The New Yorker - 06.12.2021

(EriveltonMoraes) #1

66 THENEWYORKER,DECEMBER6, 2021


BOOKS


LIVING THE LIFE ELECTRIC


Why “the spark of life” is more than just a phrase.

BY JEROMEGROOPMAN


I


n 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—
like me, a physician—and I were work-
ing 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 min-
ute, three times my resting rate. My
chest tightened and my breathing be-
came labored. I tried to be calm, tell-
ing myself no, it wasn’t a heart attack,
merely the exhaustion of the trip and

the effect of the coffee. But the symp-
toms were getting worse, and I broke
out in a sweat. I woke my wife, who
took my pulse and called an ambu-
lance. 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.
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. doc-
tor in attendance, who quickly in-
structed the medical team to place in-
travenous catheters in my arms, take
blood for testing, strap oxygen prongs

over my nostrils, and perform an elec-
trocardiogram. She said the problem
appeared to be something called an
atrioventricular nodal reëntrant tachy-
cardia. I knew what that meant. Our
heartbeat starts with an electrical im-
pulse originating in the atria, the upper
chambers of the heart, and then pass-
ing 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.
Despite this, my blood pressure
hadn’t yet plummeted to an alarming
level. So the first attempt to slow my
heart involved having me clench my
abdominal muscles, in a so-called Val-
salva maneuver, which can help con-
trol irregular heartbeats by stimulating
the vagus nerve. But several tries made
no difference, and my breathing was
becoming more labored. The attend-
ing physician then explained that she
would give me, via my I.V., 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.
One dose of adenosine did noth-
ing. But shortly after a second dose
the cardiac monitor suddenly fell si-
lent, and I glanced at the display: a
flat line. My heart had stopped. I had
an eerie sense of doom, a visceral feel-
ing that something awful would hap-
pen. 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, the
rate and rhythm returned to normal.
The electrically driven pump in my
chest was again supplying blood to
my body.

T


imothy J. Jorgensen, a professor
of radiation medicine at George-
town University, writes in his new
book, “Spark” (Princeton), that “life
Attempts to use electricity in medicine go back thousands of years. is nothing if not electrical.” In our

ILLUSTRATION BY DAVID JIEN
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