Heart attack

Pacemaker Sex

Pacemaker Sex

Getting fisted by the electronically paced flailing arms of a D.O.A. John Doe paled in comparison to what happened to my loan shark friend, Chubby.

One of his sideline enterprises was to pimp women to local clients including police officers, lawyers, bankers, and a few other unsavory fellow shysters. The women were not a consistent cadre of reliable girls from a “stable” but instead were usually indiscriminately pulled off the local sidewalks or out of grocery store parking lots.

For this reason, the women were also not consistently available, such that when something suddenly came up, he would place phone calls to line up the Johns.

He solicited sex from just about any woman he saw and when he scored would temporarily procure them for his client base until the women got tired of it or did not need the money anymore.

  • Doc, you can’t believe how many housewives are broke and what they’ll do for a buck, especially when economics is bad.

The going rate in the 1990s was about one hundred and three dollars an hour for intercourse and thirty-three dollars for oral sex, although he once got a staggering one thousand and three dollars out of a retired but impotent eighty-year old business tycoon and former CEO of a major US steel company who paid just to have the girl sit naked in a chair and talk to him for an hour. The arbitrary rounding on the price was based on a superstitious love of the number three.

Several years later, this same tycoon was indicted in an insurance fraud scheme in which he tried to smuggle a vintage Mercedes-Benz sport coupe out of the country after reporting it stolen; an act that everyone who knew him and how much money he was worth thought to be stupidly perplexing in its perverse logic.

Chubby said:

  • I don’t know, doc. It’s like he just got a soft spot in his brain.

Later in life, Chubby happened to have had a heart attack. Several years after the fact he then had an AICD (Automatic Implanted Cardiac Defibrillator) implanted for unexplained fainting that later turned out be related to poor blood flow in the posterior cerebral circulation. Even though the essential point was that implanting it was probably not necessary, it was done anyway because of uncertainty about the possibility of lethal ventricular arrhythmias. This underscores the fact that sometimes medicine, for all its sophistication is nothing better than a guessing game.

These electronic devices are set to deliver sequential shocks of about 15 to 30 joules of direct current internally to the heart which will reset the cardiac rhythm if a life threatening one is detected. The shock is not at all comfortable. It can also be felt by anyone who happens to grab hold of the victim who might be collapsing when the arrhythmia then secondarily causes his blood pressure to bottom out. Some spouses have stated they suffer from the guilty dilemma of deciding between letting their loved one fall down, as opposed to being exposed to the shared experience of internal electrocution. Personally, I thought the original contract called “For better or for worse.”

Chubby reluctantly accepted to have the implant but said he would feel much better about it if we were going to put in a pacemaker that would give him a permanent erection instead of an electrocution.

  • You doctors are all numb. Forget Viagra. With modern technology yez should be able to do a better job with boners.

One afternoon I received a frantic call from him. He said he wasn’t sure what had happened, but he thought his device had discharged.

  • Doc. I think my thing went off.

When I asked the circumstances, he said he had picked up a tried and true regular at the supermarket, a local housewife who had already been paid thirty-three dollars for blowjob.

As she was in the middle of the head-bob he said he was suddenly lifted two feet off the bed, that all he saw was a bright white light, and that his hair stuck straight out off his head. At the same time, the girl had been blasted and fell across the room, then banged her head on the bedroom door.

She got up screaming that he was a crazy demented pervert and what a shitty way that was get off, as she bounded out the door, following that diatribe with a statement that no matter what he might ever pay her, she was never coming back.

  • Doc. The woist part of it was I lost my thirty-three dollars and didn’t even get off. But oh, what a thrill!

As all the data is stored in memory, when one of these devices fires it is customary to interrogate it to see if the shock was appropriately sensing a real event.

So, when Chubby came to the office to let me look at it, I discovered that the trigger for the shock was a paroxysm of not a lethal ventricular tachycardia but rather a harmless one that had originated in the atrium. Perhaps the excitement had over stimulated his epinephrine producing adrenal glands as well as his testosterone loaded gonads.

The device was fooled into doing its job by a rapid heart rate that was associated with an abnormally wide configuration of its cardiac complexes. It was essentially acting appropriately in an inappropriate situation; as was the housewife whore when she perceived she was being perversely abused.

I felt compelled to share this story with a colleague at the specialty hospital I had customarily referred not only Chubby, but also numerous other cases for AICD implants. Although the implanting physician, Joe, was amused, he then told me he had a story that might be even better than mine.

He queried:

  • You know how the Japanese perfected the art of autoerotic asphyxiation?

With me answering in the affirmative, he then told me about the wife of one of his patients who had brought that art-form to a new escalated jaded height. He said her affect was a little rough around the edges. She also tipped the scales at an estimated 250 lbs.

Apparently, her husband had suffered a heart attack, and then required an AICD implanted, but because of his relative debilitation, along with a lack of stamina she became accustomed to screwing him in the female-on-top sexual position.

On one occasion, the device discharged but instead of reacting negatively this woman immediately derived a great deal of pleasure from the experience. I suppose it was like having a mini electric socket inserted into the vagina, which in her mind was better than any orgasm she could achieve by using a conventional AA battery powered vibrator. Or perhaps her blubber not only attenuated electricity but then also made her threshold for sexual stimulation much higher than that of her average contemporaries.

But the perverse thing about the whole scenario was that the woman then educated herself about shocking devices. Then each time she went with her husband to the clinic to have his device was checked, she would beg the doctor to turn down the rate sensor on the AICD, so that there would be a greater probability of the thing going off when she climbed on top to rev up the sex.

So here is this poor bastard with a bad heart to begin with, losing consciousness as his heart is fibrillating, while he is getting jolted; simultaneously his lovely fat wife also gets a DC shock jolt as she sinks into the stirrups to giddy-up the old dying horse. If nothing else, at least this was a clear-cut situation of her ability to turn the worse for him toward the better for herself: A classic combination of both positive and negative feedback loops.

Not only does it go to show that everyone has a different threshold for pain, but also gives great credence to the aphorism: To each his own.

I said to my colleague, Joe:

  • Yes. In the category of interesting clinical pacemaker anecdotes; you win the gold medal.





Uncle Bill and the Kennedy Assassination

Uncle Bill and the Kennedy assassination 

I was in the tenth grade sitting in Social Studies class when it was announced on the PA system that John F. Kennedy had been shot. It is probable that almost everyone who was alive at the time can remember exactly where he was and exactly what he was doing on the day this news was delivered. It was also an earth-shaking event that truly seemed beyond comprehension.

At that time my Uncle Bill lived in Dallas where he also owned a popular bar.

William Howard Cooper being a hard living, hard driving, hard loving man, was the kind of person who could be best described as a “real high flyer.” He admitted to smoking a pack of cigarettes a day as well as to drinking a case of beer and just short of a quart of Jack Daniels Bourbon to go along with it.

Beside this addiction to alcohol and tobacco he also had an addictive penchant for gambling that would take him on frequent round trip junkets to Las Vegas. One week he would be asking Granny Cooper to hide upwards of $50,000 in winnings for him in a suitcase under her bed, saying, “ I don’t want my wife Jean to know about this,” then go back to Vegas with it the next week returning empty handed and begging his momma for grocery, beer, whiskey and cigarette money.

He was also involved in some shady sideline business dealings as suspected by him showing up for brief visits at our house in New York toting or trying to fob off anything from newly hijacked microwave ovens to recently fenced multi-stone diamond rings. The deals for these items that apparently had just “fallen of a truck” were so good, that my mother could not resist them; and although Bill never directly stole, he never seemed to mind being in the “secondary retail broker market.”

As Aunt Jeannie used to say about it:

  • Bill is not really an outright liar. He’s just plain outright devious.

On these occasional trips “up North,” my mother would ask him to stay with us for a few days, but after about twelve hours of fidgety boredom or endless to and fro pacing, he would usually depart to go back to run his bar.

  • Ya’ll just don’t understand, Ruth. Ya see it all goes down like this. Ever’ night when they close up, my employees take out mah cash drawer and throw it up to the ceilin’ an’ ever’ thing that sticks on the roof, they say belongs to me, and ever’ thing that falls back down on the floor they get to keep for themselves. I got to go back or I’ll be broke in no time flat.

He had an old eighteen-foot teak Chris Craft boat with an inboard engine that he kept on the Texas Colorado River near Matagorda. Every once in a while when he got good and liquored up would aimlessly and recklessly race it up around the riverfront, much to the consternation of local sport fishermen or other folks of more genteel persuasion.

Even though he was arrested for this habit on more than one occasion, for some strange reason he always seemed to have a certain persuasion with the local police, who would then at some later date be seen riding out on the river with him themselves “hootin’ and a hollerin‘ and, of course, at similar breakneck speeds.

My father took one ride with him, one time and one time only. He said the escapade was so harrowing it nearly caused him to wet his pants.

uncle Bill


At one time Bill even cashed in on the football craze by running a Bar-Bus out to Arlington Stadium so that the drunken Dallas Cowboy fans that had signed on with him would have a safe ride back and forth. This was a motorized four wheeled cocktail lounge, undoubtedly quite novel for its time or place in the scheme of customer service innovations. But I also wonder how legal it may have been or how many political payoffs were involved to keep it in operation.

Unfortunately however, just about any Evetts descendant who smokes will also risk the curse of early vascular disease, because of what the additive effects nicotine brings to their genetically inherited high cholesterol levels along with a generalized predisposition to being overweight.

Aunt Thelma Jean, for example, who also smoked excessively and whose favorite libation was Schlitz beer; eventually had just about every artery in her body replaced by Denton Cooley. She used to say that if he got up to ten operations she would ask him to give her the next one free “just like at the car wash.”

After he had his third heart attack wild Bill Cooper checked himself out of the hospital. He told the doctors that enough was enough. He said:

  • Thanks anyway doc, but I just ain’t gonna lay around this dump anymore like some ol’ cripple. 

With that comment and despite the doctor’s protestations he pulled out his IV, checked out AMA (against medical advice) went home and died shortly thereafter in the comfort of his own living room recliner chair. He was 54 years old.

My mother used to say that Bill had nine lives. I told her that no, in fact he had lived nine lives while secretly thinking to myself that in doing so he had made up for all four of his sister’s conservatively self-inflicted solitary lives of boredom.

Sometime within the week after John Kennedy was killed, then subsequently Lee Harvey Oswald, my mother called Bill in Dallas and asked him “what in tarnation is going on down there? “ He told her that he knew Jack Ruby personally because Ruby had frequently patronized his bar. It was one of those hangouts where the mob, the politicians and the police crossed paths, exchanging information… and probably “a whole lot more.”

  • I don’t rightly know Ruth, but ever body down here knows that Jack was mobbed up and all the police are in on the take too. So I just don’t rightly know for certain, and I can’t really say so for sure but it seems to me like somethin’ mighty funny is going on.

A great many people still immutably believe to this very day in both their hearts and to the core of their souls that on November 20 in1963 something honestly and truly was very rotten in the Lone Star State’s notorious city of Dallas.



Dealy plaza

Now I don’t rightly know for sure Ruth, but it seems purdy likely to me that somethin’ mighty fishy is goin’ on down here. Yes indeedy. Somethin’ mighty fishy. 

(Uncle Bill)

Dealy Plaza Photo © www.2lc-online.com




Playing Switch


There is no good in arguing with the inevitable. The only argument available with an East wind is to put on your overcoat.

James Russel Lowell

 Watching a person have a massive heart attack and being unable to intervene in a meaningful way was a very frustrating part of cardiac care in the 1970’s. Now modern science has given us clot-busting drugs, angioplasties and stents, such that cardiac damage can be limited or actually aborted.

But in these early days having to just stand by and helplessly watch a catastrophe in evolution was somewhat analogous to the advice my Uncle Bill gave my mother on how to survive a tornado. It had been a few years since my mother had been home to Texas. She was sitting outside on the front porch with her brother, Bill, on a sultry hot summer day when the radio began to broadcast local tornado warnings.

My mother turned to my uncle to inquire if there were any new recommendations about what to do or what precaution to take if a tornado comes your way.

My uncle said not really, unless you happened to have a storm cellar, which he did not. He then said that after years of experience he had found the best plan to prepare for it was to simply stay put on the front porch and “play switch.”

My mother said:

  • Play switch, Bill? And just what in hell is that?

My uncle replied:

  • Well, Ruth. When ya see a tornado off on the horizon and ya don’t know what it’s really gonna do, or which way it’s a comin’; or if it’s gonna hit ya or just pass ya by; ya put your right thumb in your mouth, and ya put your left thumb up your ass. Then ever’ once in a while… ya just switch ‘em.


A Texas Twister

Photo source http://www.en.wikopedia.org/wiki/Tornado


The Angel Of Death (1970s)

The Angel of Death

When I was training as a Cardiology Fellow in 1978 there was a sixty-odd year woman on our service who had a massive heart attack about a week before.

In that era we did not have the availability of modern treatments such as clot busting drugs or the ability to immediately balloon open and place a stent into a coronary artery, thus limiting the amount of damage to the heart. It was very frustrating to deal with situations in which large amounts of heart tissue was being damaged. We could only stand by helplessly watching it happen, and then wait later to field the resulting serious consequences of heart failure or cardiac rhythm issues; some of which were potentially lethal.

This particular woman had a rough hospital course complicated by cardiac shock, respirator support, heart failure and life threatening arrhythmias. It took a while, but she gradually improved to the point of sitting up and mobile enough to sit in a chair. The medical staff believed that the worst was over and that she would be able to go home in a few more days. Every time we rounded on her she seemed highly agitated, anxious and unfocused. She was jittery, tremulous, on sometimes delusional and was difficult to sedate; a typical scenario for what patients like her had been through.

Then on about her tenth morning in the Coronary Care Unit she greeted us with an unusual presence of serene calm, lucidity and a completely normal affect. Delighted that her affect had normalized, she seemed to have made enough progress to go to a regular floor; and while noting her placidly recovered lucidity, we told her she was only a few days away from being discharged to her home.

But we were startled by her immediate contradicting comment. She said:

  • I am not going home today. I am never going home. Today is the day that I am going to die.

We told her this was preposterous, as she had progressed so well to this point that in both jocular or condescending tones asked her how she knew this was going to happen.

She answered by telling us that early on that particular morning when she awoke from sleep, an angel had appeared who was sitting on the end of her bed. The angel told her that she was going to die on this very day, but not to worry because everything was going to be perfectly fine and that he was going to take good care of her. She had simply accepted her fate and was resigned to moving on to the afterlife.

We placated her with reassurances that this apparition surely must have been her imagination, a dream, a hallucination or somehow related to her medications, because every indicator told us she had been through the worst of her illness. The medical team then moved on to the next patient.

About six hours later, she had a cardiac arrest from which she could not be resuscitated. The doctors and nurses on service who had heard her prediction were stunned into silent sobriety thinking the episode to be eerily macabre indeed. Then in critiquing our care to see if we had made any errors, the senior supervising Attending Physician did come to realize that we had, in fact, made one small but ultimately serious mistake.

He looked around at the team primarily responsible for her and said;

  • So in your secular scientific doubting hubris; did any of you happen ask her what that Angel looked like?

In the deafening silence, you could hear a pin drop.

Angel of Death

 There is a Reaper, whose name is Death,

And with his sickle keen,

He reaps the bearded grain at a breath,

And the flowers that grow between.

 Oh not in cruelty, not in wrath,

The Reaper came that day;

‘Twas an angel visited the green earth,

And took the flowers away.


Photo source: http://www.broterofyeshua.com/deadmen.htm