Did The Umpire
Have To Die?
MARSHALL FRANKLIN SPECIAL TO THE JEWISH NEWS
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• .:Et?. .5.4
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in our
Classified
Section
hen he was a kid he
was fat and slow, yet he
dreamed of being a ma-
jor-league ballplayer
someday.-In high school a chari-
table coach let him umpire some
games. That lit the fire in him to
make the major leagues. He took
odd jobs at the stadium in addi-
tion to his regular work. He con-
tinued to practice and train to
achieve his dream, and his dream
came true.
There he was on opening day,
ready to start his first game. He
took his position on the field and
waited for the first pitch. When
it crossed the middle of home
plate he raised his right arm and
exclaimed for all to hear: "S-T-E-
E-E-RIKE ONE!" His career as
a major-league umpire had be-
gun.
That career ended April 1,
1996, when, on opening day in
Cincinnati, John McSherry
reeled back from home plate and
fell dead on his beloved baseball
field before the first pitch was
thrown.
He died of something called
"sudden cardiac death," a fatal
irregularity of the heartbeat that
renders the heart incapable of
pumping blood to the body. The
usual culprit is ventricular fib-
rillation, which converts the or-
ganized heartbeat into a jumble
of uncoordinated wriggles that
do not propel blood to its vital
destinations. At one time it was
universally fatal.
Many of us saw McSherry die
on our television screens. I felt
the helplessness of those who at-
tempted to save his life. I thought
back to a time, years ago, before
CPR and external defibrillators.
As house . officers we carried
scalpels in our pockets whenev-
er we were in the hospital.
If we were called to a cardiac
arrest, we had to cut open the
chest at the level of the heart and
squeeze the hand between the
ribs and under the heart to
squeeze the blood into the circu-
lation. We used an internal de-
fibrillator to deliver an electric
shock directly to the surface of
the heart, inside the chest, in the
hope of stopping the ventricular
fibrillation and bringing back the
normal heartbeat. Not many vic-
tims survived such an ordeal
then.
In the early-to mid-1960s ex-
ternal cardiac massage was de-
veloped and combined with
assisted respiration to form what
we now call cardiopulmonary re-
Dr. Marshall Franklin is a San
Diego-based cardiologist.
suscitation. External cardiacde-
fibrillators could deliver the life-
saving electric shock through the
chest wall. No chest incision
would be needed. At last, we
could stop carrying that scalpel.
Most middle-age and older
adults who succumb to sudden
cardiac death have coronary
artery problems as the underly-
ing cause. Many have angina
pectoris or have had a heart at-
tack. Once the heart muscle has
been damaged, as with a heart
attack, the damaged area caus-
es irregularity of the electrical
impulse that keeps the heart-
beat organized. In years past,
doctors prescribed anti-ar-
rhythmic drugs in an attempt to
keep these arrhythmias from de-
teriorating into ventricular fib-
rillation.
In the 1970s and '80s, special
heart catheterization tests were
developed that could actually
measure electrical activity inside
the heart. Effectiveness of drug
therapy could be assessed this
way. Research and time revealed
that, for many patients, this was
not enough. Something more was
needed.
In the late 1980s and early
'90s, new technologies were de-
veloped. Pacemakerlike devices
were developed that could deliv-
er the lifesaving electric shock
automatically when the heart
needed it. These devices are sur-
gically implanted just under the
skin and connected to wires
threaded through veins into the
chambers of the heart.
The device constantly monitors
the patient's electrocardiogram,
and when it detects the life-threat-
ening cardiac irregularity, it zaps
the heart back to normal Patients
tell me they can feel it, but it
doesn't hurt. As one patient said,
"It's better than dying."
I understand McSherry had
been diagnosed as having some
form of a heart condition with an
irregular beat. He had planned
to see a doctor Tuesday, but he
died Monday. I don't know what
kind of heart condition he had or
what treatments, if any, might
have been prescribed. It is fairly
clear that, at age 51 and 328
pound, he was an accident wait-
ing to happen.
From what I have heard and
read, McSherry was well-re-
spected and well-liked. I can't
help but wonder if his major-
league career might have been
prolonged if he had taken better
care of himself and made better
use of the modern technologies
available. ❑