On Having a Heart Attack: A Medical Memoir

William O’Rourke (paper, 151 pages, University of Notre Dame Press , 2006; $18)

Reviewed by Diether Haenicke

In October, 1991, William O’Rourke had a heart attack and, luckily, lived to write about it. Books about heart attacks and heart disease abound, mostly authored by health care professionals who specialize in the treatment of heart patients or work as nutritionists. Books written by actual survivors of an MI, as a myocardial infarction is called in medical shorthand, are rare and a book such as this, written by someone who is both a survivor and a noted author, is certainly the exception.

People with a history of heart attacks don’t particularly enjoy remembering them. As a survivor of several MIs, both mild and severe, I speak from experience. For this reason, I found the book painful to read because O’Rourke describes with precision and in gruesome detail all the raw physical aspects of the attack. Yet the book had an even greater emotional impact on me because of the author’s stunningly accurate account of what plays in the patient’s mind during the heart attack: the existential fear felt when being wheeled into the operating room; the flashback scenes of one’s life; and the on-the-spot resolution to make life changes if one survives. And later, during recovery, he reveals the patient’s often melancholy realization that family, friends, and colleagues begin to see him differently than before the MI. The drastic event changes the survivor in the eyes of those around him, and the patient is keenly aware of it. He is suddenly perceived as reduced; he is treated differently; he is now, in the eyes of many, damaged goods.

Hard as it was for me to deal with a subject matter which rekindles so many unpleasant memories, the book nevertheless grasped me once I had read the first few pages. It is divided into ten chapters of about equal length, each of which deals with a significant aspect of the ordeal. The opening chapters describe the actual heart attack, the angiogram and the angioplasty, and the subsequent hospitalization during the immediate recovery, and they draw the reader forcefully into the story. O’Rourke’s crisp style and his almost detached observation of what goes on around him produce a unique narrative not found in the typical heart attack book. It becomes immediately clear that here an outstanding writer provides an unmatched account of hospitals, doctors, nurses, and treatment plans from a patient’s view—a perspective that should be required reading for all hospital workers.

Lying in bed for several days, immobilized by tubes and heavy sandbags on the leg incisions, inevitably leads thinking persons to reflection and self-examination. And such journeys into one’s personal past are accompanied by melancholy, depression, and even tears. One’s spouse, children, parents, and close friends suddenly assume new positions in the patient’s emotional universe. Conversations that should have happened years ago take place. Viewing the past after this particular experience leads to corrected perspectives. What was formerly important becomes less important and tangential. In the lonely hours that follow the MI, the patient rearranges his life—past, present, and future.

The chapters dealing with this reflective process—chapters five through ten, the second half of the book—I consider the strongest. In them the storyteller comes to life and there is no holding him back. Friends and lovers from the past float by, receiving warm and thankful looks; the professional life’s work up to this point is critically examined, that of a well-known writer without the “breakthrough” book; the scholarly ambitions of an energetic, much younger wife (“Is he your father?” a doctor asks) are compared with his own; the much loved only child moves more into the life center. Here O’Rourke is at his best: a very fine writer who, with simple prose, provides deeply touching vistas into emotions and hopes without ever getting sentimental and teary-eyed.

Rather, irony and good humor shine through in some of the direst situations. O’Rourke finds amusing aspects in his encounters and discussions with nurses and physicians; the ways he changed after the arrival of his first child, as well as the idiosyncrasies of parents, uncles, and aunts, are remembered with humor and charm. All this makes the book eminently readable.

Is it a self-help book? The answer to this question is both yes and no. Yes, because it offers an unusual amount of straightforward medical-clinical information. O’Rourke obtained his medical records and nurses’ notes from the hospital and studied them very carefully. He is thus able to dispense good advice on a broad range of heart-related issues. He comments on life-style questions, gives diet suggestions, and attaches to the memoir a lengthy glossary of medical terms that helps any patient find his way through a conversation with his time-challenged physicians. A list of dos and don’ts is also useful to the general reader.

But this memoir is much more than just a self-help book. The author examines the many personal thoughts the patient stricken by a heart attack unavoidably encounters. Nobody tells him, for instance, that deep sadness will envelop him after he survives the infarction. O’Rourke’s book is a medical memoir, as the title suggests, but it reaches far beyond that: it is a person’s look at his own mortality and the end of all things. It is a touching and thought-provoking book about the turning points in our lives and a profound reflection on family and friends and on hope and love. It is a book that doctors and nurses should read and learn from, and one that all those should read who are potentially threatened with heart disease through wrong life-style choices. But beyond that I recommend the book to anyone who loves fine writing and a good, meaningful story.

Diether Haenicke is a former president of Western Michigan University .