Broken Heart Syndrome: Debbie Reynolds and Me
Broken hearts are real.
Posted Feb 10, 2017
As we are close to Valentine’s Day, it seems fitting to pay tribute not only to love and romance but also to acknowledge the reality of heartbreak, for which there is actually a medical term: broken heart syndrome.
The passing of Debbie Reynolds (age 84) a day after the death of her daughter Carrie Fisher (age 60) has prompted interest in this term. We are all familiar with the phrase “broken heart” as a way of expressing the pain and suffering caused by the loss of a loved one. But we are unlikely to take this metaphor literally.
Well, now it seems that we can.
As Benedict Carey, in his New York Times article, explains, the Japanese first observed this phenomenon, which manifests as a heart attack, but generally resolves itself when properly treated. The Japanese named this condition “Takotsubo syndrome,” derived from their word for octopus trap, “because the heart looks as if it’s caught from below, its upper chambers ballooning as if trying to escape.”
Graphic and frightening, though generally not fatal.
What happens, according to Carey, is that the shock of a sudden loss triggers a flood of stress hormones, which “causes a temporary weakening of the heart muscle…unlike a classic heart attack in which a clot blocks blood flow.” In time, and with appropriate treatment, the heart returns to normal.
Debbie Reynolds, as Carey points out, had health issues that she had been struggling with prior to the news of her daughter’s death. Some have speculated that she died of a stroke. But can we rule out the impact of the shock of her daughter’s death as a contributing factor? Her son Todd Fisher reported his mother as saying “I want to be with Carrie.”
Having experienced my own version of “broken heart syndrome,” I am inclined to credit both medical and psychological explanations of Debbie Reynolds’ death.
Within the space of a single year, I suffered two sudden and unrelated losses, each involving a painful and complex process of mourning. In the midst of my shock and grief, I felt my heart behaving strangely. It would skip a beat, race and pound uncontrollably. I felt as if I had a scared rabbit in my chest. I reminded myself that I was under stress, but this awareness did not help. Nor did my attempts at meditation, my brief experimentation with anti-depressants, and foray into talk therapy. Through it all, my heart kept lurching, beating too hard or too fast and generally making a nuisance of itself. Pay attention to ME it seemed to be saying, but what good was that?
Being the rational person that I am, I visited my internist to ask for a referral to a cardiologist. My greatest fear at that time was that I was succumbing to the heart diseases that had claimed most of the members of my family. Three of my grandparents, my mother, and both of my siblings had died of heart ailments: congestive heart failure, atherosclerosis, and stroke. Was I next?
My cardiologist ordered an echocardiogram, a 24-hour Holter monitor, which is an electrocardiography (ECG) device, and a blood test. The results were less than alarming. I was diagnosed with P’VC (premature ventricular contractions), which I felt as the skipping and pounding of my heart) and a lesser degree of AVC (atrial ventricular contractions), neither of which required treatment.
So I wasn’t dying.
But here’s the thing. I knew I was suffering from anxiety, but my worries were only partially relieved by my medical diagnosis. The turning point moment in my gradual recovery from this disturbing set of symptoms came when I underwent the echocardiogram ordered by my cardiologist.
A nurse technician administered this test, talking to me calmly throughout. At one point, she said, a propos of my PVCs, “Oh you have a lot of these.” I was feeling so vulnerable at this point and so grateful for her attention that I blurted out my recent history. “I’ve just lost two close relationships and am feeling under a lot of stress.” She looked at me kindly and said “Oh honey, you do know there’s such a thing as ‘broken heart syndrome?’”
She went on to explain how sudden loss can trigger stress hormones that temporarily overwhelm the heart. I felt her sympathy and began to calm down. I can’t say that my symptoms were immediately relieved, but they began to subside. I don’t think it was the diagnosis she offered that had such an impact on me so much as her expression of concern.
In the long aftermath of these major losses, I recalled how sad and lonely I had felt as a child when my father died at the age of forty-two. I was only nine years old and had no way to understand or integrate such a painful experience. Having had two bouts of rheumatic fever before he died, I succumbed to a third, more virulent round. I survived, but had no comprehension of how my dad’s death might have affected my vulnerability to a recurrence of this childhood form of heart disease. As I look back on this experience now, I would say, echoing Todd Fisher, that some part of me may have wanted to die, so I could be with my father.
Sandra Gilbert, in Death’s Door (2006), her extended memoir/essay about the loss of her beloved husband Elliott, writes about the permeable membrane between life and death that the survivor feels in the immediate aftermath of a devastating loss. She calls this “death’s door,” that moment in time in when the worlds of the living and the dead seem to interpenetrate, which we celebrate on Halloween and All Soul’s Day, the days when ghosts rise from their graves and walk through our world—a superstition that expresses a psychological reality. She writes movingly about the moment when she viewed her husband’s body.
He wasn’t there, but he was there. And his thereness, his presence at the center of massive absence, was what made death plausible, what flung it open like a door into an all too easily accessible space…into which it would be frighteningly simple to step.
In other words, she wanted to be with him.
We, in the twentieth and twenty-first centuries, are not the first to observe the seductive pull toward death that the loss of an intimate relationship may involve. William Shakespeare, over four hundred years ago, recognized how one’s heart may break at what feels like an intolerable loss. King Lear is the only one of his tragic heroes to die by no one’s hand, his own or that of an enemy. Instead, he appears to die from grief.
Holding his beloved daughter Cordelia in his arms at the end of his long suffering, he wails “Thoul’t come no more/ Never, never, never, never, never” then expires under the illusion (perhaps) that she still lives: “Look on her! Look! her lips/Look there, look there!” His attendants attempt to revive him, but his companion Kent, who has witnessed his folly, his mental breakdown, and his torment at the hands of his older daughters, pleads otherwise. “Break, heart,” he says, “break.” (V. iii. 307-12). Lear is old yet remarkably resilient. By this time, he has lost everything but his daughter Cordelia, the one loss that he cannot survive.
I don’t know how it was for Debbie Reynolds, but I know how it is for me. When my dad died, I thought that my life was over. It wasn’t. Nor is it now.
As my cardiac symptoms have abated, I’ve had time to reflect on the meaning of the relationships I have lost and to hold them quietly in my heart. I wish the same for all of us who are not celebrating a new or enduring love this Valentine’s Day but honoring ones that are gone—in part by opening our hearts to those whose suffering may exceed ours and living our lives as fully as we can.