I know what I’m up against. The current New Yorker has an article by Jerome Groopman, MD. It’s an account of Electricity and the Body that is both interesting and informative. However, getting my readers to read a review of a book they will themselves never read is a fool’s errand. So, rather than pointing to the New Yorker review, here, let me just say this: The book is called “Spark” and it’s by Timothy J. Jorgensen, a professor of radiation medicine at Georgetown.
Contained within Jorgensen’s book are lots of cool anecdotes from the history of medicine. Like the one from 1747 where a French cleric named Jean-Antoine Nollet demonstrated the effect of electricity on the human body by passing an electric current through a chain of seven hundred Carthusian monks – some of whom actually survived the ordeal. Imagine that.
Or this one from around the turn of the 20th century:
Don’t try this at home. But there were plenty of electrotherapy devices designed for home use and mailed directly and confidentially to consumers. Pulvermacher’s Electric Belt, for example, was worn around the waist, with batteries providing a steady electric current to the skin. A pouch attached to the front of the belt held the testicles, like a jockstrap. This allegedly enhanced “sexual vitality.” Jorgensen explains this was a euphemism for treating erectile dysfunction.
Yikes! Thanks anyway, but can’t I try a little blue pill instead?
Providing the bread around the “Spark” sandwich is Groopman’s account of how errant electrical conductivity in his own heart nearly killed him. And how that same conductivity was ultimately used to save his life. I’ll let him tell the tale because he’s a wonderful writer and this bit of medical arcana is worth knowing even if you never have to undergo the procedure.
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In the early hours of Independence Day, 2018, I found myself awake. I put it down to jet lag. I’d just returned from South Africa, where my wife and I were working with a medical charity. I decided to get up, and drank a cup of strong coffee. Within minutes, my heart was racing. I attributed this to the caffeine, but my heart rate went on rapidly accelerating.
I counted beats on my watch: A hundred and eighty a minute, three times my resting rate. My chest tightened and my breathing became labored. I tried to be calm, telling myself no, it wasn’t a heart attack, merely the exhaustion of the trip and the effect of the coffee. But the symptoms were getting worse, and I broke out in a sweat. I woke my wife, who took my pulse and called an ambulance. As I lay in the ambulance, the siren blaring above me, I prayed that I would not die before making it to the emergency room.
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The first days of July are said to be a perilous time to be in the hospital because that’s when new residents begin their training. But despite the early hour, there was a senior E.R. doctor in attendance who quickly instructed the medical team to place intravenous catheters in my arms, take blood for testing, strap oxygen prongs over my nostrils, and perform an electrocardiogram. She said the problem appeared to be something called an atrioventricular nodal reëntrant tachycardia.
I knew what that meant. Our heartbeat starts with an electrical impulse originating in the atria, the upper chambers of the heart, and then passing to the ventricles, causing them to contract. In a normal heart, there is a delay before the next heartbeat starts. In my heart, electrical impulses were circling back immediately via a rogue pathway. My ventricles were receiving constant signals to contract, giving scant time for blood to enter them and be pumped out to my tissues.
The attending physician then explained that she would give me a dose of adenosine, a drug that arrests the flow of electrical signals in the heart. My heart would completely stop beating. Hopefully, she said, it would re-start on its own, at a normal pace. Of course, the adenosine might fail to work. She didn’t elaborate, but I knew: The next step would be to try to reboot my heart with electroshock paddles.
Don’t try this at home!
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One dose of adenosine did nothing. But shortly after a second dose the cardiac monitor suddenly fell silent. I glanced at the display: A flat line. My heart had stopped. I had an eerie sense of doom. A visceral feeling that something awful would happen. But then there was a kind of thud, as if I had been kicked in the chest. My heart started to beat — slowly, forcefully. Within a few minutes, rate and rhythm returned to normal. The electrically driven pump in my chest was again supplying blood to my body.
Eventually, I was discharged from the emergency room with a beta-blocker prescription to suppress the runaway electricity in my heart. But the side effects proved intolerable. Even at low doses, my heart rate slowed so much that I could not climb a flight of stairs without stopping and gasping for air.
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I consulted a cardiologist at my own hospital, Peter Zimetbaum, who is an expert in arrhythmias. He performed an ablation to eradicate the errant pathway. Zimetbaum threaded catheters into the right and left femoral vessels in my groin and up into my heart. He injected small doses of isoproterenol, an adrenaline-like drug, which artificially induced the tachycardia that had landed me in the hospital.
Then he mapped the pathways conducting electricity in my heart — the one that would carry normal impulses, and the aberrant one that caused the heartbeat of a hundred and eighty. After he pinpointed the aberration, he destroyed it with heat from high-frequency radio waves. I was awake throughout the procedure, with just low doses of a painkiller, so that I could report whether what I experienced recapitulated that July morning.
After Zimetbaum had finished performing the ablation, he tried to trigger my tachycardia again. But my heart stayed steady. Electricity gone awry could have ended my life. Electricity in expert hands identified the defect in my heart and eliminated it. Now I was again a healthy body electric.