“Do I have to have the cardioversion today? I mean, my INR was even lower than yesterday,” Jean asks the doctor, clearly very worried. This was our second trip to emergency in just as many days. Her racing heart rate and atrial fibrillation was a concern for everyone.
“I spoke to Dr. Mason and he’s prepared to do the procedure. But … we don’t have to do anything today. We can wait to see if the drugs take effect.”
“And what’s the risk if I don’t do the procedure?”
“Your heart’s been overworking itself for a while and it can only do so for so long. Then it will stop.”
Jean nods. If she has the procedure then based on her blood work, she’d be at high risk for a stroke. If she waits, she’s at risk for a heart attack. What was she to do?
“What would you do?” she asks the doctor.
“I don’t know what I would do,” he says. “What I do know is that my wife is on the same meds you are, but her dosages are higher. And we had another gentleman in here last week and his dosages were double what you’re taking. Everyone responds differently.”
There is a pause as Jean continues to weigh her decision.
Jean is a widow who lives about three houses down from me. She had heart surgery a few months back and last week was the second time her heart started racing. Her cardiologist’s office had told her on Friday to go to emergency. And that’s when she phoned me.
We’d spent the day before in this very same emergency room, under the care of this very same doctor. He’d ask us to return today at noon, hoping the drugs he’d given and prescribed yesterday would have made a difference. They had not. I watched Jean struggle with her decision, knowing it was hers alone to make.
“I think I’d rather wait the day,” she says at last.
The doctor looks at her and at me.
“Let’s do that. I certainly don’t want to keep you here longer than we have to. It’s draining on you both.”
I was touched. Here was a doctor who acknowledged both the patient and the neighbour who was there for support.
“Can you come back to emerg tomorrow after 6pm?” he asks looking at me. I nod yes. “That’s when my shift starts. We’ll do another ECG and check your INR. Now, you’re taking 4.5 grams of ….”
I listen as Jean and the doctor go through the medications and the dosages one more time.
I could not help but feel that this physician was extraordinary. Jean was lucky to have him. Once again, he gave her a slip of paper with his name stamped on it along with a directive. It was her pass card so the emergency room administration staff would place her into his queue when we returned on Sunday. It was a small thing, but it showed personal interest in her care. We left the hospital, hopeful things would work out.
And they did. Jean and I returned to emergency on Sunday night. When we left five hours later, she had a normalized pulse without a cardioversion.
This story wrote itself. It’s about two remarkable people: Jean, my neighbour whose heart beats depended on her decision and a special doctor who cared for her.
Cardioversion is a medical procedure done to restore a normal heart rhythm for people who have certain types of abnormal heartbeats
INR (international normalized ratio) stands for a way of standardizing the results of prothrombin time tests, used to measure how long it takes blood to clot.
ECG (electrocardiogram) records the electrical activity of the heart over time.