Archive for September 1st, 2010

With Bela’s permission, I give you one more example of Erzsebet’s amazing medical knowledge, knowledge which had an unexpected twist for all concerned. Bela had called me with symptoms of feeling weak at times. After listening to his story with all senses on red alert, it was clear that he had a dangerous heart rate irregularity. Erzsebet strongly recommended his seeing his primary care physician immediately, relating the story to him, obtaining an EKG, and suggesting the use of a Holter monitor (records heart activity over a long time period). This was duly arranged and accomplished. The results were so disturbing to the doctor, that he put Bela in the hospital and arranged for heart catheterization. No blockages in the vessels feeding the heart were seen. There still remained determining the cause of the heart-beat irregularity. A cardiology consult revealed an area of irritability in the ventricles of his heart that caused aberrant beats, resulting in non-optimal heart action. Next came a trip to a cardiac physiologist, a heart specialist who also performs minor surgery on areas of the heart. Concurring with the cardiologist on the nature of the irritable focus, the cardiac physiologist now turned his attention to problem solving. In this, the physiologist had three recommendations, in this order: 1) do nothing, 2) medication, or, as a last resort, 3) cell ablation (removal of cells). My other ears, with Erzsebet’s help, immediately picked up that Bela’s choice for optimal heart health should be to do nothing. Indeed, the cardiac physiologist’s first recommendation was to do nothing, since Bela had had this condition for decades without ill effects.

Erzsebet’s recommendation was also to do nothing. Being a man of both action and logic, this advice did not sit well with Bela, especially when the cardiologist was encouraging him to have the ablation as the cure for the cardiac irritability. Again, I attempted to help him understand that the cardiac physiologist, the one who had many years experience with these issues, recommended doing nothing. This was to no avail, as Bela had made up his mind that the answer lay in ablating the area of irritability. Honoring his decision, his free will, and his choice, I gave up trying to persuade him to listen to Erzsebet.

Then, for some unknown reason, I called him on a Saturday to inquire of his health. He said that the minor surgery was scheduled for the following Monday. I found myself telling him to call the physiologist and cancel the surgery. We were both stunned. Erzsebet did not recommend surgery—he must cancel the appointment. He did not cancel, but went ahead as planned. The plan had been to have a quick session on Monday, kill the cells, and home with him. Monday evening did not find him at home. On Tuesday he was not home. When he was not at home on Wednesday, I tracked him down in the hospital and heard a strange story. In attempting to ablate the cells responsible for the irregular heart beat, the cardiac physiologist ablated some, but found most of them to be in intimate contact with some vital arteries. He was unable to ablate these last cells, for fear of doing more harm than good. Everyone, except Erzsebet, was surprised. The last word from all of these learned men of medicine was that Bela’s heart condition could not be cured and, interestingly, even medication did not help. Erzsebet refrained from voicing a well-deserved “I told you so”.

Several months later, while visiting Bela, we discussed this latest episode of his arguing with Erzsebet. Bela again spoke of his “need” for logic and that, to him, logic dictated a “simple” procedure in which cells were ablated, thus eliminating heart irregularity. Through Erzsebet’s words, I pointed out to him that, indeed, this sounded like a simple procedure. However, a surgeon never truly knows what will be present until it is actually present. While Erzsebet did not give a reason for refraining from undergoing this procedure, she, along with the cardiac physiologist, did not recommend the procedure at all. After being faced with the physiology of Bela’s heart, everyone now knows why Erzsebet recommended having no procedure: it would do no good, since the problem could not be solved by ablation; and foregoing the procedure would avoid killing off needed cells. Now that Bela had elected to undergo this unnecessary and ill-advised surgery, not only was the problem not fixed, but important cells, vital to electrical conduction, had been removed. Quietly, Bela agreed that he had made a mistake. Erzsebet encouraged him to evaluate his focus on logic and analysis and gently reminded him that logic is always wrong while intuition is always right.

Humbled, Bela is attempting to open a mind that, like many of ours, had rusted shut eons ago and is in dire need of massive amounts of WD-40. The next post, titled Collapsing Probabilities, is inspired by Bela’s experience and discusses the ramifications of rigid thinking.