An Arrow Through the Heart: One Woman's Story of Life, Love, and Surviving a Near-Fatal Heart Attack

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It happened without warning. She was thin and fit, ate all her vegetables, never touched a cigarette. There was no family history of heart disease. Yet somehow, at the age of forty-four and in the middle of her weekly yoga class, Deborah Heffernan felt her heart explode. After emergency surgery and a flood of complications, she was left with half a functioning heart, a defibrillator under her skin, and the looming prospect of a transplant.

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Overview

It happened without warning. She was thin and fit, ate all her vegetables, never touched a cigarette. There was no family history of heart disease. Yet somehow, at the age of forty-four and in the middle of her weekly yoga class, Deborah Heffernan felt her heart explode. After emergency surgery and a flood of complications, she was left with half a functioning heart, a defibrillator under her skin, and the looming prospect of a transplant.

An Arrow Through the Heart is the unflinching chronicle of that first -- and, potentially, last -- year after Deborah's near death. It is a story of raw emotions -- from childlike bewilderment to despair to jubilation -- that followed her return to the world, of "finding meaning everywhere, like Easter eggs." Anchored by the fierce love of her husband, and by their two families, who set aside their differences to rally around her, Deborah learned to do simple things all over again. One breath at a time, she regained the strength to climb a flight of stairs, to walk around the block, even to resume her yoga -- always knowing that a deadly arrhythmia might cause "the box" in her chest to fire. Amazingly, five years later, she has not yet needed the heart transplant doctors once predicted she would need within two.

Of course, the heart is more than a muscle, and this is a story about healing the soul as well as the body. Never trusting that she'd wake to see the next morning, Deborah found miracles in every moment -- in the tiny green leaves of a sapling, in the ice floes that signaled the change of seasons in Maine, even in the eating of a single lemon drop. She used her confinement to explore the Buddhist idea of death in life and to lay to rest old hurts from the past. And ultimately, though her life after the heart attack was severely restricted, she came to feel that it had been immeasurably enlarged.

Heart disease is the leading cause of death among women, claiming more than half a million lives each year. But, as Deborah writes, "statistics are aerial photographs," and this book gets below the treetops. For fellow cardiac sufferers, it will be a welcome companion on the road to recovery, one of the very few memoirs by women with heart disease. Above all, it is a book about rebounding after catastrophic change, a testament to the unexpected joy that can come from living in a state of impermanence.

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Editorial Reviews

Publishers Weekly
Despite her apparent good health, in May 1997, Heffernan suffered a massive heart attack during a yoga class. Proximity to a Cambridge, Mass., hospital and the swift response of rescue workers saved her initially. Emergency double bypass surgery and the subsequent implantation of a defibrillator has allowed her to survive for the past five years. Surprisingly, Heffernan was relatively young (44), physically fit and a nonsmoker with low cholesterol who adhered to a nutritious diet when her heart failed her. In this insightful and openly emotional account, Heffernan details her illness and the life changes that occurred afterward. Happily married since 1989 to Jack, 13 years older with five grown children, Heffernan saw her relationship with her husband grow even stronger as he became her caregiver during a lengthy convalescence. Heffernan gave up her high-pressure job as a corporate training executive, and she and Jack moved permanently from Cambridge to their peaceful Maine vacation home. The author's enforced period of inactivity forged links with Jack's children, who had formerly been distant from their father's new wife, and she became closer to her sisters. Although her heart has been severely damaged and a transplant may eventually be needed, Heffernan nicely describes how she has found peace of mind and a new pleasure in daily living because of this unexpected brush with death. (May) Copyright 2002 Cahners Business Information.
Library Journal
At the age of 44, Heffernan suffered a massive heart attack that resulted in cardiomyopathy and ventricular tachycardia, with only half her heart still functional. Only her quick recognition of her symptoms, prompt medical treatment, and the availability of specialized medical services and personnel saved her life. This engrossing account of her initial battle for survival shows the depths of human emotion and strength in times of crisis, for both the victim and her family. The struggle to make rational medical decisions, overcoming ICU- and medication-induced psychosis, the vital role of family support, and the emotional roller coaster of both patient and family are touchingly documented. The following year of convalescence, moving from beliefs of health to acceptance of disability, is emotively portrayed. Heffernan's fight to regain some quality of life for herself and her family will resonate with all persons dealing with chronic illness and inspire them to find their own blessings in life. A moving story in the face of sudden catastrophe; recommended for all health collections. Janet M. Schneider, James A. Haley Veterans' Hosp., Tampa, FL Copyright 2002 Cahners Business Information.
Kirkus Reviews
A commanding chronicle of a year in a woman's recovery from an unexpected and near-fatal heart attack. Not only was Deborah Heffernan relatively young, only 44, but she had never smoked, she ate her fruits, vegetables, and whole grains, she maintained a healthy weight, and her family had no history of heart disease. Moreover, she had a loving husband, good friends, and a successful career. But there she was in yoga class, pressure crushing her chest. "I'm having a heart attack," she told her teacher. Within minutes, the EMS was there, transporting her to a hospital and bypass surgery, while her family and friends stood a death watch. Heffernan did not die, but her life and the lives of everyone around her changed as she slowly worked her way back to health, with a defibrillator implanted to monitor every beat of the half a heart she now lived with. Her recovery, from her first hesitant walk from hospital bed to bathroom to a vacation in the Alaskan bush a year later, is described in sections that mirror the change of seasons. It encompasses longer and longer walks in the Maine woods, yoga, massage, and psychotherapy for her and her husband. It also involves a long and sometimes painful exploration of why, given her remarkably healthy lifestyle. Long years of hidden stress, going back to her mother's death 30 years before and culminating in a job that found her living out of suitcases was her answer. The damage will never be undone, and a heart transplant may be in her future. On the positive side, Heffernan's medical crisis mended years of strained family relationships, and she has learned to find significance in even the most casual encounters. Her personal tale is interspersed withsalient information about heart disease, including the fact that it is the number one cause of death among American women, more than all cancers combined. Unmarred by self-pity, an arresting story that women and men suffering from heart disease will find, well, heartening.
From the Publisher
Caroline Myss Author of Sacred Contracts Not only a book of hope and inspiration, it is also a journey of spiritual intrigue....This book is magnificent.

Mehmet Oz, M.D. Director of the Cardiovascular Institute at Columbia-Presbyterian Medical Center and author of Healing from the Heart Using her heart as a magnifying glass, Deborah Heffernan provides readers with a window into their souls.

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Product Details

  • ISBN-13: 9780743229227
  • Publisher: Free Press
  • Publication date: 4/7/2002
  • Pages: 320
  • Product dimensions: 5.60 (w) x 8.66 (h) x 1.07 (d)

Read an Excerpt

Prologue

Statistics are aerial photographs. The photographer in the airplane circling high above us looks for the big picture -- where land gives way to water, where mountains rise, where the desert begins. There is nothing to distract him from the landscape, no movement telling of life below the treetops. Yet we are there nonetheless, waving, waving, each with our own story, each with a heart whose beat gives us life and makes love a possibility.

The aerial photograph of cardiovascular disease shows that sixty million Americans suffer from it. That's one out of every five, making it the number-one killer in this country. Cardiovascular disease is also the number-one killer of American women, afflicting one out of every two. Each year 2.5 million women are hospitalized for it and about five-hundred thousand die. That's more women than died from all other causes combined, including lung, breast, ovarian, and uterine cancer.

Unlike men, most women who die suddenly from heart attacks don't have any previous symptoms. And even though more women die of cardiovascular disease than men, many doctors still do not prepare women to recognize the signals of a heart attack -- certainly not young women in good health with no risk factors. This is tragic. According to a 2001 report from the Centers for Disease Control and Prevention, of the leading causes of death among women ages twenty-five to forty-four, heart disease is significantly ahead of breast cancer, and ranks second only to accidents and other adverse events.

When death came for me on May 12, 1997, I was a healthy forty-four-year-old with no family history of heart disease; in fact, one grand-aunt had lived to a hundred and six. My annual physical had just confirmed my usual low blood pressure and low cholesterol. I'd never touched a cigarette, let alone smoked one. I was slender, exercised regularly, and ate all my vegetables. I even made whole-grain bread each week. I was certainly not a candidate for a massive, near-fatal heart attack, emergency open-heart surgery, and ventricular tachycardia (a deadly malfunctioning of the heart's electrical system). Neither would I have believed that I could be unconscious for eight days of my life. And I certainly never dreamed that a heart transplant would be in my future. I was in my prime, assuming my American birthright in grabbing cash from the ATM machine, throwing toothpaste and tomato paste into the market basket, and driving to work. Besides, I am a woman; I thought that in the matter of my heart's health, my gender would protect me. Wrong.

A year and a half after my heart attack and surgery, on a flight to Anchorage, I met a cardiac surgeon from the Southwest who was recovering from open-heart surgery himself. I told him that I was drafting this book, and he said, "Even as a doctor who's prepared and operated on hundreds of patients in all circumstances, I had no idea what I was facing. Write your book for all of us. We need to understand more about what the patient goes through, from the patient's point of view."

And so I did. But my book is as much for families, friends, and people who deliver hospital breakfast trays and home heating oil as it is for patients and medical professionals. Matters of the heart cannot be separated from the muscle, I've discovered, so every person has an impact on the cardiac patient, who now believes that every moment is her last.

Each year nearly eleven times more women die of heart disease or stroke than of breast cancer. Yet there are virtually no memoirs about cardiovascular disease on the bookshelves. During my critical first year after being discharged from Massachusetts General Hospital in Boston, I found only a couple of books that offered the companionship and guidance I craved. There are plenty of books about fighting heart disease with diet and exercise, meditation and medication, but I wanted to know: Is anyone in the universe like me -- young, fit, female, shocked? What did you feel like? What happened to your life, to the lives of others close to you? How did you change, or did you not? In the end, I've written the book that I searched for about heart disease. But it is also a book about facing catastrophic change of any kind and doing the work required for true healing.

As happens with most people who find themselves suddenly in what writer Susan Sontag calls the "kingdom of the ill," I grappled with cosmic questions after I had sought medical explanations. Why me? Why my heart and not my toe? What could I have done to prevent this? Who is at fault? My year's stay in the monastery of illness -- a peculiar place of both confinement and release -- took me deep into my past and I discovered that, as intuitive healer Caroline Myss writes, "Your biography can become your biology." While my biography is certainly not yours, perhaps like me you gain more from being swept up by the story of a real person's life than by a river of statistics.

The first year following a heart attack is the most critical period of recovery, a time when in closing your eyes at night, you can't trust that you will be there in the morning. Doctors struggle to prepare patients for this uncertainty, but there is no experience like personal experience. I have stuck strictly to that year and tried to be unflinching in my descriptions of the devastation, terror, joy, setbacks, insights, and unbelievable humor that accompany dying and returning to life again.

So come with me through five seasons in western Maine, where I recovered my body and soul. The first spring lasted only a month, yet I dwell on it the longest because after being given back life I observed it as fixedly as a child observes a bug. As the seasons progress, my descriptions of them shorten, reflecting my gradual return to healthy-people time -- a time when a lemon drop no longer demands full attention until completely dissolved. We cannot meet our worldly responsibilities, which I did not for more than a year, while paying rapt attention to every raindrop on the windshield.

Simply by slowing us down, disease can tell us what our souls need to know. It becomes a diagnostic tool for the spirit. Difficult as that year was, I miss the languorous pace enforced by confinement. Driving thirty miles an hour no longer feels like speeding to me; I make lists of things to do and feel a tug if the day doesn't give me time to complete them; I occasionally walk by a flower without peering into it. But I doubt I will ever be truly inattentive again. I emerged from that monastery seeing my broken heart in a whole new light -- as a metaphor. It's ironic that a devastating attack on my literal heart brought healing to my spirit-heart. I now understand that healing and curing are two very different things.

My doctors told me that by the time I reached the one-year anniversary of my heart attack I would feel strong and confident again. And they were right. But I didn't believe them for even one minute, not when the act of eating a chunk of fruit took centuries as the sun rose in a chilly hospital room.

Ultimately, this book is not about heart disease at all, but about digesting that fruit.

Copyright © 2002 by Deborah Daw Heffernan

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Table of Contents

Prologue

Spring

Summer

Autumn

Winter

Second Spring

Epilogue

A Note about Organ Donation

Acknowledgments

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First Chapter

Chapter 1

There is a weight on my chest. Right between my breasts, pressing on my breastbone -- as though the atmosphere ripped open a shaft from the heavens to me and the sky poured down onto this one spot. Observant, detached, slowing down, breathing carefully, I think with my body.

"I am having a heart attack," I say to Zoe, my yoga teacher.

I am in Cambridge, Massachusetts, lying on my back on Zoe's clean, polished floor looking at white walls and gleaming wooden window frames. The pressure on my chest has become very specific. It is bearing down now and revolving like a vise, cranking my chest tighter and tighter. I feel no pain, just curiosity. It is the alert, still curiosity of an animal at the sound of a footfall in the woods, of a child beckoned by a frightening stranger, of a bird that senses a change in the atmosphere before a storm hits. The pressure, the twisting continues. It is not going away. I am beginning to sweat.

Zoe is bending over me because she's been helping me improve a gentle yoga pose, Reclining Maricyasana. The idea, she says, is that with the shoulders relaxed and arms outstretched receptively, the heart is released and can ascend to radiance. It is one of yoga's warming poses.

But I am cold. I look at my hands. They are marble white. I sluggishly realize that Zoe has helped me sit up; I suddenly feel her small, strong hand supporting my back. Now I have the sensation of cold rivulets coursing down my arms, millions of discrete trickles running from my shoulders, over my elbows, to my wrists. Nausea rises.

"I am having a heart attack," I say again, this time with the calm, clinical finality that comes fromabsolute knowledge deep within my body.

For only a moment, my mind protests. Give it a minute. It must be a muscle pull. But Zoe does not second-guess me. Instead, she trusts the voice of my body and asks me what I want her to do.

"I want you to call 911. Tell them I need a cardiac team. Tell them to take me to Mount Auburn Hospital. My doctor is Barbara Spivak. I need a cardiologist waiting for me. Something is terribly wrong."

The icy rivers flow to my marble hands. Take charge, take charge, take charge.


The 911 guys lumber in with armfuls of equipment -- thundering male steps echoing into a serene white room with three women in tights sprawled on a polished floor. Quickly assessing what is needed, they joke that when they got the call they thought "yoga class" was code for a cult. I laugh. Everything is fine if I can laugh. They would be stern if something were wrong. I am aware of how big they are, how slender my classmates. I am amused by the space men take up and reminded of my husband in the bathroom, obliviously standing in front of the mirror I was using while happily telling me a funny story about his trip to the dump. I like these guys.

They hook me up to machines. They put a tiny pill under my tongue. They ask me how I feel. Not great yet, but better because they are here, though it's harder to look inside my body when they distract me with light bantering. I am feeling happy in this moment. It must be a muscle pull.

I laugh with them and ask, "So, what do you guys think?"

"We think you're a very lucky lady."

Whew. Take two aspirin...

But the biggest one is all business now. He finishes his response gently, firmly.

"You're coming with us to the hospital."

They strap me into a chair and will not let me move by myself. I think they are cute and want to show off how strong they are. I feel cold terror suffuse my body, taking over as the tingling trickles flowing down my arms retreat. Or am I too scared to feel them?

Two men carry me out the door backwards. It is the summer view I had as a girl riding the tailgate of Dad's woody station wagon, the same view I had as a young woman teaching in the Swiss Alps, nauseated from sitting backwards on a train and vowing never to do that again. As they load me into the van, I wave to a child and an old man, reassuring them that everything will be all right. Zoe's face is small and serious on the steps. I thank her and wonder at my self-possession. But I am simply here, in the arms of these funny strong men. Surrendering my independence, I feel a rush of relaxation.

Or am I deciding that I am relaxed when what is actually happening is that my body is failing me? What does that feel like? How would I know?

The men in the front seat are calling in to the hospital. I strain to hear what is said, muffled code words through glass. The big guy is still with me, administering more tests, asking me over and over how I feel. I no longer know. I desperately want to tell him that every test makes me feel better, but it does not, no matter how hard I try to please him. He shows no elation or disappointment. I can't read him. How am I?


I was dying of a massive heart attack, or myocardial infarction (MI). Between my first sensation of pressure and the rescue team's arrival, only ten minutes went by. Those ten minutes -- an eternity -- saved my life. I relive every second again and again. I think of all the places I could have been instead of within the serene walls of a yoga studio.

I was your typical harried workingwoman, a partner in a small but prominent corporate training company. May 12 had been a Monday like any other -- better than most because there was no packed suitcase behind my office door ready to be loaded into the four o'clock cab to Logan Airport, flung into another rental car in the evening darkness, and unzipped in another hotel in another strange city of blinking lights, with highways lacing it like a sneaker. As it happened, a client had called on Friday and switched our meeting to a phone conference later in the week. So on this Monday, instead of flying to Detroit, I was going to my yoga class and sleeping in my own bed next to my husband, the love of my life.

What if, bored and imprisoned in an airline seat a few months before, I hadn't picked up the in-flight magazine and read an article on heart attacks that described many of the symptoms I would experience? What if my Detroit client had not changed our meeting to a phone conference? What if I'd taken that one last call and been sitting in rush-hour traffic instead of in my yoga class focusing on my breathing, deeply attuned to my body?

What if I had reacted to my body's signals with denial and hubris? What if I had not acknowledged death in the moment it visited me?

I would be dead. And if I had died, I would not be here. I would not be looking up the lake at another spring, one year later, from my study in our old house in Maine. I would not be seeing our beloved Mount Washington across the border in New Hampshire, with snow lingering in Tuckerman Ravine like icing on the cake saved for last. I would not be listening to water lapping at the peninsula -- each year an exciting new sound after the silence of ice stretched shore to shore during Maine's long winter. I would not be hearing the wind chimes on the northwest corner of the house heralding several days of blue skies and sparkling water. I would not hear the loons or the mourning doves or the tree swallows busily nesting in the fantasy birdhouse, made by friends for our wedding, with a brass heart for a weathervane.

Every day I am aware of my good fortune and regard each moment of life as the exquisite miracle that it is. I am also aware that before IT happened, I had lived each day as best I could -- often too intensely, but always fully participating in life. As I write that, I pause. True? I will always wonder what I could have done differently. Did I appreciate life enough? Could I have prevented IT from happening?

With time, I am learning that the physical why is not important. That ride across Cambridge in the rescue vehicle with my burly boyfriends was the b

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Interviews & Essays

Exclusive Author Essay
Heart disease kills one out of every two women, yet only 50 to 70 percent of those fatalities can be attributed to known factors like obesity, diabetes, high cholesterol, and so on. I had none of the predictive factors and thought I was safe. Wrong. Almost dead wrong. Like many women, my first sign of heart disease was a heart attack.

My most important lesson from the year I spent recuperating on a lake in western Maine is that you simply cannot separate matters of the heart from the muscle. Writing this book helped me explore those matters -- privately, slowly, building careful, honest sentences as I built up my body to live in this world again. And in the end, although I had written An Arrow Through the Heart to warn other women and save their lives, in the process I saved my own.

I should have anticipated the power of committing thoughts to paper. I should have known that the search for just the right word can unearth truths. In perfecting a sentence that eluded grace, I discovered that my thinking was foggy, that my feelings were not clear yet, often demanding that I return to bed and stare at the ceiling, even sleep, before the truth finally emerged. Sometimes it took days or even months, appearing like skywriting when I least expected it -- in the shower, chopping onions, brushing my teeth.

I should have anticipated this miraculous process because I taught it once in an international boarding school in the Swiss Alps, armed with no other qualifications than a recent college degree and the fact that I was there, scrubbing pots in the kitchen, when the real English teacher resigned. It was a hippy school, with lovely notions of world peace based on educating children of different nations together. But I had no idea what to do with a handful of teenagers of different ages, races, cultures, and abilities whose only commonality was English as their first language. They were a troubled, sullen lot, pawns in international divorces, and I was failing miserably to inspire them, especially Obi, black as the Nigerian night. He was gorgeous, privileged, and the laziest kid I've ever met.

One day in a frustrated fit, I stormed out of the classroom and into the first snow of the season, ordering my charges to follow. We made our way to a boulder at the edge of a field behind the school. Suddenly obedient, they one by one handed their notebooks to me, climbed the boulder, and jumped into the fresh snow. Then I handed their notebooks back and, without brushing any of the snow off, they wrote one sentence about how it felt.

Obi was last. This was the first snow he had ever seen, but he was too cool to admit it. Off he leapt, terror and elation fighting in his face. And then there was the beauty of ebony skin on pure white snow. And his laughter. His incredulity. The tall body emerging from the snow as from a bubble bath, and racing for his notebook. He wrote, "The snow is cold."

And we went from there until, days later, he had pushed and pushed himself to write a sentence that unlocked one feeling, a sentence so beautiful it made me cry and the other kids applaud. I wish I could remember it.

Over that year of miserable adolescence, as those kids wrote their sentences, slowly building them into paragraphs and then whole stories packed with meaning and truth, they found their voices. And so it was with me after my heart attack. Sentence by sentence I put myself back together again. Words saved my life. And perhaps by reading my book, you will save yours or the life of someone you love. (Deborah Daw Heffernan)

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Sort by: Showing all of 3 Customer Reviews
  • Anonymous

    Posted March 31, 2002

    A must read for all.

    Every person who either is taking care of a loved one, or ministers to patients; doctors, nurses, health care workers, should read this book so they can know how the patient feels, why certain things happen, and how the caretaker can reach into and touch the problem. No one has explained this sector of health and life before.

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  • Anonymous

    Posted May 6, 2002

    Terrific Story on the Journey Back from Death

    This story matches my personal experience with the Heart- I had the same medical problem one year ago and coping with emotions and continuing my journey back from Cardic Arrest. Loved the book and recommend for all heart patients to read- very informitive about how other people cope with a new life style.

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  • Anonymous

    Posted January 25, 2010

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