I guess Billy Joel was right when he crooned, "Only the good die young."
We lost one of the greats when actor James Gandolfini, died of a possible heart attack in Italy at the age of 51 on Wednesday.
Gandolfini rose to fame as crime boss, Tony Soprano in HBO's hit drama, "The Sopranos."
To me, Gandolfini represented part of my life that taught me a lot about being a real person. "The Sopranos," which was recently named by the Writers Guild as the best written television show ever, is immeasurable when it comes to the amount of heart and soul each actor put into their character.
It's been widely reported that Gandolfini preferred to stay largely out of the limelight in the years since the show ended -- appearing in some supporting roles and working with soldiers suffering from PTSD in his downtime. He had many admirable qualities, no doubt.
Now, I don't know much about Gandolfini's personal life, but I always felt -- just like many Americans felt when they watched him as Tony Soprano -- that Gandolfini's interpretation of that complex character was something relatable to what many of us carry inside our own souls. We saw his evil side, his compassionate side and even, ironically as it may have seemed as a powerful crime boss, his weak side.
As a doctor, I remember always thinking 'This character is on the verge of a health breakdown. How could you have so much pent up stress? How could you have a lifestyle that always brought you to the edge?'
We don't know much about the details of his sudden death at this point, but we do know that heart disease is still the No. 1 killer of both men and women in the United States.
The U.S. Centers for Disease Control and Prevention estimate that 785,000 Americans will have a new coronary attack each year, and about 470,000 will have a recurrent attack.
A number of factors can influence a person’s risk for heart disease, including heredity and lifestyle choices such as smoking, excessive drinking, history of diabetes and consuming a high fat diet. High blood pressure and high cholesterol are also risk factors for heart disease.
We don't know what health issues Gandolfini may have had -- if any. Yes, we know that he was overweight, maybe he had some unhealthy habits, and certainly, any working actor who travels a lot probably has high stress levels.
In a December 2012 interview with The Associated Press, Gandolfini said he gravitated to acting as a release, a way to get rid of anger. "I don't know what exactly I was angry about," he said.
"I try to avoid certain things and certain kinds of violence at this point," he said last year. "I'm getting older, too. I don't want to be beating people up as much. I don't want to be beating women up and those kinds of things that much anymore."
As a doctor, I stress the importance of living a healthy life to patients and family. But as I tell my own children, life is also about making a difference. About being noticed. About being remembered.
I think that Gandolfini will be remembered for eternity, and generation after generation will be impacted by his interpretation of a complex character with many flaws, but who certainly taught us all it was okay to just be human.
Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.