the typical mother part and the typical female leader part, like, ‘Me I’ll take it all upon myself.” Ultimately, that meant adding a “highly contentious divorce” to an already stressful mix.
What Casalan understood about doing everything and caring about everyone but yourself is this: “If you don’t listen to your body, it will eventually speak for you… My invincible personality has been re-educated.”
Good leaders are vulnerable – and know how to deal with setbacks
Casalan had learned some important lessons when she finally returned to work. “In order for my team to have confidence and understand where we were all at that point, I had to be very honest about everything – including my limitations. And that was very difficult.” But what she says was encouraged “was the openness of us as a team to talk about the realities we are all dealing with and how we can help and support each other.”
The biggest change in her leadership style, however, is “the way I deal with setbacks,” she says. That’s because she faced even more problems during her recovery – namely a 70 percent blockage in another artery, her left main artery, which was discovered during a stress test at the doctor’s office and required immediate robotic bypass surgery pulled out.
“That was hard,” she says. “I think I always expected there would be a setback…[but] This is not what I expected, that my healing would somehow be accelerated and derailed.”
As a leader, she shares, in her aforementioned “indestructible phase,” she had a tendency to “overcome all obstacles” and believed, “There is no constraint that we cannot eliminate.” We set out to do it, and we can do it.” But her second blocked artery changed her attitude.
“Now the way I think about setbacks is that some of them are very far outside of our control and influence,” she says. And it is more inclined to consider a range of options for moving forward – with the understanding that these may need to serve as a fulcrum for a different way of thinking. “I think it opened up a lot of creative conversations,” she says. “Before we just give up or move on, we should really take the time to think about what this setback means and how we can respond to it.” And giving the time and grace to do that has made a significant difference.”
It really does take a village
When Casalan was unconscious and carried out of her home on a stretcher the night of her heart attack, her two boys were there – both on the autism Spectrum – unfortunately we didn’t sleep. “They saw the paramedics taking me away and it’s still, you know, it’s still a moment for them,” she says.
But they were quickly comforted and cared for by many people in their lives. “I’m very lucky. I come from the line of iron women, they are pretty impressive,” she says. These include her sisters who came from the East Coast, one stayed for eight weeks, and her mother, who ended up staying a year. She also has “an exceptional nanny.”
Despite the crisis, she recalls, “the most important thing for her children was that they were surrounded by love and a sense of security and optimism.” We didn’t really talk about what happened until I was well again – “For example, we didn’t talk about the severity of what happened.” Since then, they have – just as they recently attended a local fire and rescue open house, where they all personally thanked the paramedics who were there that evening, which brought some closure.
Now, she says, she speaks openly about her encounters with death — particularly with her younger son, who coincidentally underwent corrective heart surgery when he was 10 months old. Sometimes they “compare scars,” she said, and recently they hosted an American Heart Association event together.
Both boys can even joke about it. “They’re funny,” she says. “They’ll say, ‘Well, Mom, you know you only live once!’ Except you.’”
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