Tuesday, June 12, 2007

Funny As a Heart Attack

Of the various stories I bring from my 35 year college reunion, none are funnier than the defibrillator story.

One of my college buddies had a heart attack a few years ago (see the laughs start coming right off the bat). It was a fairly major one, though he says that the lasting heart damage was not too great. He had total blockage in one of the coronary arteries, etc., and now he has a stent, plus some other stuff, including a personal defibrillator that he wears on chest.

But the story isn’t about him. Having had a heart attack, plus wearing a defib, makes my college chum a magnet for others’ stories about heart attacks and defibrillators, just like I now know a lot of cancer stories I wouldn’t have otherwise heard.

Anyway, this is a defibrillation story. The defib scene is now a staple of medical drama, what with the rising tone and the barked “Clear!” letting the EMT guys look and sound so cool and macho. Defibrillation is used essentially to “reboot” a cardiac control system that has gang agley, where an “arrhythmia” has become a “seizure.” This tends to happen most often in a rapidly beating heart, where, in fact, the heart is trying to beat so rapidly that it begins to lose pumping efficiency. In the extreme, the poor organ is just quivering, unable to deliver blood to the body, including itself, so it begins to die. The quicker defibrillation is applied, the better the outcome, hence personal, implantable defibs.

The personal devices constantly monitor a person’s heart rate, ready to apply the electric shock if the rate gets too high. The problem for the guy in this story was two-fold. First, he had a tendency for a runaway heart rate in the first place, some form of tachycardia, though I don’t know which kind. Second, his personal defibrillator had been set a little two low.

Ah, you can see this coming, can’t you?

It happened while he was playing softball, maybe not the best recreational activity for someone with a heart condition, but who am I to make that particular call? The way I heard the story was that there was a thunderstorm brewing, but you play until the rain begins, that’s part of the deal. Let’s say also that our protagonist was chasing a fly ball in the outfield under a darkening sky.

Then, suddenly, wham! He’s now flat on his back, his defibrillator having kicked in, its tiny little microchip brain sure that it was needed to save his life.

Now here’s the thing: being zapped with an electrical current to stop and restart your heart is not a window into sartori. No, it’s quite scary, and will do a good job of accelerating your heart rate. So our protagonist gets several seconds of an adrenal rush with a soundtrack of his own heartbeat in his ears, said heartbeat going faster and faster, then…wham! Yes, Our Friend the Defibrillator has come to the rescue once again.

Okay, now he’s both scared and angry, because this was not in the sales brochure. He struggles a bit, trying to maybe get up, or at least lift his head to call for help and wham! Another reboot.

So now he’s just stuck on his back, realizing he’s completely helpless, in the grip of a deranged robot that’s smaller than a pack of cigarettes, but it’s got a couple of electrodes jammed into his chest, and it’s gonna keep zapping him until help arrives, or it runs out of juice, whichever comes first. And maybe by now the lightning from the thunderstorm is beginning to light things up, and he is trying everything he can to CALM DOWN DAMMIT! But all he can do is listen to his own heartbeat accelerate, punctuated every now and then by another zap.

He went through the entire cycle maybe five or six times before the EMT guys got there and either switched off the defib or gave him something to calm down the tachychardia. What lets the whole thing be funny, of course, is that he lived to tell the tale. In fact, it’s probably the funniest story he knows, and he can probably dine out on it for the rest of his (and I do fervently wish it to be long) life.

You know, Dick Cheney has an implanted defibrillator. I’m absolutely sure you can’t hack one of those things, but still, it’s a funny thought.

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