I had a very moving experience a few months ago when I attended a double funeral for a couple who had died within a few days of each other.
Donald had suffered a stroke several years before, had become increasingly immobile and was eventually unable to live at home. His wife of 62 years, Anne, who had tried desperately to take care of him, finally reluctantly agreed to have him admitted to a long term care facility.
But just a week or so later, Anne herself suffered a heart attack and died. I was asked, as a family friend, to help relay the sad news to Don. He grasped what had happened and after a few tears, chatted for a while as he told me about how they met and about the wonderful life they had shared together.
“See you soon” were his final and surprisingly cheerful words to me as I left. I received a phone call from the family the very next morning that Donald had been found in bed having died in his sleep. Her funeral became their funeral – two coffins beside each other, the couple united in death as they had been in life. Dying within days of each other was lovely for them, but very difficult for their family to lose BOTH parents within such a short time.
People said at the funeral that he died of a broken heart. It is certainly a romantic notion, but now there is scientific research suggesting it can actually happen. Dr. Sunil Shah, a senior lecturer at St. George’s University in London, U.K., has published research suggesting that losing a loved one may double your risk of having a heart attack or stroke. “Particularly the first few weeks and months after you lose someone are a time when people are at increased risk of poorer health and sadly, death,” he writes. “We found quite clearly that people who had lost their husband or wife were at twice the risk of having either a heart attack or stroke in the first month.”
But, can a person die of a broken heart? Scientific evidence or not, their daughter believes that her parents left this world together, just as they always planned. “I believe their love was so strong that that’s the reason they went together. ‘We’re not going without each other,’ my mother would say, ‘When he goes in that graveyard, I’m going with him.’ They did everything together in life, and stayed true right until the end when they died within 24 hours of each other.”
But it’s not just people who lose a spouse. Lesley had always dreamt of becoming a mother so when, at age 30, she discovered she was pregnant, she and her husband couldn’t wait for the birth of their first child, a daughter they had already named Katy. Tragically, when she was 11 days overdue, doctors induced labor only to discover the baby had died in the womb.
Five hours after delivering the baby and cradling it in her arms, Lesley herself lost consciousness and died. Her distraught husband commented, “There was no reason to think anything would go wrong. She walked in there fit and healthy. In my view she was so heartbroken that she wanted to be with the baby.”
Medical proponents of the “broken heart syndrome” speculate that in any situation where there is overwhelming shock, the heart muscle is suddenly weakened or stunned, becomes paralyzed and the left ventricle, one of the heart’s main chambers, actually changes shape. Usually the paralysis eases, but occasionally the acute stress can lead to a cardiac arrest due to the disturbance in the heart’s intrinsic electrical activity.
The term “broken heart syndrome” is known more formally as “stress cardiomyopathy”. In the 1990s Japanese researchers coined the term “takotsubo cardiomyopathy” to describe this stress-induced apparent heart attack. The term “takotsubo” is taken from the Japanese name for of a type of fishing pot used to trap octopuses which has a shape similar to the ballooning configuration that occurs in the left ventricle in the typical form of this disorder.
Usually this is a temporary condition, and many people simply recover as the stress goes away and the heart returns to its normal shape. But occasionally in some acute episodes due to a disturbance in the heart’s intrinsic electrical activity, and mainly among the elderly or those with a heart condition, the change in the shape of the heart can prompt a fatal heart attack.
About three quarters of people diagnosed with takotsubo cardiomyopathy have experienced significant emotional or physical stress prior to becoming unwell. This stress might be bereavement but it could be a shock of another kind. (e.g., death of relatives, particularly if unexpected, domestic abuse, arguments, catastrophic medical diagnoses, devastating financial or gambling losses, natural disasters.)
There are documented cases of people suffering the condition after being severely terrified by someone pulling a prank, or even suffering the stress of speaking to a large group of people. The theory is that the sudden release of hormones, in particular adrenaline, causes the “stunning” of the heart muscle. This is different from a heart attack, which is a stopping of the heart because the blood supply is constricted, often by clogged arteries.
With no other cause of death known at the time, it is conceivable that Lesley experienced a huge adrenaline surge with her emotional stress, which caused the paralysis that led to cardiac arrest.
One of the previously mentioned authors, Dr Sunil Shah said: “We often use the term a ‘broken heart’ to signify the pain of losing a loved-one and our study shows that bereavement can have a direct effect on the health of the heart.” Current figures suggest that around 2% of the ‘heart attacks’ each year will, in fact, be broken heart syndrome. And there are definitely cases where people like Lesley and Donald give up on life.
But while some people are vulnerable to dying of a broken heart, it is a mistake to conclude they all die simply because they can’t fend for themselves or are just too weak to handle the stress. There is no doubt that the loss of a spouse at the end of a long relationship is stressful, but to suggest that that is all that is going on here is demeaning.
A 10 year study by the Harvard Medical School into “Broken Heart Syndrome” several years ago (2003) focused on the “human event” rather than equating it to just stressful events. The study showed that some people are connected in such an intimate fashion that the health of one person is related to the health of another. These days, we give attention to relationships of celebrity infidelity and the high percentage of marriages that end in divorce. We tend to ignore the relationships that last a lifetime, the ones where people kept their promises and remained devoted to each other until the very end. That’s not to say all marriages or relationships ending in broken heart syndrome were perfect, but almost every single one of them passed the test of time. The relationship was so close that they simply couldn’t live without each other.
The Harvard study brought to light some striking findings:
- When a spouse is hospitalized, the partner’s risk of death increases significantly and remains elevated for up to two years. The period of greatest risk is over the short run, within 30 days of a spouse’s hospitalization or death. Over this time frame, hospitalization of a partner can confer almost as much risk of dying as the actual death of a spouse.
- Broken heart syndrome most often takes place in older people who have been together for a long time. Surprisingly, the study indicates certain illnesses affect the remaining spouse differently. The more a disease interferes with a spouse’s physical and mental ability and the more burdensome it is, the worse it is for the health of the partner. If a wife was hospitalized with dementia, her husband’s risk was 22 percent higher. Similar effects were seen in women whose husbands were hospitalized.
- Men are more likely to die of broken heart syndrome than women. Over the 10 years of the study, 74 percent of husbands and 67 percent of wives were hospitalized at least once; (49 percent of husbands and 30 percent of wives died. The mean age of men in the study was 75 years and the mean age of women was 72 years.
Whatever the science behind “broken heart syndrome”, the results are bitter-sweet. There is, of course, the grief of a bereaved family who have lost two people they love. But there is also often a relief that a couple deeply in love should have exited life together.
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