TWELVE – technology isn’t all it’s cracked up to be

“What a man does when he is taken off his guard is the best evidence for what sort of man he is.” – C S Lewis

It sounds counter-intuitive (or maybe it doesn’t) but it seems to me that we are at our most vulnerable when things are going well. Perhaps it is because the fall is so much further and consequently the pain so much greater as we strike rock bottom once again. I can’t speak for you but it seems to me that we are ever tripped as we stumble through life. Is it overly grand to claim that we are all Sysyphus and it is our fate that it should ever be so? Except that we are blessed with death, a privilege denied to him. Albert Camus, of course, who famously hijacked this character, would have us all debating the merits of throwing ourselves off bridges that we really shouldn’t have had the inclination to build, were it not for the need to write another book. Can we imagine ourselves happy with nothing more than our rock? Sounds absurd, doesn’t it? 

Following the 1993 incident I was put on beta blocker medication and this seemed to have the required effect. I experienced no problems for nearly three years. I was doing OK at work, although things had taken a turn for the worse as we had a new General Manager who very much subscribed to the view that we should tell Head Office as little as possible. I would be lying if I didn’t call him anything but a good liar, which sounds like an oxymoron but there is, in fact, no oxy. Moron covers it pretty well. Needless to say, I disliked him intensely and in 1995/96 we began to have serious differences. This was something of an issue for him as by this time I was dual-roled, being both Financial Controller and Deputy General Manager (the title of Finance Director having been lost in what was euphemistically termed a Group Restructure but, in fact, was intended as a dead wood clearing exercise with a little bit of old-score settling). I won’t bore you with the details of it all (extremely tedious) except to say that it was the time of the veiled threat and ridiculous management double-speak. For example, he wanted me to sign off a back-dated performance appraisal which laid out objectives that had not been met so that I could be sacked for not achieving them. Did he really think I was that much of a dummy? One of us was, that’s for sure. Let’s just say that stress levels were mounting but that I was coping. No arrhythmias, no therapies from the device. (Listen hard and you might hear chickens being counted).

I mention therapies plural because these new-fangled, high tech defibrillators can do some very clever things. As you will have gathered by now, a defibrillator can monitor your heartbeat and deliver a shock when your heart exceeds a certain speed. Very clever you may think, but hold on there, that is not all. It can also pace your heart out of an arrhythmia. This is an alternative therapy to a shock (too many shocks to the heart are not good for it, apparently – of course, we already knew that). Anyway, by way of explanation, it works as follows: the defibrillator, sensing a dangerously fast arrhythmia introduces pacing beats into the heart at a rate slower than the detected arrhythmia. It then gradually accelerates this pacing until it exceeds the speed of the arrhythmia in such a way that the heart does not pick up this acceleration. It then gradually slows the pacing beat and attempts to catch the arrhythmic beat, thus bringing the heart rate down as it decelerates. Hey presto, job done.

My defibrillator was set so that this pacing therapy was on. I didn’t have to take the word of the medicine man for this as late one evening in the late summer of 1996 I was party to a dramatic demonstration.

My memory of the events of the evening in question are a little befuddled so forgive me if this description doesn’t sound as clear as it ought.

I remember that it had been a tough day at work. The General Manager and Head Office Human Resources had been giving me a bit of a rough time and I came home pretty tired and extremely stressed. I cannot clearly recall how the event started but I know for sure that I was upstairs. I think I was sleeping but that could be the fuzziness of distant memory. All I clearly recall initially is that my heart was in VT (ventricular tachycardia). The next thing I remember is the sensation of an alternative heartbeat being generated in my heart alongside the heart-rate in VT, accelerating past it and then gradually slowing. Weird is not the word, like having your heartbeat in unsynchronised stereo. It was very discombobulating. Yes, I think it is fair to say that I was definitely discombobulated. Despite this, I realised that pacing therapy had kicked in. I held my breath.

My heart decelerated and dropped out of VT. I had a few seconds relief before I suddenly realised that my heart had kicked back into VT. Shit, I muttered, somewhat understating the matter. For twenty seconds or so, nothing much but then ping….. ping…..ping….ping…ping.. as the pacing therapy kicked in again. Once more it accelerated and decelerated and successfully caught my heartbeat as it had the first time, slowing it into sinus rhythm. Again, I sighed relieved. Unfortunately, the second therapy was reversed just as the first one was, with my heart surging back into VT. Yet again, the pacing therapy kicked in but this time the decelerating pacing failed to catch my heartbeat and it did not bring me out of VT.

At this point, things were not ideal but neither were they catastrophic. Sixty seconds or so later this was to change. Let me explain. The pacing therapy is a wonderful therapy when applied to a single episode of VT. However, I was now in what is termed a VT storm whereby my heart was prone to multiple VT. Thus, termination of the arrhythmia was only a temporary solution and would be followed by an immediate reversion to VT. And here’s the rub. There is one major risk with pacing therapy and that is that it will occasionally catch the heartbeat on the way up and accelerate it into VF (ventricular fibrillation). For the uninitiated, this is cardiac arrest. When you’re in a storm, of course, the law of probability ensures that as sure as eggs is eggs you are going to find yourself victim to the vagaries of this law. Like being hunted; trying to escape but knowing that at some point it will get you. There is nothing quite so disempowering as being screwed over by your own body.

And so it was. After a few pacing therapies I felt my heart accelerate to mega-dangerous speeds and my next memory is of waking up, lain on the floor, completely non-compos mentis. I had suffered VF and collapsed, only for my heart to be restarted by my defibrillator. There is a King Crimson track called Epitaph in which the opening lyric is Confusion will be my epitaph. Had I pegged out there and then, that would have been my swansong. I alternated between disorientation, full conscious awareness and unconsciousness over and over again. It felt like relentless hopelessness. And I don’t use the word relentless lightly. It went on and on and on and both Sandra and I were powerless to stop it. I had a powerful magnet somewhere with which I could have disabled the device but strangely enough in all the kerfuffle I couldn’t remember where it could be found. Kerfuffle, there’s a word. Often to be found in Little Britain. And, did those feet? Never thought about it.

Eventually, the storms abated and I discovered the true nature of mercy. I have never felt so grateful in my life. Next thing I remember is the ambulance. Once again, I was on my way back to hospital. The boulder lay once more at the foot of the mountain.

 

Read on……