My Claim to Fame

My name may not be displayed on the cover (yet), but it is mentioned in the “Acknowledgements” section of a book that debuted at number one on the New York Times Fiction Best Sellers list. Get your geek on, because the heart of my claim to fame story is a medical tidbit about the ever-fascinating human heart.

The book that bears my name was authored by Jodi Picoult. In March 2006 I attended one of her Minneapolis readings, and she told the audience that her 2008 release featured a character who had a heart transplant. During my two-minute chat with Jodi while she signed The Tenth Circle, I told her I had recently discovered the really cool answer to a heart transplant question that had haunted me for many years. She asked me to email her the story, which I promptly did, and now I’ll share it with you.

One of the strangest tasks I’ve been assigned while working in the medical device industry was to purchase human hearts through organ transplant organizations. Unfit for human use, these organs were designated for medical research. One day I received a heart that had originally belonged to a nineteen-year-old male and had been transplanted into a thirty-something female who later died. As I examined that heart and observed the intricate sutures used to “hook up the plumbing” when it was transplanted into the woman, I couldn’t help but wonder how the surgeon connected the “electrical cord” so that the brain could tell the heart when to speed up and slow down. 

That question stayed with me for about four years. A former FDA Branch Chief who was a licensed electrophysiologist told me it was a very good question, but the only answer he could offer was that hormones play a role in heart rate. A friend who worked at Medtronic, the birthplace of pacemakers, told me about the SA-node and how the heart has its own electrical system. Interesting, but I was still convinced the brain had a more direct connection to heart rhythm. I tried Google again and finally hit the right search terms that led me to an answer.

It turns out the heart is directly connected to the brain via sympathetic and parasympathetic nerves. During a transplant procedure, those nerves are severed, referred to as “cardiac denervation,” and this definitely impacts rhythm management. The resting heart rate in transplant patients is 90 to 110 beats a minute, which is faster than the rate for normal adults (60 to 100 beats a minute). Without a direct brain-to-heart nerve connection, the heart cannot abruptly respond to changes in activity level. Heart transplant patients need a longer, slower warm-up until the adrenal system can do its thing. Transplant patients prove that humans can live with a denervated heart, but they’d probably be the first to say that life is a little easier when that busy little pump has full hook-ups for both plumbing and electrical service.

After I sent the story to Jodi, she replied and said, “Barb, that is REALLY cool! I will have to see if I can work it in!” Fast forward two years. When I attended the 2008 book reading where Change of Heart was released, I flipped open the first few pages, and out popped my name at the top left corner of page iii. It was listed after a string of doctors Jodi thanked as her “medical team.” That made my day, and I was glad my sister was there to share the thrill. After I got home, I couldn’t wait to see how Jodi worked this trivia into the story, and boy did I have to wait … until the Epilogue, on page 446 of the 447-page book. I won’t give any spoilers about this final scene, but this is what the main character, Claire, says:

“My mother told me once, in her dump truck-load of fun facts about cardiac patients, that when you do a transplant the nerve that goes from the brain to the heart gets cut. Which means that it takes people like me longer to respond to situations that would normally freak us out. We need the adrenaline to kick in first.”

Jodi is known for digging into her research, and I thought it was neat that she shared one of my favorite cardiac fun facts with her broad audience. So that’s my claim to fame story. Now maybe I better get to work on writing a New York Times Best Seller that has my name on the cover!

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