A Story, by Bernard Lown, renowned cardiologist, as it appears in the book Full Catastrophe Living, by Jon Kabat-Zinn.
The experience still invokes in my a
shudder of disbelief. Some 30 years ago I had a postdoctorate
fellowship with Dr. S.A. Levine, professor of cardiology at the
No sooner was Dr. Levine out of the door than Mrs. S.'s demeanor abruptly changed. She appeared anxious and frightened and was now breathing rapidly, clearly hyperventilating. Her skin was drenched with perspiration, and her pulse had accelerated to more than 150 beats per minute. In reexamining her, I found it astonishing that the lungs, which a few minutes earlier had been quite clear, now had moist cackles at the bases. This was extraordinary, for with obstruction of the right heart valve, the lungs are spared the accumulation of excess fluid.
I questioned Mrs. S. as to the reasons for her sudden upset. Her response was that Dr. Levine had said that she had TS, which she knew meant "terminal situation." I was initially amused at this interpretation of the acronym for tricuspid stenosis. My amusement, however, rapidly yielded to apprehension, as my words failed to reassure and as her congestion continued to worsen. Shortly thereafter she was in massive pulmonary edema. Heroic efforts did not reverse the frothing congestion. I tried to reach Dr. Levine, but he was nowhere to be located. Later the same day she died from intractable heart failure. To this day the recollection of this tragic happening causes me to tremble at the awesome power of the physicians word.