The celebrated indie filmmaker spoke to his fans and followers from his hospital room at the Glendale Adventist Medical Center, where he is still recovering, recalling the moments before and after his devastating medical scare, which occurred after he had filmed one of two comedy shows on Sunday evening.
The 47-year-old director admitted that, at first, he thought he had gotten sick because he "felt a little nauseous." After laying down on the floor and then throwing up, Smith said that he figured he just drank "some bad milk."
"I was trying to get over it so I could do the next show once they loaded everybody in," Smith said, recalling that he then laid down on a couch in the theater which is when he realized something more serious was happening.
"I started feeling pressure on my chest. But not like, 'There's an elephant on my chest,' just I couldn't catch my breath. Honestly, I was never really in pain," he explained. "So, because of that and because I'm 47, I didn't really piece together 'heart attack.'"
It wasn't until paramedics were called to the scene and began administering life-saving procedures that Smith started to wrap his head around the severity of his situation.
Even after being rushed to the hospital and strapped to monitors, he still didn't believe he was dealing with a heart condition until one of the doctors informed him that they needed to transport him to the emergency room because he'd suffered "a massive heart attack and we have to look inside your heart right away."
As Smith revealed on Instagram the morning after his emergency surgery, doctors discovered a 100 percent blockage of his left anterior descending artery, which is commonly referred to as a widow-maker heart attack.
While the Dogma director never really got scared during the incident -- albeit mainly because he didn't grasp how serious it was -- he said there was one thing that really concerned him, and it had to do with the way in which the doctors accessed his heart.
"Here's me, in the Emergency Room, dying. Literally dying, and this was my biggest concern: a guy comes in and goes, 'I have to shave your groin,'" Smith recalled. "I said, 'For what?' He goes, 'They go up through your groin to get into your heart.'"
"My biggest fear in life: Death, No. 1. No. 2: People seeing my d**k," he joked, recalling how he began to bargain with the guy to let him keep his underwear on. Later, when they made him take them off, he tried to cover up with his shirt. "Finally, somebody had the good sense to be like, 'He doesn't quite realize that hiding his d**k is not the most important thing right now.'"
Ultimately, the doctor successfully removed the blockage and saved Smith's life.
As for the cause of the heart attack, Smith said many factors played a role. Despite losing around 90 pounds over the last seven years, he faced previously existent plaque build-up and has a family history of heart disease. Smith's father, Donald, died of a heart attack when he was 67, and his mother, Grace, has two stents in two arteries in her heart.
"I went through lifestyle changes, and some s**t don't matter," he said. "Some s**t you just can't beat, because it's genetic."
"I remember reading kind things from people who normally don't say kind things about me or my career, and I was like, 'This is what it's gonna be like when I die one day, hopefully. People will say nice things,'" the Yoga Hosers creator shared. "And I realized that as long as I keep my nose clean from now until the end… they might be kind at the end. I won't be one of these people who die [and they go], "Good riddance you fat f**k!'"
One star who sent kind words over was Chris Pratt, who tweeted, "I have loved you since Clerks and I’m praying my ass off for you." The Guardians of the Galaxy star received some criticism for offering his prayers, but Smith dismissed any negativity, calling Pratt "one of my favorite actors on the planet" and expressed his gratitude for the sweet sentiments.
"Thanks to Chris Pratt. How sweet was that?" Smith said. "Star-Lord is praying for me."
Addressing his immediate future, Smith says he's going to be taking a lot of pills, including blood thinners and beta-blockers, and will have to see a cardiologist regularly. Despite the changes, he said he's feeling better than he could have expected and he's walked away from the scare with a "zest for life."
As his message came to a close, the director began to get emotional reflecting on how close he came to death and thinking about the legacy he would have left behind if he hadn't gotten the help he needed so quickly.
"I thought about my parents and how they raised me, and my brother and my sister, and my friends, and my wife and my kid, and this weird wonderful career that I’ve had for so long," Smith shared as he fought back tears. "And I was like, content."
"It was weird. I don't know how to say it. I didn't want to die, don't get me wrong," he added. "But what a ride it's been. What an incredible f**king ride it's been."