My Father's Heart
When Dad was born in 1919, Jack and Anna McKee could reasonably have expected their second baby boy to live until he was about fifty-six years old. Cause of death, using the statistics of the day, pneumonia or influenza. Those were no idle threat. Buffalo's population had grown nearly 20 percent between 1910 and 1920, to more than half a million people, but the great influenza of 1918 had hit the city hard. Buffalo was a significant inland port of entry, and through it poured the so-called Spanish flu. For a time, the city itself was in the coffin-making business because private contractors couldn't meet demand. Worldwide, the death toll was staggering, surely beyond Jack's and Anna's comprehension. Even today there is no final count: fifty million people isn't conservative. Weld any such number to the killing machine that was World War I, ended barely two months when Dad was born, and it's safe to assume that for Mr. and Mrs. John McKee, "atherosclerosis" was not on their worry list.
Perhaps it should have been. "Diseases of the heart" had occupied the top spot as the leading cause of death in the United States since at least 1910, save for the three influenza years of 1918, 1919, and 1920. Ironically, part of what was happening here was that people were finally living long enough for heart disease to manifest its deadly characteristic.
That same year of 1919, Dr. James B. Herrick of Chicago published a study in the Journal of the American Medical Association that concluded that a heart attack — a myocardial infarction, or death of heart muscle — didn't have to be fatal. It was a direct contradiction of the era's sclerotic dogma (heart attack = death), and it would eventually change most of the accepted thinking about cardiovascular disease. The study was a follow-up to a 1912 Herrick paper in JAMA that had met with near-universal indifference, a reaction that had stunned the doctor. But his 1919 publication had the advantage of an electrocardiograph machine to measure the heart's electrical impulses. The implications were enormous, even if they took even more years to be appreciated. In time, they would reveal the cardio epidemic.
Mom remembers almost nothing about that day, Saturday, February 2, 1963, when the epidemic found Dad for the first time as he was tapping on a ceiling tile in the basement on Wilshire Drive. She remembers only that earlier in the day she had attended a fund-raising luncheon of the local York, Pennsylvania chapter of the American Heart Association (true story) and then came home to a husband in acute distress. Her subsequent memory is of our being assembled in the early evening at the Flicks, York Crowd family friends, to catch our breath and contemplate the new reality. That's it. Nor is she interested in remembering more.
I was at basketball practice — St. Joe's Black Knights fifth-sixth–grade team — across town in West York, at the old York Catholic High School building. Mr. Grady gave me a ride home. Our house on Wilshire Drive was dark, empty, foreboding, though I admit that's hindsight talking. Then suddenly Mr. Grady was back in the driveway, suggesting that I come to his place. After some time there, Mr. Flick arrived to take me to his house. On that ride, more hindsight: why had he picked me up? At Flicks I walked into a crowded kitchen. Mom and my sister Kathy, Mr. and Mrs. Flick, Jeff, Linda, Steve, Barbie, Greg, and Amy. I'd bet Mr. and Mrs. Philbin were there, more York Crowd friends; Mr. and Mrs. Ochs and Judy Ochs, too, Kathy's best friend, from across the street. Everyone there, gathered. I looked for Mom. There she was — thin lips, square jaw. Now I knew: something was wrong. Mom and Dad were supposed to go out tonight for Mrs. Schmitt's birthday. Mom took me to the downstairs powder room. I can still see the pink toilet and sink, the knit cover on the extra roll of toilet paper sitting on the tank. Dad's in the hospital. He'll be okay. He had a heart attack.
Did Mom drive Dad to the hospital or call for an ambulance from Springettsbury Township? Did she go to the emergency room, or was Dad admitted directly through his family doctor? Mom won't say and there are no records extant. In today's world, the chances are about 50-50 that Mom drove Dad to the hospital, because that's how about half the people in an "emergent cardiac situation" get there. Someone drives them. Or sometimes they drive themselves. Not a good idea. "Time is muscle," as the saying goes in heart attack circles. The longer it takes to get to treatment, the more muscle dies. And it's not coming back.
When Dad got to the hospital emergency room, he received the hospital's state-of-the-art care, circa the Kennedy Administration. He was probably hooked up to a six-lead electrocardiogram to gather some rudimentary information. He was likely administered Coumadin as an anticoagulant. If the pain was severe there would have been morphine. He was placed on oxygen. Time, however, was not of the essence. In 1963, York Hospital was still five years from its first heart catheterization. Dad's personal physician would have been called, and once he arrived, however long it took, he was in charge. That is not as awful as it may sound to our ears today. Just seeing his own doctor walk into the emergency room could have proved a major tonic for Dad. Dad's doctor knew Dad, a huge plus. He applied this knowledge, listened with his stethoscope, observed his patient. He then found Dad a bed somewhere — anywhere — in the hospital. Once he got Dad to his room and flat on his back, he ordered him not to raise his arms above his head, a dictum in effect for weeks. He told Dad they had to rest his heart, assess the damage, give it a chance to come back — to find out if it could come back. Wait-and-see began.
State of the art, and we were grateful for it.
From My Father's Heart: A Son's Journey by Steve McKee (Da Capo Lifelong Books, 2008).