I first learned to fear my heart on the slopes of an active volcano. I was visiting Costa Rica with a college class and a local doctor. Near a sign that warned of unexpected eruptions, I felt a string of erratic beats flutter in my chest. I was more curious than concerned, but, when I mentioned them to the doctor, he looked grave. He told me to visit a cardiologist as soon as I got home.
The palpitations came back when I returned to Ohio. This time, my chaotic heartbeat terrified me, and I begged my brother to drive me to the hospital. By the time doctors examined me, however, my heart had returned to its regular rhythm, and they interpreted my symptoms as a panic attack. I was left questioning whether the problem was in my chest or my mind.
As I finished my first year of college and turned nineteen, palpitations and panic attacks haunted me. I was frightened of my heart but still thought of myself as healthy; I wasn’t ready to see an expert who might confirm that I had a heart condition. Instead, I made an appointment with a university therapist. He told me to read a book called “Staring at the Sun: Overcoming the Terror of Death.”
Late that spring, I felt a new sensation in my chest—a rapid and forceful booming that left me light-headed and struggling to breathe. It was nothing like the heavy thud of my pulse after exercise; it felt wrong, even as it remained invisible to others. My partner drove me to the hospital, where I was immediately admitted and given a dose of adenosine. The drug slammed into me: my heart juddered, then resumed its habitual rhythm. A cardiologist studied my electrocardiogram but said that it wasn’t clear enough for a conclusive diagnosis. I was instructed to rush back to the hospital if it happened again.
I hated that I was alone with the irregular ticking of my heart. Having no explanation for my condition meant having no hope for a cure. Once, while sailing on my family’s boat around Lake Erie, I felt the second, more disruptive kind of palpitation. Far from land, getting to the hospital was not an option. I tried to explain what I was feeling to my mom and pointed at the veins in my throat, where my pulse was pounding with uncomfortable force. “I don’t see anything,” she told me. Twenty minutes later, the palpitations dissipated as though they had never been there.
One of the things that unsettled my heart, in those anxious years, was the weather, something else that I could not control. As a child, I wasn’t especially afraid of storms, not even the tornado that once ripped through my home town. But that had changed. During one thunderstorm, a gust sent my car skidding across the parking lot of my sailing club. I ran through the darkness to get inside, then hid my panic by burying my face in a friend’s shoulder.
A few years later, another storm hit with little warning on a sunny summer afternoon. I was getting ready to move to New York City with my partner, and we took a last walk along Lake Erie. As we wandered the shore, thick clouds blossomed over the horizon, but neither of us expected anything more than rain.
The clouds darkened as we returned to the car. My partner was driving us back to his family’s home when hail started to batter the roof. It grew to the size of golf balls, and a tornado siren sang out. We exchanged worried looks; I gripped his thigh as he sped up.
As we pulled into his family’s neighborhood, the wind and hail and rain obscured everything beyond a few feet. A large tree crashed onto the road, blocking our path.
“Drive around it!” I shouted. The tires left wet grooves in a neighbor’s lawn.
We pulled into his family’s driveway and the garage door creaked open. We doubled over to get inside as quickly as possible. I paced between the kitchen and living room, breathing hard, feeling small palpitations in my heart and shaking so badly I couldn’t speak.
The adrenaline lasted longer than the storm. Meteorologists called it a microburst—a brief, extreme downdraft within a thunderstorm that hit one small segment of the little peninsula of Catawba Island.
Later, when the pounding of the rain and my heart both slowed, we wandered the streets. A confetti of leaves coated the sidewalks. The hail had turned front yards into pebble gardens. We saw downed trees, tangled power lines, and crushed cars. Neighbors wandered the streets, too, taking pictures and gaping.
If we’d left the beach a few minutes earlier and a tree had fallen on our car, would we still be here? If the tiny storm in my heart hadn’t abated, would I still be here?
I moved to New York City for journalism school in July, 2012. In October, a storm named Sandy grew into a hurricane on its way north from the Caribbean. The governor’s office issued emergency-preparedness orders; the mayor ordered evacuations from parts of all five boroughs. My apartment was only a block outside the Manhattan evacuation zone, so I slept on a classmate’s couch on the Upper East Side, listening to the wind banging around the fire escape.
The morning brought news of the calamity: power off for dozens of blocks, flooding in all the boroughs, houses destroyed, subway lines filled with water. Ultimately, forty-four New York City residents died. My journalism professors sensed an opportunity to learn about disaster reporting and breaking news, so, in the days that followed, I interviewed people who had lost their homes. Some survived the storm only to learn that their neighbors had died.
Two weeks later, my heart went wrong again.
My partner and I walked ten panicked blocks to a Manhattan urgent-care clinic. My pulse raced at a hundred and fifty beats per minute. Each boom seemed to shake my collarbone and throat. My lungs heaved like a rusty bellows.
My partner took a seat in the waiting room. In a bare examination room, an after-hours doctor asked whether this had happened before. “Yes, five or six times,” I told her. She connected a tangle of wires to my chest, torso, and arms so that an EKG could monitor my heart. She wanted to keep me under observation in hopes that the palpitations might subside.
They grew worse. I had more trouble breathing. My limbs went numb, then began to seize up. The doctor called for paramedics. While we waited, spasms shook my muscles. By the time the E.M.T.s arrived, my arms were locked in a bird-wing position; they forced my arm to straighten and exposed the veins near my elbow.
The first attempt to insert an I.V. resulted in a spray of blood from my arm. It covered my shirt, my bra, and the floor.
“What’s happening to me?” I tried to ask.
But my face had gone numb. The inability to speak, to make myself understood, scared me more than anything else.
Eventually, the needle went in. The first dose of adenosine momentarily stopped my heart. But almost immediately, the palpitations came back. I squeezed my eyes shut, thinking that this might kill me and telling myself to think of family.
“We’re going to try a second dose,” one of the paramedics said.
I felt another burst of intense pressure and heat. And then the drumming ceased.
I pried my eyes open. I was being taken to an ambulance. When my partner saw me, he looked horrified. On the drive to the hospital, I threw up, a side effect of the adenosine.
I did not sleep that night. I had blood tests and heart tests, and potassium was pumped into my veins. Finally, a doctor declared that I had supraventricular tachycardia. The electrical signals that become heartbeats, the doctor said, were following an abnormal electrical pathway. Most episodes of SVT are too brief and infrequent to need treatment, but the worst can cause cardiac arrest. My symptoms were severe enough that I’d need surgery.
For more than four years, I’d been struck by these palpitations without knowing what to call them. To have a name, a path forward, a possible cure—it almost let me forget the ordeal.
I was discharged at daybreak into the cold, gray streets. Many subway lines were still flooded, so we walked home. We went to bed as the sun rose.
I made it through the rest of the semester without talking about my heart problems. I thought about dying suddenly at twenty-three. I thought about people who had drowned in their homes and their cars, or were crushed by falling trees while walking their dogs. When I visited cardiologists and electrophysiologists and nurses, I did not ask many questions, even though, as a journalist, asking questions was my job. They described me as calm and pleasant. “This is a young woman who is comfortable on the examination couch,” one doctor wrote in his notes.
I scheduled my surgery for winter break and told hardly anyone that it was happening. My heart was almost unbearably calm. It reminded me of a cloudless day after the hurricane that brought joy and respite, but also felt like a taunt. My body was too unsettled to accept repose.
I was awake for the procedure. Defibrillator pads pressed against my back and chest. The surgeon cut two blood vessels near my groin, then inserted sheaths and wires that wound their way through my abdomen. Once they reached my chest, they delivered shocks to speed up the beats and determine the source of my arrhythmia. I felt as though someone was gripping my heart, forcing it to beat. My heart rate reached three hundred beats per minute—so fast that it felt less like a pulse than a thrumming vibration.
A new burning sensation. “What is that?” I asked.
“Don’t talk,” the doctor said. “We’re burning the pathway.” A scar would form across my heart and impede the faulty electrical signal.
The morning after, I was exhausted and moved gingerly from the pain of the incisions. I was also elated. For the first time in years, I thought I could trust the steady beating of my heart.
Surgery stopped one type of palpitation, but the others have never gone away. Doctors now tell me that I suffer from premature atrial contractions, which are extra heartbeats originating in one of the upper chambers of the heart. They are mostly benign, unless they are too frequent, but no one can really say how often is too often. I sometimes experience thousands one day and none the next. I never get used to them because they are, by definition, irregular. They may be with me until my heart stops beating. Then again, they might not.
Research has linked arrhythmias to electrolyte imbalances, heart-valve disease, and even exposure to pesticides, but none of it fully explains what is going on in my body. Maybe I was born with extra cells that conduct electricity in my heart. Maybe my thyroid disease caused symptoms that I cannot see, and which predisposed me to palpitations. We don’t even know what we don’t know—there could be other triggers that scientists have not yet thought to look for.
Last winter, my palpitations sent me to the hospital again. I thought I was no longer afraid of them, but chest pain convinced me otherwise. The E.R. doctor told me that I wasn’t having a heart attack, but could not explain what was happening or why. Back at home, my partner comforted me by saying, “It’s a bit of bad body weather. It’s scary right now, but it’ll get better.”
“Body weather” became a kind of shorthand, in the private language between us, for the turbulence inside me. We often come up with our own words and phrases: the flu is “bubonz,” a silly riff on the bubonic plague; when we feel a cold coming on, we are “sick around the edges.”
But I started to think that the connection between body and weather, between our interior and exterior worlds, runs deeper. Our most basic greetings reflect these twin obsessions: “How are you?” and “Nice weather we’re having.” When we’re sick, we’re “under the weather.” Hippocrates, the Greek physician who is sometimes called the father of medicine, wrote in the fifth century B.C.E. that the body has four humors—phlegm, yellow bile, black bile, and blood—which correspond to the hot, cold, wet, and dry weather of the Mediterranean. Later, Europeans attributed yellow fever to the hot and humid climate in the lands that they colonized. They believed that, when their eyes, noses, and mouths bled, their bodies were purging an excess of the hot and wet humor.
These explanations were wrong, but I can understand why they might have felt right. I think about them when bad weather makes my joints ache, as people with arthritis have reported for decades. I think about them when I decide, each morning, whether to go for a walk around the Chicago suburb where I live. I skip this ritual only when the weather is terrible, or when I feel too much pain or fatigue. About once a week I stay home, often for both reasons simultaneously.
Chicago recently experienced the wettest, grayest spring it has seen in sixty-three years. News reports warned that the weather might cause symptoms of depression in city dwellers; they recommended light-therapy lamps and spending time outdoors. My heart had been mostly quiet for months, thanks to a new medication, but the weather started to get to me. I had nightmares about going into cardiac arrest and woke up gasping. I wondered whether the dreams were triggered by old fears or by actual palpitations that occurred as I slept.
Near the end of April, I visited some friends in Ohio and a burst of warm weather broke through. I felt so much better that I wrote “perfectly blue skies” in my journal. My partner and I spent so much time outdoors that we turned pink.
We walked through my old neighborhood. I posed for a picture in front of the house that I once lived in, before I paid much attention to storms or sickness. One afternoon was so hot that we sat in the shade of an umbrella, drinking ice water.
Then we drove back to Chicago, and the foul weather returned. For two weeks, the sky was gray; rain pooled in my back yard, and the clouds hid the sun and the stars.
Still, that one bright weekend reminded me of something obvious—that the weather is always changing. Inconstancy can be a reason for hope as well as a reason for fear. The good weather never lasts as long as I’d like. But the bad isn’t permanent, either. ♦
