Rob Dunn - The Man Who Touched His Own Heart: True Tales of Science, Surgery, and Mystery

H eart diseases are so common that it was almost inevitable that someone I knew well would suffer from a problem heart while I was writing this book. I just didnt think it would be my mother. On January 4, 2013, my mother, who lives in Wasilla, Alaska, went to her doctor. Her doctor took her blood pressure, ran an electrocardiogram, and then took immediate action. My mothers heartbeat was irregular (arrhythmia) and her heart rate was extraordinarily high (tachycardia)184, the sort of heart rate more often associated with a small bird than a human. Her blood pressure was up too. There was no telling how long she had lived with these conditions. Months? Years? Immediately, my mother was put on a cocktail of drugs to lower her heart rate and blood pressure and to sort out the wriggling arrhythmia. Both of the problems from which my mother was suffering at this point in the story are common. Arrhythmia affects as many as one out of three adults over sixty, tachycardia fewer, but still hundreds of thousands. This very commonness was, to a son many miles away, reassuring.

What was not reassuring was that the cocktail of drugs that were given to my mother did not seem to fix her problems, at least initially. Slowly, her heart rate began to come down. This seemed like progress, but her arrhythmia did not go away; it seemed to get worse. Inside her body, her heart flopped and then flopped again.

On January 15, my mother was scheduled for a more extreme intervention. Doctors were going to shock her heart. They would stop it in the way that lightning can, electrically. The hope was that, when her hearts rhythm resumed, it would be normal. Such a procedure is the medical equivalent of kicking the TV when it flickers in the hopes that whatever is loose will reconnect itself. It works about half the time.

My mother was terrified. The doctors seemed to have been told by someone to avoid using the word shock in describing the treatment. My mother asked, So you will shock me? The doctors replied, No, no, it is not a shock. Do not worry. No one, however, told the technician about the party line, and so, in the moments before the procedure, he asked my mother, Are they going to shock you? They shock people all day every day in here. Lightning is lightning, whatever you call it. They shocked my mothers heart. It stopped, restarted, and then resumed the fumbling beat it had had before the procedure, still arrhythmic.

My mother went home, her heart slowed but still skipping beats, sending blood irregularly through her body. She was worn out. Maybe she had been worn out for a while and had not realized it. She slept for twelve, and then more, hours a day. It could have been, it seemed, the effect of not getting enough blood through the body. It could have been other things. It was, it would turn out, other things.

On February 5, after about a month of feeling terrible (and probably a number of months before that of feeling poorly but not knowing why), my mother went to the doctor again. When she did, they took her blood pressure. They measured her heart rate. They ran an electrocardiogram, an EKG. Once again, the doctors, this time a different set, were alarmed. My mother was admitted to the ICU.

My mother had, unwittingly, been given too much of one of her drugs by her first heart doctor. The first doctor had prescribed a version of digitalis. Digitalis lowers heart rate, but its effects are highly dependent on its dosage. Too little, and it has no effect; a hair too much, and it can prove dangerous, deadly even. My mother had been given too much. The first symptom was yellowed vision (everything seen as if through amber-colored glasses). The second, although she didnt know it was a symptom, was sleepiness, an intense sleepiness that made her sleep at first ten and then twelve and then ultimately sixteen or so hours a day. The third symptom was a lack of appetite; my mother, it turned out, was not eating much at all and had been losing weight quickly. Then there were cognitive problems that reached their peak on the day my father took her back to the doctor. She could barely form words and even when she could, she could not seem to put them in the right order. Digitalis, a drug that should have made her better, had become her poison.

In the ICU, doctors put my mother on four IVs. They watched her constantly. They did test after test. Nothing seemed to make her better. It took a while for them to realize that all of her symptoms, apart from the heart-rate problems, were due to the digitalis, and even some of the heart-rate problems seemed to be related to the digitalis. Whereas her heart had once beaten too fast, it now beat too slowly, far too slowly, akin to the rate of an elephant: