On the evening of June 24, 2014, I suffered a heart attack. In this post I’ll describe what should have happened that night. In my next post I’ll describe what actually happened. After that we’ll consider why there was such a difference between the two, and what the implications might be – for you, my readers, not for me.
I was an unlikely candidate for a heart attack. I had no family history of heart trouble and my blood pressure and cholesterol levels had always been normal. True, I smoked heavily as a young man – two packs a day of unfiltered Camels – but I quit the day I was mustered out of the Army, January 19, 1972, and haven’t smoked a cigarette since. I have a physical exam every year and a stress test every few years.
But that’s precisely the problem with modern medicine. Medical science is all about Big Data, mass statistics, t-statistics. If your only concern is about national health policy, this makes a kind of grim sense. If medical research suggests that treating everyone with a cholesterol level over X or a blood pressure level over Y will reduce the incidence of heart trouble (and therefore reduce medical costs), then everyone with a cholesterol level over X (or blood pressure over Y) is going to be prescribed powerful drugs. And if your cholesterol levels are below X and Y, you’re not going to be treated.
But think about this for a minute. A great many people, me among them, are suffering from serious coronary issues but are ignored and untreated. Far worse, millions of people who will never develop heart trouble whether they are treated or not are ingesting strong poisons every day that are killing them.(1) The fact that these drugs are hugely profitable to Big Pharma – and that medical researchers can dine out forever on massive government support for their research, as long as that research supports medicating the masses – keeps this Death Machine going.
To the medical world, in other words, we aren’t individual human beings, we are simply statistics. Medication that will help some will kill others. Medication that will help your heart will hurt your chances of dying from cancer. Too bad. Some day personalized medicine will be the order of the day, but not during the lifetime of most of us.
But back to my story. Unbeknownst to me, when I was in my thirties (probably), my coronary arteries began to “occlude,” that is, to fill up with gunk. I was asymptomatic for decades and had no idea this was going on. Neither did my doctors. It wasn’t until I was in my sixties that I began to notice a decline in my health. But the idea that I might have heart trouble never crossed my mind. I thought maybe I had some sort of cancer. Then I was sure it was diabetes. Eventually I concluded that I was just getting old, that being in pain was part of the cost of not dying young. I especially concluded that getting old and continuing to work like I was thirty was a large part of the problem.
I was, of course, flat out wrong. The problem was that I was dying. Slowly, to be sure, but surely. By mid-2014 all four of my coronary arteries were 75% to 90% blocked and my heart was a bomb ready to go off. Blithely unaware of this, I flew to France with my family.
June 24 had been a wonderful day. We’d spent much of it with my great uncle, André Heintz, one of the last survivors of the French Resistance. (I wrote a four-part series of blog posts about Uncle André.(2)) Back at our hotel in the tiny Lower Normandy village of Lisieux, I went to bed feeling physically lousy but emotionally happy.
Just before midnight, I had an “acute myocardial infarction,” a heart attack. One of my coronary arteries had become completely blocked. As happens, my heart muscle, deprived of oxygen, began to die. I was in great pain – actually, strike that, I was in intense discomfort. But the pain wasn’t in my chest (it was in my throat) and it wasn’t radiating down my arm. Although I didn’t know it, my lungs were filling up with fluid.
My heart was pumping away like crazy, trying to keep itself and my brain alive. But because it wasn’t just one artery that was the problem – all of them were wholly or mostly blocked – a process called the “ischemic cascade” should have launched itself: heart cells around the blocked coronary artery die and the heart slips into a lethal arrhythmia called ventricular fibrillation, the leading cause of sudden cardiac death.(3) To say nothing of the death of the host – me.
Except that I didn’t die. Why not? The answer sounds like something out of a novel by Robin Cook. See my next post.
(1) We know, for example, that people who take certain massively over-prescribed heart medications die at faster rates than identical people who don’t take the meds. True, they die of heart trouble more slowly, but they die of other diseases (cancer, diabetes, Alzheimer’s, etc.) at rates so high their overall death rate is higher. Whatever happened to “first, do no harm?”
(2) When you’re a blogger who has to post something new every Friday, having a heart attack is a serious nuisance. On Thursday, July 3, I was editing the first post about André Heintz when the transportation crew arrived in my hospital room to take me down to the OR for open heart surgery. “Hold the hell on!” I shouted. I quickly posted “André Heintz, Part 1,” eight minutes before I went under the knife.
(3) It turns out that injured heart tissue conducts electrical impulses more slowly than normal heart tissue and it is this difference that triggers the arrhythmia.
Next up: How to Survive a Heart Attack (Part 2)
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