Cardiologist examines matters of the heart
“Perhaps the most consequential event in my life occurred fifteen years before I was born,” writes Sandeep Jauhar in the introduction to his third book of medical storytelling, following the acclaimed memoirs “Intern” and “Doctored.” He’s referring to the sudden death of his paternal grandfather in India at age 57 duetoaheart attack — also the killer of his maternal grandfather. These losses led to a family obsession with the heart; both Jauhar and his older brother became cardiologists.
Then three years ago, Jauhar, at 45, learned that he, too, suffered from serious coronary blockage. This life-changing incident forms the prologue of “Heart: A History” (Farrar, Straus and Giroux; $27) which goes on to tell a tale of scientific and cultural development from 13th-century Persia to the present day.
Newsday spoke with him recently by phone; the conversation has been edited for length and clarity.
Newsday: In “Heart,” you tell us that the doctor who contributed most to the invention of the heart-lung machine — a pump used during heart procedures — had been thinking of quitting med school to pursue a career in writing until his family dissuaded him. “That advice sounded very familiar,” you say. Yet now you have a successful career in both fields. How did you manage it?
Sandeep Jauhar: To my father, a top geneticist, “nonscience is nonsense.” To him, a career in writing was anathema. When I was in medical school in St. Louis and was offered an internship at the St. Louis Post-dispatch, he didn’t think I could do both at once. My brother, on the
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other hand, pointed out that there’s a lot of time in each day, and much of it actually goes to waste. If I took the job, I would have to catch up with all the lectures I missed at school by reading written transcripts. Still, I thought I could do it. That internship taught me to write on deadline and gave me a strong set of clips. Those clips landed me an assignment from The New York Times.
The idea of not wasting time stands me in good stead now. I write at night,
after the kids are in bed;
I’ll steal a few minutes in between patients, or if one cancels; I do a lot of writing while driving, by dictating scenes into a tape recorder. I’m doing what I enjoy.
What do you consider the most surprising revelation in your book?
The heart for millennia was considered the locus of our feelings, and while this is incorrect, we have now learned that the heart is highly responsive to emotion. In fact, you can die of a broken heart. The medical term is Takotsubo cardiomyopathy, named for a pot used by the Japanese to trap octopus. In response
to grief, fear and extreme stress, the heart muscle weakens, and the organ assumes a bizarre shape similar to that of the pot.
Have you seen it in your own practice?
I had a patient in her mid50s who had recently split up with her boyfriend of many years, then got into an argument with her teenage son that deepened her sense of loss and loneliness. Suddenly she found herself with chest pains, short of breath and in the ICU. Like most patients with broken heart syndrome, she recovered. But not all do. An epidemiologist in Europe studied tombstones
— he found that when one partner dies, there’s a strong likelihood that the death date on a spouse’s neighboring tombstone will be less than a year later.
And it’s not always a single dramatic loss, right? Ongoing misery in your life can cause heart disease.
Yes, a stressful job, an unhappy marriage, stress and anxiety — all these take a toll. In fact, although the notion that “Type A” alpha male overachievers are the most likely to suffer heart attacks dominated our thinking in the 1960s, ’70s and ’80s, we now know that the biggest personality risk
factor is depression.
With the many advances in medicine and technology, the death rate from heart attacks has been in steady decline since
1968. Recently, however, improvement has slowed. Smoking cessation rates have slowed down, we’re getting more obese. We are going to have to make changes in how we live.
As I say in the book, your mindset, your coping strategies, how you navigate challenging circumstances, your capacity to transcend distress, your capacity to love — these things are actually a matter of life and death.