In my heart
I wrote a note for Fox Jr.'s cardiac surgeon this morning, letting him know that the arrhythmia came back. It was a disappointment to us, and will be to him: it means that the procedure to fix it hadn't worked after all, and it was back. Darn.
It came back Saturday night, and we ended up in Emergency after midnight. Summer Saturday night in a Northern boom town, Emergency is a busy and bloody place. A bald man with not one but two black eyes walking out, dismissed. Another man, sitting and waiting, holding a cloth to his bleeding hand, his girlfriend patiently waiting with him. Coming in behind me, two young men, one helping another, the other stooped, in a white undershirt and gold chains, all dripping with blood from his head. "Can we get some stitches for my friend here? He's still bleeding..." You need to talk to the Triage nurse, right here. The nurse sat him down, cheerily asking, "so what happened?" "Well, I was just sitting on the sidewalk, chillin'..." I never heard what happened after the chillin'. The EMT next to me told me that her job is thwarting natural selection.
Fox Jr. didn't have to wait. Heart stuff is funny: even if you're acting fine, if you have no pulse, or your pulse is too rapid or irregular for the basic machines to measure, you go right in. I guess if your heart doesn't work for even a few minutes, you're dead, so we take heart stuff seriously. And by convention, we call you dead if your heart doesn't beat for even a few seconds. That happened to Fox Jr. once, in ER late some previous night. He hadn't converted spontaneously, so they administered adenosine. A short sharp pulse of drug, plunged straight into a vein, rapidly followed with a pulse of saline, to drive it straight into his heart. His heart stopped beating, the ECG lines went flat, and he was dead. This will feel funny, they'd warned him. Yeah, I'll bet it did. It restarted within a couple of seconds, a slowed irregular beat or two, then a normal rhythm, carefully traced out on the ECG chart. He'd been rebooted.
A common experience when having your heart stopped is "an impending feeling of doom". I've heard that phrase before, it's also been reported for people experiencing severe transfusion reactions. The scientist in me wonders about the nature of the doom receptor, or the doom sensation pathway. Where is it? What are the triggers? At what levels are the signals processed? However it works, it would seem to be accurate.
My sister-in-law saw a guy die recently. She's thinking of going into medicine, and somehow scored an OR visit. It was an open-heart surgery, a triple-bypass. They hooked him to a heart-lung machine, and stopped his heart. No pulse, flat line, beeee... He was now dead. Then the anesthesiologist went to lunch: her job was to keep his heart going, and that wasn't needed while it was stopped. She came back before it was time to restart it. All was very relaxed and routine, with the most excitement coming from the surgical nurse, explaining all the different kinds of specialized retractors.
The circulation of the blood was discovered by Harvey. It's so fundamental, the heart and its connection to life, it's hard to understand how people thought about themselves before the heart of Harvey. Where was the seat of life? What was that thing in the middle of the chest? Was it still the seat of emotions? As an undergrad, I read an English lit monograph called the Heart of Harvey. I didn't understand it then, but it's still on my shelf. I should read it again someday, and look for clues about what's in my heart, and the hearts of the people I love.
It came back Saturday night, and we ended up in Emergency after midnight. Summer Saturday night in a Northern boom town, Emergency is a busy and bloody place. A bald man with not one but two black eyes walking out, dismissed. Another man, sitting and waiting, holding a cloth to his bleeding hand, his girlfriend patiently waiting with him. Coming in behind me, two young men, one helping another, the other stooped, in a white undershirt and gold chains, all dripping with blood from his head. "Can we get some stitches for my friend here? He's still bleeding..." You need to talk to the Triage nurse, right here. The nurse sat him down, cheerily asking, "so what happened?" "Well, I was just sitting on the sidewalk, chillin'..." I never heard what happened after the chillin'. The EMT next to me told me that her job is thwarting natural selection.
Fox Jr. didn't have to wait. Heart stuff is funny: even if you're acting fine, if you have no pulse, or your pulse is too rapid or irregular for the basic machines to measure, you go right in. I guess if your heart doesn't work for even a few minutes, you're dead, so we take heart stuff seriously. And by convention, we call you dead if your heart doesn't beat for even a few seconds. That happened to Fox Jr. once, in ER late some previous night. He hadn't converted spontaneously, so they administered adenosine. A short sharp pulse of drug, plunged straight into a vein, rapidly followed with a pulse of saline, to drive it straight into his heart. His heart stopped beating, the ECG lines went flat, and he was dead. This will feel funny, they'd warned him. Yeah, I'll bet it did. It restarted within a couple of seconds, a slowed irregular beat or two, then a normal rhythm, carefully traced out on the ECG chart. He'd been rebooted.
A common experience when having your heart stopped is "an impending feeling of doom". I've heard that phrase before, it's also been reported for people experiencing severe transfusion reactions. The scientist in me wonders about the nature of the doom receptor, or the doom sensation pathway. Where is it? What are the triggers? At what levels are the signals processed? However it works, it would seem to be accurate.
My sister-in-law saw a guy die recently. She's thinking of going into medicine, and somehow scored an OR visit. It was an open-heart surgery, a triple-bypass. They hooked him to a heart-lung machine, and stopped his heart. No pulse, flat line, beeee... He was now dead. Then the anesthesiologist went to lunch: her job was to keep his heart going, and that wasn't needed while it was stopped. She came back before it was time to restart it. All was very relaxed and routine, with the most excitement coming from the surgical nurse, explaining all the different kinds of specialized retractors.
The circulation of the blood was discovered by Harvey. It's so fundamental, the heart and its connection to life, it's hard to understand how people thought about themselves before the heart of Harvey. Where was the seat of life? What was that thing in the middle of the chest? Was it still the seat of emotions? As an undergrad, I read an English lit monograph called the Heart of Harvey. I didn't understand it then, but it's still on my shelf. I should read it again someday, and look for clues about what's in my heart, and the hearts of the people I love.
posted by TFox at
10:28 AM
