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Professional, Adult Faculty Cornelia Sampson, Director THE DETROI T J EWIS H NEWS Call for a Free Brochure - (810) 681-5376 - Open House & Registration - Register by phone or visit our studio Sept. 4th 10 a.m. - 8 p.m. Sept. 5th 10 a.m. - 8 p.m. 3080 Orchard Lake Road, Keego Harbor • • • • .:Et?. .5.4 • 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. ❑