Learning to Live with a Broken Heartbeat

I first learned to fear my heart on the slopes of an active volcano. I was visiting Costa Rica with a college class and a local doctor. Near a sign that warned of unexpected eruptions, I felt a string of erratic beats flutter in my chest. I was more curious than concerned, but, when I mentioned them to the doctor, he looked grave. He told me to visit a cardiologist as soon as I got home.

The palpitations came back when I returned to Ohio. This time, my chaotic heartbeat terrified me, and I begged my brother to drive me to the hospital. By the time doctors examined me, however, my heart had returned to its regular rhythm, and they interpreted my symptoms as a panic attack. I was left questioning whether the problem was in my chest or my mind.

As I finished my first year of college and turned nineteen, palpitations and panic attacks haunted me. I was frightened of my heart but still thought of myself as healthy; I wasn’t ready to see an expert who might confirm that I had a heart condition. Instead, I made an appointment with a university therapist. He told me to read a book called “Staring at the Sun: Overcoming the Terror of Death.”

Late that spring, I felt a new sensation in my chest—a rapid and forceful booming that left me light-headed and struggling to breathe. It was nothing like the heavy thud of my pulse after exercise; it felt wrong, even as it remained invisible to others. My partner drove me to the hospital, where I was immediately admitted and given a dose of adenosine. The drug slammed into me: my heart juddered, then resumed its habitual rhythm. A cardiologist studied my electrocardiogram but said that it wasn’t clear enough for a conclusive diagnosis. I was instructed to rush back to the hospital if it happened again.

I hated that I was alone with the irregular ticking of my heart. Having no explanation for my condition meant having no hope for a cure. Once, while sailing on my family’s boat around Lake Erie, I felt the second, more disruptive kind of palpitation. Far from land, getting to the hospital was not an option. I tried to explain what I was feeling to my mom and pointed at the veins in my throat, where my pulse was pounding with uncomfortable force. “I don’t see anything,” she told me. Twenty minutes later, the palpitations dissipated as though they had never been there.

One of the things that unsettled my heart, in those anxious years, was the weather, something else that I could not control. As a child, I wasn’t especially afraid of storms, not even the tornado that once ripped through my home town. But that had changed. During one thunderstorm, a gust sent my car skidding across the parking lot of my sailing club. I ran through the darkness to get inside, then hid my panic by burying my face in a friend’s shoulder.

A few years later, another storm hit with little warning on a sunny summer afternoon. I was getting ready to move to New York City with my partner, and we took a last walk along Lake Erie. As we wandered the shore, thick clouds blossomed over the horizon, but neither of us expected anything more than rain.

The clouds darkened as we returned to the car. My partner was driving us back to his family’s home when hail started to batter the roof. It grew to the size of golf balls, and a tornado siren sang out. We exchanged worried looks; I gripped his thigh as he sped up.

As we pulled into his family’s neighborhood, the wind and hail and rain obscured everything beyond a few feet. A large tree crashed onto the road, blocking our path.

“Drive around it!” I shouted. The tires left wet grooves in a neighbor’s lawn.

We pulled into his family’s driveway and the garage door creaked open. We doubled over to get inside as quickly as possible. I paced between the kitchen and living room, breathing hard, feeling small palpitations in my heart and shaking so badly I couldn’t speak.

The adrenaline lasted longer than the storm. Meteorologists called it a microburst—a brief, extreme downdraft within a thunderstorm that hit one small segment of the little peninsula of Catawba Island.

Later, when the pounding of the rain and my heart both slowed, we wandered the streets. A confetti of leaves coated the sidewalks. The hail had turned front yards into pebble gardens. We saw downed trees, tangled power lines, and crushed cars. Neighbors wandered the streets, too, taking pictures and gaping.

If we’d left the beach a few minutes earlier and a tree had fallen on our car, would we still be here? If the tiny storm in my heart hadn’t abated, would I still be here?

I moved to New York City for journalism school in July, 2012. In October, a storm named Sandy grew into a hurricane on its way north from the Caribbean. The governor’s office issued emergency-preparedness orders; the mayor ordered evacuations from parts of all five boroughs. My apartment was only a block outside the Manhattan evacuation zone, so I slept on a classmate’s couch on the Upper East Side, listening to the wind banging around the fire escape.

The morning brought news of the calamity: power off for dozens of blocks, flooding in all the boroughs, houses destroyed, subway lines filled with water. Ultimately, forty-four New York City residents died. My journalism professors sensed an opportunity to learn about disaster reporting and breaking news, so, in the days that followed, I interviewed people who had lost their homes. Some survived the storm only to learn that their neighbors had died.

Two weeks later, my heart went wrong again.

My partner and I walked ten panicked blocks to a Manhattan urgent-care clinic. My pulse raced at a hundred and fifty beats per minute. Each boom seemed to shake my collarbone and throat. My lungs heaved like a rusty bellows.

My partner took a seat in the waiting room. In a bare examination room, an after-hours doctor asked whether this had happened before. “Yes, five or six times,” I told her. She connected a tangle of wires to my chest, torso, and arms so that an EKG could monitor my heart. She wanted to keep me under observation in hopes that the palpitations might subside.

They grew worse. I had more trouble breathing. My limbs went numb, then began to seize up. The doctor called for paramedics. While we waited, spasms shook my muscles. By the time the E.M.T.s arrived, my arms were locked in a bird-wing position; they forced my arm to straighten and exposed the veins near my elbow.

The first attempt to insert an I.V. resulted in a spray of blood from my arm. It covered my shirt, my bra, and the floor.

“What’s happening to me?” I tried to ask.

But my face had gone numb. The inability to speak, to make myself understood, scared me more than anything else.

Eventually, the needle went in. The first dose of adenosine momentarily stopped my heart. But almost immediately, the palpitations came back. I squeezed my eyes shut, thinking that this might kill me and telling myself to think of family.

“We’re going to try a second dose,” one of the paramedics said.

I felt another burst of intense pressure and heat. And then the drumming ceased.

I pried my eyes open. I was being taken to an ambulance. When my partner saw me, he looked horrified. On the drive to the hospital, I threw up, a side effect of the adenosine.

I did not sleep that night. I had blood tests and heart tests, and potassium was pumped into my veins. Finally, a doctor declared that I had supraventricular tachycardia. The electrical signals that become heartbeats, the doctor said, were following an abnormal electrical pathway. Most episodes of SVT are too brief and infrequent to need treatment, but the worst can cause cardiac arrest. My symptoms were severe enough that I’d need surgery.