A Broken Heart

It was August 1976. The Reagan people in the balcony would not shut up. Roberts' Rules of Order could go to hell. The Californians on one side of the hall screamed, "!Viva!" and those on the other side howled back, "!Ole!" The convention nominated Gerald Ford anyway. Reagan would have to wait four years. I smoked three or four packs that day and, in the bluish cigarette haze of a room in the Muehlbach, wrote TIME's cover story: dreary convention, dismal story; hot, clear Kansas City summer outside. At least that's what I remember of it now.

As I finished writing the last paragraph, a sensation like poisoned gas began to wraith around inside my chest--a sick green glow, the lightly radioactive foretaste of something awful. Then a vise beneath my breastbone tightened...and tightened...and tightened, a slow-motion black implosion of the body's core. I had a heart attack. Quite a surprise. I was 36.

Thus, 22 years ago, began my cardiac education, which--with another heart attack in 1993 and with the reappearance last spring of the radioactive symptoms--is well along in its postgraduate phase. I share this with you (as they say in group) because the history of my heart's misadventures happens, luckily for me, to parallel the story of the late 20th century's medical advances in the treatment of heart disease. And because at the American Heart Association's meeting last week in Dallas, still more remarkable new treatments were auditioned. I have enjoyed, so far, an existential scissors graph: my heart gets worse; medicine gets better. (How long will this happy pattern last?)

I have managed to get this far--bodysurfing on each new wave of knowledge--with the help of two multiple coronary bypasses (1976, 1993), an angioplasty with stents (successful just the other day; a couple of efforts to unblock other coronary tunnels by angioplasty failed painfully), and a supporting cast of ACE inhibitors, beta blockers, cholesterol thwarters, diuretics, aspirin to make the platelets slippery, nitroglycerine, blood-pressure suppressants, vitamin E, folic acid, a rowing machine, a stoic personality and the diet of a desert mystic. It goes without saying that a heart attack is also a good way to quit smoking. I was instantly cured of nicotine addiction that night in Kansas City.

Heart disease has a way of upping the ante: the future always needs tending. After two bypasses my heart will not take a third--too dangerous for a surgeon to work with all the rubbery scar tissue on the heart, like so much plastic in his hands. With an ejection fraction of 31% (the ejection fraction is the percentage of blood expelled, with each heartbeat, from the left ventricle; normal is 50% or more), with venous grafts to the left anterior descending artery and with the right coronary artery totally occluded, I have pretty much exhausted the surgical techniques available until now.

From here on the going gets dicier and, in terms of the future of heart treatment, more interesting. On the horizon, and closing fast, are experimental techniques--most immediately gene and laser therapies--that have the potential to make yesterday's miracles (bypasses and angioplasties) seem like rudimentary plumbing repairs. Remember: potential.

So, with the guidance of my cardiologist, Dr. Robert Ascheim, I am shopping in the experimental boutiques.